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简易纠纷调解协议书
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________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 纠纷简要情况：__________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 经调解，自愿达成如下协议：______________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 履行协议的方式、地点、期限：____________________________________________ ________________________________________________________________________ ________________________________________________________________________ 当事人（签名或盖章）:_______________________________________________ 调解员（签名或盖章）:_______________________________________________
调解日期：年月日
简易纠纷调解协议书
玉环经济开发区人民调解委员会
年月日
