不服不起诉决定申诉书
申诉人:
申诉人因_________________一案,不服____________人民检察院于________年_____月_____日所作出的______________字第__________号不起诉决定书,特提出申请。
请求事项:___________________________________________________________________
事实和理由:_________________________________________________________________
_____________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
此致
_________人民检察院