申请人(本诉原告):__________________
申请内容:________________________________________________________________________________________________________
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申请理由:________________________________________________________________________________________________________
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为保证诉讼顺利进行,维护国家利益,根据我国《中华人民共和国行政诉讼法》第三十六条之规定,特向你院申请保全证据。
此致
______人民法院
申请人:__________
____年____月____日