Ѻͬ
ǶԷɵ˽ͬԽԽͬǶ˫ıһԼŴΪдͬ˰ɣСĵѺͬӭҷ
Ѻͬ1
: (.Ѻ) ֤: ַ:
ҷ ˫Эһ¾ͻѺºͬ:
һ.ŵڽڼ佫ѺƷ: ͺ ̨պ ܺ Ѻoҷ.Ѻֵ: ԪXX( Ԫ)
ڶ.: ԪΪ %ÿ ȡϢ Ԫ
.˫ͬ⣬ͳϢҷ ˻У˻Ϊ
.ޣXXX__XXX__աʮ ʮϢʮİʵϢ
.δдԼҷȨǰֹͬϢۺϷüΥԼʻѺȨ
.ѺķΧ Ѻͬ顷µĽϢۺϷʵծȨ͵ѺȨķ(ѺǼǷѣʦѣϷѣִзѣѵ)ϢԼӦ֧ΥԼ⳥ȡ
˫Σ 1,֤ԵѺȨڵѺǰδתõѺѺȫȣκξþףоԸеȫΡ 2Ѻıգɼչ˾Ͷշɼ 3Ѻҷ档 4ڵѺڼ䣬ҷƱܼĵѺɳԭȻɿԭɵijҷ⳥Ρ 5Ѻڼ䣬ֵ٣ҷΪбҪԻ¹ƣԺ¹ƺҷΪֵԵծȨʱǰֻȫ 6泵ҷ档 7ҷʹѺȨѺüۿ峥ծģҷȨŵѺһҷʹѺȨҷṩϷЧ.
.˫бͬзִ˫Э̽Э̲ɣҷڵԺߡ
ڰ.ͬڼۺϷúҷṩĵѺ֤ȷֹͬ
ھ.ͬһʽݣף˫ִһءͬδˣ˫ԲЭķʽԼ
ʮ.ʾ ĶͬӦҪҷѾͺͬӦ˵Աͬĺ弰Ӧķɺȫ֪Գ֣ȷ⡣
֤ţ ҷ ֤ţXXX__
Ѻͬ2
(Ѻ)֤룺
ס绰룺
ҷ(ѺȨ)֤룺
ס绰룺
Ϊȷҷϵ˫Эһ£ǩЭ顣
һ(д) (Сд )
˱밴ʱϢۺϷֱ峥ծΪֹ
ֽķʽҷ(д) Ԫҷ;(ǩ)Ѹ塣
ġҷŵڽڼ佫е(Ǽ֤ŵѺѺȨֵ
塢Ѻڼ䣬ѺɼʹãӦάޡ֤Σʱҷ顣ʹõѺʱɵײײ˵һкɼԳе
ҷӦһԳıҷЭԼϢȨѺѺÿ峥ЭҷȫծÿծȨ֣ҷ;ÿֲЭҷ.ȫծģҷʹȨ
ߡЭδ˸Эһ¿ǩЭ飬Э뱾ЭͬȷЧ;Э̲XXԺϡ
ˡЭԼ˫ǩָ֮Чһʽݣ˫ִһݡ
šЭѺ˵עΪЭЧɲ֣뱾ЭͬЧ
(ǩ)ҷ(ǩ)
Ѻ
Ѻƣ
ѺȨ
ע
ϳ˱֤ʵġʵµѺЧѺֵΣʹѺȨȨģԸеһзɺش!
Ѻǩ֣
Ѻͬ3
()
֤ţϵ绰
סַ
ҷ()
֤ţϵ绰
סַ
˫˴һǩ˺ͬ
һ;
ҷҪ徭Ӫһʽת
ͻʱ䣺
ҷ(Сд)Ԫ(д)ԪԼǰѽϢһԻ
ޣ
һֹ꣬
ġϢ
˫ԼΪ12.5%
塢Ȩ
跽Ȩලʹ˽ijծ
Ӧʵṩйصϡ粻ͬ涨ʹýȨջȫֽΥԼֲй涨շϢǰģ˫ԼǰϢ1.5%Ϣһ°һ¼㡣ΥԼ跽Ҫǰڻʱ䣬Ϣ
1.5%գһ°һ¼㡣ҷ裬ǰһüͬⲢǩͬºִͬС
֤
1.ҷе`ڣ¥ԪҵķΪѺ(֤ţ)ҷڲܹ黹跽Ľ跽ȨѺƷҪ˨ΪϢ黹ϢģѺȨ
2.밴ͬ涨;ʹýŲãýΥ
3.밴ͬ涨Ϣ
4.ͬУΪ֤ˣ֤Σ粻ͬԼʱ黹ģȨҪ֤˳ҪZ֤еĵѺ
ߡǿִ뻹ʱ䣺
1.ס˫ͱ֤˹ͬȷϣйطɵĹ涨ѾҪǿִеȨؿǣͬⱾЭǩ豾ЭǿִЧ
2.˱ʽĵʱΪգʼʱЧҷڲȨݱͬЭԺǿִҷӦ֧ȫδҷ͵ԸԺǿִС
ˡͬĽʽ
ͬйз飬ɵѺЭ̽Ҳɵ˵⣬Э̻ⲻɵģһԺߡ
šͬǩ֮Чͬһʽ3ݣ˫͵˨1ݡÿݾͬȷЧ
ʮͬδԼģաлͬйع涨ִС
(ǩ)
ҷ(ǩ)
֤(ǩ)
Ѻͬ4
ࣺ_________
ͬţ_________
˼Ѻˣ_________
绰_________
סַ_________
룺_________
˼ѺȨˣ_________
ˣ_________
绰_________
棺_________
ַ_________
룺_________
֤˼۷λ_________
ˣ_________
绰_________
棺_________
ַ_________
룺_________
סס_________йĺְ͡סѺ취涨ҷԸסΪѺ
ҷͬⷢŴ
ڵѺסķزȨ֤ҷѺ֮ǰԸΪṩ֤
ΪȷԵȨסҡйطɹ涨Эһ£ִͬͬС
һ
ҷ_________Ԫ
ڶ;
ڹ졢__________________ֵ_________·_________Ū__________________ҵס
ͬ______________________________________________________ֹ
ʰǩͬʱȷΪ_________%
ڽʱйй涨
Գʽ
ӦڱͬǩҷڴԳʽ뱸á
趯üˣͬԱͬżͷͬѪֳԳʽģṩ֤ͬҷ
ѽԳʽ֧۷λڷվݵĿ档
۷λסͨزг˽ļڴ˲ɳȨҷڰסѺǼǻ֮ͬӪҵڽͬԳʽȫԼת۷λزгп˻
졢ססģڱͬЧԳʽҪʱҷʽҷĻڴ˻)֧̽á
Ϣðµȶʽ
ӷŵĴ»Ϣ
ݵȶļ㹫ʽÿµȶϢȥԪȷÿ»ϢһαϢ塣
һÿ»ϢΪ_________Ԫ
ڶԺÿ»Ϣݵйĸסʼ㣬ҷ֪ͨΪͬʱ䶯ÿ»Ϣ
趯ͬˣͬԱͬסżֱϵѪڳϢģÿ_________·ݰһΣ뱾ֳͬԳʽͬ
ÿ
_________дÿίҷԶתʷʽϢ봢˻ÿ˻֤ҷܹʵʩתʻ
ԭÿʧʱֽԭл
ǰδڴȫ壬ҷǰַѣҲ˻ذԭͬȡĴϢ
ڰ
ͬ¼סɱṩԱ֤
δزȨ֤ҷѺǰ緢ΥԼǷϢϢطãڽӵҷб֤֪ͨ顷ʮڸΪ峥
֤Ӵ֮ҷȡ÷زȨ֤Ѻ֮Ϊֹ
֤ڼ䣬ͬļףҷЭͬݣӦñͬ⡣
ͬ¼졢'סΪĵѺɼףҷǩסѺͬ
ڷģӦԤۺͬҷܡ
ھ֤ͬ
סҡԱͬǩ֮ʮڣ֤ذͬͼףҷǩסѺ֤ͬ
ʮͬıͽ
ͬЧκһԱͽͬ
罫ͬµȨתøӦйع涨ӦȾһͬ⣬תΪ÷ҷǩͬЧ
ʮһס˫Ȩ
ȨҪҷͬԼŴ;
ӦںͬԼҷ黹ȫϢ;
밴Լ;ʹҷδҷͬ⣬ýҷŲá
ҷӦͬ涨ʱŴ
ʮΥԼ
ִбͬڼ䣬δ³ϢΪڴҷ涨Ƿÿ_________֮_________ķϢ;
ɼڻڴ˻ڴһµĴ֤ʱ黹ҷ
δϢطãʱṩϲʵԼδѷͬԽѺס⣬ۣȷʽֵѺסģҷȨǰջشϢֱֵѺס粻ԳǷûмǷȨ
δҷͬԼʹöŲãŲòְ涨ÿ֮ʮķ
ʮͬʽ
бͬзʱͨЭ̽Э̲ɣҷڵԺߡ
Э̻ڼ䣬ͬ漰鲿ֵС
ʮԼ
ʮͬԼףңǩЧ֤ƷġزȨ֤͡زȨ֤֤ҷִֹܺ
ף˫еͬ´Ϣطȫ峥Ϻֹ
ʮͬһʽݣסҡִһݣ֤أزǼǻִһݣȷУ_________йһݡ
_________ҷ_________
ˣ_________
__________________________________
_________
ˣ_________
_________________
Ѻͬ5
Ѻˣ¼Ƽ
סַ
ѺȨˣ¼ҷ
סַ ֤룺
ҷ˫Эһͬ⣬еIJƲ ¼ƼѺΪѺѺҷҷṩ˫̶Ľ־йЭ飺
һΪ Ԫ Ԫ
ڶޣ ֹƣ ꡣ֮峥
ƽ зѺҷṩЭԼĵѺķӦѺȨǼǣȨ֤ѺȨ趨ʱҷӦȫһν
ѺȨ趨Ǽǣӡ˰ǼǷѼѾɼԼѺȨ趨ǼǺ䷿ȨȨ֤ҷִ
ѺΧΧծȨϢΥԼ⳥𡢱ܵƲϷѡȫѡʦѡ÷ѵʵֵȨķá
ʣйͬڴִС
֤ںͬ涨.ڰڻϢ
ڰѺЧֹ֮
ھԼǰҷӦͬѺȨעǼǣýʵѻӡ
ʮЭǩδҷͬⲻýѺ⡢ۡתáٵѺʽ֡
ʮһΥԼΡΥԼӦԼ֧ܶ30%ΥԼ
ʮδͬ涨黹ҷȨйϽȨԺѺڵֳϢвֳ֣ҷȨֱҷȫϢΪֹ
ʮ˫ӦЭ̽Эйгֵ⣬Э̲ЭеԺߡ
ʮͬһʽݣһݡҷִһݣһݡ
ʮЭԼ˫ǩ֮ѺȨǼǺЧ
ҷ
Ѻͬ6
Ѻ ˣ (¼Ϊ) ѺȨˣ (¼Ϊҷ)Ϊȷס˫__________ ǩ
(³ͬ)УѺԸȨֵķزѺѺȨ˾ʵؿ飬ڳ˽Ȩ״ʹ״ĻϣܼͬķزѺ˫ƽȡԸ`ԭͬзزѺͬԱ㹲ͬء
ݵѺҷʱ÷ռ÷ΧʹȨһѺҷش
һ Ѻķزڣ䷿ݽ_______m2ռ_______m2֤ ___________________ʹȨţ____________________;
ڶ ͬ(ͬ)ס˫ȷϣծΪ____________________;ծȨΪ ˵Ѻ____________________________
ز زֵΪ___________________________(д)__________(Сд)ͬ˫ȷϣҷծȨĶ()____________________(д)__________(Сд)ѺΪٷ֮__________
֤زȨȨծȨծɼи𣬲е;ɴ˸ҷ˾ʧɼһԸҷ⳥
ԪΪҷ⳥
ҷ֤ͬеҷɾʧģҷе⳥Ρ
Ѻز_________________________ʹá
ڵѺڼԵѺķزеάޡб֤ѺزΣʱҷļල
ڵѺڼʹòɻҷȨҪָزԭ״ṩҷϿɵµĵѺزĻϣҷȨҪծǰϢ
Ѻڼ䣬תáѺزظ趨Ѻδҷͬ⣬ΪЧӦĺɼи
ڰ Ѻڼ䣬Ϊ˻֯緢ϲɱܵѺزеֱеͬ涨ɢƲҷȨҪǰѺزȨ
ھ ͬЧסκһԱͬҪͬʱӦ˫Эһ£Э飬ЭδǰͬȻЧ
ʮ ִͬ飬˫ӦȡЭ̰취ͬٲûٲãЭ̻ﲻٲʱԺߡ
ʮһ ڵѺڼ䣬ѺزǨʱ뼰ʱ֪ҷҸݾѺͬԷزǨܳۿȳҷıӦϢ
ʮ Ѻծ˲ܳծϢδͬҷЭģҷȨдָõѺ
Ȩκʽи档ҷѺز峥ծϢѺزüۿԳծϢͳеõģҷȨ;ۿծϢʣģҷӦ˻
ʮ ͬδˣ˫Э֮в䣬뱾ͬͬȷЧ
ʮ ͬԼ˫ڴ˺ͬǩºзЧ
ʮ ͬһʽݣܼҳ˫ִһݣ 浵һݡ
ʮ ˫̶
(ǩ) ҷ(ǩ)
֤룺 ֤룺
סַ סַ
ϵ绰 ϵ绰
ͬǩʱ䣺
Ѻͬ7
Ѻ_______________֤ţ_______________
ҷ_______________֤ţ_______________
ԸȨֵIJƲѺҷҷܼͬIJƲѺס˫йطɹ涨Эһ£Լ
һ
ԡѺ嵥֮Ʋ趨Ѻ
ڶ
ѺĽдԪΪ________꣬ҷ涨ʻ֮㣬________________________________ա
֤ԵѺȨӪȨ
ڱͬЧ֮սѺȨ֤ļҷѺڼõѺȨ֤ļҷΪܡ
ѺķΧдԪϢӦ֧ΥԼ𣨰Ϣ⳥ԼʵֽծȨ͵ѺȨķãʦѡϷѵȣ
ͬ'ЧڱĽͬͬЧӰ챾ͬЧ
ͬйصաǼǡܵȷþɼе
ڰ
ѺڼڣƱܵѺֵѺ𣬲ʱҷļ顣
ھ
ҷΪѺڵѺڼƲյģӦѺڵѺڼIJƲڲƲյӦдעҷΪˣ뱣ڱյرԼһ¹ʣӦ⳥ֱӻҷָʻӦյ֤ҷΪܡ
ʮ
Ѻڼڣ˵ΪµѺֵٵģ⳥ӦΪ֤ɼҷָʻڽδ峥ծ֮ǰöáѺֵδٵIJ֣ΪծȨĵ
ʮһ
Ѻֵ٣Ӧ30ҷṩٵļֵ൱ĵ
ʮ
ѺڼڣѺɻȾӦɼеΡ
ʮ
Ѻڼڣδҷͬ⣬롢Ǩơ⡢תáٵѺκηʽֱͬµѺ
ʮ
Ѻڼڣҷͬ⣬תõѺõļۿӦҷǰ峥ծȨ
ʮ
ͬδ峥ծҷȨԵѺۼۻѺüۿܳʵֵѺȨ
ʮ
Ѻڼڣ֮һҷȨǰֵѺʵֵѺȨֹͣǰջؽϢ
1ΥͬڰھʮһʮԼΥԼΪ
2˱ʧ٣Ʋ˾ܾбͬģ
3ɥʧΪ˾ܾбͬģ
4ƲϷ̳˾ܾбͬģ
5²лȱծΪ
6˾شϻٲóɾףӰ䳥ծ
ʮ
ѺڹС顢⡢ѹ趨ѺȨҷɾʧģӦҷ֧%ΥԼΥԼֲҷʧģӦͲ㲿⳥
ʮ
ҷֵѺõļۿ˳䣻
1ֵ֧Ѻķã
2峥ǷҷϢ
3峥Ӧ֧ΥԼ𣨰Ϣ⳥ȣ
4֧á
ʮ
Լ
ڶʮ
ͬĽͬйз飬Э̽ҲֱҷڵصԺϡЭ̻ڼ䣬ͬ漰鲿ֵС
ڶʮһ
ͬЧ
1ͬѺ嵥еĵѺǼǵѰǼǣ
2ͬǩ֡ҷȨǩֲӸǹ¡
ڶʮ
ͬһʽݣ˫ִһݡ
ǩ£_______________ҷǩ£_______________
________________________________
ǩ__________ǩ
Ѻͬ8
Ѻ(¼Ƽ) ú˾
շ(¼ҷ) в
ΪȷͬУԸȨʲѺҷˣܼͬ.ʲѺ˫Эһ£ͬ
һΪѺʲһɣγ
ڶΪѺʲֵܹΪ50Ԫҡ
ѺʲɼбܣҷӦʹãڵѺڼڼάޡ֤𣬲ʱҷļ顣
ڱͬЧڣ緢ϲɱĻеֱеͬɢƲʱҷȨǰѺʲ
ڼδܰԼʱҷȨѺʲ
ͬɼ˫ǩֲӸǵλ֮ЧͬʧЧʱԶʧЧ
ͬһʽݣ˫ִһݡ
() ҷ()
ˣǩ ˣǩ
ڣ
Ѻͬ9
ծȨ/ѺȨˣ¼Ƽ
_______________________________
֤룺__________________________
ϵַ____________________________
ϵ绰_____________________________
ծ/Ѻˣ¼ҷ
_______________________________
֤룺__________________________
ϵַ____________________________
ϵ绰_____________________________
һݣ
1ܽ_______________________________________
2;___________ҪΪǷʹá
3ޣ____________________________ֹ֮峥
4ϢϢΪ_____ҷ֤ںͬ涨ĽڰϢ
ڶѺ
1ѺƣҷԼеһ____ɫ_________ƺţ___________ţ______________ܺţ______________ʻ֤Ǽˣ__________________յѺ
2Ѻֵҷ֤˫鶨Ϊ_________Ԫ
3ѺޣԱͬЧ֮ҷ뱾ͬйصȫϢΪֹ
˫
һ
1ҷѺ֤ҪƱܣʧ١
2ҷڻѺȫݡ֤ҷ
ҷ
ո֪ĿǰеĵѺеIJضĵѺõǵǼҪ壬Ҳ辭Ǽ֮ѺЧծ`ܳȨԵǩ걾֮ͬӦеѺǼǡ
1ĵѺǼǣϸպͬ涨ʱϢ
2֤ڵѺڼѺﲻҷƲʲָתõӰ졣ҷѺΥͬ涨ڣ֪ͨҷֹͬѽȫϢ
3ҷδͬⲻýѺ⡢ۡתáٵѺʽ֡
ΥԼ
1ҷβͬ涨֧ɾϵʧҷӦΥԼΡ
2ҷ粻ڸϢйϽȨԺѺڵֳϢвֳ֣ȨҷֱҷȫϢΪֹ
涨
1֮һʱȨֹͣͬջӦϢ
1ҷṩϲʵ
2ҷ߷ϣϢ
3ҷʲֳܶ为ծܶ
2ҷκһҪͬͬijһǰʽ֪ͨԷ˫ЭǰͬеĸȻЧ
3˫ṩĽƾ֤ͬйصϣΪͬɲ֣뱾ͬͬȷЧ
Ľͬлķɡ棬飺
1˫Э̽
2Э̲ɣйزŵ⣻
3ⲻɣԺߡͬԼЧͬһʽݣ˫ִһݣͬıͬȷЧ
ǩ£__________
ҷǩ£_______________
ͬǩʱ䣺_____________
Ѻͬ10
Ѻˣ(ѺȨ)
ͬݡл䡷зزѺ취ȹ涨ƽȡԸʵšЭһµԭΪȷΣãǩ֤ͬͬء
һֽ
һ;֮ͬϷʹá
ڶΪ(д)ԪСдԪ(СдһʱԴдΪͬ)
ޣΪ£ֹ
ʣڵ(/)Ϊ(д)(Сд)
ʽѡµֻʽ
1һλϢ汾;
2(/)ϢϢ֧Ϊÿ(/)ĩգʱ汾塣
3
ǰǰӦôͬ⡣ͬǰģͬԼʼʵʹϢԼij⡷˫Լ
ǰջشǰջشӦýͬ⡣Ϣ취˫ԼΣȨʱҪһǰ峥ֻȫϢ
1˽ڷǷ;
2Ѻʧʵֱ֮ͬĿģ˺͵Ѻ˲ṩ˿ܵ;
3
ڰ˵Ȩ
1ʵṩй֤֤ϣܴ˵ļලͼ;
2֤ڷǷ;
3ձͬԼȡý𣬲ʱϢ
ھ˵Ȩ
1֤ʽԴϷ;
2ȨԱͬµѺķвѯͺʵ;
3ڱͬµĵѺϵѺǼǺڣ˷Ŵ;
4ȨձͬԼȡϢȨԼʹѺȨڶֵѺ
ʮѺΪȷлѺԸӵȨȨֵλڶӪк¥ԪĺϷ(Ȩ֤ţȨֵ֤
ţƽ)ԼӦʹȨ(¼Ʒز)ѺˣΪ˹黹ĵѺ˱֤÷زκȨ飬ڱ⡢ѵѺѳ˹еģͬ⽫÷زѺˣܱͬͬԼ
ʮһѺֵͬȷϣǰڵѺ'زֵΪ(д)Ԫ(Сд)Ԫ(۱ţֵں)
ʮѺǼǣͬǩ(ڼ˳)Ѻ˫ӦַȨ֤֤ܲŰݵѺǼѺṩٲϻڸҪʵ²ܰѺǼǡѺǼЧ߱עģ˺͵ѺӦԴ˳еӦΡ
ʮѺΧΪͬµĴϢϢΥԼԼʵծȨзáδձͬԼ仹ʱ۴˶ԱͬµծȨǷӵ˾ȨֱҪѺԸ÷زеΡ
ʮ
ڶסѺΪסլģ˶ԱͬµѺȨʵֵķгֵԤ֪ѺǷӦгߵڶסĵ
ҷ
Ѻͬ11
Ѻ(ˣ¼Ƽ)_________
סַ_________
֤룺_________
ѺȨ(ˣ¼ҷ)_________
סַ_________
֤룺_________
ʽҪҷ˫Эһͬ⣬з(¼ƼѺ)ΪѺҷҷṩ־йЭ飺
һ ҷΪ: _________Ԫ( _________Ԫ)
ڶ ޣ_________
λ _________ţȨ֤Ϊ_________ ţзѺҷԱͬǩ֮5ڣ˫ӦܲŰѺǼǣǼɷ _________е
ͬΧΪ֮ͬϢΥԼԼʵծȨ͵ѺȨķãʦѡϷѼȫѣ
ѺȨ3 ڣ䷿ȨȨ֤ȽҷִҷӦ֧
ʣ_________
֤ںͬ涨.ڻϢʱҷϰѺȨעǼǣԼϢҷȨõѺ
ڰ ѺԱͬЧ֮ϱֹͬ
ھ ǩͬδҷͬⲻýѺ⡢ۡתáٵѺʽ֡ҷȨҪ黹ȫϢԺѺڵֳϢвֳ֣ҷȨֱҷȫϢΪֹ
ʮ бͬľף˫Э̽Э̲ɵģ _________ڵԺϽ
ʮһ ͬһʽݣһݡҷִһݣִܲһݡ
ͬͬرͬȫ
_________ҷ_________
ڣ _________ڣ_________
Ѻͬ12
(ѺȨ)_________
ˣ_________
Ѻˣ_________
ˡˡѺЭһ¡ݹйطɡ桢µĹ涨ǩͬ
һ ;
ͬ˷Ŵ(д)_________Ϊ_________;Ϊ_________
ڶ
ͬΪ______________________________________________________ֹʵʷſԼһµģԽΪ
ͬΪ_________롣йлʵһ()µģͬԼʲ;һģʸйߵӦĵҴ˲֪ͨ˺͵Ѻˡ
ʽ
ͬԼʽΪ_________(¡)Ϣÿ_________(¡ĩ»ĩ)20ΪϢգΪϢգڸϢΪΥԼʱһԹ黹汾塣رԼ˵ʻʽģʴĻʽԼ
ѺԸȫȨIJƲ
(1Ѻ嵥)ΪѺΪͬ˵ծȨṩѺͬʱرԼ£
(һ)ѺķΧϢ(ϢϢ)ΥԼ⳥ʵծȨķáʵծȨķðʦѡֲ÷Ѻá
()ѺЧڵѺ֮ȨϢ⳥𡢱սȨѺȨҪѺ˰ѺﱣգѺΪѺıաڵѺϵڼ䣬ΪñյĵһˡѺӦѺȨƾ֤յȽɴ˱;ѺȨ˴ΪѺ˰ȫȷ˳ʾͬڱչ˾˼رȨ;ѺڵʧʱѺӦñǰӦϢɴ˽档Ѻ𣬵ѺЧڵѺֵ֮ѺȫֵѺֵۼʱӦʮṩټֵ൱ĵѺЧ
()תծȨѺӦԵѺеѺΡ
()ѺǼɵѺ˸ӦϵѺ˰ѺǼ
()ͬͬЧѺЧҵѺͬԴͬЧµһծȨ(Ȩ)ͬйصѺԼеΡ
()ͬծȨ˵ĵĵѺȫѺֵΪծȨĵ
()Ѻﱻ˾ز⡢ѺȡȫʩģѺ˱뼰ʱ֪ѺȨˡѺ˲ʱ֪ʹѺȨʧ`ѺӦȫ⳥Ρ
չ
ӳޣӦڽǰ淽ʽ롣˺͵Ѻͬɴˣ˺͵ѺǩչڻЭ顣Ѻ˳ŵչںĴԱͬѺеѺΣɽˡѺ˸չڻЭѺѺǼӦϡչںʰۼʵȷ
ΥԼ
(һ)ΥԼΥԼΣ
1ڹ黹(չ)֮Լʼ_________GķϢʼշϢ
2ڳϢϢʼոϢ
3ͬԼʹôԼռŲõĴŲڼ䰴Լʼ_________GķϢʼշϢ
4ǰ黹뾭ͬ;˶ǰ黹ĴȨͬԼޡȡϢôͬ⣬ɰͬԼʺʵϢ
5˷֮һģȨֹͣͬδŵĴǰջδڴǰõѺ峥
(1)ڳ֧ϢرԼĻʽ黹Ϣ;
(2)ԼĴ;ʹô;
(3)ܻϴ˶ʹIJѯܵ;
4δڹ黹δ峥κνڻ˵ծģ
5ˡ֮ˡɶԱȲشIJΥΥΪģ
6Ʋܺ¼ģ
7شϵģ
8ششģ
9ӪƶͣЪҵģ
10ҵ״Ӫ״ѡʽ𣨱ģ
11δôͬʵгаޡʡ沢תɷƸעʱȵģ
12ҵơˡɶסػӪΧȹ̵Ǽδڱһǰ֪˵ģ
13͵ӣ˰ͣҵٻӪҵִյģ
14Ӱ쳥ʧȥεġ
ΥԼΥԼ δԼṩģӦ˳еΣ
1ΥԼڷϢʺΥԼ֧ΥԼ
2⳥ΥԼֱֵʧʧͿɵ治⳥Χ ڰ ͬijЧͬԸǩ֣£֮ԵѺǼǰ֮Чڱ֮ͬʮڣѺδѺǼģȨͬ
ھ ͬ
һӦڱУ磩˻˽˻ʱΪ˷Ŵ֮
ջصڴϢԼǰջشϢֱӴӽ˻пۻ ʮ ˡѺͬ˸йкڹŵйع涨йиϢݿ⼰йϢϵͳ¼루ѯ¶ˡѺ˵йϢ ʮһ Լ ______________________________
ʮ ͬףɴסԺϽ
ʮ
һݺͱͬDZͬɲ֣뱾ͬͬЧ
ͬĵѺǼǷѡշѡѡѺ֤ѵȣɽ˻Ѻ˳е
ˡѺ˶Աͬȫ桢ȷ⣬ԱͬصˡѺرʾͳֵ˵ͬҪڶǰ˳ִ̡
ģͬһʽ________ݣ˳ֶݣ˺͵Ѻ˸ִһݣЧͬȡ
ˣǩ£________ ˣǩ֣________ ίдˣǩ֣
________ ǩԼص㣺________ ǩԼʱ䣺________________
ˣǩ£________ ˣǩ֣________ ίдˣǩ֣________
ǩԼص㣺________ ǩԼʱ䣺________________
Ѻˣǩ£________ ˣǩ֣________ ίдˣǩ֣________
ǩԼص㣺________ ǩԼʱ䣺________________
Ѻͬ13
ˣѺˣ_________֤_________ϵ绰_________
ˣѺˣ_________֤_________ϵ绰_________ˣѺȨˣ_________ϵ绰_________
ˣѺȨˣ_________ϵ绰_________֤_________֤_________ϵ绰_________
ˡϵϵͬйطɡ棬ƽԸĻϣΪȷΡãЭһǩִͬͬС
һΪңд_________ԪСд_________Ԫ
ڶ;_________˲κɽŲáδͬԼ;ʹôȨŲôŲ֮𰴱ͬԼĴϸ_________%ΥԼ
ʡΪ2 %ϢӴ֮ʼ㲢¸Ϣ
Ϊ_________¡______________________________________________________ֹʵԽݻнƾΪ
ֽ_________Ԫ⣬˲ɳȨڵѺǼǺתʽָʻ__________________ʺ_________ΪΪ˽Ȩලʹá
˫̶ý𣬽˰¸ϢϢΪÿ_________աһԻ屾Ϣ
δͬԼϢȨڴϢ֮𰴱ͬԼϸ50 %ȡծȨķã÷ѡѵȣ
ڰǰģӦǰ_________֪ͨˡǰ֣15յݼϢ15ղһµİһ¼Ϣ
ھͬЧڣģȨκһ¼ʱǰˡ֤˷ǰҪڡǰ涨峥ֻȫϢΥԼ𣩣
һΥͬԼʹΪ˽лй黹Ϣģ
˱ɥʧΪʧ١̳ˡˡƲ˻ˣ
˵ļ̳ˡˡƲ˻˾ܾΪгϢ
ģϢڻڱͬۼϢδʱϢ
Ҽ
壩ݱͬԼ֤ΥԼʹ֤ǰǰֵѺģ
ߣδչ˾ָյģ
ˣŲýģ
ţݺͬ68涨ȷ֤֤ĽӰ黹˴ϢΡ
ʮ˺ͽ˫κһ֪ͬͨԷ˫Эһ£ͬʱñ֤ͬɱԼij⡣
ʮһִбͬйطãɽ˳е
Ѻ
ʮѺԸдȨijѺˣѺȨˣΪ֮ͬĵ֤еΡѺϸ£_________Ʒͺ_________ɫ__________________ʶ_________ƺ_________
ʮѺΧΪͬµĴϢڡŲΥԼ𣩡黹ϢΥԼ⳥ԼʵծȨķãٲ÷ѡʦѡͨѵȣ
ʮѺڼӵѺǼ֮ͬȫծֹ
ʮѺڵѺڼӦƱܵѺάޡ֤Ѻʱܴ˵ļල飨ܴڵѺϰװGPSװãװɽ˳еѺ˱γ⡣
ʮѺڼڵѺ˵'ɵѺֵ٣ӦɵѺ˳еΣѺӦʮڻ˹涨ṩٵļֵ൱ĵѺ˲ṩֵ൱ĵģѺȨ˿ѡǰֵѺʹѺȨ
ʮѺѺڼ䣬Ѻ˳ԱֳծȷʽֵѺȨģôͬ⡣ѺԴֵѺ˵ʧɵѺ˳еΡ
ʮ趨ѺҪܲŽеѺǼǣѺӦˡ֤˺ѺڱͬѺ趨Ǽ֮գõѺȨ֤ļǼ֤飩ѺȨ˱ܡ
ʮͬھǰջشδ峥ģȨǰֵѺ
ѺֻںϷΧʹáͣŵѺûӰGPSװõܣΪΥԼȨʱȫծȨ
ڶʮչ˾գӦԵѺȨΪյһˡѺڣ˲κжϻաΪֹжϣ˿ԴͶշɽ˳еȨˡѺڼ䣬⳥¹ʣȨ¹ʼ˵ľǷˡ緢ʧ⳥⳥ӦȫάӦȫ״̬緢ȫƶȫȫȱ¹ʡ
Ѻͬ14
ѺȨˣ________
Ѻˣҷ________
һΪȷ______________³ƽˣǩ__________________Žͬ³ƽͬУҷԸȨֵλ______________Уأ____________________________·֣____________________֮زȫȨ棨³ƸõѺƲѺ嵥ѺΪ֮ͬĵ
ڶѺͬΧΪ֮ͬϢΥԼڻյĸͼյϢӦ֧ΥԼ⳥ԼʵִծȨ͵ѺȨķãʦѺϷѣ
ͬЧڱĽͬĽͬЧӰ챾ѺͬЧ
ͬйصաǼǡܵȷþҷе
ѺͬĵǼ
ҷɳȨڱͬǩִͬͬͬȫйظõѺ֤ļйصķزذѺĵǼDZ
ҷɳȨڻøõѺʽȨ֤йطɷĹ涨йصķزذõѺʽѺǼõѺȨ֤鼰ѺǼ֤ڼ
Ѻʹúͱ
ҷ뱣֤õѺĺʹãðѵѺڱֹųκηʽκĿġ
ڰδͬ⣬ҷöԸõѺκʵԽṹı䡣ҷΥͬĸıʹõѺκԶתΪͬĵѺ
ھѺڼ䣬δͬ⣬ҷýõѺתá⡢ٵѺֳծκʽáɴκʧҷеΡ
ʮҷԸõѺƱܣάޡ֤Σʱܼļල顣ԸõѺɵκҷеΡ
ʮһҷɸ漰õѺһ˰ѡҷиԼɵһʧҷӦ⳥
Ѻı
ʮҷȡøõѺ___________ڣָıչ˾ָıΪõѺﹺայ⳥ΧӦõѺκλ֡ˮ֡Ȼֺ¹µƻ٣Ͷ¹õѺȫ֮ͬգҷеڻѺӦգֱͬ´ϢȫΪֹʮҷڱʮڣյܡյĵһΪյøκӰȨκβ⳥'Ǽͬ⣩ʮҷɳȨΪĴˣܻ֧䱣⳥𣬽սɸõѺݵٲֻ廹ͬ½ǷĿȨǾͬⲻɳʮѺڣҷκжϻաҷ⳥ܵһʧ
ʮҷΥձ֮ͬĹ涨Ϊգзҷ֧
ʮѺڼ䣬õѺĻҷӦּʱṩµĵӦ
ѺĴ
ʮģҷͬȨǰֵѺ
һݽͬԼͬǰڵģ
ҷΥͬڰʮʮʮʮʮʮ
κξסϡٲ÷ܶԵѺвӰġ
ʮҷ֤ڽ˲нͬԼʱȨʹָõѺļۿܳ
ڶʮֱѺ֮ͬд
һڽɸõѺ֧һзã
ڿ۽Ƿһ˰ҷӦһзã
ۻݱͬҷӦĴϢһп
ڶʮһָõѺļۿӦ֣Ӧ˻ҷ
Ѻ֤
ڶʮҷرͬͬʱ֤£
һṩһϾʵɿκαʵ֮
ȨˣκκʱõѺԱ飻
ҷڹλ緽ʽȷ仯ʱʮ֪ͨ
ģҷռиõѺڼ䣬Ӧع涨ʱõѺĸã֤õѺܿѺ漰ϡ粻Σ⳥ܵʧ
壩κϡٲ÷ܶԸõѺвӰʱҷ֤ʮʽ֪ͨ
ΥԼ
ڶʮκһΥͬκԷɾʧģӦԷ֧ͬ´___________%ΥԼΥԼֲԷʧģΥԼӦͲ㲿⳥
Ľ
ڶʮбͬκξף˫ӦѺЭ̽Э̽ɵģɼ˫ͬѡзʽ֮һ
һύõѺڵԺϽ
ύٲίԱþ
ڶʮδڼ䣬⣬Ӧбͬ涨
ڶʮ˫̶
ڶʮͬеĽ˰ڸͬԼĽϢãбͬȫκֹͬЭҷزܲŰѺעǼѺȨȨ֤ļվ˻ҷ
ڶʮͬһʽ__________ݣͬЧ_________ִһݣǼǻش浵һݡ
ѺȨס________
Ѻס________
绰________
˻У________
棺________
˺ţ________
룺________
绰________
棺________
룺________
£________
ҷ£________
ˣǩ֣________
ˣǩ֣____
________________
____________
Ǽǻأ________
ѺǼDZţ________
ѺǼڣ___________
Ѻͬ15
____________(¼Ƽ)
_____________(¼ҷ)
Ϊά˫棬ųʵãݻԭЭһ£ݡ䡷涨˺ͬͼҷһǩѺͬ£
һԼµĿͳһҷѺպ_____________________ܺ___________
ڶҷ()____________Ԫ(д)_______________
;_________________
Ϣ________%ۺϷ________%
______£_______________________________ֹ
ʽԴͻʽ
1ʽԴ___________________
2ʽ_________________________
֤
1ڲܳҷĽҷȨѺдҷĽϢۺϷʱҷѺ˻
2밴սͬĹ涨ʹýŲãýڷǷ
3밴ͬ涨ҷĽϢۺϷá
ڰ˫Ը֤ͨԽͬй֤֤ɼ()е
ھΥԼ
1ڣδͬ涨`ʱ䳥ϢۺϷã______ڵģ______ϢۺϷá_______ղձͬϢۺϷãеΥԼΡ
2ͬںûаʱҷĽҲûǰҷЭǩͬµϢۺϷãҷƾ֤ͬѺд()ԳϢۺϷáԺǿִУ鲢еҷͬķãʦѣ߷ѣִзѣͨѵȷá
3ͬЧӳͬ½ޣ߱ͬӦ˫ͬⲢЭ顣
ʮĽʽס˫бͬз飬˫Э̽Э̲ɣ̨ԺߺǿִС
1ͬɼס˫ǩֺЧ
2ͬһʽݣס˫ִһݡ֤һݣͬȷЧ
()_______________
(ǩ)_________
_________________
ҷ()_________
(ǩ)_________
_________________
Ѻͬ£
Ѻͬ06-29
Ѻͬ10-18
Ѻͬ06-27
[]Ѻͬ07-20
Ѻͬ䣩08-04
[ѡ]Ѻͬ08-17
Ѻͬ10-18
ڵѺͬģ ѺЭģ04-19
ͬѺͬ07-02