┌────────────────────────────────────────┐
│ │
│ (此处印制公安机关名称) │
│ 提前解除收容教育决定书 │
│ │
│ ×公( )解教决字[ ]第 号│
│ │
│被收容教育人_________________性别________________出生日期_______________________│
│ │
│现住址_________________________________________________________________________ │
│ │
│工作单位________________________________________________________________________│
│ │
│收容教育决定书文号______________________________________________________________│
│ │
│提前解除收容教育原因____________________________________________________________│
│ │
│提前解除收容教育日期____________________________________________________________│
│ │
│收容教育地点____________________________________________________________________│
│ │
│承办人________________________________________________________________________ │
│ │
│批准人________________________________________________________________________ │
│ │
│填发人________________________________________________________________________ │
│ │
│填发日期_______________________________________________________________________ │
│ │
└────────────────────────────────────────┘