申请人姓名：                                                                                                       

被申请人：                                                                                                          

联系电话：                                                                                                           

请求事项：请求对被申请人价值                                    元的财产进行保全。

财产线索如下：                                                              

 1、冻结银行帐号的写明银行帐号、开户行、户名；                                     

        此致

日博备用地址

 

                                                          申请人（签名、捺指印或盖章）：

 

                                                                                                               年       月       日