調(diào)解調(diào)查筆錄范本調(diào)解調(diào)查筆錄范本調(diào)解調(diào)查筆錄范本調(diào)解調(diào)查筆錄范本編制僅供參考審核批準(zhǔn)生效日期地址：電話：傳真:郵編:人民調(diào)解調(diào)查筆錄編號：時(shí)間：_______________地點(diǎn)：_______________記錄員：___________案由：______________參加人：_______________________________被調(diào)查人：_________________________________________________記錄：你好，我們是某某街道人民調(diào)解委員會調(diào)解員______________；今天就雙方申請?jiān)谀衬辰值廊嗣裾{(diào)解委員會調(diào)解_____________糾紛一案依法進(jìn)行調(diào)解調(diào)查，根據(jù)《中華人民共和國人民調(diào)解法》的法律規(guī)定，你可以自主表達(dá)意愿，是否接受調(diào)解如自愿申請調(diào)解，請如實(shí)陳述此次調(diào)查，并提供相關(guān)證據(jù)。請問聽清楚了嗎有無異議被調(diào)查人：_________________________________________________調(diào)查人：請陳述一下糾紛的基本情況。被調(diào)查人：_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________調(diào)查人：請陳述一下對于本糾紛的訴請及要求。被調(diào)查人：_________________________________________________________________________________________________________________________________________________________________________________（接第頁）__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________以上筆錄請你細(xì)閱，如有遺漏或錯誤，請指正，我們給予更正，如沒有錯誤，請簽字確認(rèn)。調(diào)查人：