รวมระเบียบ คำสั่ง เกี่ยวกับการจดทะเบียนสิทธิและนิติกรรมประเภท ก่อภาระผูกพัน และอื่น ๆ (ปี 2552)

ÒÙ¯

(ı) §” —Ëß°√¡∑–‡∫’¬π∑’Ë¥‘π ∑’Ë ˜/ÚÙˆÛ ≈ß«—π∑Ë’ ÚÙ ¡‘∂ÿπ“¬π
æ√–æÿ∑∏»—°√“™ ÚÙˆÛ

(ˆ) §” Ë—ß°√¡∑–‡∫’¬π∑’Ë¥‘π ∑’Ë Ú/ÚÙˆ¯ ≈ß«—π∑’Ë ÚÒ °√°Æ“§¡
æ√–æ∑ÿ ∏»°— √“™ ÚÙˆ¯

(˜) §” —Ëß°√¡∑’Ë¥‘π·≈–‚≈À°‘® ∑Ë’ ¯/ÚÙ˜˜ ≈ß«—π∑Ë’ Òˆ μÿ≈“§¡
æÿ∑∏»°— √“™ ÚÙ˜˜

(¯) §” ß—Ë °√¡∑¥Ë’ π‘ ·≈–‚≈À°®‘ ∑’Ë ÙÒ/ÚÙ¯ ≈ß«π— ∑’Ë Û ¡’π“§¡
æÿ∑∏»—°√“™ ÚÙ¯

(˘) §” ß—Ë °√¡∑¥Ë’ ‘π·≈–‚≈À°‘® ∑’Ë ˜/ÚÙ¯Ò ≈ß«—π∑’Ë Ú ¡‘∂πÿ “¬π
æÿ∑∏»—°√“™ ÚÙ¯Ò

(Ò) §” ßË— °√¡∑’¥Ë ‘π·≈–‚≈À°®‘ ∑Ë’ ÒÛ/ÚÙ¯Û ≈ß«π— ∑’Ë ÚÙ °—𬓬π
æÿ∑∏»—°√“™ ÚÙ¯Û

(ÒÒ) Àπß—  Õ◊ °√¡∑¥’Ë π‘ ∑’Ë ˜˘ı/ÚÙ˘Ò ≈ß«π— ∑’Ë ÒÒ °¡ÿ ¿“æπ— ∏å ÚÙ˘Ò
(ÒÚ) §” —ßË °√¡∑’¥Ë ‘π ∑’Ë ÒÒ/ÚÙ˘Ú ≈ß«π— ∑’Ë Òı ∏π— «“§¡ ÚÙ˘Ú
(ÒÛ) §” Ë—ß°√¡∑¥’Ë ‘π ∑’Ë ˜/ÚÙ˘˘ ≈ß«π— ∑Ë’ Ò¯ °π— ¬“¬π ÚÙ˘˘
(ÒÙ) §” —ßË °√¡∑¥Ë’ π‘ ∑Ë’ ˘/Úı ≈ß«—π∑Ë’ Ú °π— ¬“¬π Úı
(Òı) §” ß—Ë °√¡∑’Ë¥π‘ ∑Ë’ Ò/Úı ≈ß«—π∑’Ë Ú˜ °π— ¬“¬π Úı
(Òˆ) §” ß—Ë °√¡∑¥Ë’ ‘π ∑’Ë ÒÒ/Úı ≈ß«π— ∑’Ë Òˆ μ≈ÿ “§¡ Úı
(Ò˜) §” ß—Ë °√¡∑Ë¥’ π‘ ∑Ë’ ÒÙ/Úı ≈ß«—π∑’Ë Ò٠惻®‘°“¬π Úı
(Ò¯) Àπ—ß ◊Õ°√¡∑’Ë¥‘π ∑’Ë Ò˜ˆÙ/ÚıÙ ≈ß«π— ∑’Ë ˆ ¡’π“§¡ ÚıÙ
(Ò˘) Àπß—  Õ◊ °√¡∑¥Ë’ ‘π ∑’Ë ÚÒˆı/ÚıÙ ≈ß«π— ∑’Ë Ú ¡’π“§¡ ÚıÙ
(Ú) Àπß—  Õ◊ °√¡∑’Ë¥‘π ∑Ë’ ˜ıÚˆ/ÚıÙ ≈ß«—π∑Ë’ Ò¯ μ≈ÿ “§¡ ÚıÙ
(ÚÒ) Àπ—ß ◊Õ°√¡∑’Ë¥‘π ∑Ë’ ¯Ù˘ı/ÚıÙ ≈ß«—π∑Ë’ ÚÒ æƒ»®‘°“¬π
ÚıÙ
(ÚÚ)Àπß—  ◊Õ°√¡∑¥Ë’ ‘π ∑’Ë ıÚ˜˘/Úıˆ ≈ß«—π∑Ë’ Ú  ß‘ À“§¡ Úıˆ
(ÚÛ)Àπ—ß ◊Õ°√¡∑Ë’¥‘π ¥à«π¡“° ∑’Ë ¡∑ ˆ˜/¯ı˘ˆ ≈ß«π— ∑Ë’ ÒÛ
惻®°‘ “¬π Úı˜
(ÚÙ) Àπß—  Õ◊ °√¡∑¥Ë’ π‘ ∑Ë’ ˆ¯/ÛÛˆ˘ ≈ß«π— ∑’Ë Ò٠情¿“§¡ Úı¯
(Úı) Àπß—  Õ◊ °√¡∑Ë¥’ ‘π ∑’Ë ¡∑ ˆÒ/« ÛÙ˘Û ≈ß«—π∑’Ë Òı 情¿“§¡
ÚıÒ
(Úˆ) §” —ßË °√¡∑¥Ë’ ‘π ∑’Ë Ò/ÚıÒÚ ≈ß«—π∑’Ë Ú¯ ¡’π“§¡ ÚıÒÚ
(Ú˜)Àπß—  Õ◊ °√¡∑¥Ë’ π‘ ∑’Ë ¡∑ ˆ¯/« ˜ÛıÛ ≈ß«π— ∑Ë’ ÚÚ æƒ…¿“§¡
ÚıÒÚ

ÒÙ˘

(Ú¯) Àπ—ß ◊Õ°√¡∑¥’Ë π‘ ∑Ë’ ˆ¯/« Ò˜Ò˜ ≈ß«—π∑’Ë Ò °√°Æ“§¡
ÚıÒÚ

(Ú˘)Àπß—  ◊Õ°√¡∑’¥Ë ‘π ∑’Ë ¡∑ ˆ¯/« ˆ˜Û¯ ≈ß«π— ∑Ë’ Òˆ ¡’π“§¡
ÚıÒÙ

(Û) Àπß—  Õ◊ °√¡∑¥Ë’ π‘ ∑’Ë ¡∑ ˆ¯/« Û˘˘ı ≈ß«π— ∑’Ë Û ¡°√“§¡
ÚıÒˆ

(ÛÒ) Àπß—  ◊Õ°√¡∑¥Ë’ π‘ ∑’Ë ¡∑ ˆÒÚ/Ò/« ¯Ú¯ ≈ß«π— ∑Ë’ ˜ ¡π’ “§¡
ÚıÒ¯

(ÛÚ)Àπ—ß ◊Õ°√¡∑’Ë¥‘π ∑Ë’ ¡∑ ˆÒÚ/Ò/« ÒÙÛÛÒ ≈ß«π— ∑’Ë Ù  ‘ßÀ“§¡
ÚıÚÒ

(ÛÛ) Àπß—  Õ◊ °√¡∑¥Ë’ π‘ ∑’Ë ¡∑ ˆÒÚ/Ò/« ÛÚÒ ≈ß«π— ∑’Ë ÒÛ °¡ÿ ¿“æπ— ∏å
ÚıÚÚ

(ÛÙ) Àπ—ß ◊Õ°√¡∑Ë’¥‘π ∑Ë’ ¡∑ ˆÒÚ/Ò/« ˆÒÚ˘ ≈ß«π— ∑Ë’ Ú˘ ¡π’ “§¡
ÚıÚÚ

(Ûı) Àπß—  Õ◊ °√¡∑’Ë¥π‘ ¥«à π∑ ’Ë ¥ÿ ∑’Ë ¡∑ ˆÒÚ/Ò/« Û˘ı¯ ≈ß«—π∑Ë’
ÒÙ °ÿ¡¿“æπ— ∏å ÚıÚˆ

(Ûˆ) Àπß—  Õ◊ °√¡∑¥’Ë ‘𠥫à π¡“° ∑Ë’ ¡∑ ˜¯/« ˆı¯˘ ≈ß«—π∑’Ë ÚÛ
¡π’ “§¡ ÚıÚ˜

(Û˜)Àπß—  Õ◊ °√¡∑¥’Ë π‘ ∑’Ë ¡∑ ˜¯/« ÚÚ˜˜˜ ≈ß«π— ∑Ë’ ÚÙ μ≈ÿ “§¡
ÚıÛÒ

(Û¯) Àπß—  Õ◊ °√¡∑¥Ë’ π‘ ∑Ë’ ¡∑ ˜¯/« ÚÛÙ˜Ú ≈ß«π— ∑’Ë Ú æƒ»®°‘ “¬π
ÚıÛÒ

(Û˘)Àπ—ß Õ◊ °√¡∑¥Ë’ π‘ ∑Ë’ ¡∑ ˜¯/« ÚıÙÛÙ ≈ß«π— ∑’Ë Ù ∏—𫓧¡
ÚıÛÛ

(Ù) Àπ—ß Õ◊ °√¡∑Ë¥’ π‘ ∑’Ë ¡∑ ˆÒ/« ÚÚˆ˜˜ ≈ß«π— ∑Ë’ ÚÙ  ß‘ À“§¡
ÚıÛˆ

(ÙÒ) Àπß—  ◊Õ°√¡∑¥Ë’ ‘π ∑’Ë ¡∑ ˆÒ/« ÛÙÚÚ˜ ≈ß«—π∑’Ë Úˆ °π— ¬“¬π
ÚıÛ˜

(ÙÚ) Àπß—  ◊Õ°√¡∑¥Ë’ ‘π ∑Ë’ ¡∑ ˆÒ/« ÒÚ˜ˆ ≈ß«π— ∑’Ë Û æƒ…¿“§¡
ÚıÛ¯

(ÙÛ) Àπß—  Õ◊ °√¡∑¥’Ë π‘ ∑’Ë ¡∑ ˆÒ/« Ú¯˘ıı ≈ß«π— ∑’Ë Ù æƒ»®°‘ “¬π
ÚıÛ˘

Òı

(ÙÙ) Àπß—  Õ◊ °√¡∑¥’Ë π‘ ∑’Ë ¡∑ ˜Ò/« Òˆ˜˘ ≈ß«π— ∑Ë’ Ú¯ 情¿“§¡

ÚıÙ

(Ùı) Àπß—  Õ◊ °√¡∑¥Ë’ π‘ ∑’Ë ¡∑ ˜Ò/« ÛˆÚ ≈ß«π— ∑’Ë Ò¯ 惻®°‘ “¬π

ÚıÙ

(Ùˆ) Àπß—  ◊Õ°√¡∑Ë’¥π‘ ∑’Ë ¡∑ ıÒı/« ¯Ú¯ı ≈ß«π— ∑’Ë Òı ¡π’ “§¡

ÚıÙ˘

(Ù˜) Àπ—ß ◊Õ°√¡∑’Ë¥‘π ∑’Ë ¡∑ ıÒı/« ÒÙÚÒ˜ ≈ß«—π∑’Ë ÚÙ

情¿“§¡ ÚıÙ˘

°√≥¡’ ¢’ âÕ¢—¥·¬âß°—π ∫√√¥“√–‡∫¬’ ∫ ¢Õâ °”Àπ¥ À√Õ◊ §” ßË— Õπ◊Ë „¥∑°’Ë ”À𥉫·â ≈«â „π√–‡∫¬’ ∫π’È

À√Õ◊ ´÷Ëߢ¥— À√◊Õ·¬ßâ °—∫√–‡∫’¬∫πÈ’„Àâ„™â√–‡∫¬’ ∫πÈ·’ ∑π

ºŸâ√°— …“°“√√–‡∫¬’ ∫ ¢Õâ Ù „À⺟âÕ”π«¬°“√ ”π—°¡“μ√∞“π°“√∑–‡∫’¬π∑’Ë¥‘π‡ªìπºâŸ√—°…“

°“√μ“¡√–‡∫’¬∫πÈ’

À¡«¥ Ò
°“√¬π◊Ë §”¢Õ·≈–°“√ Õ∫ «π

°“√¬◊Ëπ§”¢Õ ¢Õâ ı ‡¡Ë◊Õ¡’∫ÿ§§≈„¥· ¥ß§«“¡ª√– ß§å¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–

π‘μ‘°√√¡‡°’ˬ«°—∫°“√®”πÕß∑’Ë¥‘π·≈–Õ —ßÀ“√‘¡∑√—æ¬åÕ¬à“ßÕ◊Ëπ „Àâ∫ÿ§§≈π—Èπ¬Ë◊π

§”¢Õμ“¡·∫∫ ∑.¥.Ò  ”À√∫— ∑¥Ë’ π‘ ∑¡Ë’ ‚’ ©π¥∑¥Ë’ π‘ À√Õ◊ ·∫∫ ∑.¥.Ò °  ”À√∫— ∑¥Ë’ π‘

∑Ë’¬—߉¡à¡’‚©π¥∑Ë’¥‘π·≈–Õ —ßÀ“√‘¡∑√—æ¬åÕ¬à“ßÕ◊Ëπ μàÕæπ—°ß“π‡®â“Àπâ“∑’Ëæ√âÕ¡

Àπ—ß ◊Õ· ¥ß ‘∑∏‘„π∑’Ë¥‘πÀ√◊ÕÀ≈—°∞“π ”À√—∫Õ —ßÀ“√‘¡∑√—æ¬åÕ¬à“ßÕË◊π·≈–

À≈°— ∞“π∑‡Ë’ °¬’Ë «¢âÕß

 Õ∫ «πμ“¡ ¢Õâ ˆ „Àæâ π°— ß“π‡®“â Àπ“â ∑ ’Ë Õ∫ «πº¢âŸ Õμ“¡π¬— °Æ°√–∑√«ß©∫∫— ∑’˘

°Æ°√–∑√«ß ©∫∫— ∑Ë’ ˜œ (æ.».ÚÙ˘˜) ÕÕ°μ“¡§«“¡„πæ√–√“™∫—≠≠—μ‘„Àâ„™âª√–¡«≈°ÆÀ¡“¬∑Ë’¥‘π

æ.».ÚÙ˘˜ ·≈–°Æ°√–∑√«ß©∫—∫∑Ë’·°â‰¢‡æË‘¡‡μ‘¡ ‡æË◊Õ„Àâ∑√“∫∂÷ß ‘∑∏‘·≈–

§«“¡ “¡“√∂¢ÕߧŸà°√≥’∑È—ß ÕßΩÉ“¬ §«“¡ ¡∫Ÿ√≥å·Ààßπ‘μ‘°√√¡ μ“¡ª√–¡«≈

°ÆÀ¡“¬·æßà ·≈–æ“≥™‘ ¬å ¢Õâ °”Àπ¥ ∑‘ ∏‘„π∑¥Ë’ π‘ ·≈–°“√°”À𥧓à ∏√√¡‡π¬’ ¡

„π°“√®¥∑–‡∫¬’ π®”πÕß

ºŸâ®”πÕßμÕâ ߇ªìπ ¢âÕ ˜ „Àâæπ—°ß“π‡®â“Àπâ“∑Ë’ Õ∫ «πºâŸ®”πÕß„À≥⧫“¡™—¥‡®π·≈–

‡®“â ¢Õß ‡ªìπ∑’ˇ™◊ËÕ‰¥â«à“ºŸâπÈ—π‡ªìπ‡®â“¢Õß∑’Ë¥‘π·≈–Õ —ßÀ“√‘¡∑√—æ¬å∑Ë’¢Õ®¥∑–‡∫’¬π∑’Ë

·∑®â √ß‘ ·≈–„Àºâ √⟠∫— ®”πÕß„À∂â Õâ ¬§”¬π◊ ¬π— ‰«¥â «â ¬«“à º®âŸ ”πÕ߇ªπì º∑⟠μË’ π‰¥μâ ¥‘ μÕà

·≈–√Ÿâ·≈â««à“‡ªìπ‡®â“¢Õß∑Ë’·∑â®√‘ß®÷ß¡“∑” —≠≠“ ‚¥¬¬‘π¬Õ¡√—∫º‘¥™Õ∫„π

ÒıÒ

§«“¡‡ ’¬À“¬μà“ßÊ ∑Ë’‡°‘¥®“°§«“¡º‘¥æ≈“¥‡æ√“–º‘¥μ—«‡®â“¢Õß∑Ë’¥‘π·≈–
Õ ß— À“√‘¡∑√—æ¬å ∑Ë®’ ”πÕß«“à

ç¢â“懮⓺âŸ√—∫®”πÕߢլ◊π¬—π«à“ „π°“√∑” —≠≠“π’È¢â“懮Ⓣ¥âμ‘¥μàÕ ∫π— ∑°÷ ¬π◊ ¬π— º√⟠∫—
°—∫‡®â“¢Õß∑Ë’¥‘π‚¥¬μ√ß ‰¥â¡’°“√μ°ª“°≈ߧ” —≠≠“°—π¡“Õ¬à“ß·πàπÕπ·≈â« ®”πÕß
®÷ߢÕ∑” —≠≠“·≈–¢Õ®¥∑–‡∫’¬π®”πÕß À“°‡°‘¥°“√º‘¥æ≈“¥‡æ√“–º‘¥μ—«
‡®â“¢Õß∑’Ë¥‘π ¢â“懮ⓢÕ√—∫º‘¥™Õ∫‡Õß∑È—ß ‘Èπ ‰¡à‡°’ˬ«·°àæπ—°ß“π‡®â“Àπâ“∑’Ë·μà
Õ¬“à ß„¥

æπ—°ß“π‡®â“Àπ“â ∑’ˉ¥âÕ“à π¢Õâ §«“¡¢â“ß∫ππÈ’„À⢓â 懮“â øíß‚¥¬μ≈Õ¥·≈«â
¢â“懮â“∑√“∫·≈–‡¢â“„®¢âÕ§«“¡¥—ß°≈à“«¥’·≈â« ®÷ß≈ß≈“¬¡◊Õ™◊ËÕÀ√◊Õæ‘¡æå≈“¬
πÈ‘«¡◊Õ‰«â‡ªπì À≈°— ∞“πμàÕÀπ“â 欓π·≈–æπ—°ß“π‡®“â Àπâ“∑Ë’

≈ß™◊ËÕ...............................................º√Ÿâ —∫®”πÕß
≈ß™Ë◊Õ............................................... 欓π
≈ß™Ë◊Õ............................................... 欓π
≈ß™◊ËÕ...............................................‡®“â æπ—°ß“π∑Ë’¥‘πé
¢Õâ ¯ „Àâæπ—°ß“π‡®â“Àπâ“∑’Ë Õ∫ «πºŸâ®”πÕß·≈–ºŸâ√—∫®”πÕß„Àâ‰¥â  Õ∫®”πÕߪ√–°π—
§«“¡™—¥‡®π«à“‰¥â¡“¢Õ®¥∑–‡∫’¬π®”πÕ߇æ◊ËÕª√–°—π°“√™”√–Àπ’Èμ“¡ —≠≠“„¥ ÀπÕÈ’ –‰√
·≈–„À‡â μ¡‘ ¢Õâ §«“¡„π ≠— ≠“®”πÕß ¢Õâ Ò „À™â ¥— ‡®π«“à ‡ªπì °“√ª√–°π— „π‡√Õ◊Ë ß„¥
‡™àπ ∂â“°√≥’°“√®”πÕ߇æË◊Õ‡ªìπª√–°—π°“√°âŸ¬◊¡‡ß‘π´Ë÷ߧŸà°√≥’∑” —≠≠“°Ÿâ¬◊¡°—π
¡“·≈â« „Àâ‡μ‘¡§”«à“ ç°“√°Ÿâ¬◊¡‡ß‘π´÷ËߺŸâ®”πÕ߉¥â°Ÿâ®“°ºŸâ√—∫®”πÕßμ“¡ —≠≠“
°âŸ¬◊¡‡ß‘π ©∫—∫≈ß«—π∑Ë’........‡¥◊Õπ..................æ.». ....é ∂â“§àŸ°√≥’¬—߉¡à‰¥â∑”
Àπ—ß ◊Õ —≠≠“°âŸ¬◊¡‡ß‘π°—π „Àâ‡μ‘¡§”«à“ ç°“√°Ÿâ¬◊¡‡ß‘π´÷ËߺŸâ®”πÕ߉¥â°âŸ‡ß‘π®“°
ºŸâ√—∫®”πÕß ·≈–„Àâ∂◊Õ«à“ —≠≠“®”πÕßπÈ’‡ªìπÀ≈—°∞“π°“√°Ÿâ¬◊¡‡ß‘πé ∂Ⓡªìπ°“√
ª√–°—π°“√‡∫‘°‡ß‘π‡°‘π∫—≠™’ „Àâ‡μ‘¡§”«à“ çμ“¡ —≠≠“‡∫‘°‡ß‘π‡°‘π∫—≠™’ ©∫—∫
≈ß«—π∑Ë’........‡¥◊Õπ..................æ.». ....é À√◊Õ∂Ⓡªìπ°“√ª√–°—𧫓¡√—∫º‘¥„π
°“√ªØ‘∫μ— ‘μ“¡ ≠— ≠“„¥Ê „À‡â ¢’¬π¢âÕ§«“¡∑’Ë §à°Ÿ √≥μ’ °≈ß°π— ·≈«â ·μà°√≥’
¢Õâ ˘ °√≥’∑Ë’§àŸ°√≥’‰¡à‰¥â∑” —≠≠“°Ÿâ¬◊¡‡ß‘π°—π·μà‰¥â¡Õ∫Õ”π“®„Àâ¡“ °√≥’¡Õ∫Õ”π“®
®¥∑–‡∫’¬π®”πÕß „Àâæπ—°ß“π‡®â“Àπâ“∑Ë’μ√«® Õ∫Àπ—ß ◊Õ¡Õ∫Õ”π“®¥â«¬«à“‰¥â √∫— ®”πÕ߰⬟ ◊¡
√–∫ÿ¢âÕ§«“¡„π∑”πÕß∑Ë’„ÀâºâŸ√—∫¡Õ∫Õ”π“®∑” —≠≠“°Ÿâ¬◊¡‡ß‘πÀ√◊ÕÀ≈—°∞“π°“√
°Ÿâ¬◊¡‡ß‘π‰¥â¥â«¬ À“°‰¡à‰¥â√–∫ÿ¢âÕ§«“¡¥—ß°≈à“« ºŸâ√—∫¡Õ∫Õ”π“®®–∑” —≠≠“
®”πÕß‚¥¬√–∫„ÿ π ≠— ≠“®”πÕß«“à ç„À∂â Õ◊  ≠— ≠“®”πÕ߇ªπì À≈°— ∞“π°¬Ÿâ ¡◊ ‡ßπ‘ ¥«â ¬é
‰¡à‰¥â

ÒıÚ

°√≥’π” —≠≠“°â¬Ÿ ◊¡ ¢Õâ Ò °√≥’∑’褈١√≥’‰¥â®—¥∑”μ√“ “√Õ—π‡ªìπÀ≈—°∞“π °“√°Ÿâ¬◊¡‡ß‘π

¡“„Àâμ√«®°“√ª¥î À√◊Õ‡∫‘°‡ß‘π‡°‘π∫—≠™’ „Àâæπ—°ß“π‡®â“Àπâ“∑Ë’μ√«® Õ∫μ√“ “√Õ—π‡ªìπÀ≈—°∞“π

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·≈–©∫∫— ‡®“â ¢Õß∑Ë¥’ π‘ „Àâμ√ß°π— ¥«â ¬

¢Õâ Ú¯ °“√·°â∑–‡∫’¬π„π “√∫—≠®¥∑–‡∫’¬π°√≥’ª√–‡¿∑®”πÕß °“√‡¢’¬π™Ë◊Õ„π°“√
„π™Õà ߺŸâ„À â ≠— ≠“„À‡â ¢’¬π™◊ÕË ‡®“â ¢Õßμ“¡Àπ—ß ◊Õ· ¥ß ‘∑∏‘„π∑’¥Ë ‘π À“°¡’À≈“¬ ·°∑â –‡∫¬’ π

™Ë◊Õ„À⇢’¬π§√∫∑ÿ°™◊ËÕæ√âÕ¡À¡“¬‡≈¢≈”¥—∫°”°—∫‰«â ·≈–„π™àÕߺâŸ√—∫ —≠≠“„Àâ

‡¢’¬π§”«“à çºâ√Ÿ —∫®”πÕßé °”°—∫‰«â¥«â ¬ À“°‡ªπì °√≥ª’ √–‡¿∑‰∂∂à Õπ®“°®”πÕß

„π™àÕߺŸâ„Àâ ≠— ≠“‡¡◊ÕË ‡¢’¬π™Ë◊Õº√⟠—∫®”πÕß≈߉«·â ≈«â „À‡â ¢¬’ π§”«à“ çº√Ÿâ ∫— ®”πÕßé

°”°∫— ‰«â ·≈–„π™Õà ߺ√⟠∫—  ≠— ≠“‡¡Õ◊Ë ‡¢¬’ π™ÕË◊ ‡®“â ¢Õß·≈«â „À‡â ¢¬’ 𧔫“à çºâŸ‰∂∂à Õπé

°”°—∫‰«â¥â«¬ À“°‡ªìπ°√≥’®¥∑–‡∫’¬πª√–‡¿∑∑Ë’‡®â“¢Õ߇¥‘¡¬—ß¡’°√√¡ ‘∑∏‘ÏÀ√◊Õ

ÒˆÙ

 ‘∑∏‘§√Õ∫§√Õß„π∑Ë’¥‘πÕ¬Ÿà „À⇢’¬π™◊ËÕ‡®â“¢Õ߇¥‘¡πÈ—π‡√’¬ßμàÕ‰ªμ“¡≈”¥—∫

æ√âÕ¡∑ȗ߇¢’¬πÀ¡“¬‡≈¢≈”¥∫— °”°∫— ‰«¥â ⫬

π”·∑ߢâ“ß ∑.¥.Ò °√≥’°“√®¥∑–‡∫’¬πª√–‡¿∑∑Ë’μâÕßÀ¡“¬‡Àμÿ‰«â ≥ √‘¡¥â“π´â“¬¢Õß

„ à„π∑–‡∫¬’ 𠧔¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–π‘μ‘°√√¡ (∑.¥.Ò, ∑.¥.Ò °) „ÀâÀ¡“¬‡Àμÿ„π “√∫—≠

®¥∑–‡∫’¬π‡™àπ‡¥¬’ «°—π¥â«¬

μ—«Õ¬“à ß › ∑.¥.Ò °“√®¥— ∑”§”¢Õ®¥∑–‡∫¬’ π ∑‘ ∏·‘ ≈–πμ‘ °‘ √√¡ (∑.¥.Ò, ∑.¥.Ò °) §”¢Õ

›  —≠≠“ Àπ—ß ◊Õ —≠≠“ ∫—π∑÷°¢âÕμ°≈ß ·≈–°“√®¥∫—π∑÷°„π “√∫—≠®¥∑–‡∫’¬π„Àâ

› ·°â∑–‡∫’¬π

ªØ‘∫—μ‘·≈–„™â·∫∫Àπ—ß ◊Õ —≠≠“·≈–∫—π∑÷°¢âÕμ°≈ßμ“¡μ—«Õ¬à“ß∑⓬√–‡∫’¬∫

› ¡μ’ —«Õ¬“à ß∑Ë’ Ò›ÚÙ (μ“¡μ—«Õ¬“à ßÀ¡“¬‡≈¢ Ò›ÚÙ)

·∫àß·¬°√–À«“à ß ¢Õâ Ú˘ «‘∏’°“√®¥·®âߧ√Õ∫®”πÕß·≈–«‘∏’°“√ª≈Õ¥®”πÕß∑’Ë¥‘π

®”πÕß °√≥’¡’°“√¢Õ®¥∑–‡∫’¬π·∫àß·¬°∑’Ë¥‘π„π√–À«à“ß°“√®”πÕß „Àâæπ—°ß“π

‡®“â Àπ“â ∑’¥Ë ”‡ππ‘ °“√ ¥—ßπÈ’

°√≥’§√Õ∫®”πÕß (Ò) °√≥’∑’ËÀπ—ß ◊Õ· ¥ß ‘∑∏‘„π∑’Ë¥‘π‰¥â¡’°“√®¥∑–‡∫’¬π®”πÕ߉«â

∑—ßÈ Ú ·ª≈ß μàÕ¡“ºâŸ∂◊Õ°√√¡ ‘∑∏‘Ï¢Õ®¥∑–‡∫’¬π·∫àß·¬°‚¥¬§Ÿà°√≥’μ°≈ß„Àâ∑’Ë¥‘π·ª≈ß

§ß‡À≈◊Õ·≈–·ª≈ß·¬°ÕÕ°‰ª¡’°“√®”πÕßÕ¬Ÿàμ“¡‡¥‘¡ „Àâæπ—°ß“π‡®â“Àπâ“∑Ë’

‡¢’¬π§”«à“ ç(§√Õ∫®”πÕß)é ‰«âμàÕ∑⓬À√◊Õ„μâ™Ë◊Õª√–‡¿∑°“√®¥∑–‡∫’¬π

·∫àß·¬°„π§”¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–π‘μ‘°√√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π

 “√∫—≠®¥∑–‡∫¬’ π·ª≈߇¥¡‘ æ√Õâ ¡∑—Èß„ÀâÀ¡“¬‡Àμ‰ÿ «â ≥ √¡‘ ¥“â π´“â ¬¢Õߧ”¢Õ

®¥∑–‡∫¬’ π ∑‘ ∏‘·≈–πμ‘ °‘ √√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π√“¬°“√®¥∑–‡∫’¬π«à“

ç∑’Ë¥‘π·ª≈ß∑Ë’·¬°‰ªπÈ’·≈–·ª≈ߧ߇À≈◊Õ°“√®”πÕ߬—ߧߡ’Õ¬àŸμ“¡ —≠≠“

› ¡μ’ —«Õ¬“à ß∑Ë’ Úı ®”πÕß©∫∫— ≈ß«—π∑.’Ë .....‡¥Õ◊ π...............æ.». ....é (μ“¡μ«— Õ¬à“ßÀ¡“¬‡≈¢ Úı)

«‘∏’°“√§√Õ∫®”πÕß Àπ—ß ◊Õ· ¥ß ‘∑∏‘„π∑Ë’¥‘π·ª≈ß·¬°„À⇢’¬π™Ë◊Õ‡®â“¢Õß∑’Ë¥‘π‡ªìπºâŸ∂◊Õ

·ª≈ß·¬° °√√¡ ‘∑∏Ï‘‰«â¥â“πÀπâ“ ·≈–¬°√“¬°“√®¥∑–‡∫’¬πª√–‡¿∑®”πÕ߉ª®¥·®âß„π

 “√∫≠— ®¥∑–‡∫¬’ π æ√Õâ ¡∑ß—È À¡“¬‡Àμ°ÿ “√§√Õ∫®”πÕß ‚¥¬‡¢¬’ 𧔫“à ç(§√Õ∫

®”πÕß)é „π√“¬°“√®¥·®â߉«μâ Õà ∑⓬À√Õ◊ „μâ™◊ÕË ª√–‡¿∑°“√®¥∑–‡∫¬’ π®”πÕß∑Ë’

¬°¡“®¥·®âß „π™àÕ߇πÈ◊Õ∑’Ë¥‘πμ“¡ —≠≠“„Àâ≈ß®”π«π∑Ë’¥‘πμ“¡Àπ—ß ◊Õ· ¥ß

 ‘∑∏‘„π∑Ë’¥‘π„À¡à ·≈â«À¡“¬‡Àμÿ«à“ ç°“√®”πÕ߬—ߧߡ’Õ¬Ÿàμ“¡ —≠≠“®”πÕß

©∫—∫≈ß«—π∑.’Ë .....‡¥◊Õπ........æ.». ....é  ”À√—∫«—𠇥◊Õπ ªï ∑Ë’®¥∑–‡∫’¬π ·≈–

™Ë◊Õ‡®â“æπ—°ß“π∑Ë’¥‘π„Àâ„™â™Ë◊Õ·≈–«—𠇥◊Õπ ªï ‡¥‘¡ ‚¥¬‡®â“æπ—°ß“π∑Ë’¥‘π§π

ªí®®ÿ∫—π≈ß™◊ËÕ æ√âÕ¡«—𠇥◊Õπ ªï °”°—∫‰«â °√≥’∑Ë’™◊ËÕºŸâ®”πÕßÀ√◊ÕºŸâ√—∫®”πÕß

‡ª≈’¬Ë π·ª≈߉ª „À⬰√“¬°“√∑‡Ë’ ª≈Ë’¬π·ª≈߉ª®¥·®â߉«â„π∑”πÕ߇¥’¬«°π— ¥«â ¬

› ¡μ’ —«Õ¬à“ß∑Ë’ Úˆ (μ“¡μ—«Õ¬à“ßÀ¡“¬‡≈¢ Úˆ)

Òˆı

(Ú) °√≥’∑’ËÀπ—ß ◊Õ· ¥ß ‘∑∏‘„π∑’Ë¥‘π‰¥â¡’°“√®¥∑–‡∫’¬π®”πÕ߉«â °√≥∫’ “ß·ª≈ߧ√Õ∫

μàÕ¡“¡’°“√¢Õ®¥∑–‡∫’¬π·∫àß·¬°‚¥¬§àŸ°√≥’¬‘π¬Õ¡„ÀâÀπ—ß ◊Õ· ¥ß ‘∑∏‘„π › ∫“ß·ª≈ߪ≈Õ¥
∑Ë’¥‘π∫“ß·ª≈ß¡’°“√®”πÕßÕ¬àŸμ“¡‡¥‘¡ ∫“ß·ª≈ßæâπ®“°°“√®”πÕß ‡™àπ °√≥’ ®”πÕß (§√Õ∫›

ª≈Õ¥®”πÕß)

·∫ßà ·¬°„ππ“¡‡¥¡‘ „À∑⠥˒ π‘ ·ª≈ß·¬°∑’Ë Ò æπâ ®“°°“√®”πÕß  «à π∑¥’Ë π‘ ·ª≈ß·¬°

∑Ë’ Ú ·≈–·ª≈ߧ߇À≈◊Õ¬—ߧߡ’°“√®”πÕßÕ¬Ÿàμ“¡‡¥‘¡ „Àâæπ—°ß“π‡®â“Àπâ“∑Ë’

À¡“¬‡Àμ„ÿ Àâª√“°Ø°“√§√Õ∫®”πÕßÀ√◊Õª≈Õ¥®”πÕß‚¥¬‡¢¬’ 𧔫“à ç(§√Õ∫›

ª≈Õ¥®”πÕß)é ‰«âμàÕ∑⓬À√◊Õ„μâ™Ë◊Õª√–‡¿∑°“√®¥∑–‡∫’¬π ·∫àß·¬°„π§”¢Õ

®¥∑–‡∫’¬π ‘∑∏‘·≈–π‘μ‘°√√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π “√∫—≠®¥∑–‡∫’¬π

·ª≈߇¥‘¡ æ√âÕ¡∑—ÈßÀ¡“¬‡Àμÿ‰«â ≥ √‘¡¥â“π´â“¬¢Õߧ”¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–

πμ‘ °‘ √√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π√“¬°“√®¥∑–‡∫’¬π∑’Ë¥‘π·ª≈ß·¬°∑Ë’ Ò «à“

ç∑Ë’¥‘π·ª≈ß∑’Ë·¬°‰ªπ’Èæâπ®“°°“√®”πÕßμ“¡ —≠≠“®”πÕß ©∫—∫≈ß«—π∑’Ë......

‡¥◊Õπ............æ.». .... μ“¡∫π— ∑°÷ ¢âÕμ°≈ߪ≈Õ¥®”πÕß ≈ß«—π∑’.Ë .....‡¥Õ◊ π........

æ.». ....é  «à π∑Ë’¥π‘ ·ª≈ß·¬°∑’Ë Ú ·≈–·ª≈ߧ߇À≈◊Õ „ÀÀâ ¡“¬‡Àμ«ÿ à“ ç∑¥Ë’ ‘π

·ª≈ß∑Ë’·¬°‰ªπ’È·≈–·ª≈ߧ߇À≈◊Õ°“√®”πÕ߬—ߧߡ’Õ¬àŸμ“¡ —≠≠“®”πÕß©∫—∫

≈ß«π— ∑.’Ë .....‡¥◊Õπ........æ.». ....é  ”À√—∫√“¬°“√®¥∑–‡∫¬’ π®”πÕß∑®Ë’ –¬°‰ª®¥

·®ßâ ‰«â„πÀπß—  ◊Õ· ¥ß ∑‘ ∏‘„π∑¥Ë’ ‘π·ª≈ß·¬°„À¡à „ÀâªØ‘∫μ— ‘μ“¡ (Ò) «√√§ Õß

(μ“¡μ—«Õ¬à“ßÀ¡“¬‡≈¢ Ú˜) À√◊Õ°√≥’·∫àߢ“¬„Àâ∑Ë’¥‘π·ª≈ß·¬°æâπ®“° › ¡μ’ —«Õ¬à“ß∑’Ë Ú˜

°“√®”πÕß·≈–∑’Ë¥‘π·ª≈ߧ߇À≈◊Õ¬—ߧߡ’°“√®”πÕßÕ¬àŸμ“¡‡¥‘¡ „Àâæπ—°ß“π

‡®â“Àπâ“∑’ËÀ¡“¬‡Àμÿ„Àâª√“°Ø°“√§√Õ∫®”πÕßÀ√◊Õª≈Õ¥®”πÕß‚¥¬‡¢’¬π§”«à“

ç(§√Õ∫›ª≈Õ¥®”πÕß)é ‰«âμàÕ∑⓬À√◊Õ„μâ™◊ËÕª√–‡¿∑°“√®¥∑–‡∫’¬π

·∫àߢ“¬„π§”¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–π‘μ‘°√√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π

 “√∫≠— ®¥∑–‡∫’¬π·ª≈߇¥¡‘ æ√âÕ¡∑ß—È À¡“¬‡Àμ‰ÿ «â ≥ √¡‘ ¥â“π´â“¬¢Õߧ”¢Õ®¥

∑–‡∫¬’ π ∑‘ ∏·‘ ≈–πμ‘ °‘ √√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π√“¬°“√®¥∑–‡∫¬’ π·∫ßà ¢“¬

«à“ ç∑’Ë¥‘π·ª≈ß∑’Ë·¬°‰ªπ’Èæâπ®“°°“√®”πÕßμ“¡ —≠≠“®”πÕß ©∫—∫≈ß«—π

∑Ë’......‡¥◊Õπ..............æ.». .... μ“¡∫—π∑÷°¢âÕμ°≈ߪ≈Õ¥®”πÕß ≈ß«—π∑Ë’......

‡¥◊Õπ.......æ.». ....é  «à π·ª≈ߧ߇À≈◊Õ °“√®”πÕ߬—ߧߡ’Õ¬àŸμ“¡‡¥‘¡é (μ“¡

μ«— Õ¬“à ßÀ¡“¬‡≈¢ Ú¯) ‡ªìπμâπ › ¡’μ«— Õ¬à“ß∑Ë’ Ú¯

(Û) °√≥’∑’ˉ¥¡â °’ “√®¥∑–‡∫¬’ π®”πÕ߇©æ“– «à π‰«â ∂“â ºŸâ∂Õ◊ °√√¡ ‘∑∏‘Ï °√≥®’ ”πÕß

√«¡·≈–ºŸâ®”πÕßμ°≈ß·∫àß·¬°∑’Ë¥‘πÕÕ°®“°°—π „Àâ欓¬“¡·∫àß à«π¢Õß ‡©æ“– à«π‰«â
ºŸâ®”πÕ߉«â‡ªìπ·ª≈ߧ߇À≈◊Õ ·≈–„Àâ·ª≈߇©æ“– à«π¢ÕߺâŸ∂◊Õ°√√¡ ‘∑∏‘Ï∑’ˉ¡à (§√Õ∫›ª≈Õ¥®”πÕß)

‰¥â®”πÕß®¥∑–‡∫’¬πª√–‡¿∑ª≈Õ¥®”πÕß„À⇠√Á®„π«—π®¥∑–‡∫’¬π·∫àß·¬°

·≈–„Àâæπ—°ß“π‡®â“Àπâ“∑Ë’À¡“¬‡Àμÿ„Àâª√“°Ø°“√§√Õ∫®”πÕßÀ√◊Õª≈Õ¥®”πÕß

Òˆˆ

‚¥¬‡¢’¬π§”«à“ ç(§√Õ∫›ª≈Õ¥®”πÕß)é ‰«âμàÕ∑⓬À√◊Õ„μâ™Ë◊Õª√–‡¿∑°“√

®¥∑–‡∫’¬π·∫ßà ·¬° „π§”¢Õ®¥∑–‡∫’¬π ∑‘ ∏‘·≈–πμ‘ ‘°√√¡ (∑.¥.Ò, ∑.¥.Ò °)

·≈–„π “√∫—≠®¥∑–‡∫’¬π·ª≈߇¥¡‘ æ√Õâ ¡∑ß—È À¡“¬‡Àμ‰ÿ «â ≥ √¡‘ ¥â“π´â“¬¢Õß

§”¢Õ®¥∑–‡∫¬’ π ∑‘ ∏·‘ ≈–πμ‘ °‘ √√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π√“¬°“√®¥∑–‡∫¬’ π«“à

ç∑Ë’¥‘π·ª≈ß∑Ë’·¬°‰ªπÈ’æâπ®“°°“√®”πÕß μ“¡ —≠≠“®”πÕ߇©æ“– à«π©∫—∫≈ß

«—π∑’Ë......‡¥◊Õπ........æ.». .... μ“¡∫—π∑÷°¢âÕμ°≈ߪ≈Õ¥®”πÕß ≈ß«—π∑’Ë......

‡¥◊Õπ........æ.». ....é  à«π∑’Ë¥‘π·ª≈ߧ߇À≈◊Õ„ÀâÀ¡“¬‡Àμÿ‰«â ≥ √‘¡¥â“π´â“¬

¢Õߧ”¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–π‘μ‘°√√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π√“¬°“√

®¥∑–‡∫’¬π«à“ ç∑’Ë¥‘π·ª≈ߧ߇À≈◊Õ°“√®”πÕ߬—ߧߡ’Õ¬Ÿàμ“¡ —≠≠“®”πÕß

› ¡’μ—«Õ¬à“ß∑Ë’ Ú˘ ‡©æ“– «à π©∫∫— ≈ß«π— ∑.’Ë .....‡¥◊Õπ.........æ.». ....é (μ“¡μ«— Õ¬“à ßÀ¡“¬‡≈¢ Ú˘)

«∏‘ °’ “√§√Õ∫›ª≈Õ¥ °√≥’∑ËÀ’ π—ß ◊Õ· ¥ß ‘∑∏‘„π∑Ë’¥‘π·∫àß·¬°ÕÕ°®“°°—π·≈â«·μ à «à π¢Õß

®”πÕß ·μà≈–·ª≈ß ºŸâ®”πÕ߇ªìπ·ª≈ß·¬° „ÀâÀ¡“¬‡Àμÿ‰«â ≥ √‘¡¥â“π´â“¬¢Õߧ”¢Õ®¥∑–‡∫’¬π

 ‘∑∏‘·≈–π‘μ‘°√√¡ (∑.¥.Ò, ∑.¥.Ò °) ·≈–„π√“¬°“√®¥∑–‡∫’¬π·∫àß·¬°

‡©æ“–·ª≈ߢÕߺ⟮”πÕ߉«â¥â«¬«“à ç∑’Ë¥‘π·ª≈ß∑’Ë·¬°‰ªπ’È°“√®”πÕ߬—ߧߡ’Õ¬Ÿà

μ“¡ —≠≠“®”πÕ߇©æ“– à«π ©∫—∫≈ß«—π∑Ë’.....‡¥◊Õπ........ æ.». ....é  ”À√—∫

√“¬°“√®¥∑–‡∫¬’ π®”πÕß∑®’Ë –¬°‰ª®¥·®ßâ ‰«â„πÀπß—  Õ◊ · ¥ß ∑‘ ∏‘„π∑¥Ë’ π‘ ·ª≈ß

·¬°„À¡à „Àªâ Ø∫‘ μ— μ‘ “¡ (Ò) «√√§ Õß ‡«âπ·μ™à ◊Ëէࠟ —≠≠“∑—ßÈ Ú Ω“É ¬ „π™Õà ß

ºâŸ„Àâ —≠≠“„À⬰¡“·μà‡©æ“–™◊ËÕ§àŸ —≠≠“®”πÕ߇∑à“πÈ—π ™◊ËÕºâŸ∂◊Õ°√√¡ ‘∑∏Ï‘ÕË◊π

´ß÷Ë ¡‘‰¥‡â ªπì §à Ÿ ≠— ≠“‰¡μà Õâ ߬°¡“¥â«¬  «à π·ª≈ߧ߇À≈Õ◊ ∑’ˉ¡¡à °’ “√®”πÕߧ√Õ∫

쥑 ‰ª¥«â ¬ „À®â ¥∑–‡∫¬’ πª√–‡¿∑ª≈Õ¥®”πÕß„À‡â  √®Á „π«π— ®¥∑–‡∫¬’ π·∫ßà ·¬°

·≈–„ÀâÀ¡“¬‡Àμ‰ÿ «â ≥ √¡‘ ¥“â π´â“¬§”¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–π‘μ‘°√√¡ (∑.¥.Ò,

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·μàÕ¬“à ß Ÿß‰¡à‡°‘π Ú, ∫“∑ μ“¡°Æ°√–∑√«ß´Ë÷ßÕÕ°μ“¡§«“¡„πæ√–√“™
∫≠— ≠μ— ‘„Àâ„™ªâ √–¡«≈°ÆÀ¡“¬∑Ë¥’ π‘ æ.».ÚÙ˘˜

¢âÕ Ù˜ „π°“√®¥∑–‡∫’¬πª√–‡¿∑ª≈Õ¥®”πÕß°√≥’°“√®¥∑–‡∫’¬π ª≈Õ¥®”πÕß°√≥’
·∫àß·¬°„Àâ‡√’¬°‡°Á∫§à“∏√√¡‡π’¬¡ª√–‡¿∑‰¡à¡’∑ÿπ∑√—æ¬å μ“¡®”π«π·ª≈ß∑Ë’¥‘π ·∫ßà ·¬°
∑¢Ë’ Õ®¥∑–‡∫’¬πª≈Õ¥®”πÕß

„π°“√®¥∑–‡∫¬’ πª≈Õ¥®”πÕß°√≥°’ “√®¥∑–‡∫¬’ π·∫ßà °√√¡ ∑‘ ∏√Ï‘ «¡ ª≈Õ¥®”πÕß°√≥’
∑Ë’¡’ºŸâ∂◊Õ°√√¡ ‘∑∏‘Ï√«¡§π‡¥’¬«À√◊ÕÀ≈“¬§π®”πÕ߇©æ“– à«π‰«âÀ≈“¬ —≠≠“ ·∫àß°√√¡ ∑‘ ∏√‘Ï «¡
·≈–§àŸ°√≥’μ°≈ß„Àâ∑Ë’¥‘π¢ÕߺŸâ∂◊Õ°√√¡ ‘∑∏Ï‘√«¡∑Ë’®”πÕß∫“ߧπ·ª≈߇¥’¬«·≈–
∫“ߧπÀ≈“¬·ª≈ß ª≈Õ¥®“°°“√®”πÕß „Àâ‡√’¬°‡°Á∫§“à ∏√√¡‡π’¬¡®¥∑–‡∫’¬π
ª≈Õ¥®”πÕߪ√–‡¿∑‰¡à¡’∑ÿπ∑√—æ¬åμ“¡®”π«π·ª≈ß∑Ë’¥‘π∑’˪≈Õ¥®”πÕß ·≈–
‡√’¬°‡°Á∫§à“∏√√¡‡π’¬¡®¥∑–‡∫’¬πª≈Õ¥®“°®”πÕߢÕߺŸâ∂◊Õ°√√¡ ‘∑∏‘Ï√«¡
∑Ë’ ‰¡à‰¥â®”πÕß „Àâ‡√’¬°‡°Á∫μ“¡®”π«π —≠≠“®”πÕß∑Ë’ºâŸ∂◊Õ°√√¡ ‘∑∏Ï‘√«¡
§πÕË◊πÊ ‰¥â®”πÕ߉«â

ª√–°“» ≥ «π— ∑’Ë ÚÚ  ß‘ À“§¡ æ.».Úıı
(≈ß™ÕË◊ ) ™—¬ƒ°…å ¥‘…∞Õ”π“®
(𓬙¬— ƒ°…å ¥…‘ ∞Õ”π“®)
Õ∏∫‘ ¥°’ √¡∑Ë¥’ π‘

(ª√–°“»√“™°‘®®“πÿ‡∫°…“ ‡≈à¡ ÒÚÙ μÕπ懑 »… ÒÚÚ ß
≈ß«π— ∑Ë’ ÚÒ‹ °π— ¬“¬π Úıı)

Ò˜Ù

μ«— Õ¬à“ßÀ¡“¬‡≈¢ Ò (∑.¥. Ò)
∑∫Ë’ “â π

∑’Ë «π/‰√à

∑’Ëπ“

∑’.Ë .............

§”¢Õ®¥∑–‡∫’¬π ‘∑∏·‘ ≈–π‘μ‘°√√¡ πÕ°‡¢μ
·≈–°“√ Õ∫ «π ∑‘ ∏‘„π∑¥Ë’ ‘π ª√–‡¿∑.......®..”..π..Õ..ß............................... „π‡¢μ

μ”·Àπàß∑Ë’¥‘π

√–«“ß.........................................................................................μ”∫≈.........................................................................................

‡≈¢∑Ë’¥π‘ .....................................................................................Õ”‡¿Õ........................................................................................

Àπâ“ ”√«®..................................................................................®ß— À«¥— ........................................................................................

‚©π¥∑¥Ë’ ‘π

‡≈¢∑Ë.’ ...........................................‡≈à¡........................................Àπâ“....................................
®”π«π∑’Ë¥π‘ ............Ò.......................‰√.à .............›...................ß“π...............›....................μ“√“ß«“

Ò. ¢â“懮“â ºŸ¡â π’ “¡μÕà ‰ªπÈ’ ¡’§«“¡ª√– ß§å¢Õ®¥∑–‡∫¬’ π ‘∑∏·‘ ≈–πμ‘ °‘ √√¡‡°¬Ë’ «°—∫Õ —ßÀ“√¡‘ ∑√æ— ¬å∑’°Ë ≈“à «¢“â ß∫ππ’È ·≈–

‰¥âªØ‘≠“≥μπ·≈«â ¢Õ„À∂â âÕ¬§”¥â«¬§«“¡ —μ¬å®√‘ß ∂â“¢“â 懮ⓄÀâ∂Õâ ¬§”‰¡à‡ªπì §«“¡®√‘ß„Àâ„™∂â Õâ ¬§”πÈ’¬—π¢“â 懮“â „π∑“ߧ¥’Õ“≠“‰¥â

Ú. ¢“â 懮â“..............π..“..¬....°............................ ‡≈¢ª√–®”μ—«ª√–™“™π ºŸ.â ..®..”..π..Õ..ß...........................

.................................................

Õ“¬ÿ..................................ªï  —≠™“μ‘.......‰..∑..¬..............................∫‘¥“/¡“√¥“™ËÕ◊ .............................................................................

‚ ¥ À¡“â ¬ § Ÿà ¡√ ™Ë◊Õ..........................................................................................

Õ¬∑Ÿà Ë’∫â“π/À¡∫àŸ â“π..........................‡≈¢∑Ë.’ ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡àŸ∑’Ë..............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®ß— À«¥— .................................À¡“¬‡≈¢‚∑√»æ— ∑å.....................

Û. ¢“â 懮â“............∏..π..“..§..“..√....‡.Õ...................... ‡≈¢ª√–®”μ—«ª√–™“™π º.⟠..√..—∫...®..”..π..Õ..ß......................

................................................
Õ“¬ÿ..................................ªï  —≠™“μ‘........‰.∑...¬.............................∫¥‘ “/¡“√¥“™◊ËÕ.............................................................................

‚ ¥ À¡“â ¬ §Ÿ à ¡√ ™Õ◊Ë ....................................................... ≠— ™“μ.‘ ......................

Õ¬Ÿ∑à Ë’∫â“π/À¡àŸ∫â“π..........................‡≈¢∑.Ë’ ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡∑àŸ Ë.’ .............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®ß— À«—¥.................................À¡“¬‡≈¢‚∑√»—æ∑å.....................

Ù. ¢â“懮“â ¢Õ· ¥ß√“§“∑√—æ¬å∑¢’Ë Õ∑”πμ‘ °‘ √√¡π’ȇªìπ‡ß‘π.......................Û.......,...........................∫“∑.........›........... μ“ߧå

ı. ¢“â 懮“â ¢Õ√∫— √Õß«“à ( “¡· π∫“∑∂«â π)

(Ò) ¢“â 懮Ⓣ¡à‰¥√â ∫— ‚Õπ·∑πÀ√◊Õ‡æËÕ◊ ª√–‚¬™π·å °à∫§ÿ §≈μà“ߥ“â «

(Ú) √“§“∑√æ— ¬∑å ’·Ë  ¥ß‰«â„π Ù. ‡ªìπ√“§“∑·’Ë ∑â®√ß‘
(Û)  ...ßË‘ ..ª..≈..°Ÿ... ..√..â“..ß..„.π..∑...Ë¥’ ..π‘..·...ª..≈..ß..π...’È∑..Ë¡’..Õ’...¬..à·Ÿ..≈...«â .·...≈..–..∑..®’Ë...–..¡..’¢..÷πÈ..„..π..¿..“..¬...À..π..â“..®..”..π..Õ...ß..¥..«â..¬..∑...—ßÈ .. ..È‘π...............................................
(Ù) ®..”..π..Õ...ß..‡.æ...◊ÕË ..‡.ª...πì ..ª..√..–..°...π— ..°..“..√..°..Ÿ¬â...¡◊ ..‡.ß..π‘...´..÷Ëß..º..Ÿâ®..”..π..Õ...ß..‰.¥..â°...®âŸ ..“..°..º..âŸ√..∫—...®..”.π...Õ..ß....................................................................
(ı) Õ...μ— ..√..“..¥..Õ...°..‡.∫..¬È’...√..Õâ ..¬..≈...–...Ò..ı....μ...àÕ..ª..ï..·..≈..–..π...”.. ..àß..¥..Õ...°..‡.∫..¬È’...ª..≈ï..–...À..π..ß÷Ë..§...√..Èß— ......................................................................

«π— ∑.Ë’ ...........‡¥Õ◊ π..............................æ.»..................
≈ß™Õ◊Ë .....................π...“.¬....°..........................ºŸâ¢Õ ®”πÕß
≈ß™ÕË◊ ..................∏..π...“..§..“..√...‡..Õ....................ºŸâ¢Õ √∫— ®”πÕß

≈ß™ÕË◊ ......................................................º Ÿâ Õ∫ «π

(......................................................)

 ”À√∫— æπ—°ß“π‡®â“Àπâ“∑’Ë

Ò) √“§“ª√–‡¡π‘ ∑πÿ ∑√æ— ¬.å ....................................................................................................∫“∑........................................ μ“ߧå

Ú) ‚©π¥∑Ë’¥‘π„À¡à√–«“ß............................................‡≈¢∑¥Ë’ ‘π...............................................Àπâ“ ”√«®.........................................

‚©π¥∑’¥Ë ‘π‡≈¢∑’.Ë ..................................................‡≈¡à ......................................................Àπâ“..................................................

®”π«π∑¥Ë’ π‘ ......................................................‰√.à ................................................ß“π..................................................μ“√“ß«“

§ß‡À≈Õ◊ ...........................................................‰√.à ................................................ß“π..................................................μ“√“ß«“

Û) ‰¥â®¥∑–‡∫’¬π·≈«â ·μà«π— ∑’Ë.................................‡¥◊Õπ............................................æ.»......................

≈ß™◊ËÕ.......................................................

(......................................................)

‡®â“æπ—°ß“π∑’Ë¥‘π

μ—«Õ¬à“ßÀ¡“¬‡≈¢ Ò Ò˜ı

(∑.¥. Òı)

Àπß—  ◊Õ ≠— ≠“®”πÕß∑Ë¥’ π‘

∑Ë’¥‘π

‚©π¥∑Ë.’ .........................................‡≈¢∑¥’Ë π‘ .........................................Àπ“â  ”√«®...............................................

μ”∫≈............................................Õ”‡¿Õ............................................®—ßÀ«¥— ....................................................

Àπß—  Õ◊  —≠≠“πÈ’‰¥∑â ”‡¡◊ÕË «π— ∑Ë.’ .................‡¥◊Õπ..............................................æÿ∑∏»—°√“™.............................................

≥  ”π°— ß“π∑¥’Ë π‘ ®ß— À«¥— .................................................... } { }................
ºŸ®â ”πÕß Õ“¬ÿ ................ ªï
‡≈¢ª√–®”μ—«ª√–™“™π ................

{ }...............................................

√–À«à“ß ...............π..“..¬....°.........................

...............................................

 ≠— ™“μ‘............‰.∑..¬.....................∫‘¥“/¡“√¥“™ÕË◊ ...............................................................................................................................

Õ¬∑àŸ ’Ë∫“â π/À¡àŸ∫“â π................................................‡≈¢∑.’Ë ................μ√Õ°/´Õ¬............................∂ππ............................À¡∑Ÿà .Ë’ ..........

μ”∫≈/·¢«ß..................................Õ”‡¿Õ/‡¢μ................................®—ßÀ«¥— ................................À¡“¬‡≈¢‚∑√»æ— ∑.å .........................

‡≈¢ª√–®”μ—«ª√–™“™π

{ }............................................... } { }................
º√⟠∫— ®”πÕß Õ“¬ÿ ................ ªï
°∫— .............∏..π..“..§..“..√....‡.Õ...................
............................................... ................

 ≠— ™“μ‘..............‰.∑...¬..................∫‘¥“/¡“√¥“™ËÕ◊ ...............................................................................................................................

Õ¬Ÿ∑à Ë∫’ “â π/À¡àŸ∫“â π................................................‡≈¢∑.’Ë ................μ√Õ°/´Õ¬............................∂ππ............................À¡∑àŸ ’.Ë ..........

μ”∫≈/·¢«ß..................................Õ”‡¿Õ/‡¢μ................................®—ßÀ«¥— ................................À¡“¬‡≈¢‚∑√»æ— ∑.å .........................

∑ß—È  ÕßΩÉ“¬‰¥âμ°≈ß∑” —≠≠“°—π¥ß— μàÕ‰ªπ’È
¢Õâ Ò. º®Ÿâ ”πÕßμ°≈ß®”πÕß∑Ë’¥‘π·ª≈ß∑Ë’°≈à“«¢“â ß∫ππ’È∑—ßÈ ·ª≈ß·°àºŸâ√—∫®”πÕß ‡æË◊Õ‡ªπì °√–°—π..°...“..√..°..⬟ ..¡◊..‡..ß..‘π..´..÷Ëß..º...⮟ ..”.π...Õ..ß..
‰..¥..â°..⮟..“..°..º...√Ÿâ ..—∫..®..”..π..Õ...ß.........................................................................................................................................................................
‡ªìπ®”π«π‡ßπ‘ ..................Û.......,.................................∫“∑ (‡ßπ‘ .................. ...“.¡...·.. ..π..........................................∫“∑) ‚¥¬„Àâ¥Õ°‡∫Ȭ’
..................√..âÕ..¬................≈–...............Ò...ı...μ...Õà ..ª..ï............../.μ/Õà /‡/¥/Õ◊ /π/ ·≈–μ°≈ßπ” ßà ¥Õ°‡∫¬’È ..........ª...≈ï ..–..À..π...Ë÷ß......................§√ßÈ— ‡ ¡Õ‰ª

¢Õâ Ú. ºŸ√â —∫®”πÕßμ°≈ß√—∫®”πÕß∑Ë¥’ ‘π·ª≈ßπ’μÈ “¡¢âÕμ°≈ß„π¢âÕ Ò ∑ÿ°ª√–°“√

¢Õâ Û. ºŸâ®”πÕ߉¥â√—∫‡ßπ‘ ‡ªìπ°“√‡ √®Á ·≈«â
¢âÕ Ù.  ...‘ßË ..ª..≈..°Ÿ.. ...√..â“..ß..„.π..∑...¥’Ë ..π‘..·...ª..≈..ß..π...’È∑..Ë’¡..’Õ...¬..Ÿà·..≈..«â..·...≈..–..∑..®’Ë..–...¡..¢’ ..Èπ÷..„..π..¿..“..¬...À..π..â“..®..”..π..Õ...ß..¥..«â..¬..∑...—Èß.. ..‘Èπ...............................................

....................................................................................................................................................................................................

∑È—ß ÕßΩ“É ¬μ°≈ß°π— ¬Õ¡„Àâ...............................................‡ªπì ºŸâ∂Õ◊ ‚©π¥∑¥’Ë ‘π√“¬π’È„π√–À«à“߇«≈“∑’Ë„™ â ≠— ≠“®”πÕßπÈ’

Àπ—ß ◊Õ —≠≠“πÈ’‰¥â∑”‡ªìπ “¡©∫—∫¡’¢âÕ§«“¡μ√ß°—π  ”À√—∫ ”π—°ß“π∑’Ë¥‘πÀπ÷Ëß©∫—∫ ºŸâ®”πÕß·≈–ºâŸ√—∫®”πÕß∂◊Õ‰«â

Ω“É ¬≈–ÀπË÷ß©∫∫— (©∫∫— π È’ ”À√—∫..............................................................)

∑È—ß ÕßΩÉ“¬‰¥âμ√«®¥ŸÀπ—ß ◊Õ —≠≠“®”πÕß·≈–‡¢â“„®¢âÕ§«“¡μ≈Õ¥·≈â« ®÷߉¥â≈ß≈“¬¡◊Õ™Ë◊Õ À√◊Õæ‘¡æå≈“¬π‘È«¡◊Õ‰«â‡ªìπ

 ”§≠— μàÕÀπâ“欓π·≈–‡®â“æπ—°ß“π∑Ë’¥‘π
(≈ß≈“¬¡◊Õ™Õ◊Ë ºâŸ®”πÕß)......................π..“..¬....°......................................
(≈ß≈“¬¡◊Õ™◊ÕË ºŸâ√—∫®”πÕß)..................∏..π..“..§..“..√....‡.Õ..............................

(≈ß≈“¬¡Õ◊ ™ËÕ◊ 欓π).......................................................................

(≈ß≈“¬¡◊Õ™◊ËÕ欓π).......................................................................

Àπß—  ◊Õ ≠— ≠“π’ȉ¥∑â ”μàÕÀπ“â

.................................................................................‡®“â æπ—°ß“π∑Ë¥’ ‘π

ª√–∑∫— μ√“μ”·Àπßà ‡ªπì  ”§—≠

........................................................º‡âŸ ¢’¬π

........................................................ºŸμâ √«®

μ«— Õ¬“à ßÀ¡“¬‡≈¢ Ò Ò˜ˆ

 “√∫≠— ®¥∑–‡∫’¬π

®¥∑–‡∫’¬π ª√–‡¿∑°“√ ºŸâ„À â ≠— ≠“ ºŸâ√—∫ —≠≠“ ‡π◊ÈÕ∑’Ë¥‘π ‡π◊ÈÕ∑Ë’¥‘π √–«“ß ‡®â“æπ—°ß“π∑Ë’¥‘π
«π— ‡¥◊Õπ ªï ®¥∑–‡∫¬’ π 𓬠°. μ“¡ —≠≠“ §ß‡À≈Õ◊ ‡≈¢∑’Ë¥‘π ≈ß≈“¬¡Õ◊ ™Õ◊Ë
∏𓧓√ ‡Õ ‚©π¥∑Ë’¥‘π„À¡à ª√–∑∫— μ√“
«π— ∑’Ë..................... ®”πÕß ºâŸ√—∫®”πÕß ‰√à ß“π μ“√“ß ‰√à ß“π μ“√“ß
‡¥◊Õπ................... «“ «“
æ.». .....................
Ò››››› › (≈ß™◊ËÕ)........................

μ«— Õ¬à“ßÀ¡“¬‡≈¢ Ú Ò˜˜

(∑.¥. Ò)
∑∫Ë’ “â π

∑’Ë «π/‰√à

∑’Ëπ“

∑.Ë’ .............

§”¢Õ®¥∑–‡∫’¬π ‘∑∏·‘ ≈–πμ‘ ‘°√√¡ πÕ°‡¢μ
·≈–°“√ Õ∫ «π ‘∑∏‘„π∑’Ë¥‘π ª√–‡¿∑.......®..”.π...Õ..ß..‡.©...æ..“..–.. ..à«..π............... „π‡¢μ

μ”·Àπàß∑Ë’¥‘π

√–«“ß.........................................................................................μ”∫≈.........................................................................................

‡≈¢∑¥Ë’ π‘ .....................................................................................Õ”‡¿Õ........................................................................................

Àπ“â  ”√«®..................................................................................®—ßÀ«¥— ........................................................................................

‚©π¥∑Ë’¥‘π

‡≈¢∑’Ë............................................‡≈à¡........................................Àπâ“....................................
®”π«π∑¥Ë’ π‘ ............Ò.......................‰√.à .............›...................ß“π...............›....................μ“√“ß«“

Ò. ¢“â 懮⓺Ÿâ¡’π“¡μÕà ‰ªπ’È ¡’§«“¡ª√– ß§å¢Õ®¥∑–‡∫¬’ π ∑‘ ∏‘·≈–π‘μ‘°√√¡‡°¬Ë’ «°∫— Õ ß— À“√‘¡∑√—æ¬å∑’°Ë ≈“à «¢â“ß∫ππ’È ·≈–

‰¥ªâ Ø‘≠“≥μπ·≈â« ¢Õ„À∂â Õâ ¬§”¥«â ¬§«“¡ —μ¬å®√‘ß ∂“â ¢â“懮ⓄÀâ∂Õâ ¬§”‰¡à‡ªì𧫓¡®√‘ß„Àâ„™â∂Õâ ¬§”πÈ’¬π— ¢“â 懮Ⓞπ∑“ߧ¥’Õ“≠“‰¥â

Ú. ¢“â 懮“â ..............Ò.....π..“..¬....°........................ ‡≈¢ª√–®”μ—«ª√–™“™π ºŸâ...®..”..π..Õ..ß...........................

𓬠°. ®”πÕ߇©æ“– à«π¢Õßμπ·°à 𓬠ß. à «π¢ÕߧπÕ◊Ëπ§ß‡¥‘¡ .................................................
‡ ⮓æπ—°ß“π Ë’∑ ‘¥π Õ“¬ÿ..................................ªï  —≠™“μ.‘ ......‰..∑..¬..............................∫¥‘ “/¡“√¥“™◊ÕË .............................................................................

‚ ¥ À¡“â ¬ §à Ÿ ¡√ ™◊ËÕ..........................................................................................

Õ¬Ÿà∑Ë∫’ “â π/À¡à∫Ÿ â“π..........................‡≈¢∑’.Ë ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡à∑Ÿ ’Ë..............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®ß— À«—¥.................................À¡“¬‡≈¢‚∑√»—æ∑.å ....................

Û. ¢“â 懮â“...............π..“..¬....ß........................... ‡≈¢ª√–®”μ—«ª√–™“™π º.⟠..√..∫—...®..”..π..Õ..ß......................

................................................
Õ“¬.ÿ .................................ªï  ≠— ™“μ‘........‰.∑...¬.............................∫¥‘ “/¡“√¥“™◊ËÕ.............................................................................

‚ ¥ À¡“â ¬ § àŸ ¡√ ™◊ËÕ....................................................... —≠™“μ‘.......................

Õ¬àŸ∑’Ë∫“â π/À¡àŸ∫â“π..........................‡≈¢∑.Ë’ ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡àŸ∑’Ë..............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®ß— À«—¥.................................À¡“¬‡≈¢‚∑√»æ— ∑.å ....................

Ù. ¢â“懮ⓢշ ¥ß√“§“∑√—æ¬∑å ’Ë¢Õ∑”πμ‘ ‘°√√¡π’ȇªπì ‡ß‘π.......................Û.......,...........................∫“∑.........›........... μ“ߧå

ı. ¢“â 懮“â ¢Õ√∫— √Õß«“à ( “¡· π∫“∑∂«â π)

(Ò) ¢“â 懮Ⓣ¡à‰¥√â ∫— ‚Õπ·∑πÀ√Õ◊ ‡æ◊ÕË ª√–‚¬™πå·°à∫§ÿ §≈μ“à ߥ“â «

(Ú) √“§“∑√æ— ¬∑å Ë·’  ¥ß‰«â„π Ù. ‡ªπì √“§“∑’Ë·∑â®√‘ß

(Û)  ...Ëß‘ ..ª..≈..°Ÿ... ..√..â“..ß..„.π..∑...Ë’¥..π‘...·..ª..≈..ß...π..È∑’ ..Ë¡’...’Õ..¬..Ÿ·à..≈...â«..·..≈..–..∑...’Ë®..–..¡..¢’..÷πÈ...„.π..¿...“.¬...À..π..“â..®..”..π..Õ...ß..¥..â«..¬..∑...—Èß.. ..‘πÈ...............................................

(Ù) ®..”..π...Õ..ß..‡.æ...◊ËÕ..‡.ª...πì ..ª..√..–...°..—π..°..“..√..°..⬟...¡◊ ..‡.ß..‘π...´..ßË÷ ..º..®âŸ..”..π..Õ...ß..‰.¥...°â ..Ÿâ®..“..°..º..â√Ÿ..∫—...®..”..π..Õ..ß..μ...“.¡... ..—≠...≠...“..°...Ÿ¬â ..¡◊ ..‡.ß..‘π....©...∫..—∫..≈...ß..«..π— ..∑..Ë’......................
‡..¥..◊Õ..π............................................................................æ....»..............................................................................................................................................

(ı) Õ...μ— ..√..“..¥..Õ...°..‡.∫...Ȭ’ ..√..Õâ ..¬..≈...–...Ò...ı...μ...àÕ..ª..ï..·..≈..–..π...”.. ..ßà..¥..Õ...°..‡.∫...¬È’ ..ª..≈ï...–..À..π..ßË÷..§...√..È—ß......................................................................

«π— ∑.’Ë ...........‡¥Õ◊ π..............................æ.»..................
≈ß™◊ÕË .....................π...“.¬....°.........................ºâŸ¢Õ ®”πÕß

≈ß™Õ◊Ë .....................π...“.¬....ß..........................ºŸâ¢Õ √∫— ®”πÕß

≈ß™◊ËÕ......................................................º âŸ Õ∫ «π

(......................................................)

 ”À√∫— æπ—°ß“π‡®â“Àπ“â ∑Ë’

Ò) √“§“ª√–‡¡π‘ ∑πÿ ∑√—æ¬å.....................................................................................................∫“∑........................................ μ“ߧå

Ú) ‚©π¥∑¥Ë’ π‘ „À¡à√–«“ß............................................‡≈¢∑’Ë¥‘π...............................................Àπâ“ ”√«®.........................................

‚©π¥∑¥Ë’ ‘π‡≈¢∑’.Ë ..................................................‡≈à¡......................................................Àπâ“..................................................

®”π«π∑¥Ë’ π‘ ......................................................‰√.à ................................................ß“π..................................................μ“√“ß«“

§ß‡À≈Õ◊ ...........................................................‰√.à ................................................ß“π..................................................μ“√“ß«“

Û) ‰¥â®¥∑–‡∫’¬π·≈â«·μ«à π— ∑.’Ë ................................‡¥Õ◊ π............................................æ.»......................

≈ß™◊ÕË .......................................................

(......................................................)

‡®â“æπ—°ß“π∑Ë’¥‘π

Ò˜¯

μ—«Õ¬à“ßÀ¡“¬‡≈¢ Ú

(∑.¥.Òı °)

Àπß—  Õ◊  ≠— ≠“®”πÕß∑Ë’¥‘π‡©æ“– «à π

∑Ë’¥‘π

‚©π¥∑Ë.’ .........................................‡≈¢∑¥Ë’ ‘π.........................................Àπâ“ ”√«®...............................................

μ”∫≈............................................Õ”‡¿Õ............................................®—ßÀ«¥— ....................................................

Àπ—ß Õ◊  —≠≠“π’ȉ¥∑â ”‡¡◊ÕË «π— ∑Ë.’ .................‡¥◊Õπ..............................................æÿ∑∏»°— √“™.............................................

≥  ”π°— ß“π∑Ë¥’ π‘ ®—ßÀ«¥— .................................................... } { }................
ºŸâ®”πÕß Õ“¬ÿ ................ ªï
‡≈¢ª√–®”μ—«ª√–™“™π ................

{ }...............................................

√–À«à“ß ...............π..“..¬....°.........................

...............................................

 —≠™“μ‘............‰.∑..¬.....................∫¥‘ “/¡“√¥“™Õ◊Ë ...............................................................................................................................

Õ¬à∑Ÿ ∫’Ë â“π/À¡Ÿà∫“â π................................................‡≈¢∑’Ë.................μ√Õ°/´Õ¬............................∂ππ............................À¡Ÿ∑à ’.Ë ..........

μ”∫≈/·¢«ß..................................Õ”‡¿Õ/‡¢μ................................®ß— À«¥— ................................À¡“¬‡≈¢‚∑√»—æ∑.å .........................

‡≈¢ª√–®”μ—«ª√–™“™π

{ }............................................... } { }................
º√⟠—∫®”πÕß Õ“¬ÿ ................ ªï
°∫— .............∏..π..“..§..“..√....‡.Õ...................
............................................... ................

 ≠— ™“μ.‘ .............‰.∑...¬..................∫‘¥“/¡“√¥“™◊ÕË ...............................................................................................................................

Õ¬àŸ∑Ë’∫“â π/À¡Ÿà∫â“π................................................‡≈¢∑Ë.’ ................μ√Õ°/´Õ¬............................∂ππ............................À¡Ÿà∑Ë.’ ..........

μ”∫≈/·¢«ß..................................Õ”‡¿Õ/‡¢μ................................®—ßÀ«—¥................................À¡“¬‡≈¢‚∑√»æ— ∑.å .........................

∑—Èß ÕßΩÉ“¬‰¥âμ°≈ß∑” —≠≠“°π— ¥ß— μàÕ‰ªπÈ’

¢âÕ Ò. ºâŸ®”πÕßμ°≈ß®”πÕß∑¥Ë’ π‘ ·ª≈ß∑Ë’°≈“à «¢“â ß∫ππÈ’‡æ¬’ ߇©æ“– à«π°√√¡ ‘∑∏Ï¢‘ Õßμπ·°ºà âŸ√∫— ®”πÕ߇ªπì ª√–°π— ........
°..“..√..°...⬟ ..◊¡..‡.ß..‘π...´..÷ßË..º..Ÿ®â..”..π...Õ..ß..‰.¥...â°..®Ÿâ ..“..°..º..Ÿâ√..∫—...®..”..π..Õ..ß....μ..“..¡.. ...≠— ...≠...“..°..⟬..◊¡...‡.ß..‘π....©..∫...∫— ..≈..ß..«..—π...∑...Ë’ ................‡..¥..Õ◊..π.....................................................æ....».......................................................
‡ªìπ®”π«π‡ß‘π..........Û.......,...............∫“∑ (‡ß‘π..... ..“..¡...·.. ..π.....................∫“∑) ‚¥¬„À¥â Õ°‡∫Ȭ’ .......√..Õâ..¬.........≈–.....Ò..ı....μ...Õà ..ª..ï...../μ/àÕ/‡/¥/Õ◊ /π/
·≈–μ°≈ßπ” ßà ¥Õ°‡∫¬’È .......ª...≈ï ..–..À..π...÷Ëß.............§√—È߇ ¡Õ‰ª ·≈–„π°“√®”πÕßπÈ’‰¡‡à °Ë’¬«∂÷ß «à π°√√¡ ∑‘ ∏¢Ï‘ ÕߧπÕËπ◊

¢âÕ Ú. º√⟠—∫®”πÕßμ°≈ß√∫— ®”πÕß∑¥’Ë π‘ ·ª≈ßπ‡’È æ¬’ ߇©æ“– à«π°√√¡ ‘∑∏¢‘Ï ÕߺŸ®â ”πÕß μ“¡¢Õâ μ°≈ß„π¢Õâ Ò ∑ÿ°ª√–°“√

·≈–º®âŸ ”πÕ߉¥√â ∫— ‡ß‘π®“°ºŸâ√∫— ®”πÕ߇ªπì °“√‡ √®Á ·≈«â

¢âÕ Û. º®âŸ ”πÕß·≈–º√⟠∫— ®”πÕß√∫— √Õß«“à ‰¡à∑√“∫‡¢μ·≈–‡πÈÕ◊ ∑Ë·’ ππà Õπ«“à ¡’‡æ¬’ ß„¥

¢Õâ Ù. .....................................................................................................................................................................

....................................................................................................................................................................................................

∑—Èß ÕßΩÉ“¬‰¥μâ °≈ß°π— ¬Õ¡„Àºâ â√Ÿ ∫— ®”πÕß ‡ªìπºâ∂Ÿ ◊Õ‚©π¥∑’Ë¥‘π√“¬π’È„π√–À«à“߇«≈“∑’Ë„™ â —≠≠“®”πÕßπ’È

Àπ—ß ◊Õ —≠≠“πÈ’‰¥â∑”‡ªìπ “¡©∫—∫¡’¢âÕ§«“¡μ√ß°—π  ”À√—∫ ”π—°ß“π∑’Ë¥‘πÀπË÷ß©∫—∫ ºâŸ®”πÕß·≈–ºâŸ√—∫®”πÕß ∂◊Õ‰«â

ΩÉ“¬≈–ÀπËß÷ ©∫∫— (©∫∫— π È’ ”À√—∫.............................................)

∑—Èß ÕßΩÉ“¬‰¥âμ√«®¥ŸÀπ—ß ◊Õ —≠≠“®”πÕß·≈–‡¢â“„®¢âÕ§«“¡μ≈Õ¥·≈â« ®÷߉¥â≈ß≈“¬¡◊Õ™◊ËÕ À√◊Õæ‘¡æå≈“¬πÈ‘«¡◊Õ

‰«â‡ªì𠔧—≠μàÕÀπâ“欓π·≈–‡®â“æπ°— ß“π∑¥Ë’ π‘
(≈ß≈“¬¡◊Õ™ÕË◊ º®Ÿâ ”πÕß)........................π...“.¬....°....................................
(≈ß≈“¬¡Õ◊ ™ÕË◊ ºâŸ√—∫®”πÕß)....................π..“..¬....ß...................................

(≈ß≈“¬¡Õ◊ ™◊ÕË æ¬“π).......................................................................

(≈ß≈“¬¡◊Õ™Õ◊Ë æ¬“π).......................................................................

Àπ—ß Õ◊  —≠≠“πÈ’‰¥â∑”μÕà Àπâ“

.................................................................................‡®â“æπ°— ß“π∑Ë¥’ π‘

ª√–∑—∫μ√“μ”·Àπà߇ªπì  ”§≠—

........................................................ºŸâ‡¢¬’ π

........................................................ºμ⟠√«®

μ«— Õ¬“à ßÀ¡“¬‡≈¢ Ú

 “√∫≠— ®¥∑–‡∫¬’ π

®¥∑–‡∫¬’ π ª√–‡¿∑°“√ ºŸâ„À â ≠— ≠“ ºŸâ√—∫ —≠≠“ ‡πÈ◊Õ∑Ë’¥‘π ‡π◊ÈÕ∑Ë’¥‘π √–«“ß ‡®â“æπ—°ß“π∑’Ë¥‘π
«—𠇥◊Õπ ªï ®¥∑–‡∫’¬π μ“¡ ≠— ≠“ §ß‡À≈Õ◊ ‡≈¢∑’Ë¥‘π ≈ß≈“¬¡Õ◊ ™Õ◊Ë
‚©π¥∑’¥Ë π‘ „À¡à ª√–∑∫— μ√“
‰√à ß“π μ“√“ß ‰√à ß“π μ“√“ß
«“ «“

«—π∑.’Ë .................... ®”πÕ߇©æ“– «à π Ò. 𓬠°. 𓬠ß. Ò››››› › (≈ß™Õ◊Ë )........................

‡¥◊Õπ................... Ú. 𓬠¢. ºâŸ√∫— ®”πÕß π“¬ °. ®”πÕ߇©æ“– à«π¢Õßμπ·°à 𓬠ß.

æ.». ..................... Û. 𓬠§.  «à π¢ÕߧπÕË◊π§ß‡¥¡‘

Ò˜˘

Ò¯

μ—«Õ¬à“ßÀ¡“¬‡≈¢ Û (∑.¥. Ò)
∑∫’Ë “â π

∑ Ë’ «π/‰√à

∑’Ëπ“

∑’Ë..............

§”¢Õ®¥∑–‡∫’¬π ‘∑∏·‘ ≈–πμ‘ °‘ √√¡ πÕ°‡¢μ
·≈–°“√ Õ∫ «π ∑‘ ∏‘„π∑’Ë¥π‘ ª√–‡¿∑.......®..”.π...Õ..ß..‡.æ...¡‘Ë..À...≈..°—..∑...√..æ— ..¬..å....... „π‡¢μ

μ”·Àπàß∑Ë’¥‘π

√–«“ß.........................................................................................μ”∫≈.........................................................................................

‡≈¢∑Ë’¥‘π..................................................................................... Õ”‡¿Õ........................................................................................

Àπâ“ ”√«®..................................................................................®—ßÀ«¥— ........................................................................................
°“√®”πÕßπÈ’‡ ìªπ°“√®”πÕ߇æ‘Ë¡À≈—°∑√—æ¬å‡ ◊ËæÕ‡ªìπª√–°—πÀπÈ’´Ë÷߉¥â®¥∑–‡∫’¬π®”πÕß∑’Ë¥‘π‚©π¥∑’Ë¥‘π ‡≈¢∑Ë’............Õ”‡¿Õ...........................
®—ßÀ«—¥.........................‡ ìªπª√–°—π‰«â·≈â«μ“¡ —≠≠“®”πÕß©∫—∫≈ß«—π∑Ë’..........‡ ◊¥Õπ...............................æ.».................. ‚©π¥∑¥Ë’ π‘
‡®â“æπ—°ß“π Ë’∑¥‘π
‡≈¢∑’Ë............................................‡≈à¡........................................Àπâ“....................................
®”π«π∑Ë¥’ ‘π............Ò.......................‰√à..............›...................ß“π...............›....................μ“√“ß«“

Ò. ¢“â 懮⓺Ÿâ¡π’ “¡μàÕ‰ªπÈ’ ¡§’ «“¡ª√– ß§å¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–π‘μ°‘ √√¡‡°¬Ë’ «°—∫Õ —ßÀ“√¡‘ ∑√æ— ¬∑å ’Ë°≈“à «¢“â ß∫ππ’È ·≈–

‰¥ªâ Ø≠‘ “≥μπ·≈«â ¢Õ„Àâ∂Õâ ¬§”¥«â ¬§«“¡ —μ¬å®√‘ß ∂“â ¢“â 懮ⓄÀâ∂âÕ¬§”‰¡à‡ªì𧫓¡®√ß‘ „Àâ„™∂â âÕ¬§”π’¬È π— ¢“â 懮Ⓞπ∑“ߧ¥Õ’ “≠“‰¥â

Ú. ¢â“懮“â ..............π..“..¬....°............................ ‡≈¢ª√–®”μ—«ª√–™“™π ºâ.Ÿ ..®..”..π..Õ..ß...........................

.................................................
Õ“¬.ÿ .................................ªï  ≠— ™“μ‘.......‰..∑..¬..............................∫¥‘ “/¡“√¥“™◊ÕË .............................................................................

‚ ¥ À¡“â ¬ §Ÿ à ¡√ ™Õ◊Ë ..........................................................................................

Õ¬∑àŸ ∫Ë’ â“π/À¡∫Ÿà “â π..........................‡≈¢∑’.Ë ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡∑àŸ Ë.’ .............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®ß— À«¥— .................................À¡“¬‡≈¢‚∑√»æ— ∑.å ....................

Û. ¢“â 懮“â ...............π..“..¬....¢........................... ‡≈¢ª√–®”μ—«ª√–™“™π ºŸ.â ..√..∫—...®..”..π..Õ..ß......................

................................................
Õ“¬ÿ..................................ªï  —≠™“μ.‘ .......‰.∑...¬.............................∫¥‘ “/¡“√¥“™Ë◊Õ.............................................................................

‚ ¥ À¡“â ¬ §Ÿà ¡√ ™◊ËÕ....................................................... ≠— ™“μ‘.......................
Õ¬à∑Ÿ ∫’Ë “â π/À¡à∫Ÿ â“π..........................‡≈¢∑.’Ë ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡Ÿà∑Ë’..............
μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®—ßÀ«¥— .................................À¡“¬‡≈¢‚∑√»æ— ∑.å ....................

Ù. ¢“â 懮ⓢշ ¥ß√“§“∑√æ— ¬å∑¢Ë’ Õ∑”π‘μ°‘ √√¡π‡’È ªìπ‡ß‘π.............................›............................∫“∑.........›........... μ“ߧå
ı. ¢“â 懮“â ¢Õ√∫— √Õß«“à

(Ò) ¢“â 懮Ⓣ¡à‰¥â√∫— ‚Õπ·∑πÀ√Õ◊ ‡æËÕ◊ ª√–‚¬™πå·°à∫ÿ§§≈μ“à ߥ⓫
(Ú) √“§“∑√—æ¬∑å ·’Ë  ¥ß‰«â„π Ù. ‡ªπì √“§“∑’Ë·∑®â √ß‘
(Û) ®..”..π..Õ...ß..‡.æ..◊ÕË...‡.ª..πì...ª..√..–..°...—π..À..π...´È’ ..ßË÷ ..‰.¥..®â...¥..∑..–..‡..∫..¬’..π...®..”..π..Õ..ß..∑...’¥Ë ..π‘ ..‚..©..π..¥...∑..¥’Ë..‘π...‡.≈..¢..∑...’Ë .............Õ..”..‡..¿..Õ......................®..ß—..À...«.—¥.....................

‡.ª...ìπ..ª...√..–..°..—π..‰.«..·â...≈..«â..μ..“..¡.. ...≠— ...≠...“..®..”..π..Õ...ß...©..∫...∫— ..≈..ß..«..—π...∑...’Ë........................‡.¥..Õ◊..π...........................................................æ....»..............................................................
(Ù) °..“..√..®..”..π..Õ...ß..π..ȇ’.ª...ìπ..°..“..√..®..”..π..Õ...ß..‡.æ..Ë‘¡...À..≈..°—...∑..√..æ—...¬..å .®..”..π..«..π...‡.ß..π‘..∑...®’Ë ..”..π..Õ..ß..·...≈..–..¢..Õâ..μ...°..≈..ß..Õ...π◊Ë ..Ê....§..ß..‡.ª...πì ..‰.ª...μ..“..¡.. ...≠— ...≠...“..®..”..π..Õ..ß...

∑..ÿ°...ª..√..–..°..“..√......................................................................................................................................................
«π— ∑.’Ë ...........‡¥Õ◊ π..............................æ.»..................

≈ß™Ë◊Õ.....................π...“.¬....°.........................ºâŸ¢Õ ®”πÕß
≈ß™◊ËÕ.....................π...“.¬....¢.........................ºŸâ¢Õ √—∫®”πÕß
≈ß™Ë◊Õ......................................................º âŸ Õ∫ «π

(......................................................)

 ”À√∫— æπ—°ß“π‡®“â Àπ“â ∑’Ë
Ò) √“§“ª√–‡¡π‘ ∑πÿ ∑√—æ¬.å ....................................................................................................∫“∑........................................ μ“ߧå
Ú) ‚©π¥∑’¥Ë ‘π„À¡à√–«“ß............................................‡≈¢∑¥Ë’ ‘π...............................................Àπâ“ ”√«®.........................................

‚©π¥∑Ë¥’ ‘π‡≈¢∑.Ë’ ..................................................‡≈¡à ......................................................Àπ“â ..................................................
®”π«π∑¥’Ë π‘ ......................................................‰√.à ................................................ß“π..................................................μ“√“ß«“
§ß‡À≈Õ◊ ...........................................................‰√.à ................................................ß“π..................................................μ“√“ß«“
Û) ‰¥®â ¥∑–‡∫¬’ π·≈â«·μà«—π∑’Ë.................................‡¥Õ◊ π............................................æ.»......................

≈ß™Ë◊Õ.......................................................
(......................................................)
‡®â“æπ—°ß“π∑’Ë¥‘π

μ«— Õ¬à“ßÀ¡“¬‡≈¢ Û Ò¯Ò

(∑.¥. Òı)

Àπß—  Õ◊  ≠— ≠“®”πÕß∑Ë’¥π‘ ‡æ‘Ë¡À≈—°∑√—æ¬å

∑Ë’¥‘π

‚©π¥∑Ë’..........................................‡≈¢∑¥’Ë π‘ .........................................Àπ“â  ”√«®...............................................

μ”∫≈............................................Õ”‡¿Õ............................................®ß— À«¥— ....................................................

Àπ—ß ◊Õ —≠≠“πÈ’‰¥∑â ”‡¡ËÕ◊ «—π∑.’Ë .................‡¥Õ◊ π..............................................æÿ∑∏»—°√“™.............................................

≥  ”π°— ß“π∑’¥Ë ‘π®ß— À«¥— .................................................... } { }................
ºâ®Ÿ ”πÕß Õ“¬ÿ ................ ªï
‡≈¢ª√–®”μ—«ª√–™“™π ................

{ }...............................................

√–À«à“ß ...............π..“..¬....°.........................

...............................................

 —≠™“μ.‘ ...........‰.∑..¬.....................∫‘¥“/¡“√¥“™Ë◊Õ...............................................................................................................................

Õ¬Ÿà∑∫’Ë “â π/À¡à∫Ÿ â“π................................................‡≈¢∑Ë’.................μ√Õ°/´Õ¬............................∂ππ............................À¡Ÿ∑à ’Ë...........

μ”∫≈/·¢«ß..................................Õ”‡¿Õ/‡¢μ................................®ß— À«¥— ................................À¡“¬‡≈¢‚∑√»—æ∑å..........................

‡≈¢ª√–®”μ—«ª√–™“™π

{ }............................................... } { }................
ºâ√Ÿ —∫®”πÕß Õ“¬ÿ ................ ªï
°∫— .................π..“..¬....¢....................... ................
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 ≠— ™“μ‘..............‰.∑...¬..................∫¥‘ “/¡“√¥“™Õ◊Ë ...............................................................................................................................

Õ¬Ÿ∑à ∫Ë’ â“π/À¡∫àŸ “â π................................................‡≈¢∑’.Ë ................μ√Õ°/´Õ¬............................∂ππ............................À¡Ÿà∑’Ë...........

μ”∫≈/·¢«ß..................................Õ”‡¿Õ/‡¢μ................................®ß— À«—¥................................À¡“¬‡≈¢‚∑√»—æ∑å..........................

∑—Èß ÕßΩÉ“¬‰¥μâ °≈ß∑” ≠— ≠“°—π¥—ßμÕà ‰ªπ’È

¢Õâ Ò. ºŸâ®”πÕßμ°≈ß®”πÕß∑’Ë¥‘π·ª≈ß∑°’Ë ≈“à «¢“â ß∫ππ∑È’ —Èß·ª≈ß·°ºà Ÿâ√∫— ®”πÕß ‡æË◊Õ‡ªπì °√–°π— ..À...π..È´’..Ë÷ß..‰..¥..®â..¥...∑..–..‡.∫...’¬..π........
®..”..π..Õ...ß..∑..’¥Ë...π‘ ..‚.©..π...¥..∑...¥Ë’ ..‘π..‡..≈..¢..∑...’Ë.............................................Õ..”..‡.¿..Õ.....................................................................®..ß—..À..«..—¥.................................................................‡..ª..πì..ª...√..–..°..π—..‰..«..â·..≈..â«..μ...“.¡... ..—≠...≠....“.®..”..π...Õ..ß........
©...∫..—∫..≈...ß..«..—π..∑..’Ë.........................‡.¥..Õ◊...π....................................................æ.....»..........................................................................................................................................................
‡ªìπ®”π«π‡ßπ‘ ..........................›................................∫“∑ (‡ßπ‘ ...........................›............................................∫“∑) ‚¥¬„À¥â Õ°‡∫È’¬
......................................≈–...................›......................../μ/Õà /‡/¥/Õ◊ /π/ ·≈–μ°≈ßπ” ßà ¥Õ°‡∫¬È’ ....................›........................§√ß—È ‡ ¡Õ‰ª

¢Õâ Ú. ºŸ√â —∫®”πÕßμ°≈ß√∫— ®”πÕß∑Ë’¥π‘ ·ª≈ßπ’μÈ “¡¢âÕμ°≈ß„π¢Õâ Ò ∑°ÿ ª√–°“√
¢Õâ Û. °..“..√..®..”..π..Õ...ß..π..ȇ’.ª...ìπ..°..“..√..®..”..π..Õ...ß..‡.æ..Ë¡‘...À..≈..—°...∑..√..—æ..¬...å .®..”..π..«..π...‡.ß..π‘..∑...Ë®’ ..”..π..Õ..ß..·..≈...–..‡.ß..ËÕ◊..π...‰.¢..¢..Õâ...μ..°..≈...ß..Õ..◊Ëπ..Ê....§..ß..‡..ª..πì..‰..ª..μ..“..¡.............
 ...≠— ...≠...“..®..”..π..Õ..ß..∑...°Ë’ ..≈..“à..«..„.π...¢..âÕ....Ò...∑...°ÿ ..ª..√..–..°...“..√.......................................................................................................................................

∑Èß—  ÕßΩ“É ¬μ°≈ß°π— ¬Õ¡„Àâ...............................................‡ªπì º∂⟠◊Õ‚©π¥∑’Ë¥‘π√“¬π’È„π√–À«“à ߇«≈“∑’Ë„™ â —≠≠“®”πÕßπ’È

Àπ—ß ◊Õ —≠≠“πÈ’‰¥â∑”‡ªìπ “¡©∫—∫¡’¢âÕ§«“¡μ√ß°—π  ”À√—∫ ”π—°ß“π∑’Ë¥‘πÀπ÷Ëß©∫—∫ ºâŸ®”πÕß·≈–ºâŸ√—∫®”πÕß∂◊Õ‰«â

Ω“É ¬≈–Àπß÷Ë ©∫∫— (©∫∫— π’È ”À√∫— ..............................................................)

∑—Èß ÕßΩÉ“¬‰¥âμ√«®¥ŸÀπ—ß ◊Õ —≠≠“®”πÕß·≈–‡¢â“„®¢âÕ§«“¡μ≈Õ¥·≈â« ®÷߉¥â≈ß≈“¬¡◊Õ™◊ËÕ À√◊Õæ‘¡æå≈“¬π‘È«¡◊Õ‰«â‡ªìπ

 ”§≠— μÕà Àπâ“欓π·≈–‡®â“æπ°— ß“π∑¥’Ë π‘
(≈ß≈“¬¡Õ◊ ™ÕË◊ ºâŸ®”πÕß)......................π..“..¬....°......................................
(≈ß≈“¬¡Õ◊ ™◊ËÕºâŸ√∫— ®”πÕß)..................π..“..¬...¢.......................................

(≈ß≈“¬¡◊Õ™ÕË◊ 欓π).......................................................................

(≈ß≈“¬¡Õ◊ ™◊ËÕ欓π).......................................................................

Àπß—  Õ◊  ≠— ≠“πÈ’‰¥â∑”μÕà Àπ“â

.................................................................................‡®“â æπ°— ß“π∑¥Ë’ π‘

ª√–∑—∫μ√“μ”·Àπßà ‡ªì𠔧≠—

........................................................º‡âŸ ¢’¬π

........................................................ºμ⟠√«®

μ—«Õ¬“à ßÀ¡“¬‡≈¢ Û Ò¯Ú

 “√∫≠— ®¥∑–‡∫’¬π

®¥∑–‡∫’¬π ª√–‡¿∑°“√ ºâŸ„À â ≠— ≠“ ºâŸ√—∫ —≠≠“ ‡πÈ◊Õ∑’Ë¥‘π ‡πÈ◊Õ∑Ë’¥‘π √–«“ß ‡®â“æπ—°ß“π∑’Ë¥‘π
«π— ‡¥◊Õπ ªï ®¥∑–‡∫’¬π 𓬠°. μ“¡ —≠≠“ §ß‡À≈Õ◊ ‡≈¢∑Ë’¥‘π ≈ß≈“¬¡Õ◊ ™ÕË◊
‚©π¥∑’¥Ë ‘π„À¡à ª√–∑∫— μ√“
«π— ∑.Ë’ .................... ®”πÕ߇æ‘Ë¡ ‰√à ß“π μ“√“ß ‰√à ß“π μ“√“ß
‡¥◊Õπ................... À≈—°∑√æ— ¬å «“ «“
æ.». .....................
𓬠¢. Ò››››› › (≈ß™ÕË◊ )........................
º√Ÿâ ∫— ®”πÕß
°“√®”πÕßπ’ȇªìπ°“√®”πÕß‡æ‘¡Ë À≈°— ∑√—æ¬å
‡æË◊Õ‡ªìπª√–°π— Àπ’È´÷ßË ‰¥â®¥∑–‡∫¬’ π®”πÕß
∑¥Ë’ ‘π‚©π¥∑’¥Ë π‘ ‡≈¢∑’.Ë .............Õ”‡¿Õ................
®—ßÀ«¥— ...........................‡ªπì ª√–°π— ‰«·â ≈«â μ“¡
 ≠— ≠“®”πÕß ©∫∫— ≈ß«π— ∑.Ë’ .......‡¥Õ◊ π..............
æ.».. ..........

À¡“¬‡Àμÿ ∂“â μ“¡ ≠— ≠“®”πÕ߇¥‘¡‰¥®â ¥∑–‡∫’¬π®”πÕß∑Ë’¥‘π‡ªπì ª√–°—π‰«â√«¡À≈“¬‚©π¥„Àâ√–∫ÿ‚©π¥∑’Ë¥‘π∑’ˉ¥â
®¥∑–‡∫¬’ π®”πÕ߉«πâ —Èπ‡æ’¬ß‚©π¥‡¥¬’ « ‡™πà °“√®”πÕßπ’ȇªìπ°“√®”πÕ߇æ‘Ë¡À≈°— ∑√æ— ¬å ‡æ◊ËÕ‡ªìπª√–°π— ÀπÈ’
´ß÷Ë ‰¥®â ¥∑–‡∫¬’ π®”πÕß∑¥Ë’ ‘π‚©π¥∑’Ë¥π‘ ‡≈¢∑Ë.’ ............œ≈œ Õ”‡¿Õ..................®ß— À«¥— ....................√«¡................‚©π¥
‡ªπì ª√–°π— ‰«·â ≈â«μ“¡ —≠≠“®”πÕß ≈ß«—π∑Ë’.........‡¥Õ◊ π.......................æ.»...............

μ«— Õ¬à“ßÀ¡“¬‡≈¢ Ù Ò¯Û

(∑.¥. Ò)
∑∫’Ë “â π

∑Ë’ «π/‰√à

∑’Ëπ“

∑.Ë’ .............

§”¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–πμ‘ ‘°√√¡ πÕ°‡¢μ
·≈–°“√ Õ∫ «π ∑‘ ∏‘„π∑¥Ë’ ‘π ª√–‡¿∑.......¢..È÷π..‡.ß..‘π...®..“..°..®..”..π..Õ..ß............... „π‡¢μ

μ”·Àπàß∑Ë’¥‘π

√–«“ß......................................................................................... μ”∫≈.........................................................................................

‡≈¢∑¥’Ë π‘ ..................................................................................... Õ”‡¿Õ........................................................................................

Àπâ“ ”√«®.................................................................................. ®—ßÀ«—¥........................................................................................

‚©π¥∑Ë¥’ ‘π

‡≈¢∑Ë’............................................‡≈à¡........................................Àπâ“....................................
®”π«π∑¥’Ë π‘ ............Ò.......................‰√à..............›...................ß“π...............›....................μ“√“ß«“

Ò. ¢“â 懮⓺⡟ ’π“¡μÕà ‰ªπÈ’ ¡§’ «“¡ª√– ß§å¢Õ®¥∑–‡∫’¬π ∑‘ ∏·‘ ≈–πμ‘ ‘°√√¡‡°Ë’¬«°—∫Õ ß— À“√‘¡∑√æ— ¬∑å °Ë’ ≈“à «¢“â ß∫ππ’È ·≈–

‰¥âªØ≠‘ “≥μπ·≈â« ¢Õ„À∂â Õâ ¬§”¥«â ¬§«“¡ —쬮å √ß‘ ∂“â ¢â“懮“â „À∂â âÕ¬§”‰¡à‡ªπì §«“¡®√‘ß„Àâ„™∂â Õâ ¬§”πÈ’¬—π¢â“懮“â „π∑“ߧ¥’Õ“≠“‰¥â

Ú. ¢â“懮â“..............π..“..¬....°............................ ‡≈¢ª√–®”μ—«ª√–™“™π º.Ÿâ ..®..”..π..Õ..ß...........................

.................................................

Õ“¬ÿ..................................ªï  —≠™“μ‘.......‰..∑..¬..............................∫‘¥“/¡“√¥“™ËÕ◊ .............................................................................

‚ ¥ À¡“â ¬ §àŸ ¡√ ™◊ËÕ..........................................................................................

Õ¬àŸ∑Ë∫’ â“π/À¡Ÿ∫à â“π..........................‡≈¢∑’Ë................μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡àŸ∑’.Ë .............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®—ßÀ«—¥.................................À¡“¬‡≈¢‚∑√»æ— ∑å.....................

Û. ¢â“懮“â ...............π..“..¬....¢........................... ‡≈¢ª√–®”μ—«ª√–™“™π ºŸ.â ..√..∫—...®..”..π..Õ..ß......................

................................................
Õ“¬ÿ..................................ªï  —≠™“μ.‘ .......‰.∑...¬.............................∫¥‘ “/¡“√¥“™Õ◊Ë .............................................................................

‚ ¥ À¡“â ¬ § Ÿà ¡√ ™Ë◊Õ....................................................... —≠™“μ.‘ ......................

Õ¬∑àŸ Ë’∫“â π/À¡∫Ÿà â“π..........................‡≈¢∑Ë’................μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡Ÿ∑à .Ë’ .............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®—ßÀ«—¥.................................À¡“¬‡≈¢‚∑√»æ— ∑.å ....................

Ù. ¢“â 懮ⓢշ ¥ß√“§“∑√—æ¬å∑’Ë¢Õ∑”π‘μ‘°√√¡π’ȇªìπ‡ßπ‘ .......................Û.......,...........................∫“∑.........›........... μ“ߧå

ı. ¢“â 懮“â ¢Õ√∫— √Õß«“à ( “¡· π∫“∑∂«â π)

(Ò) ¢“â 懮“â ‰¡à‰¥â√∫— ‚Õπ·∑πÀ√Õ◊ ‡æÕË◊ ª√–‚¬™πå·°∫à ÿ§§≈μà“ߥ⓫

(Ú) √“§“∑√æ— ¬å∑·Ë’  ¥ß‰«â„π Ù. ‡ªìπ√“§“∑·’Ë ∑®â √‘ß
(Û) ‡..¥..¡‘ ..®..”..π..Õ...ß..μ..“..¡.. ..—≠....≠...“..®..”..π..Õ..ß....≈..ß..«..π—..∑...Ë’ ............‡.¥..◊Õ...π...........................æ...».................‡..ª..πì..‡..ß..π‘ ..........................∫...“..∑....¢..πÈ÷ ..‡.ß..‘π...®..“..°..

®..”..π..Õ...ß..§..√..È—ß..π...’È .‡.ª...ìπ..‡.ß..‘π..................................................∫..“..∑....√..«..¡..‡.ª...ìπ..‡.ß..π‘...∑..’®Ë..”..π..Õ...ß...∑..È—ß.. ...πÈ‘ ...................................................∫..“..∑......................................
(Ù) ‡.ß...◊ËÕ..π..‰..¢..·..≈..–..¢..âÕ...μ..°..≈...ß..Õ..◊πË..Ê....‡.ª...πì ..‰.ª...μ..“..¡.. ...—≠...≠...“..®..”..π..Õ..ß..‡..¥..¡‘....................................................................................

.....................................................................................................................................................................

«π— ∑.Ë’ ...........‡¥Õ◊ π..............................æ.»..................
≈ß™◊ËÕ.....................π...“.¬....°.........................ºâŸ¢Õ ®”πÕß
≈ß™ËÕ◊ .....................π...“.¬....¢.........................ºŸâ¢Õ √∫— ®”πÕß

≈ß™ÕË◊ ......................................................º âŸ Õ∫ «π

(......................................................)

 ”À√∫— æπ°— ß“π‡®â“Àπâ“∑Ë’

Ò) √“§“ª√–‡¡‘π∑πÿ ∑√—æ¬å.....................................................................................................∫“∑........................................ μ“ߧå

Ú) ‚©π¥∑¥Ë’ π‘ „À¡à√–«“ß............................................‡≈¢∑’¥Ë ‘π...............................................Àπ“â  ”√«®.........................................

‚©π¥∑Ë¥’ ‘π‡≈¢∑.Ë’ ..................................................‡≈à¡......................................................Àπ“â ..................................................

®”π«π∑¥Ë’ π‘ ......................................................‰√.à ................................................ß“π..................................................μ“√“ß«“

§ß‡À≈Õ◊ ...........................................................‰√.à ................................................ß“π..................................................μ“√“ß«“

Û) ‰¥â®¥∑–‡∫’¬π·≈â«·μà«π— ∑.Ë’ ................................‡¥◊Õπ............................................æ.»......................

≈ß™◊ÕË .......................................................

(......................................................)

‡®â“æπ—°ß“π∑’Ë¥‘π

Ò¯Ù

μ—«Õ¬à“ßÀ¡“¬‡≈¢ Ù
(∑.¥. Òˆ)

∫π— ∑°÷ ¢Õâ μ°≈ߢÈ÷π‡ß‘π®“°®”πÕß

∑Ë’¥‘π
√–«“ß...............................................................................μ”∫≈........................................................................
‡≈¢∑’Ë¥‘π...............................Àπâ“ ”√«®............................Õ”‡¿Õ.......................................................................
‚©π¥À¡“¬‡≈¢∑Ë’...............................................................®—ßÀ«—¥.......................................................................
∑’«Ë à“°“√.....................................................................

«—π∑.Ë’ ...............‡¥Õ◊ π........................................æ.».....................

¢“â 懮“â .....................π..“..¬....°.......º..®âŸ..”..π..Õ...ß.................................................... ‡≈¢ª√–®”μ—«ª√–™“™π

.....................π..“..¬....¢.......º..â√Ÿ ..—∫..®..”..π...Õ..ß................................................

Õ“¬ÿ...................ªï ‡™ÈÕ◊ ™“μ‘............................... ≠— ™“μ‘...............................∫‘¥“/¡“√¥“™ËÕ◊ ............................................................

Õ¬àŸ∑∫Ë’ â“π/À¡Ÿà∫â“π......................................‡≈¢∑’.Ë .............μ√Õ°/´Õ¬.....................................∂ππ.................................À¡∑àŸ Ë’..........

μ”∫≈/·¢«ß...............................Õ”‡¿Õ/‡¢μ...............................®ß— À«¥— ................................À¡“¬‡≈¢‚∑√»—æ∑å..............................

¢//Õ//ª//Ø//‘≠//“/≥///μ//π//·/≈//–//„/À//â∂//Õâ //¬/§//”//μ/àÕ//......‰.¥..∑â...”..∫..π—..∑...°÷ ..¢..Õâ..μ...°..≈..ß..μ...Õà ..‡.®..â“..æ...π..—°..ß..“..π..∑...¥’Ë ..π‘.....................................................................................

¥//â«//¬//§//«/“/¡// //—μ//¬//å®/√//‘ß/ ¥ß— μàÕ‰ªπ’È :›
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.............................∫...—π..∑...°÷ ..¢...âÕ..μ...°..≈..ß..π...È’‰..¥..∑â...”..μ..Õà...À..π...“â ......................................................................................................................................
............................................................................................≈..ß...™..Ë◊Õ.....................................................................................................................................‡.®..“â..æ...π...°— ..ß..“..π..∑...¥’Ë..π‘..........................
..........................................................................................................ª..√..–..∑...—∫..μ...√..“..μ...”.·...À..π...ßà ..‡.ª...ìπ.. ...”..§..≠—..........................................................

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μ«— Õ¬“à ßÀ¡“¬‡≈¢ Ù

 “√∫≠— ®¥∑–‡∫’¬π

®¥∑–‡∫’¬π ª√–‡¿∑°“√ ºŸâ„À â ≠— ≠“ ºâŸ√—∫ —≠≠“ ‡π◊ÈÕ∑Ë’¥‘π ‡πÈ◊Õ∑’Ë¥‘π √–«“ß ‡®â“æπ—°ß“π∑Ë’¥‘π
«π— ‡¥◊Õπ ªï ®¥∑–‡∫¬’ π μ“¡ ≠— ≠“ §ß‡À≈Õ◊ ‡≈¢∑’Ë¥‘π ≈ß≈“¬¡Õ◊ ™ÕË◊
𓬠¢. ‚©π¥∑Ë’¥π‘ „À¡à ª√–∑∫— μ√“
ºâŸ√∫— ®”πÕß ‰√à ß“π μ“√“ß ‰√à ß“π μ“√“ß
«“ «“

«π— ∑’Ë..................... ¢Èπ÷ ‡ß‘π®“°®”πÕß π“¬ °. Ò››››› › (≈ß™Õ◊Ë )........................
‡¥◊Õπ...................
æ.». .....................

Ò¯ı

Ò¯ˆ

μ«— Õ¬à“ßÀ¡“¬‡≈¢ ı (∑.¥. Ò)
∑∫Ë’ “â π

∑’ Ë «π/‰√à

∑Ë’π“

∑’Ë..............

§”¢Õ®¥∑–‡∫¬’ π ∑‘ ∏‘·≈–π‘μ‘°√√¡ πÕ°‡¢μ
„π‡¢μ

μ”·Àπàß∑’Ë¥‘π ·≈–°“√ Õ∫ «π ‘∑∏‘„π∑’Ë¥π‘ ª√–‡¿∑.......‰.∂..à∂..Õ...π..®..“..°..®..”..π..Õ...ß..............

(μ“¡ —≠≠“®”πÕß ≈ß«—π∑.’Ë .........‡¥◊Õπ......................æ.». ...........)

√–«“ß.........................................................................................μ”∫≈.........................................................................................

‡≈¢∑’¥Ë ‘π.....................................................................................Õ”‡¿Õ........................................................................................

Àπ“â  ”√«®..................................................................................®ß— À«—¥........................................................................................

‚©π¥∑¥Ë’ π‘

‡≈¢∑.’Ë ...........................................‡≈à¡........................................Àπ“â ....................................
®”π«π∑Ë¥’ π‘ ............Ò.......................‰√.à .............›...................ß“π...............›....................μ“√“ß«“

Ò. ¢â“懮“â º¡Ÿâ ’π“¡μÕà ‰ªπÈ’ ¡’§«“¡ª√– ß§¢å Õ®¥∑–‡∫’¬π ‘∑∏·‘ ≈–π‘μ‘°√√¡‡°Ë¬’ «°—∫Õ ß— À“√‘¡∑√æ— ¬∑å °’Ë ≈“à «¢â“ß∫ππÈ’ ·≈–

‰¥âªØ‘≠“≥μπ·≈«â ¢Õ„Àâ∂Õâ ¬§”¥â«¬§«“¡ —쬮å √ß‘ ∂â“¢“â 懮ⓄÀ∂â âÕ¬§”‰¡à‡ªì𧫓¡®√‘ß„Àâ„™∂â âÕ¬§”πȬ’ π— ¢“â 懮Ⓞπ∑“ߧ¥’Õ“≠“‰¥â

Ú. ¢â“懮“â ..............π..“..¬...¢............................. ‡≈¢ª√–®”μ—«ª√–™“™π º.Ÿâ ..√..—∫..®..”..π..Õ...ß......................

.................................................
Õ“¬ÿ..................................ªï  —≠™“μ.‘ ......‰..∑..¬..............................∫¥‘ “/¡“√¥“™ÕË◊ .............................................................................

‚ ¥ À¡“â ¬ § àŸ ¡√ ™◊ËÕ..........................................................................................

Õ¬∑àŸ ∫Ë’ â“π/À¡Ÿà∫“â π..........................‡≈¢∑.’Ë ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡Ÿ∑à Ë’..............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®—ßÀ«—¥.................................À¡“¬‡≈¢‚∑√»æ— ∑å.....................

Û. ¢“â 懮“â ...............π..“..¬....°........................... ‡≈¢ª√–®”μ—«ª√–™“™π ºâ.Ÿ ..‰..∂..∂à ..Õ..π...........................

................................................
Õ“¬ÿ..................................ªï  ≠— ™“μ‘........‰.∑...¬.............................∫¥‘ “/¡“√¥“™◊ÕË .............................................................................

‚ ¥ À¡“â ¬ §à Ÿ ¡√ ™ÕË◊ ....................................................... ≠— ™“μ‘.......................
Õ¬à∑Ÿ Ë’∫“â π/À¡∫Ÿà “â π..........................‡≈¢∑.’Ë ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡Ÿà∑’Ë..............
μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®ß— À«—¥.................................À¡“¬‡≈¢‚∑√»æ— ∑.å ....................

Ù. ¢â“懮“â ¢Õ· ¥ß√“§“∑√æ— ¬å∑¢’Ë Õ∑”π‘μ‘°√√¡π’ȇªπì ‡ßπ‘ .............................›............................∫“∑.........›........... μ“ߧå
ı. ¢“â 懮“â ¢Õ√∫— √Õß«“à

(Ò) ¢“â 懮“â ‰¡à‰¥√â —∫‚Õπ·∑πÀ√Õ◊ ‡æ◊ÕË ª√–‚¬™πå·°∫à ÿ§§≈μà“ߥ⓫
(Ú) √“§“∑√æ— ¬å∑·’Ë  ¥ß‰«â„π Ù. ‡ªπì √“§“∑’·Ë ∑â®√‘ß
(Û) .....................................................................................................................................................................
(Ù) .....................................................................................................................................................................
(ı) .....................................................................................................................................................................

«π— ∑.Ë’ ...........‡¥Õ◊ π..............................æ.»..................
≈ß™◊ËÕ......................π..“..¬....¢........................ºâŸ¢Õ √∫— ®”πÕß
≈ß™Ë◊Õ......................π..“..¬....°.........................ºâŸ¢Õ ‰∂∂à Õπ
≈ß™◊ËÕ......................................................º âŸ Õ∫ «π

(......................................................)
 ”À√—∫æπ°— ß“π‡®â“Àπ“â ∑’Ë
Ò) √“§“ª√–‡¡π‘ ∑ÿπ∑√æ— ¬å.....................................................................................................∫“∑........................................ μ“ߧå
Ú) ‚©π¥∑Ë’¥‘π„À¡√à –«“ß............................................‡≈¢∑Ë’¥π‘ ...............................................Àπ“â  ”√«®.........................................
‚©π¥∑Ë¥’ ‘π‡≈¢∑.’Ë ..................................................‡≈¡à ......................................................Àπ“â ..................................................
®”π«π∑¥Ë’ π‘ ......................................................‰√.à ................................................ß“π..................................................μ“√“ß«“
§ß‡À≈Õ◊ ...........................................................‰√.à ................................................ß“π..................................................μ“√“ß«“
Û) ‰¥®â ¥∑–‡∫’¬π·≈«â ·μ«à π— ∑’Ë.................................‡¥Õ◊ π............................................æ.»......................

≈ß™◊ËÕ.......................................................
(......................................................)
‡®â“æπ—°ß“π∑Ë’¥‘π

Ò¯˜

μ«— Õ¬“à ßÀ¡“¬‡≈¢ ı (∑.¥. Òı)

∫√√¬“¬‡≈°‘  ≠— ≠“¥“â πÀπ“â  —≠≠“∑ÿ°©∫∫—

‰«¡â ÿ¡∫π¥“â π¢«“«“à

‡≈‘° ≠— ≠“‚¥¬‰¥â‰∂à∂Õπ®“°°—π‡ √®Á ·≈«â

·μ«à π— ∑.Ë’ ....‡¥Õ◊ π................æ.». .........

Àπ—ß ◊Õ —≠≠“®”πÕß∑¥’Ë ‘π

‡®“â æπ°— ß“π∑’¥Ë π‘

∑Ë’¥‘π

‚©π¥∑’.Ë .........................................‡≈¢∑¥Ë’ π‘ .........................................Àπâ“ ”√«®...............................................

μ”∫≈............................................Õ”‡¿Õ............................................®ß— À«—¥....................................................

Àπß—  ◊Õ ≠— ≠“π’ȉ¥∑â ”‡¡◊ËÕ«—π∑Ë.’ .................‡¥Õ◊ π..............................................æÿ∑∏»°— √“™.............................................

≥  ”π—°ß“π∑Ë’¥‘π®—ßÀ«¥— .................................................... } { }................
ºŸâ®”πÕß Õ“¬ÿ ................ ªï
‡≈¢ª√–®”μ—«ª√–™“™π ................

{ }...............................................

√–À«à“ß ...............π..“..¬....°.........................

...............................................

 ≠— ™“μ.‘ ...................................∫¥‘ “/¡“√¥“™◊ÕË ...............................................................................................................................

Õ¬Ÿà∑∫’Ë “â π/À¡à∫Ÿ â“π................................................‡≈¢∑.’Ë ................μ√Õ°/´Õ¬............................∂ππ............................À¡Ÿ∑à .Ë’ ..........

μ”∫≈/·¢«ß..................................Õ”‡¿Õ/‡¢μ................................®—ßÀ«¥— ................................À¡“¬‡≈¢‚∑√»—æ∑å..........................

‡≈¢ª√–®”μ—«ª√–™“™π

{ }............................................... } { }................
ºâ√Ÿ ∫— ®”πÕß Õ“¬ÿ ................ ªï
°∫— ...............π...“..¬...¢.........................
............................................... ................

 ≠— ™“μ‘....................................∫‘¥“/¡“√¥“™ËÕ◊ ...............................................................................................................................

Õ¬∑Ÿà ’∫Ë “â π/À¡àŸ∫â“π................................................‡≈¢∑.Ë’ ................μ√Õ°/´Õ¬............................∂ππ............................À¡à∑Ÿ .Ë’ ..........

μ”∫≈/·¢«ß..................................Õ”‡¿Õ/‡¢μ................................®ß— À«—¥................................À¡“¬‡≈¢‚∑√»—æ∑.å .........................

∑ßÈ—  ÕßΩÉ“¬‰¥μâ °≈ß∑” —≠≠“°—π¥ß— μÕà ‰ªπ’È

¢âÕ Ò. ºŸ®â ”πÕßμ°≈ß®”πÕß∑Ë¥’ π‘ ·ª≈ß∑’Ë°≈à“«¢“â ß∫ππÈ∑’ È—ß·ª≈ß·°ºà Ÿ√â ∫— ®”πÕß ‡æ◊ÕË ‡ªπì °√–°—π......................................

.....................................................................................................................................................................................................

‡ªπì ®”π«π‡ß‘π..........................................................∫“∑ (‡ß‘π.......................................................................∫“∑) ‚¥¬„Àâ¥Õ°‡∫¬È’

......................................≈–...........................................μÕà ‡¥Õ◊ π ·≈–μ°≈ßπ” ßà ¥Õ°‡∫¬’È ............................................§√ßÈ— ‡ ¡Õ‰ª

¢âÕ Ú. ºŸâ√∫— ®”πÕßμ°≈ß√—∫®”πÕß∑¥Ë’ ‘π·ª≈ßπ’μÈ “¡¢Õâ μ°≈ß„π¢Õâ Ò ∑ÿ°ª√–°“√

¢Õâ Û. ºŸâ®”πÕ߉¥√â ∫— ‡ßπ‘ ‡ªìπ°“√‡ √®Á ·≈â«

¢âÕ Ù. .....................................................................................................................................................................

....................................................................................................................................................................................................

∑È—ß ÕßΩÉ“¬μ°≈ß°π— ¬Õ¡„Àâ...............................................‡ªìπºâ∂Ÿ Õ◊ ‚©π¥∑Ë’¥π‘ √“¬πÈ’„π√–À«“à ߇«≈“∑Ë’„™ â ≠— ≠“®”πÕßπ’È

Àπ—ß ◊Õ —≠≠“π’ȉ¥â∑”‡ªìπ “¡©∫—∫¡’¢âÕ§«“¡μ√ß°—π  ”À√—∫ ”π—°ß“π∑’Ë¥‘πÀπË÷ß©∫—∫ ºâŸ®”πÕß·≈–ºâŸ√—∫®”πÕß∂◊Õ‰«â

Ω“É ¬≈–ÀπË÷ß©∫—∫ (©∫—∫πÈ’ ”À√∫— ..............................................................)

∑—Èß ÕßΩÉ“¬‰¥âμ√«®¥ŸÀπ—ß ◊Õ —≠≠“®”πÕß·≈–‡¢â“„®¢âÕ§«“¡μ≈Õ¥·≈â« ®÷߉¥â≈ß≈“¬¡◊Õ™Ë◊Õ À√◊Õæ‘¡æå≈“¬πÈ‘«¡◊Õ‰«â‡ªìπ

 ”§≠— μàÕÀπâ“欓π·≈–‡®“â æπ—°ß“π∑¥Ë’ ‘π
(≈ß≈“¬¡Õ◊ ™◊ÕË ºŸâ®”πÕß)......................π..“..¬....°......................................
(≈ß≈“¬¡◊Õ™◊ËÕºâŸ√∫— ®”πÕß)..................π..“..¬...¢.......................................

(≈ß≈“¬¡◊Õ™ÕË◊ 欓π).......................................................................

(≈ß≈“¬¡Õ◊ ™◊ÕË æ¬“π).......................................................................

Àπ—ß ◊Õ ≠— ≠“πÈ’‰¥∑â ”μàÕÀπ“â

.................................................................................‡®“â æπ°— ß“π∑¥’Ë π‘

ª√–∑∫— μ√“μ”·Àπà߇ªπì  ”§—≠

........................................................º‡Ÿâ ¢¬’ π

........................................................ºâŸμ√«®

μ«— Õ¬“à ßÀ¡“¬‡≈¢ ı Ò¯¯

 “√∫≠— ®¥∑–‡∫’¬π

®¥∑–‡∫’¬π ª√–‡¿∑°“√ ºŸâ„À â ≠— ≠“ ºŸâ√—∫ —≠≠“ ‡πÈ◊Õ∑’Ë¥‘π ‡πÈ◊Õ∑Ë’¥‘π √–«“ß ‡®â“æπ—°ß“π∑Ë’¥‘π
«π— ‡¥◊Õπ ªï ®¥∑–‡∫¬’ π μ“¡ ≠— ≠“ §ß‡À≈Õ◊ ‡≈¢∑Ë’¥‘π ≈ß≈“¬¡Õ◊ ™ÕË◊
‚©π¥∑’Ë¥π‘ „À¡à ª√–∑∫— μ√“
‰√à ß“π μ“√“ß ‰√à ß“π μ“√“ß
«“ «“

«π— ∑’Ë..................... ‰∂∂à Õπ®“°®”πÕß π“¬ ¢. 𓬠°. Ò››››› › (≈ß™◊ËÕ)........................

‡¥◊Õπ................... ºŸâ√∫— ®”πÕß ºŸâ‰∂∂à Õπ

æ.». .....................

Ò¯˘

μ«— Õ¬à“ßÀ¡“¬‡≈¢ ˆ (∑.¥. Ò)

∑∫Ë’ “â π

∑Ë’ «π/‰√à

∑Ë’π“

∑.Ë’ .............

§”¢Õ®¥∑–‡∫’¬π ‘∑∏‘·≈–π‘μ‘°√√¡ πÕ°‡¢μ
·≈–°“√ Õ∫ «π ‘∑∏‘„π∑’Ë¥‘π ª√–‡¿∑.......·..∫..àß..‰..∂..à∂..Õ..π...®..“..°..®..”..π..Õ..ß........ „π‡¢μ

μ”·Àπàß∑’Ë¥‘π

√–«“ß.........................................................................................μ”∫≈.........................................................................................

‡≈¢∑¥Ë’ ‘π.....................................................................................Õ”‡¿Õ........................................................................................

Àπâ“ ”√«®..................................................................................®ß— À«¥— ........................................................................................

‚©π¥∑’¥Ë π‘
‡≈¢∑Ë’.....................Ò.......................‡≈à¡..................›......................Àπâ“..............›......................

®”π«π∑’Ë¥‘π...................................‰√à.................................ß“π...................................μ“√“ß«“

Ò. ¢“â 懮⓺¡âŸ ’π“¡μàÕ‰ªπ’È ¡§’ «“¡ª√– ß§¢å Õ®¥∑–‡∫¬’ π ∑‘ ∏·‘ ≈–π‘μ°‘ √√¡‡°¬Ë’ «°—∫Õ —ßÀ“√‘¡∑√æ— ¬å∑’°Ë ≈“à «¢â“ß∫ππÈ’ ·≈–

‰¥ªâ Ø‘≠“≥μπ·≈â« ¢Õ„À∂â Õâ ¬§”¥«â ¬§«“¡ —쬮å √‘ß ∂“â ¢â“懮ⓄÀâ∂Õâ ¬§”‰¡‡à ªπì §«“¡®√ß‘ „Àâ„™∂â Õâ ¬§”π¬’È π— ¢â“懮“â „π∑“ߧ¥Õ’ “≠“‰¥â

Ú. ¢“â 懮â“..............π..“..¬...¢............................. ‡≈¢ª√–®”μ—«ª√–™“™π º.Ÿâ ..√..—∫..®..”..π..Õ...ß......................

.................................................
Õ“¬.ÿ .................................ªï  —≠™“μ.‘ ......‰..∑..¬..............................∫‘¥“/¡“√¥“™Õ◊Ë .............................................................................

‚ ¥ À¡“â ¬ § àŸ ¡√ ™Õ◊Ë ..........................................................................................

Õ¬àŸ∑’Ë∫“â π/À¡∫Ÿà “â π..........................‡≈¢∑.Ë’ ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡∑Ÿà Ë’..............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®ß— À«—¥.................................À¡“¬‡≈¢‚∑√»—æ∑.å ....................

Û. ¢â“懮“â ...............π..“..¬....°........................... ‡≈¢ª√–®”μ—«ª√–™“™π ºâŸ...®..”..π..Õ...ß..........................

................................................
Õ“¬ÿ..................................ªï  —≠™“μ‘........‰.∑...¬.............................∫¥‘ “/¡“√¥“™Ë◊Õ.............................................................................

‚ ¥ À¡“â ¬ § Ÿà ¡√ ™Õ◊Ë ....................................................... ≠— ™“μ.‘ ......................
Õ¬∑àŸ Ë’∫“â π/À¡∫àŸ “â π..........................‡≈¢∑’.Ë ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡àŸ∑’Ë..............
μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®—ßÀ«¥— .................................À¡“¬‡≈¢‚∑√»æ— ∑.å ....................

Ù. ¢“â 懮ⓢշ ¥ß√“§“∑√æ— ¬å∑’Ë¢Õ∑”π‘μ°‘ √√¡π’ȇªìπ‡ß‘π.............................›............................∫“∑.........›........... μ“ߧå
ı. ¢“â 懮“â ¢Õ√∫— √Õß«“à

(Ò) ¢â“懮“â ‰¡à‰¥√â —∫‚Õπ·∑πÀ√◊Õ‡æÕ◊Ë ª√–‚¬™π·å °∫à §ÿ §≈μ“à ߥ⓫

(Ú) √“§“∑√æ— ¬å∑Ë’· ¥ß‰«â„π Ù. ‡ªìπ√“§“∑Ë’·∑®â √‘ß
(Û) ·..∫...ßà ..‰.∂..à∂...Õ..π..®..“..°...®..”.π...Õ..ß..μ..“..¡... ..—≠...≠...“..®..”..π..Õ...ß..≈..ß..«..π—..∑...’Ë ........‡.¥..Õ◊...π..........................æ...»............‡.©...æ..“..–..‚.©...π..¥..∑...¥Ë’ ..π‘...‡.≈..¢..∑...’Ë .................

‡..ª..ìπ..®..”..π..«..π...‡.ß..π‘...........................∫..“..∑.... ..à«..π..‚..©..π..¥...∑..Ë¥’..‘π...‡.≈..¢..∑...Ë’.....................¬..—ß..§..ß..®...”.π...Õ..ß..‡.ª...πì ..ª..√..–...°..π— ..À..π...’∑È ..Ë’‡.À...≈..◊Õ..Õ...¬..ட..”..π..«..π................................∫..“..∑..
(Ù) ‡.ß...ÕË◊ ..π..‰..¢..·..≈..–..¢..Õâ...μ..°..≈...ß..Õ..πË◊..Ê....„.À...â‡.ª..πì...‰.ª..μ...“..¡.. ..≠—...≠....“.®...”.π...Õ..ß..‡.¥...¡‘ ..∑..ÿ°...ª..√..–..°..“..√...............................................................

«π— ∑.Ë’ ...........‡¥Õ◊ π..............................æ.»..................
≈ß™ËÕ◊ ......................π..“..¬....¢........................ºâŸ¢Õ √—∫®”πÕß
≈ß™◊ÕË ......................π..“..¬....°.........................ºŸâ¢Õ ®”πÕß
≈ß™Õ◊Ë ......................................................º âŸ Õ∫ «π

(......................................................)
 ”À√—∫æπ°— ß“π‡®â“Àπ“â ∑Ë’
Ò) √“§“ª√–‡¡‘π∑ÿπ∑√æ— ¬.å ....................................................................................................∫“∑........................................ μ“ߧå
Ú) ‚©π¥∑’Ë¥π‘ „À¡√à –«“ß............................................‡≈¢∑Ë¥’ ‘π...............................................Àπâ“ ”√«®.........................................
‚©π¥∑’¥Ë ‘π‡≈¢∑’.Ë ..................................................‡≈à¡......................................................Àπâ“..................................................
®”π«π∑¥Ë’ π‘ ......................................................‰√.à ................................................ß“π..................................................μ“√“ß«“
§ß‡À≈Õ◊ ...........................................................‰√.à ................................................ß“π..................................................μ“√“ß«“
Û) ‰¥â®¥∑–‡∫¬’ π·≈«â ·μ«à π— ∑Ë’.................................‡¥◊Õπ............................................æ.»......................

≈ß™Ë◊Õ.......................................................
(......................................................)
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μ—«Õ¬à“ßÀ¡“¬‡≈¢ ˆ

(∑.¥. Òˆ)

∫—π∑÷°¢Õâ μ°≈ß·∫à߉∂à∂Õπ®“°®”πÕß

∑’Ë¥‘π
√–«“ß...............................................................................μ”∫≈........................................................................
‡≈¢∑¥’Ë π‘ ...............................Àπ“â  ”√«®............................Õ”‡¿Õ.......................................................................
‚©π¥À¡“¬‡≈¢∑.Ë’ ..............................................................®ß— À«¥— .......................................................................
∑Ë’«“à °“√.....................................................................

«—π∑.’Ë ...............‡¥Õ◊ π........................................æ.».....................

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μ«— Õ¬à“ßÀ¡“¬‡≈¢ ˆ

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®¥∑–‡∫’¬π ª√–‡¿∑°“√ ºâŸ„À â ≠— ≠“ ºŸâ√—∫ —≠≠“ ‡πÈ◊Õ∑’Ë¥‘π ‡π◊ÈÕ∑’Ë¥‘π √–«“ß ‡®â“æπ—°ß“π∑’Ë¥‘π
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‚©π¥∑’¥Ë π‘ „À¡à ª√–∑∫— μ√“
‰√à ß“π μ“√“ß ‰√à ß“π μ“√“ß
«“ «“

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μ—«Õ¬“à ßÀ¡“¬‡≈¢ ˜ (∑.¥. Ò)
∑∫’Ë “â π

∑ Ë’ «π/‰√à

∑’Ëπ“

∑.’Ë .............

§”¢Õ®¥∑–‡∫¬’ π ∑‘ ∏‘·≈–πμ‘ °‘ √√¡ πÕ°‡¢μ
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μ”·Àπàß∑’Ë¥‘π

√–«“ß......................................................................................... μ”∫≈.........................................................................................

‡≈¢∑’¥Ë π‘ ..................................................................................... Õ”‡¿Õ........................................................................................

Àπ“â  ”√«®..................................................................................®ß— À«—¥........................................................................................

‚©π¥∑¥’Ë ‘π

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‡®â“æπ—°ß“π Ë’∑ ‘¥π
Ò. ¢â“懮⓺¡Ÿâ ’π“¡μàÕ‰ªπÈ’ ¡’§«“¡ª√– ß§¢å Õ®¥∑–‡∫’¬π ∑‘ ∏·‘ ≈–πμ‘ ‘°√√¡‡°’¬Ë «°—∫Õ —ßÀ“√‘¡∑√—æ¬å∑°’Ë ≈à“«¢â“ß∫ππ’È ·≈–

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‚ ¥ À¡“â ¬ § àŸ ¡√ ™ËÕ◊ ..........................................................................................

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μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®—ßÀ«—¥.................................À¡“¬‡≈¢‚∑√»æ— ∑å.....................

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..............Ú......π..“..¬....ß......................

Õ“¬.ÿ .................................ªï  ≠— ™“μ‘........‰.∑...¬.............................∫‘¥“/¡“√¥“™Õ◊Ë .............................................................................

‚ ¥ À¡“â ¬ §àŸ ¡√ ™ÕË◊ ....................................................... ≠— ™“μ.‘ ......................

Õ¬à∑Ÿ Ë’∫“â π/À¡Ÿ∫à “â π..........................‡≈¢∑Ë’................μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡Ÿ∑à .Ë’ .............

μ”∫≈/·¢«ß...................................Õ”‡¿Õ/‡¢μ...................................®—ßÀ«—¥.................................À¡“¬‡≈¢‚∑√»æ— ∑å.....................
Ù. ¢“â 懮ⓢշ ¥ß√“§“∑√æ— ¬∑å Ë’¢Õ∑”π‘μ°‘ √√¡π‡’È ªìπ‡ßπ‘ .............................›............................∫“∑.........›........... μ“ߧå

ı. ¢“â 懮“â ¢Õ√∫— √Õß«“à

(Ò) ¢“â 懮“â ‰¡à‰¥â√—∫‚Õπ·∑πÀ√◊Õ‡æÕË◊ ª√–‚¬™πå·°∫à §ÿ §≈μà“ߥ⓫

(Ú) √“§“∑√æ— ¬å∑’Ë· ¥ß‰«â„π Ù. ‡ªπì √“§“∑Ë·’ ∑®â √ß‘

(Û) .....................................................................................................................................................................

(Ù) .....................................................................................................................................................................

(ı) .....................................................................................................................................................................

«π— ∑.’Ë ...........‡¥Õ◊ π..............................æ.»..................
≈ß™Ë◊Õ......................π..“..¬....°.........................ºâŸ¢Õ ®”πÕß
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≈ß™◊ÕË ......................................................º âŸ Õ∫ «π

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 ”À√∫— æπ—°ß“π‡®â“Àπâ“∑’Ë

Ò) √“§“ª√–‡¡π‘ ∑πÿ ∑√—æ¬å.....................................................................................................∫“∑........................................ μ“ߧå

Ú) ‚©π¥∑Ë’¥π‘ „À¡√à –«“ß............................................‡≈¢∑¥Ë’ π‘ ...............................................Àπâ“ ”√«®.........................................

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®”π«π∑¥’Ë π‘ ......................................................‰√.à ................................................ß“π..................................................μ“√“ß«“

§ß‡À≈Õ◊ ...........................................................‰√.à ................................................ß“π..................................................μ“√“ß«“

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≈ß™ÕË◊ .......................................................

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‡®â“æπ—°ß“π∑Ë’¥‘π

μ—«Õ¬à“ßÀ¡“¬‡≈¢ ˜ Ò˘Û

(∑.¥. Òˆ)

∫—π∑÷°∂Õâ ¬§”

∑’Ë¥‘π
√–«“ß...............................................................................μ”∫≈........................................................................
‡≈¢∑Ë’¥‘π...............................Àπ“â  ”√«®............................Õ”‡¿Õ.......................................................................
‚©π¥À¡“¬‡≈¢∑Ë’...............................................................®—ßÀ«—¥.......................................................................
∑’«Ë à“°“√.....................................................................

«π— ∑.Ë’ ...............‡¥Õ◊ π........................................æ.».....................

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μ—«Õ¬“à ßÀ¡“¬‡≈¢ ˜ Ò˘Ù

 “√∫—≠®¥∑–‡∫’¬π

®¥∑–‡∫’¬π ª√–‡¿∑°“√ ºŸâ„À â ≠— ≠“ ºâŸ√—∫ —≠≠“ ‡π◊ÈÕ∑’Ë¥‘π ‡π◊ÈÕ∑’Ë¥‘π √–«“ß ‡®â“æπ—°ß“π∑Ë’¥‘π
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‚©π¥∑’¥Ë π‘ „À¡à ª√–∑∫— μ√“
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Ú. 𓬠§.

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μ—«Õ¬“à ßÀ¡“¬‡≈¢ ¯ (∑.¥. Ò)
∑∫’Ë “â π

∑ Ë’ «π/‰√à

∑’Ëπ“

∑.Ë’ .............

§”¢Õ®¥∑–‡∫’¬π ∑‘ ∏‘·≈–π‘μ°‘ √√¡ πÕ°‡¢μ
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μ”·Àπàß∑Ë’¥‘π

√–«“ß.........................................................................................μ”∫≈.........................................................................................

‡≈¢∑¥Ë’ π‘ .....................................................................................Õ”‡¿Õ........................................................................................

Àπ“â  ”√«®..................................................................................®ß— À«¥— ........................................................................................

‚©π¥∑Ë’¥π‘

‡≈¢∑Ë’............................................‡≈¡à ........................................Àπ“â ....................................
®”π«π∑¥’Ë π‘ ............Ò.......................‰√.à .............›...................ß“π...............›....................μ“√“ß«“

Ò. ¢â“懮“⠺⡟ π’ “¡μàÕ‰ªπ’È ¡§’ «“¡ª√– ß§å¢Õ®¥∑–‡∫’¬π ‘∑∏·‘ ≈–π‘μ‘°√√¡‡°Ë¬’ «°—∫Õ —ßÀ“√‘¡∑√æ— ¬∑å Ë’°≈à“«¢“â ß∫ππ’È ·≈–

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‚ ¥ À¡“â ¬ §Ÿ à ¡√ ™Õ◊Ë ..........................................................................................

Õ¬à∑Ÿ ’Ë∫“â π/À¡Ÿà∫“â π..........................‡≈¢∑Ë.’ ...............μ√Õ°/´Õ¬.......................................∂ππ.....................................À¡à∑Ÿ .Ë’ .............

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∑Ë’«“à °“√.....................................................................

«—π∑’.Ë ...............‡¥Õ◊ π........................................æ.».....................

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Õ¬∑àŸ Ë∫’ “â π/À¡Ÿà∫“â π......................................‡≈¢∑’.Ë .............μ√Õ°/´Õ¬.....................................∂ππ.................................À¡àŸ∑Ë’..........

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μ«— Õ¬“à ßÀ¡“¬‡≈¢ ¯

 “√∫—≠®¥∑–‡∫¬’ π

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