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[律师回复] _____________人力资源和社会保障局：
本人_______，于_______在工作中受伤，因身体原因，行动不便，现委托_______前往贵局申报工伤、申请劳动能力鉴定等事宜，请贵局予以方便、支持。
受委托人姓名：______________
性别：_______
联系电话：______________
工作单位及职务：______________
经常居住地：______________
委托权限：申报工伤认定、领取工伤结论书等。
                                                                                                                                                               委托人：______________
                                                                                                                                                       日期：_______年____月____日
                                                                                                                                                           受委托人：______________
                                                                                                                                                      日期：_______年____月____日

[律师回复] _____________人力资源和社会保障局：
本人_______，于_______在工作中受伤，因身体原因，行动不便，现委托_______前往贵局申报工伤、申请劳动能力鉴定等事宜，请贵局予以方便、支持。
受委托人姓名：______________
性别：_______
联系电话：______________
工作单位及职务：______________
经常居住地：______________
委托权限：申报工伤认定、领取工伤结论书等。
                                                                                                                                                               委托人：______________
                                                                                                                                                       日期：_______年____月____日
                                                                                                                                                           受委托人：______________
                                                                                                                                                      日期：_______年____月____日

[律师回复] _____________人力资源和社会保障局：
本人_______，于_______在工作中受伤，因身体原因，行动不便，现委托_______前往贵局申报工伤、申请劳动能力鉴定等事宜，请贵局予以方便、支持。
受委托人姓名：______________
性别：_______
联系电话：______________
工作单位及职务：______________
经常居住地：______________
委托权限：申报工伤认定、领取工伤结论书等。
                                                                                                                                                               委托人：______________
                                                                                                                                                       日期：_______年____月____日
                                                                                                                                                           受委托人：______________
                                                                                                                                                      日期：_______年____月____日

[律师回复] _____________人力资源和社会保障局：
本人_______，于_______在工作中受伤，因身体原因，行动不便，现委托_______前往贵局申报工伤、申请劳动能力鉴定等事宜，请贵局予以方便、支持。
受委托人姓名：______________
性别：_______
联系电话：______________
工作单位及职务：______________
经常居住地：______________
委托权限：申报工伤认定、领取工伤结论书等。
                                                                                                                                                               委托人：______________
                                                                                                                                                       日期：_______年____月____日
                                                                                                                                                           受委托人：______________
                                                                                                                                                      日期：_______年____月____日

[律师回复] _____________人力资源和社会保障局：
本人_______，于_______在工作中受伤，因身体原因，行动不便，现委托_______前往贵局申报工伤、申请劳动能力鉴定等事宜，请贵局予以方便、支持。
受委托人姓名：______________
性别：_______
联系电话：______________
工作单位及职务：______________
经常居住地：______________
委托权限：申报工伤认定、领取工伤结论书等。
                                                                                                                                                               委托人：______________
                                                                                                                                                       日期：_______年____月____日
                                                                                                                                                           受委托人：______________
                                                                                                                                                      日期：_______年____月____日