人民调解委员会书面、口头调解文书

('1、书面调解:______________________人民调解委员会调解卷宗卷名:_____________________________________卷号：____________________________________人民调解员：____________________________________调解日期:____________________________________立卷人：____________立卷日期：________________保管期限：______________________________________备注：______________________________________人民调解卷宗目录序号文书名称页号备注1人民调解申请书2人民调解受理登记表3人民调解调查记录4人民调解证据材料5人民调解记录6人民调解协议书或人民调解口头协议登记表7人民调解回访记录8司法确认有关材料9卷宗情况说明10封底101112本卷第页人民调解申请书申请人姓名___________________性别______民族______年龄______职业或职务___________________联系方式_____________________单位或住址________________________________________________被申请人姓名___________________性别______民族______年龄______职业或职务___________________联系方式_____________________单位或住址_________________________________________________纠纷简要情况:_______________________________________________________________________________________________________________________________________________________________________________________________________________________当事人申请事项：1、______________________________________2、______________________________________3、______________________________________人民调解委员会已将申请人民调解的有关规定告知我，现自愿申请人民调解委员会进行调解。申请人（签名或按指印）：______________________________年_____月____日本卷第页人民调解受理登记表__________年_____月____日，人民调解委员会依当事人申请（人民调、解委员会主动调解），经当事人同意，调解_______________、_________________之间的纠纷。纠纷类型：_____________________________________________案件来源：1、当事人申请2、人民调解委员会主动调解纠纷简要情况：___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________当事人（签名）：___________________登记人（签名）：__________________________________人民调解委员会________年______月____日备注：此表由人民调解委员会填写本卷第页人民调解调查记录时间：____________________________________地点：____________________________________参加人：___________________________________被调查人：________________________________记录：_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________调查人（签名）：________________________________________被调查人（签名）：________________________________________记录人（签名）：________________________________________本卷第页人民调解记录时间:_____________________________________地点:____________________________________当事人:____________________________________参加人:____________________________________记录人:____________________________________人民调解委员会已将人民调解的相关规定告知各方当事人。调解记录：__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________本卷第页____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________调解结果：1、调解成功2、调解不成3、有待继续调解当事人（签名盖章或按指印）：____________________________当事人（签名盖章或按指印）：____________________________人民调解员（签名）：________________________________记录人（签名）：_____________________________________________年______月_____日本卷第页人民调解协议书吴（）民调字第【】号当事人姓名___________________性别______民族______年龄______职业或职务___________________联系方式_____________________单位或住址________________________________________________当事人姓名___________________性别______民族______年龄______职业或职务___________________联系方式_____________________单位或住址_________________________________________________纠纷主要事实、争议事项：______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________经调解，自愿达成如下协议：____________________________________________________________________________________________________________________________________________________本卷第页_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________协议履行的方式、地点、期限：_________________________________________________________________________________________________________________________________________________本协议一式______份，当事人、人民调解委员会各持一份。当事人（签名盖章或按指印）：______________________________当事人（签名盖章或按指印）：______________________________调解员（签名）：__________________________________________记录员（签名）：__________________________________________________________人民调解委员会（印章）___________年______月_____日本卷第页人民调解回访记录当事人:________________________________________________调解协议编号：_________________________________________回访事由:______________________________________________回访时间:______________________________________________回访情况：_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________回访人（签名）：________________________________人民调解委员会________年______月_____日本卷第页卷宗情况说明________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________立卷人：______________________本卷第页封底立卷人：__________________________审核人：__________________________立卷日期：_______年_______月______日2、口头调解：调解卷宗卷名：卷号：人民调解员：调解日期：立卷人：立卷日期：保管期限：备注：人民调解受理登记表年月日，人民调解委员会依当事人申请（人民调解委员会主动调解），经当事人同意，调解与之间的纠纷.调解形式：①口头调解（），②书面调解（）纠纷类型：案件来源：①当事人申请（）②人民调解委员会主动调解（）纠纷简要情况：当事人（签名）登记人（签名）人民调解委员会年月日人民调解口头协议登记表编号当事人姓名性别民族年龄职业或职务联系电话单位或住址当事人姓名性别民族年龄职业或职务联系电话单位或住址纠纷主要事实、争议事项：经调解，自愿达成如下协议：履行方式、时限人民调解员（签名）（人民调解委员会印章）年月日人民调解回访记录当事人：解协议编号：回访事由：回访时间：回访情况：回访人（签名）人民调解委员会年月日',)