ⷿͬѡ12ƪ
ŷɹģͬĵλԽԽݺӣǩͬҲЧķ֮һⶨͬע࣬ȷдСΪĹⷿͬοһɡ
ⷿͬ 1
ˣ_______________
ˣ_______________
ΪȷȨϵ˫ƽԸЭһǩͬ
һ˽___________________________˾סʹá
ѶԷݵIJ֡ʩͬա
Ϊһ꣬ʱΪ________________________
ʽ
Ϊÿ_______Ԫ{______Ԫ}ҼΪ________Ԫ___________Ԫкͬǩ֮ȸµΪ_______Ԫ___________֮ǰ֧_______Ԫ
ġ˫Ȩ
1ڼ䣬геˮ硢ůҵӵطá
2˿ԸṩճƷʱýˡ
3˲ڷơӰھϢ
塢δͬ⣬ýתˣ緢ΥгеΣǷӦе`طãȨͬ
δˣ˫Э̽
ͬһʽݣ˫ִһݣ˫ǩ֮Ч
ˣ_______________
ˣ_______________
ǩڣ_______________
ⷿͬ 2
ⷽ__________________________________֤_________________ַ_________________ϵ绰_________________
ⷽҷ__________________________________֤_________________ַ_________________ϵ绰_________________
ƽȡԸЭһµĻϣס˫зݵЭ飺
1ݻ_________________
2;÷;Ϊס˫Լ⣬ҷøı;
3ޣ_________________
4_________________
5ʽҷӦڱͬЧ֮һ֧18000ңԪѺ3000Ԫ÷ݣǰ15֧⡣
6ԲȨijŵ֤÷ûвȨף˴κξþףԭκξʧģɼ
7ڷڼйطãڷڼ䣬·ҷ֧ˮѣúѣźŷѣǥʹ÷ѣҵѵȾҷе
8ֹͬ_ԭºͬеģȨֹͬջطݣɼʧģҷ⳥
AԽⷿת⡢תáת˻Եʹõ'
BԲķݽṹı;ġ
CǷһܵġ
DóⷿݴΥҼ͵ġ
Eⷿġ
9ǰֹͬʱ䣬κһֹͬǰһ֪ͨԷΥԼΪԷһ·⡣ɿԭ¸÷ٺʧģ˫е
10ͬһʽݣ˫ִһݣͬЧ
ǩ£_________________ҷǩ£_________________
__________________
ⷿͬ 3
ⷽ____________
֤룺__________________________________
ҷⷽ____________
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־˫˽⡢Э̣һ´¸ⷿЭ飺
һݵ䡢װʩ豸
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________________________________________________ա
ʱ
ÿ__________ԪҷӦÿ¸һΣȸסһҷӦڼݽͬʱ⸶ڶμԺҷӦǰһ¸塣
ġⷿѺ
ҷӦǩԼͬʱѺ__________Ԫڽ㣬黹
塢ڼԼ
1˫ӦṩʵЧķ֤֤֤
2ṩõķݡʩ豸ҷӦעⰮƻװޡṹʩ豸Ӧ⳥ʹзΪӦɼ
3ˮ硢ú绰硢ߵӵȵʹ÷Ѽҵݡѵзöҷ֧סճˮȣȣúȡзҷӦʱ塣
4ֻҷʹãҷ˽ת⡢ıʹʻǷ;±ҷӦǼǡס˿ڵǼǵǷ¼ҷԸڣȷǰջطʱӦ̵ҷͬ⣬ҷʧ'Ӧ⳥
5ͬһǩ˫ǰڣɿصбͬģͬȻֹ˫еΥԼΡ
6˫Լҷ迪߷ⷢƱ˲˰ҷ֧
7˺ͬδˣ˫Э̽뱾ͬͬЧ˫־ףѺЭ̣Э̲ɵģö
8ⷿЭ龭ǩ֣£Ч
ΥԼ
˫һΥԼģΥԼӦԼ֧ΥԼΥԼΪ__________ԪʧΥԼʱ⳥
ߡͬһʽ_____ݣִ_____ݣͬȷЧ
ǩ£_________________
绰___________________________
__________________________
ҷǩ£_____________________
绰___________________________
__________________________
ⷿͬ 4
ⷽ______֤룺______
ⷽҷ______֤룺______
ס˫ͷˣЭ飺
һλ______ݳҷסʹã____________________________________գ______¡
Ϊ______ԪʽΪѺһҷ__________________֧Ѻ______ԪÿΪһڣҷÿڵһµ______֧______Ԫסʱ䲻ڣ______Ԫ㡣
ҷڼ䣬ˮѡѡȡůѡȼԼҷסķҷʽɼ˫Эȷ
ġҷ˺⣬תˣб辭ͬ⣬Ҳܸı;ΥԼд֧ΥԼ⣬ȨЭ鲢ջطݡ
塢÷װʩ豸ʩ豸嵥ø嵥ΪձͬԼҷʹúҷڱͬ÷ʱݡҷӦʹòݼʩҷܲʹãʹݼʩϻʧģҷӦ⳥ƻصģȨջطݡ
ҷӦעס;Ӫȫвȡ𡢷Ȱȫʩǿõ簲ȫԷõ簲ȫо顣ҷʩɵʧҷгеɼݲƲʧҷȫ⳥ɵݲƲʧҷҷȫ⳥ԷΥԼ
ߡҷӦעԾάСڡҷԭڲؾģȨջطݡ
ˡڼ䣬κһֹͬǰ1֪ͨԷ˫Э̺ǩֹͬ顣һǿֹͬһ֧ΥԼ500Ԫ֮һֹͬ˫еΥԼΣ
1ɿԭʹܼͬлɵʧס˫еΡɿϵָԤܱⲢܿ˷.
2Ҫķݣʹס˫ʧģеΡ
3ԭֹͬģʵʹʱ㣬µİ㣬ٲ
šҷҪޣǰ1յҷҪ5ڴͬޣǩͬͬ£ҷȨ
ʮ飬ס˫ѺЭ̽Э̲ʱɵԺٲá
ʮһͬһʽ2ݣס˫ִ1ݣ˫ǩ֮Ч
ʩ豸嵥
ʩ嵥Ϊͬҷǩķͬĸ
ҷṩʩ豸
______ҷ______
__________________
ⷿͬ 5
ⷽ______________________
ˣҷ_____________֤_____________________
ݡлͬطɷ棬ס˫ƽȡԸЭһµĻϣзݵ.Э飺
һݻϢ
λںŵзݳ⡣
ڶ
_____£Ӧ_______________ݽҷʹ
÷ݱΪ_________Ԫ_____ÿ//꿪ʼ_______ڣҷӦ֧//
֧
ҷӦԱͬЧ֮ڽ÷ݽ
ڼط˵
ڣҷסˮ硢ů绰ҵȷҷеʱҷӦ֧á
ά
ڼ䣬ҷʩװ죬Ӧüͬ⣬еװáʱҷӦָݼʩԭ״
ΥԼ
ڣκһΥͬ涨ӦأԷ֧___%ΪΥԼҷ֧𣬼Ȩÿһҷȡ__%ɽ
ڰͬһʽݣ˫ִһݣͬЧ
ⷽ_____________
ˣҷ_____________
ⷿͬ 6
ⷽ¼Ƽ____________
ⷽ¼ҷ____________
ס˫ͷˣЭ飺_________ԪӦ__________________ǰ֧2200Ԫҷܰʱɷ⣬ǰֹͬҷеΥԼΡԼߵ֧ƾΪ֤ԪԷʣಿɼ˻ҷ
ġڼ䣬ˮѡѡȼԼҷס`ҷге
塢֤÷ȨףҷǰͬɼеΥԼΡ
δͬ⣬ҷΪ
1ת⡢ת÷ݸ˾ס
2˾סڷڡ
3ı䷿ݽṹס;ҷΥǰͬҷеΥԼΡ
ߡҷӦݼʩҷΪԭɸ÷ݡҾҵ硢ʩģҷе⳥Ρ
ˡͬһʽݣס˫ִҼݣ˫ǩ֮Ч
ǩ֣_____________
ҷǩ֣_____________
ϵ绰_________________
ϵ绰__________________
______________________
______________________
ⷿͬ 7
ⷽ____________ƣַ________________绰____________
ⷽ____________ƣҷַ________________绰________________
Ϊ˷չľý裬ߵλ˷ݵʹʣָݹ____ʡе'йط棬˫Э̣һͬǩͬͬ£
һ_______·壩֣ŵķݣ䣩ҷʹá_______סլŵķݡ__䣩ҷʹá
ڴ________________________________ֹ____________£
ҷÿ£______Ԫڵ£ڽ塣
ġͬЧҷӦ·ԪΪԼ֤𣬺ͬ˻ҷ
塢ⷿݵķز˰˰ʹ÷ѡⷿݹɷɣˮѡѡݹɷ
ҷԼǷÿ찴20%ɽǷϣȨջطݣȨܾԼ֤
ߡҷԸı䷿ݵĽṹ;ҷʧ÷ݺ豸ĻӦָԭ״⳥ʧΡ
ˡӦⷿݵάޣίгⷽάޣά㣻άίάɷݻҷΣ⳥ҷ39ʧ
šڼ䷿ɿȻֺ»𣬱ͬȻֹ˫йɰйطɴ
ʮڼ䣬˫ýʽͬҪջطݣǰ֪ͨҷȡͬ⣬ͬʱӦ˫Լ֤ҷ˷Ҳǰ֪ͨͬ⣬ͬʱҪԼ֤
ʮһڼ䣬ҷδͬ⣬ýתڽͬʱҷ谴ʱ黹ݸ⣬ǰЭ̣ڲδ⣬ֱԺ
ʮͬδˣɾ˫Э涨涨ͬͬЧ
ʮͬзףӦͨ˫Э̽Э̲ɣ뷿ŵԺ
ʮġͬɾ֤֤ͬһʽݣ˫ִһݣ֤һݣ˰һݣһݣͬȷЧ
ˣ____________ǩ£
ˣ____________ǩ£
ǩ________________
쵥λǩ£____________
ˣ____________
________________
ⷿͬ 8
ⷽ¼Ƽ__________________________
ַ֤룺_____________________________
ⷽ¼ҷ__________________________
ַ֤룺_____________________________
ס˫ͨѺЭ̣ͷ˴Э£
һص㼰ʩ
1ַ______________·_________Ū_____________ҡ____________סƽ_______________ƽס
2ڸʩ
a__________________________________________
bҾߣ__________________________________________
Լ
1ޣͬҷ_________ꡣ____________________________________ա
2ÿ___________Ԫҡ
3ʽ________֧Ѻ_____________ԪֹⷿѺ˻ҷϢһθ____________Ԫҡ
4ڵˮ硢ú绰ߵӡΰҷ֧ҵɵȷɼ֧
5ڣҷ֮һļֹͬջطʹȨҷ赣ȫΣ⳥ʧ
1ҷԽת⡢תûת'
2ҷóⷿݽзǷġ
3ҷǷ________졣
4²зõġ
˫μ
1ҷ밴ʱˮ硢ú绰ȷãؽϷʵලϷá
2κ£ҷܽѺתΪ
3ڣȷҷסýҷõķת⣨κεߡڷӼۡ
4ҷʹãӦǰ_______ɸʵͬ¸ȡ
5ڣס˫һЭģǰ________֪ͨԷЭ̺Э顣
6ҷסҵӦΧ÷жȰȫ緢¹ҷӦȫΡ
7ҷԸıڽṹϧʹʩΪĽӦ⳥緢ȻӦʱ֪ͨϼʱ
ġδ
ɼ˫Э̽Э̲ɰйзύйٲûؽٲá
Эһʽݣס˫ִҼݣǩֺЧ
塢˵
ˮ____________֡磺____________ȡ
ͬ
ͬһʽݣס˫ִҼݣÿݾͬȷЧ
ⷽ_______________ⷽ_______________
____________________________________
ⷿͬ 9
ˣ___
֤룺___
ϵ绰___
ˣҷ___
֤룺___
ϵ绰___
˫Э̣ͬԭݣ___
˴Э鲢ͬأ
һΪ______£ʱΪ__________________ֹ
Ϊ___Ԫ___Ԫ
ʽΪѹÿӦǰ֧
ġѺΪ___Ԫ___Ԫ˴貹___Ԫ___Ԫ
塢ΪӼṩߣڱⷿͬǩʱ/ڣ
Ӧ֧___ԪΪӶ
ҷӦ֧___ԪΪӶ
Эԭִⷿͬвֲ䡣Эԭͬɷָ֣ԭⷿͬͬȷЧ
ߡЭз飬ӦȡЭ̰취Э̲ɣԺߡ
ˡЭһʽݣһݣǩ֮Ч
šЧ
ʮǩЭ鵱գҷӦ__________________ңԪ___Ԫãң___Ԫ___Ԫ
ע
ˣ___
ˣҷ___
ǩڣ_________
ǩڣ_________
ⷿͬ 10
ⷽ___
֤ţ___
ҷⷽ___
֤ţ___
ݡлͬлзزйطɡ涨ƽȡԸЭһµĻϣס˫зݵЭ飺
1Ը˽סҷΪסʹã˫Լ⣬ҷı䷿;
2ҷڱ뱣ֺͰԭݽṹͷʩԲռ⳥еΣ
3ҷΥԼͼΥΪԸ
4ҷڼˮ硢ѣ·ӷ/ѼӦزţǷɵɽҷ
5ÿΪǪʰԪңҷÿɷڽǰ15츶Ѻ𣩡ڼ䣬г仯˫Э̵֮⣬ⷽκ
6__________________ֹ
7ʽҷһԽԪѺԪҴд___Ԫڷ⽻Լÿ½һΣ___ԪҷӦڵڷǰ___һԽͬǩЧ
8Ϊ˼˫棬粻⡢תҷⶼǰ֪ͨԷͬ£ҷȨ
9ͬס˫ȨֹͬҷδΥǰ¡˻Ѻҷ˫ΥΥԼӦеԼ`һоʧ
10ͬЧΪֹͬһʽݣδˣ˫Э̽
11ΥԼ
1ڼ˫غͬҷΥͬĹ涨۳ҷһΪΥԼֹͬ
2ҷԽⷿתʹãȨֹͣתΪֹͬͬʱ۳ҷȫѺͬǸ̬ԾǷƽعء
3ɿԭ¸÷ݻʧģ˫ͬȷϿɣҷɲеӦΡ
4ͬδɼס˫鶨
5ͬ丽ͲЭδ涨лйطɡִС
12Լ
һʼʱˮ硢úȱ״
1ˮΪ___ȣ
2Ϊ___ȣ
3úΪ___ȣ
4ҷӦǷýȫõϿɡ
ṩҷƷ£
1װǰú̻ȼˮϴ̨뻧Կװѣ
2ɳһš輸һӹһһš͵ĸ¹һд̨һԴһš
3ҷӦ֤ݼʩƷãʧҷӦʱ䣬ԭ35۸Ѻп۳羭պϸʱӦ˻ҷʣⷿѺ
4ҷӦṩЧ֤ĸӡ1ݼЧϵʽ
13ͬз飬ɼס˫Э̽Э̲ʱס˫Ժߡ
14ͬԼס˫ǩ֮Чһʽݣס˫ִһݣͬЧ
ǩ֣___
ҷǩ֣___
ǩʱ䣺_________
ǩʱ䣺_________
ϵ绰___
ϵ绰___
ⷿͬ 11
ⷽ_________________¼Ƽ
ⷽ_________________¼ҷ
һλڵ棨㣩ҷΪ꣬_______________յ_______________ա
_______________յ_______________գΪÿԪд_________________֧ҷӦʱ֧֧ʱΪÿ_______________ǰ_______________𣬷ոýг巿۸֧ʽȡҷδģȨֹͬջص棬ûѺ
ҷԼ'ƲưʹãάޣӦռ⳥
ġڼ䣬ˮѡѡҵѡ̡˰աݳ˰ѵһзҷɡ
塢ڼ䣬ҷװڲӰܹ۵ǰ£üͬɽУַҷ֧װֲò
ڼ䣬ҷýתøʹãȨջص棻ҷδʱͬʱûҷѺҷҵ˳⣬ͨͬ⣬ɼǩͬ˻ҷѺδͬ⣬ҷǩתЭ
Ч
ߡҷ뽫桢ĽӪƷҷд⣬ҷӦںͬǰ֪ͬ£ҷȨ
ˡ֮ͬգҷѺԪд_________________ͬҷûΥԼѺ黹ҷ
šͬǩ֮ǰһծɼи𣬱ͬǩ֮һծҷе
ͬһʽݣס˫ִһݣǩ֮Ч
___________
ҷ___________
______________
ⷿͬ 12
ⷽ¼Ƽ_________________________
ⷽ¼ҷ_________________________
ס˫зݵЭ飺
һ ݻ
ݣ¼Ƹ÷ݣ____________________________ƽףҷ_____ʹá
ڶ ;
÷;Ϊס
˫Լ⣬ҷı䷿;
__________________________________________________ֹڹ_____¡
ͬԼⷿݵģҷӵȳȨ ֹͬʱҷȷʵҵݣЭӳޣҷ֧صá
÷Ϊң____________Ԫ
ڼ䣬йߵ߹涨֮⣬ⷽκ
ʽ
ҷ֧
ҷںͬǩ֮գⷿѺ________Ԫͬʱ____________ǰ7ڽһȼ3ԺԴơѺںͬⷽκǷѰʱ˻
˫κ
һ ⷽ
1 ͬ涨ʱ䡢ݽⷽʹá
2 ڱ֤÷ʹãάޣ֤á
ⷽ
1 ڶԷݼ丽ʩά緢һ¹ʼطþɳⷽе
2 ͬ涨ʱɷ⼰ˮ硢ůҵȷá
3 ⷿݱ밮δⷽͬⲻװޡĽת⡢ô÷ʲɵΥ
4 ⷽýת⣬תûתġ⡢Ӫɻ˵ġ
5 ˲óⷿݽзǷṲ档
6 ںͬǰ֪ͨⷽǷ⣬صǩ
ΥԼ
1 ˫ںͬκһֹͬʱӦԷһµķΪΥԼ
2 ͬⷽ÷ʱ˫Էݵ'üʩղӡⷽδʱͬһδ룬ⷽӳⷽһƷΪȨκδ
3 ⷽǷⳬ7ռӳⷽԶֹͬⷽȨջطݲһڰ룬ⷽڲᣬⷽӳⷽһƷΪȨκδ
4 ⷽδⷽͬ˽ڳⷽڽװޡĽ÷ʲɵΥʱⷽȨջطݡⷽڽӵ֪ͨ7ڱ룬ڲᣬⷽӳⷽһƷΪȨκδ
5 ⷽת⣬תûתġ⡢Ӫɻ˵Ļ߽зǷṲӰϢⷽȨջطݲ7ڰ룬ⷽڲᣬⷽӳⷽһƷΪȨκδ
ڰ
һⷽΪṩƷ£
______________________________________________________________
ǰˮȱ״
ˮΪ_________ȣΪ_________ȣúΪ_________ȡ
ھ ͬз飬ɼס˫Э̽Э̲ʱס˫Ժߡ
ʮ ͬԼס˫ǩ֮Чһʽݣס˫ִһݣͬЧ
_____________________ҷ_____________________
绰_____________________绰_____________________
__________________________________________________
ⷿͬ£
ⷿͬ06-12
ⷿͬ09-01
ⷿͬ03-10
ȡⷿͬ07-01
ȡⷿͬ07-05
ṫⷿͬ06-05
ⷿͬ5ƪ09-10
ⷿͬ6ƪ03-10
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