┌────────────────────────────────────────┐
│ │
│ (此处印制公安机关名称) │
│ 终止案件调查决定书 │
│ │
│ ×公( )行终字[ ]第 号│
│ │
│案 由_________________________________________________________________________│
│ │
│违法嫌疑人________________________性别____________出生日期______________________│
│ │
│现住址__________________________________________________________________________│
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│违法单位名称____________________________________________________________________│
│ │
│地 址_________________________________________________________________________│
│ │
│终止案件调查原因________________________________________________________________│
│ │
│承办人__________________________________________________________________________│
│ │
│批准人__________________________________________________________________________│
│ │
│填发人__________________________________________________________________________│
│ │
│填发日期________________________________________________________________________│
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└────────────────────────────────────────┘