拆迁人(以下简称甲方):_________________ 法定代表人:_____________________________
地址:___________________________________
单位名称:_______________________________
邮编:___________________________________
电话:___________________________________
委托代理人:_____________________________
被拆迁人(以下简称乙方):
姓名:___________________________________
性别:___________________________________
年龄:___________________________________
住址:___________________________________
委托代理人_______________________________
........................