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<div align="center">刑事自诉状</span></span></font></div>
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<p>一、文书的制作要点：</span></span></p>
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<p >1</span>．主要内容：</span></span></p>
<p >（</span>1</span>）自诉人、被告人的姓名、年龄、民族、籍贯、出生地、文化程度、职业、工作单位、住址等自然情况。</span></span></p>
<p >（</span>2</span>）被告人的犯罪事实，包括犯罪时间、地点、手段、危害后果等。</span></span></p>
<p >（</span>3</span>）被告人行为所触犯的罪名。</span></span></p>
<p >（</span>4</span>）具体的诉讼请求。</span></span></p>
<p >（</span>5</span>）致送人民法院的名称和具体时间。</span></span></p>
<p >（</span>6</span>）证人的姓名、住址。</span></span></p>
<p >（</span>7</span>）证据的名称、件数、来源等。</span></span></p>
<p >2</span>．制作要点：</span></span></p>
<p >（</span>1</span>）事实和理由部分，把握三条标准：一是客观性；二是明确性；三是逻辑性。</span></span></p>
<p >（</span>2</span>）证据和证据来源，把握三条标准：一是全面性；二是具体性；三是逻辑性。</span></span></p>
<p >二、格式：</span></span></p>
<p align=center style='
text-align:center;line-height:22.0pt;
'>刑事自诉状</span></span></p>
<p >自诉人：姓名、性别、出生年月日、民族、籍贯、职业、工作单位和职务、住址等</span></span></p>
<p >被告人：姓名、性别等情况，出生年月日不详者可写其年龄</span></span></p>
<p >案由：被告人被控告的罪名</span></span></p>
<p >诉讼请求：</span></span></p>
<p >具体的诉讼请求：</span></span></p>
<p >事实与理由：</span></span></p>
<p >被告人犯罪的时间、地点、侵害的客体、动机、目的、情节、手段及造成的后果，理由应阐明被告人构成犯罪的罪名和法律依据。</span></span></p>
<p >证据和证据来源，证人姓名和住址：</span></span></p>
<p >主要证据及其来源，证人姓名和住址。如证据、证人在事实部分已经写明，此处只需点明证据名称、证人详细住址。</span></span></p>
<p align=right >此致</span><span> </span></p>
<p ><u><span>
</span></u>人民法院</span></span></p>
<p align=right style='text-align:right;
line-height:22.0pt;
word-break:break-all'>自诉人：</span><span>
</span></p>
<p align=right style='text-align:right;
line-height:22.0pt;
word-break:break-all'>代书人：</span><span>
</span></p>
<p align=right style='text-align:right;
line-height:22.0pt;
'>年</span><span> </span>月</span><span> </span>日</span></span></p>
<p >附：本诉状副本</span><u><span>
</span></u>份</span></span></p>
<p class=MsoBodyTextIndent>三、制作参考范例：</span></span></p>
<p align=center style='
text-align:center;line-height:22.0pt;
'>刑事自诉状</span></span></p>
<p class=MsoBodyTextIndent>自诉人：雷</span><span
style='font-family:宋体'>××，女，××年×月×日出生，×族，××市××公司职员，住××市××街××号。</span></span></p>
<p class=MsoBodyTextIndent><span style='font-family:宋体'>被告人：于××，女，××岁。</span></span></p>
<p class=MsoBodyTextIndent><span style='font-family:宋体'>案由：诽谤案</span></span></p>
<p class=MsoBodyTextIndent><span style='font-family:宋体'>诉讼请求：（1）于××应公开赔礼道歉、澄清事实，消除其言行所造成的恶劣影响；（2）于××应赔偿精神损失××元。</span></span></p>
<p class=MsoBodyTextIndent><span style='font-family:宋体'>事实和理由：</span></span></p>
<p class=MsoBodyTextIndent><span style='font-family:宋体'>（应祥述犯罪事实，此略）</span></span></p>
<p class=MsoBodyTextIndent><span style='font-family:宋体'>在此，我请求人民法院依据《中华人民共和国刑法》第246条关于诽谤罪的规定，并根据《中华人民共和国刑事诉讼法》第170条和第171条之规定，对于××的行为进行审判，维护我的合法权益。</span></span></p>
<p class=MsoBodyTextIndent><span style='font-family:宋体'>主要证据和证据来源：（1）证人证言两份。单位同事赵××和何××各出具证言一份；（2）住院证明一份。</span></span></p>
<p class=MsoBodyTextIndent align=right style='text-align:right;word-break:break-all'>此致<span>
</span></p>
<p class=MsoBodyTextIndent><span style='font-family:宋体'>××××人民法院</span></span></p>
<p class=MsoBodyTextIndent align=right style='text-align:right;word-break:break-all'>自诉人：雷××<span>
</span></p>
<p class=MsoBodyTextIndent align=right style='text-align:right;'><span style='font-family:
宋体'>代书人：××律师</span></span></p>
<p class=MsoDate align=right style='text-align:right'>××年×月×日</p>
<p class=MsoBodyTextIndent>（附：本诉状副本二份）</span></p>
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