(Ilanng. I, qup. 1)

Nalunaarsuut, Ilanngussaq I, tak. nalunaarutip § 7-ia.

Qaqortanik qernertanillu qilalugartanut allattuiffik, kommunimut tunniunneqartussaq kingusinnerpaamik qaammatip tulliani ulluisa tallimaanni:

ATEQ:_________________________________________________________
KOMMUNE:_____________________________QAAMMAT:___________
ANGALLAT BRT/Fod:___________________________________________

Qaqortat qassit	Qernertat qassit	Ulloq pisaqarfik	Sumi pisaava ?  Kommune angerlarsimaffik:	Piniariaaseq: 1: qoorortooq 2: unaaq tuu. 3: ungusinermi 4: qassutinik 5: sassani:

(Ilanng. I, qup. 2)

Pisaqaqataasut aqqi: