ⷿͬѡ16ƪ
ŷɹսռͬĵλԽԽݺӣǩͬҲЧķ֮һôĺͬʲôأСྫⷿͬӭҽοϣԴ
ⷿͬ 1
ⷽ_________
֤____________________
ⷽҷ_________
֤____________________
ݡлͬлзزйطɡ涨ƽȡԸЭһµĻϣס˫зݵЭ飺
һ ݻ
ݣ¼Ƹ÷ݣַ_____________________________________
ڶ
__________________________________________ֹ
÷Ϊ__________Ԫÿ__________Ԫҡڼ䣬г仯˫Э̵֮⣬ⷽκ
ʽ
____֧ÿ______֧Ѻ__________ԪֹⷿҷúѺ˻ҷϢ
ڷڼйط
ڷڼ䣬·______֧______еڸΥԼΣ
ˮѣ2.úѣ3.绰ѡҵѺů_____֧
ֹͬʱҷ뽫˻ҷҪޣǰ____ںͬǰ____ҷʽͬޣǩͬ
ҷֹͬԼҷ֮һģֹͬջطݣɼʧҷ⳥
1Խķתģ
2Խķתáת˻Եʹõģ
3Բijⷿݽṹıⷿ;ģ
4Ƿۼƴ____£
5óⷿݽΥ'
6ⷿݵġ
ڰڼӦע𡢷磬ִейزŹ涨ʧҷȫΡ
ھǰֹͬڼ䣬κһֹͬǰ_____֪ͨԷ˫Э̺ǩֹͬ飬ֹͬǩǰͬЧҽ衢ɿػֱͬʮ涨ΣֹͬʱһӦǰ_____֪ͨҷҷľʧ貹
ʮͬδˣɼס˫鶨ǩЭ顣Э뱾ͬһµģԲЭΪ
ͬͬ____ҳһʽ____ݣס˫ִ____ݣͬЧ
ǩ£____________ҷǩ£____________
绰_____________________绰_____________________
________________________________________
ⷿͬ 2
ˣ¼Ƽ
ˣ¼ҷ
˫Э̣Э飺
һΧ;
ͬ⽫__________·_________ҵķݼʩҷݲȨڼ
ڶṩ豸
1ҷṩӦķ豸嵥嵥ⷿͬͬЧ
2ҷʹ豸ĸҷе
ڼ
1ڼ______________________ֹ______¡
2ҷ⣬ⷿͬǰһ֪ͨͬԼ£ڱⷿͬڣҷʵбⷿͬεǰ£ҷȨȷǩⷿͬ
Ϊÿ_________ԪտݣҷӦÿ___ǰ
ҵѼ
1ҵ___ҵ˾йع涨շѱ֧
2ڵҷи
3ʹø÷.йطҷ磺ˮ硢úߵӡ绰ѵȡ
άޱ
1ڼеװ豸ҪάޱʱҷӦʱ֪ͨҵ˾ʱάޱҪ豸ҪдʱӦ֪ͨ
2άޱɼеҷԭɵҷе
3ҷеװ豸Ҫʱҷнвеá
ԭ״
1ҷԷװ䶯豸ṹʱüͬ⣬ҷе
2ҷʵʩʱʱϵϺӦ֪ͨ顣
3ҷΥͬ涨ģȨҪָԭ״⳥ʧ
ڰֹͬ
1Ȼֺɿ¼ʹݵҷʹʱͬȻֹ
2ڼ䣬Ϊأ˫ʺΡ
3ҷΥͬйع涨ġ
4ծδ
5Ȼ֮ɺԲʹãҷֹԼ
ھ
ͬȨʱⲻɣϽķڵصйԺϡ
ڶʮ
ͬҼʽݣǩ֮Ч˫ִҼΪƾ
ˣ_________________
֤룺
סַ
ˣҷ_______________
֤룺
סַ
ⷿͬ 3
ⷽ()________
ⷽ(ҷ)_________
ס˫ͷˣЭ飺
һλ________ֵ___С___¥ŵķݳҷסʹã______________________գ___¡
Ϊ_____Ԫ½ÿ³15ڣҷ֧ȫ
ҷڼ䣬ˮѡѡȡůѡȼѡ绰ѡҵԼҷסķҷʱҷ뽻Ƿѡ
ġҷʩװ죬üͬ⣬еװáʱҷ뽫ʩָԭ״
塢ҷҪޣǰ1յҷҪ7ڴͬޣǩͬͬ£ҷ'Ȩ
ڼ䣬κһֹͬǰ1֪ͨԷ˫Э̺ǩֹͬ顣һǿֹͬһ֧ΥԼ______Ԫ
ߡ飬ס˫ѺЭ̽Э̲ʱɵԺٲá
ˡͬһʽݣס˫ִһݣ˫ǩ֮Ч
_____________
ϵ绰_______________
ҷ_____________
ϵ绰_______________
ⷿͬ 4
ⷽ
֤ţ
ַ
ҷⷽ
֤ţ
ַ
н鷽
ס˫ƽȡԸĻϣѺЭ̣Э飺
һⷿص㣺ͬ__________________________________ҵķҷ֤÷ĺϷԡ
;ҷⷿݽΪ_____ʹãýκΥԸ
ڣ____________________ֹҷӦڽݹؼ
ġÿ_______Ԫң֤ⷿ______Ԫң൱___
塢ʽ
1ҷÿ__֧һΣһ֤ǩͬʱ֧Ժ𰴹涨`ǰ___콫ڷ֧
2յһսҷסĿ֤ԿȽҷǩͬʱҷӦ֧н______Ԫн鷽Ӧ֧н______Ԫн鷽
ãҷеʱãˮѡѡ绰ѡѡúѡߵѡҵѡãм
֤ⷿ𣺴ڣн鷽ΪԼ֤𣬲ϢҪڶԺֹͬʱҷڷĻã⡢Ʒȱȿ۳һԲϢ˻ҷ
ߡ
1뱣֤÷ݵĽṹʩʹã
2άɼ
3ڲõ𣬷ΥԼ
ˡҷ
1ձͬ涨ʱͷʽ֧𡢱֤ã
2δͬ⣬ҷ˽Ѹ÷IJֻȫתˣ
3ֹͬʱԼṩʩ㡢ƽȱӦֵ⳥
4ҷʹòݼʩģӦԭ״Ծ⳥ˮ硢úʹòΪɵ¹ʣ뷿н鷽أԸҷǰã۳______Ԫ
šΥԼ
1ҷΥͬڰȨֹͬջطݣûʣ粻ʧҷӦ⳥
2ΥͬӦһҷ֧ΥԼ𣬲˻ʣ֤
3ǰֹͬӦһҷ֧ΥԼ𣬲˻ʣ֤
4ҷǷ;˷밴һ·֧ΥԼ𣬼˻ʣ֤𣬷ûʣ֤
5ҷѳҷȲǩͬҲ˷Ը÷ȨҷԸ
ʮ
ϸ嵥ˮ_____ȣú_____ȣܶ_____ȣ_____ȣ_____ȡ
Կ_____ѣԿ_____ѣԿ_____ѡ
1_________________________________________________________
2_________________________________________________________
3_________________________________________________________
4_________________________________________________________
ʮһн鷽
н鷽˫ίкλΪ˫ѰҺʵҵͻʹɹڼ˫ɽͬʱн鷽ȡнѺнס˫ڼ䷢ףн鷽ɳЭ˫ס
ʮͬδˣһɰлͬйع涨˫Э˲涨涨뱾ͬͬȷЧ
ʮˮ𡢻֡Ǩͷɷ߱仯Ȳɿԭ±Э鲻ȫУסҡн鷽еΥԼΡʵʱ㣬ٲ
ʮġͬһʽݣס˫ִһݣһݣÿݾͬȷЧ
ǩ
绰
ҷǩ
绰
н鷽ǩ£
ǩԼʱ䣺_________
ⷿͬ 5
()______________
֤룺______________
ܷ(ҷ)______________
֤룺______________
ס˫ͷƽȡʵԸЭһǰ¶ͬء
һԸ֤λ_______________________________ķ(___ƽ)_______Ԫ(_______Ԫ)ļۿ۸ҷ(______________ƽ)
ҷڸúͬǩ֮_______һԽ֧
ͬǩʱס˫߱ṩ챾ݵ֤ϣΪݡҷ÷ݣҪϡȾ߱ʱӦЭҷݲȨʱ˰سýҷ˰Ѱйطɹ涨
ġͬǩԸ÷ݵʹá桢⡢ѺռеȨһתøҷþ÷˶Э顢ͬκηʽĴ֡
塢÷ʽʱҵˮ㡢ȼߵӡͨѶӷѣѷ'ãѾԤɵ`ãȨҷУ˫н㡣
ΥԼ
1Ӧҷ巿ͬʱҷ÷ݡδʱݣӦ֧ռķǧ֮һ`ΥԼҷڳ£ҷȨͬԼʱ轫յķʱȫ˻֧_______ԪΥԼΪҷʧ⳥
2ҷδͬ涨ĸڼʽġڲӦӸǧ֮һΥԼڳʱȨͬԼʱշʱȫ˻ҷ۳_______ԪΪʧ⳥
3֤⡢סѺ֪֤ͨʷΪ֮һӰ쵽ҷȨʹ߿Ȩտ˫ҷΪΥԼԵ⳥
4ͬǩκһԱͬ谴ݽʱг۵˫֧Էشɿ`ԭ±ͬ`Ӧݽʱг۷ҷݼۿ⳥ҷķװá
5滮šƲŵԭ·ݲʹùܱģӦ֪ͨҷбݵIJţӦʱȫ֧ҷӦ֧ռIJǧ֮һΥԼҷֱȫ֧ҷֹ
ߡӦʱӰ챾ͬ÷ݼֵκ¼(ڹ˾ˡͨѶʽı䣬÷ݵIJ⡢Ѻϡٲû¼)֪ͨҷڼĹɷݼֵٵģӦȡʩֹʧ⳥ҷʧ
ˡͬԸǩֻ֮Ч˫ԼӦϸСҵ÷ƣҷʵʲȨ˺ʵˣǺϷȨˣʱݲʧúͬЧ
šͬйз飬˫Э̽Э̲ɵͬǩԺߡ
ʮ˫֤ӡ÷ƽͼ
______________
ҷ______________
ϵַ__________
ϵַ_________
ϵ绰__________
ϵ绰_________
_____________________
ⷿͬ 6
ˣ_______________
֤룺__________________________
ˣ_________________
֤룺___________________________
ݡл䡷йطɡ֮涨ס˫ƽȡԸЭһµĻϣҷǩͬʹִͬС
һݵĻ__________________________________λڵ____㣬______ݽṹΪ________Ϊ______ƽף;Ϊ_______
ڶڲʩ豸__________________________________________
ͬΪ_____________________________________________________ĸ˲Ʋԭ۷λת÷ûвȨףڷݵѺծȨծԼȨ覴áδɼеҷκΡ
Ľ۸ɽ۸Ϊ___________Ԫ
ʱ취˫ֽͬʽһԸ_________ս____ʰ________Ǫ________ʰ____Ԫտҷעտ;ڶʷ____ʰ________Ǫ________ʰ____Ԫ______________ոʷ____ʰ________Ǫ________ʰ____ԪڼͬеȫǨո
ݽӦڽսǨ÷صǨһк÷йصļƱݽҷڷݽʹʱķ丽_______Կȫҷ
ǨӦڷݽǰͬеȫǨ
ڰڽݼڻǨΥԼΣɿܵȻֺ⣬δͬ涨`÷ݽҷʹãҷȨѽķۿΥԼڲ_______죬ΥԼԼݽ֮յ_____ʵʽֹ֮ÿһգҷ֧ۿ_____%ҷ֧ΥԼ𣬺ͬڳ_______죬ΪбͬҷȨе____ԼΥԼΡ
1.ҷۼѸ________%ҷ֧ΥԼ𣬺ͬУڱͬԼʵʽ֮_______ڽݡ
2.ֹͬҷۼѸȫҷ_______%ʸϢ
˷ݵԭȨˡλá⣬ӰҷľסʹʱҷȨҪ˷һʧɼеڹ涨Ĵ˷ݻǨʱδͬеȫǨΪΥԼ֧ҷΥԼǪԪӦ______ȫǨ
ھڲȨǼǵԼԺҪݲȨ֤֤˫Э̣µ____ԼС
1.ҷʵʽո÷֮𣬼ЭҷڷزȨǼǻع涨زȨǼǻذȨǼǹ`ʧҷ˫ʵʽ֮_____ȡ÷زȨ֤飬ҷȨ˷ҷ˷Ҫ֮______ڽҷѸ˻ҷ_______________ʸϢѸ______%⳥ҷʧ
2.ҷԸյ`ݼӻݲȨ֤֤ҷаݲȨ֤֤ҪҪӦṩһ֮йصϣЭҷڷزȨǼǻع涨زȨǼǻذȨǼκηʽܾӡ`ʧҷҷҪ_____ȡ÷زȨ֤飬ҷȨ˷ҷ˷Ҫ֮______ڽҷѸ˻ҷ_______________ʸϢѸ______%⳥ҷʧ
3.۷λԭ˷ݲȨ֤֤δ䷿ݹʽҪԸ˷ҷڰ˷ݲȨ֤֤ʱڷزȨǼǻع涨ڽ˷ݲȨ֤֤ȨֱӰΪҷ______£ڷݲȨ֤֤Ϻ______ڽҷã______еԭܽ˷ݲȨ֤֤ȨֱӰΪҷ______£ΪҷݲȨ֤֤____________еĹʧҷڷݲȨ֤֤Ϻ______ȡעΪҷ______ķزȨ֤飬ҷȨ˷ҷ˷Ҫ֮______ڽҷѸ˻ҷ_______________ʸϢѸ______%⳥ҷʧҷڱͬ۰ݲȨ֤֤˷⣬κηʽӡڰݲȨ֤֤ʱӦṩһ֮йصϣκηʽܾӡ
ʮͬ
1.__________________________ˣίдΪ_________ˡ˱֤ݣǩͬʱзݹвȨͬ⡣
2.ҷ_________________________________
ʮһ֤ͬҹ֤________֤֤ͬκηɹ֤ͬȵķЧͬ˫ǩ֮Ч
ʮͬɼҷ֤ͬǩֺЧͬһʽ_____ݣȨ˼ίд˹_______ݣҷ______,֤____________һݣ汸顣
ʮͬĽʽ˫ѺЭ̣ƽԭǩͬǩͬ˫ӦϸִУκɷڡԼз飬˫ͨЭ̽Э̲ɵģ˫ͬⰴµ______ַʽס
1.ύ______ٲίԱٲá
2.κһйϽȨԺϡ
ʮͬδˣ˫Լ䲹Լɼҷ֤ͬЭ̽뱾ͬͬ߷Ч
________________
֤룺__________________
ַ__________________________________________
ʱ_____________
绰_____________________
ڣ_________
__________________
֤룺___________________
ַ__________________________________________
ʱ____________
绰_________________
ڣ_________
֤_______
֤_____________________
ַ__________________________________________
ʱ____________
绰_________________
ڣ_________
ⷿͬ 7
ⷽ(³Ƽ)
֤룺
ַϵ绰
ⷽ(³ҷ)
֤/Ӫҵִպ룺
ַϵ绰
ݡлͬйع涨ͼӵеķݳҷʹãΪȷס˫Ȩ˫Э̣Э飺
һ
(һ)ҷʹõķλ_________________________
()ⷿݵľ岿Ϊ_________________________________
()ݵļΪ________䣬Ϊ_________ƽס
;
(һ)ҷΪ____________________________;
()ҷŵڣδüͬ⣬涨йزźҷԸı䷿ݵԭнṹ;
()ķݲ桢ӪȼױжΣƷ
(һ)ڣ______________________ֹ________(д_____________________________________________)
()Ȩջظ÷ݡҷģӦǰ_____Ҫüͬ˫ǩͬ
()ҷʹݼδģͬЧΪڣ˫ȨʱͬӦǰ_____֪ͨԷ
()ͬԼⷿݵģͬ£ҷȨ
ġ֧ʽ
(һ)ÿµΪ__________Ԫ(Сд_____Ԫ)
()Ȩйߡɷгձ۸ʵ߽ˮƽӦǰ____ʽ֪ͨҷ
()ҷӦڱͬ涨֮ǰ____________Ԫ(Сд_______Ԫ)ԼߵƱΪƾ֤ÿڷ_____ڸ
()ҷͨ____________ʽһ֧ÿµķ𡣼ӦʱҷտվݣտվΪҷ֧ƾ֤ҷӦƱտվݡҷԭƱݶʧɵһкҷе
塢ޱ֤
(һ)÷ʱҷӦ֧ޱ֤𣬾Ϊ___________Ԫ(Сд______Ԫ)
()ͬޱֿ֤ӦҷеķáԼҷӦеΥԼ⳥⣬ʣಿӦҷ
(һ)ڣʹò˰ҷгеҷӦʱ֧ߺйطɷ涨ҪеĿҷӦƱɽ˰ѵƱݲʱʾͬʱҷӦɷƱݶڸһݸԱ浵
()ҷδЭɷǷйؿӰ췿ݵʹԼɼʧҷе
ߡݵĽ
(һ)ҷӦ____________ǰݰԼڵհݡ˫ǩָ²ƽԿ__________________ΪɡҷڲǨȨԺߣɴʧҷ⳥
()ͬҷӦ÷ݼ丽ʩס˫ӦӦеķáڸ÷ҷδͬƷȨдá
()ҷװΡװIJ֣崦Ϊ(ҷڲݵǰ»ָԭ״/ҷָ֧ԭ״/ҷջ/)
ˡװͷݼʩά
(һ)ҷͬ⣬ɶݽװ̼ȸıԭòʡδͬ⣬ҷԸı䷿ԭòʵģҪҷںڻָԭòɷģҷӦ⳥ܵʧ
()Ķķݼ丽ʩϾסӪ(ҵ涨)ȫع涨ҷӦкϸʵļ鲿ŶԷݽвգҷе鲻ϸҷӦеݼʩֱݼϸΪֹ
()ҷ˱ܲʹãʹ÷ݼ丽ʩϵģҷӦάе⳥Ρҷܲάܲе⳥εģɴΪάҷе
()ڼ䣬ݼ丽ʩճɺάҷ𣬷ҷе
ˡת
(һ)ڣҷͬ⣬ɽ÷ݲֻȫתˡҷתģҷ֮ͬЧ
()תⷽԸ÷ݼ丽ʩģӦҷе⳥Ρ
š˫Ȩ
1ȨڶԳⷿݽȫȼ飬ҷӦϡ
2ҷӦȫʹóⷿݣַݵ
ʮͬĽ
(һ)˫Эһ£Խͬ
()֮һģֹͬ˫еΥԼΣ
1÷нҪ뷿ݲǨΧġ
2𡢻ֵȲɿʹݻʧʧ.
()ҷ֮һ`Ȩͬջظ÷ݣ
1ΣⷿݵΪ
2֧߲Լ֧______յġ
3Ƿɸô_________Ԫ(д___________Ԫ)ġ4Ըı÷;ġ
5Բı䶯ṹȸı䷿ԭòġ
6Խ÷ת˵ġ
7ø÷ݴΥġ
ʮһΥԼ
(һ)ڣǰջظ÷ݵģӦǰ____֪ͨҷȡ˻ҷ_____%֧ΥԼ
()ҷԶԸ÷ݽװޡװλģҪҷָԭ״⳥ʧ
()ڣҷǰģӦǰ____֪ͨ______%֧ΥԼ
()ҷ֧ģȨҷڵIJƲƲԵָģȨҷʣ
ʮͬĽ취
ͬ·飬˫Э̽Э̲ɵģڵصԺߡ
ʮͬIJ
ͬδˣɰյߺйطɷ棬˫ͬЭ̣涨涨뱾ͬͬЧ
ҷӦṩ֤ӡ/ס֤ӡӪҵִոӡҵ˴֤֤֤ϷЧ
ͬ˫ǩָºЧͬ5ҳһʽݣס˫ִ1ݡ
(ǩ/)
֤룺
ǩԼʱ䣺
ҷ(ǩ/)
֤/Ӫҵִպ룺
ǩԼʱ䣺
ⷿͬ 8
ⷽƼ
֤룺
ϵ绰
ϵ/ʹַ
ⷽҷ
֤룺
ϵ绰
ϵ/ʹַ
ķڸʡ_________/___ֵ___С//_______ң____ƽף豸װް____________ȡ
һ;Ϊ___________________ʹãá
ޣ______________________գ_____¡Ӧںͬǩ_____սݣڽݣҲӦ˳ӡÿΪ_______Ԫ˰ҷҪ߷Ʊ֧˰ѣ
ʽҷӦÿ_________________ԪÿθӦǰ______塣
ġͬǩ֮գҷ___________ԪΪѺ𣬵ͬҷڼӦһзò˷ݺӦѺϢ˻ҷ
塢ڼ䣺ҷӦ____________________________________á
ڼҷӳ֧ÿ찴ӳֵ`2%ΥԼӳ_____ģȨǰͬջطݣҷмҾߵδ룬Ϊɼҷ飻ȨǷΥԼ
ߡڼ䣬˫ýʽͬһҪͬģǰҼ֪ͨԷԷͬͬͬһ֧ҼµΪΥԼ⳥
ˡҷø÷֮зǷз֣ȨǰֹͬҷɵѺΪ⳥.ΥԼҷҪеǷһзΣŲ
šڼ䣬ҷӦϧһ豸ʧɸóⷿݼӦָԭ״⳥ɴɵľʧҷΪҪװ÷ʱȡüͬиװԭеĽṹҷڽʱӦָԭ״
ʮҷʱݹ黹ҷӦǰЭ̣ͬ£ҷȳȨͬҷ˳ʱмҾߵδ룬Ϊɼҷ顣
ʮһҷӦء_____ס˿ڵǼǹ涨סԱסģӦǩ֮ͬסɳס
ʮͬδˣɼסҷ˫Э̽ⶨЭ飬Э뱾ͬͬȵķЧ
ʮͬԼ˫н鷽ǩ֮ЧͬҼʽݣס˫ִҼݡ
ʮġͬǩ֮յĵ________ˮ_______ú________
ʮ塢˫кͬз飬ӦЭ̽Эδʱκһ__________ڵйϽȨԺߡ
ǩ£
ǩԼڣ_______________
ҷǩ£
ǩԼڣ_______________
ⷿͬ 9
(ⷽ)______
ס_____
ˣ_____
ҷ(ⷽ)______
ס_____
ˣ_____
ݡл䡷Ĺ涨ס˫ƽȡԸƽͳʵõĻϣЭһ£ҷˣͬ
һݻ
1ҷķ_________·___ţ÷ʹΪ___ƽף;Ϊ___Ϊ___
2Ϊ÷ݵķزȨҷϵǩͬǰѸ֪ҷ÷δ趨Ѻ
3÷ڵװޡʩ豸״Ը÷ݽʱֳΪйʩάޣҷ
;
1ҷŵ÷ֻΪ___ʹãڲԸıԼʹ;
2ҷŵڣڷŵƷأȻֺ
÷___¡__________________ֹȨջسⷿݣҷӦڽҷҪ⣬һ֮ǰ֪ͨͬǩͬ
ġ֧ʽ
1˫ԼΪ___Ԫ/(д______Ǫ______ʰ___Ԫ/)
2ܶΪ___Ԫ(д______Ǫ______ʰ___Ԫ)
3֧ʽΪ___
塢ڼطü˰
1Ӧеķã
(1)ڼ䣬ݺصIJȨ˰ɼɡйزձͬδгĿ÷йصķãӦɼ
(2)ã___
2ҷ·ã
(1)ڼ䣬ʹø÷ĵѡͨѶѡʩάѡҵѡ____ȷҷе
(2)ã___
ʹ
1ڣӦ֤ⷿݵʹðȫ÷ݼʩάξɼ(ҷʹò⣬ҷʹòɷݼʩģҷӦ⳥)ҷάӦʱṩάǰ֪ͨҷҷӦЭϡ
2___(/)ҷݽװޡƻװޡƻķΧǣ___ݵװޡơĴΪ___
ߡݷʱ״̬
1ҷ;⣬˻ҷѽ
2ҷ÷Ӧʹõ״̬ʱӦϿɣӦеķá
ˡݵתת
1ڼ䣬Ȩշתøóķݣתúͬµķ˺ҷЧ۷ݣ_____ǰ֪ͨҷ˫Э̽⡣
2δͬ⣬ҷת⡢תⷿݡڱͬͬҷת⣬ҷڣüͬ⣬ɽ÷ݲֻȫתˡͬһסݣ÷ָת⡣
3ڣҷ÷תø˳˳.ݽнüͬ⡣÷ݳȨ˻Ӧǩͬбͬ
šͬ
1ס˫ͬڣ֮һģֹͬ˫еΣ
(1)÷ռ÷ΧڵʹȨǰջصģ
(2)÷ṫнҪõģ
(3)÷ݻʧ߱ΪΣշݵģ
(4)Ѹ֪ҷ÷ݳǰ趨Ѻֱֵġ
2ס˫ͬ⣬֮һģΥԼӦһ֧ܽΪΥԼһȨͬһҪͬģΥԼӦ֧ܽΥԼ
(1)δʱ÷ݣҷ߸____δģ
(2)ĸ÷ݲϱͬԼʹʵĿģ
(3)ҷıʹ;ʹģ
(4)ҷԭɷṹģ
(5)ҷת÷ݡתø÷ݳȨ˽Գķݣ
(6)ҷ֧ͬӦеķô2µġ
ʮΥԼ
1ṩͬԼķݶͬģӦ֧ҷͬܶ____%ΪΥԼ
2ҷҪкͬģÿڽһգÿӦҷ֧_____ɽ𣻼Ӧеڽҷɵʧ
3ڼάҷ֯άģӦ֧ҷû۵𣬵ҷӦṩЧƾ֤
4ΥͬԼǰջطݵģӦԤҷʣڵ⣬Ӧպͬ_____%ҷ֧ΥԼ
5Ȩ覴ûǷⷿݶ±ͬЧʱӦ⳥ҷʧ
ʮһҷΥԼ
1ڼ䣬ҷΪ֮һģȨֹͬջظ÷ݣҷӦպͬ_____%֧ΥԼ֧ΥԼֲʧģҷӦ⳥ֱﵽֲȫʧΪֹ
(1)δͬ⣬ת⡢תʹõģ
(2)δͬ⣬ı䶯ݽṹݣ
(3)ı䱾ͬ涨;ø÷ݽΥģ
(4)Ƿۼ____ϵġ
2ڣҷڽɱͬԼӦҷķõģÿһ죬Ӧܶ____%֧ɽ
3ڣҷδͬ⣬;ģҷӦðͬ____%Ķ֧ΥԼ֧ΥԼֲʧģҷӦе⳥Ρ
4ҷ֧ÿһգҷ밴____֧ɽ
5ҷӦڽ÷ݡҷڹ黹ÿһӦ֧ԭ____ҷӦеڹ黹ɵʧ
ʮ
ͬ·飬˫Э̻⣻Э̻ɵģе_____ַʽ
1ٲίԱٲã
2йϽȨԺϡ
ʮ
1ɿԭʹܼͬлɵʧס˫еΡ
2Ҫķݣʹס˫ʧģеΡ
3ԭֹͬģʵʹʱ㣬µİ㣬ٲ
4ɿϵָ"ԤܱⲢܿ˷Ŀ"
ʮġԼ
1ͬδˣס˫Эһ£ɶͬΪͬɷָһ֣ͬ䲹ڿոдǦӡ־ͬЧ
2ס˫ǩ𱾺ͬʱԸԵȨףԸͬ涨ϸִСһΥͬһȨͬ涨⡣
3ͬ˫ǩ()֮Ч
4ͬһʽ_____ݣɼס˫ִ_____ݣͬȷЧ
()______
ˣ______
ǩڣ_____
ǩص㣺_____
ҷ()______
Ҫˣ______
ǩڣ_____
ǩص㣺_____
ⷿͬ 10
_____
ҷ_____
Լϸ
һԼڣ
ԼЧ______________________________գϼΪ_____
ڶΧ
____
ס_____
()_____
Ѱ֮˰
ϷԴסʽ
ÿһΪЧڣΪλ㣻
Ϸ۽ڱԼЧڱ֤סһ·ϷۣΥԼһµķ____Ԫ/ÿ㡣
ںԼЧڣסѡãסҵ꣬м____+____%Żݡ
ʽ
3.1 ҷԤ____ԪΪѺ
3.2 ҷÿֽ֧ͷˢÿӷѣ
3.3 ҷÿһϸڷ⣬ȨֹԼΪҷΥԼ
κ
4.1 ṩ
4.2 ṩ`ͷƷ
4.3 豣Ͽͷ豸ʩ
ҷκ
5.1 ҷؼסһй涨
5.2 ҷڷʳƷɴȼױΣƷ뷿䣻
5.3 ҷھƵڴκΥлɷĻ
5.4 ҷϧƶı䡢豸ʩеӦ⳥Σ
5.5 ҷΪ²֡ĵȣɵһʧҷе⳥Ρ
סŻݣ
6.1 ÿṩʽһݣ
6.2 ϴ·ϴ_____Żݣ
6.3 ṩˮһ̨
6.4 ÿһ
6.5 ÿ2űȯ(ԤȨ)
6.6 ÿͱֽһ(____)
6.7 Ƶ______Ż(̡ˮʡͲͷ)OKʿ߿____Ż
6.8 Ƶ공ӷ(Ÿΰ)______Żݡ
ΥԼΣ
ЭЧڣЭ˫赥ֹЭ飬еΥԼΣҷЭЧ˷ΥԼΪҷδסʱ꣬ȡΥԼ5000Ԫҷסµδһʱ꣬ȡΥԼ10000Ԫ(赲֮¼⣬սȻֺ)
ڰ
˫ͬ⣬ǩЧԼһʽݡÿҳ˫ִһݣδˣͬЭ̽
(ǩ)____ ҷ(ǩ)_____
ˣ_____ ˣ______
ַ____ ַ_____
ϵ绰____ ϵ绰_____
룺____ 룺_____
У____ У_____
˺ţ____ ˺ţ_____
֤룺_____ ֤룺______
_______________ ________________
ⷿͬ 11
ˣ____¼ơ
֤ţ______
ϵˣ____
ϵ绰______
ϵص㣺______
ˣ____¼ơҷ
֤ţ______
ϵˣ____
ϵ绰______
ϵص㣺______
֤______
ϵˣ____
ϵ绰______
ϵص㣺______
ݡлͬطɷĹ涨ס˫ƽȡԸĻϣ___·______Ԫ___ݳҷʹãΪȷ˫ȨЭһ£ͬ
һݵʩ
1ⷿ___ƽף
2÷ʩ豸ͬ
øΪձͬԼҷʹúҷڱͬ÷ʱݡ
ڶҷӦṩ֤ӡʹá
ޡ;
1÷Ҽꡣ________________ա
2ҷŵ÷ݽΪӼסʹá
3ȨջسⷿݣҷӦڽ
ҷҪ⣬һ֮ǰ֪ͨͬǩͬ
֧ʽ
1÷ÿΪ___Ԫд___Ԫ
2֧ʽ£
ҷǩͬʱһ֧___ԪͬʱѺ___ԪѺҷ黹Կײˮ硢ȷúһϢ˻
ʹ
1ڣˮ硢ֵӵȵʹ÷Ѽճάޱҷе
2ҷӦʹķݼ丽ʩƷģҷӦռ⳥
ҷı䷿ݵڲṹװöԷݽṹӰ豸ƹģΧաϵȷü'ͬʩҷεģξҷе
ݵתת
δͬ⣬ҷת⡢תⷿݡ
Լ_____
ڰͬ˫ǩֺЧ
ھͬһʽݣɼס˫ִһݡͬȷЧ
ǩ£_____
ҷǩ£______
Ȩǩ£_____
Ȩǩ£_____
ʺţ______
ʺţ_____
ǩڣ________
ǩڣ________
ǩص㣺_____
ⷿͬ 12
ⷽ()______
ⷽ(ҷ)______
֮____________ƽס豸__________ס˫()ѺЭ̣ʹͬС
һ;Ϊ_______֮ãá
ޣݶ______꣬________________________ֹÿΪ_____Ԫ(______Ԫ)
ʽҷÿ______Ӧ___Ԫÿǰ_____ڽ塣
ġͬǩ֮գҷ___ԪΪѺ𣬴ӦѺϢ˻ҷ
塢ҷԼǷѺ𣬼ÿ찴Ƿֵ____%ɽ𣬲ȨҷǷǰͬջطݡ
ڼ䣬˫ýʽͬһҪͬʱǰҼ֪ͨԷԷͬ⣬ͬ黹ݣ⳥ΥԼҼ¡ɿԭ(֡߱仯)ڴ
ߡҷҪ____סø÷֮зǷҷҪгеɴ.һзΣŲȨǰֹͬ
ˡڼڣҷ;øתס()辭ͬ⣬˽ת⡣
šڼ䣬ҷӦˮ 绰 ѡ
ʮڼ䣬ҷӦϧһ豸ʧ÷ݼʩӦָݼʩԭ״ָӦ⳥
ʮһҷӦʱݹ黹ҷ⣬ǰЭ̣ͬ£ҷȳȨҷ˳ʱмҾȲòߣΪɼҷ顣
ʮͬǩ֮յĵΪ______ˮΪ______úΪ______
ʮͬδˣɼס˫Э̽ⶨЭ顣
ͬǩ֮ЧͬҼʽݣס˫һݣҼݣݶͬȷЧ
ⷽ()_____ⷽ(ҷ)_____
________________________
ⷿͬ 13
ͬǩ_____________________
()_______________
֤ţ_______________
ݹвȨˣ_______________
֤ţ_______________
ݹвȨˣ_______________
֤ţ_______________
DZͬݵĹвȨ
(ҷ)_______________
֤ţ_______________
ݡͬзزйطɷ֮涨˫ƽȡԸЭһµĻϣҷǩͬʹִͬС
һݵĻǨø÷ݵİã______________________________;Ϊ_____________________䣬λ_____________________ƽסҷԼķ˳˽⣬Ը÷ݡ
ڶڲʩ豸װޣˮ硢ܵúȫͨ豸
ͬΪ÷ǼͥͬƲ÷ûвȨףڷݵѺծȨծԼȨ覴áδɼеҷκΡ
Ľ۸ɽ۸Ϊ______Ԫ(д______Ԫ)
ʱ䣺__________________ǰ
ݵĽ
(1)ӦڽսǨ÷صһк÷йص.ļƱݽҷ
(2)ҷʹõķӦԣʩ豸ʵԡ
(3)÷ݽʹǰˮ硢úطɼȫ塣
ӦýеȫȫǨ
ڰԱԺҪݲȨ֤֤˫Э̣ԼС
1ݰȨ֤ʹȨ֤ɵ˰պͷþɼеºӦȡ֮______ڣ쵽IJȨ֤齻ҷ
2Ѱ·ݲȨ֤֤֮Ӧ֪ҷԼݲȨ֤Լº______ڼЭҷݲȨ֤֤ط(˫ѡӪҵ˰)ȫҷеӦṩһ֮йص(ݲȨ˵IJȨ֤֤ݲȨ˽֤ӡݲȨ˷˫֤ӡݹͬ۵)κηʽܾӡ
ھΥԼ
1ڽδԼݼ丽Կȫҷ`ΪΥԼӦ֧ΥԼ______Ԫҷ
2ڽӵݲȨ֪ͨ______ղȥӦȨ֤֤ģΪҷΥԼӦ֧ΥԼ______Ԫҷ
3ԽͬԽͬҷȨҪкͬҪ˻ҷѸȨҪ֧ͬн˫ϢͬʱȨҪ֧ΥԼ______Ԫҷ
4ݱͬ`ԼݺͲȨ֤齻ҷΪΥԼҷȨҪݺͲȨ֤飬ȨҪ֧ΥԼ______Ԫ
5ݱͬԼڳ֤______첻ЭҷģΪΥԼҷȨҪкͬȨҪ֧ΥԼ______Ԫ
ʮͬЧرԼͬЧرڱͬȷЧ______⳥ҷʧ______Ԫ
ʮһͬĽʽ
˫ѺЭ̣ƽԭǩͬǩͬ˫ӦϸִУκɷڡԼз飬˫ͨЭ̽Э̲ɵģ˫һͬͬڵصطԺϡ
ʮͬδˣ˫Լ䲹ԼɼҷͬЭ̽뱾ͬͬȷЧ
ͬ˫ǩ֮ʱЧͬһʽݣȨ˹һݣҷһݣһ汸顣
_______________
ҷ_______________
ˣ_______________
__________________
ⷿͬ 14
ⷽ¼Ƽ_____
ⷽ¼ҷ_____
ס˫зݵЭ飺
һݻ
ݣ¼Ƹ÷ݣ_______________㡣
ڶ;
÷;Ϊס
˫Լ⣬ҷı䷿;
__________________ֹ
÷ΪҴдǧʰԪ
ʽ
1Ѻһ
2ÿǰ10콻ҷÿ֧
ӦڱͬЧ֮𣬽ݽҷ
ά
ճķάɼҹͬеҷʹòɷݼ豸.`ʧάãҷе⳥ʧ
ڼ䣬ȫǰۺȫȹҷӦִейزŹ涨еȫκͷӼල顣
ڰڷڼйط
ڷڼ䣬·ҷ֧
1ˮѣ
2úѣڣ÷ݽҷ
ھѺ
ס˫Աͬǩ֮ҷ֧൱1·ĽΪѺ
ʮ
1ҷҪޣͬޣ
2δȷʾģΪͬҷ⣻
ʮһΥԼ
ڼҷδһ꣬ҷݳȥ˻ѺҷߣѺ˻
ʮͬ˫ǩ£Ч
ʮͬһʽ_____ݣɼס˫ִ_____ݡͬȷЧ
_____
ҷ_____
ǩڣ_____
ⷿͬ 15
ⷽ_________________
֤룺________________
ҷⷽ__________________
֤룺________________
˫Э̼λ_____________ݳҷסʹá
һⷿ_______________________ֹ
Ϊ____ԪΪ____֧һΣңд_________Ԫ____ԪԺӦǰ___֧
Լ
1ҷסʱӦʱءʹò֡硢ֺȷȻֺʧҷ
2ҷȨת⡢ת衢ת÷ݣڼҾҵ磬ԸĶݽṹʩΪԭʧӦάãռ⳥÷𣬷©ˮ̨ڷšİȫʧԸ
3ҷ밴ʱɷ⣬ΪҷΥԼЭֹ
4ҷӦؾסڸƶȣʱˮ硢ˡ绰ҵȷá
5֤÷ȨסǨҷѽδ˻
6ע________________________
ġͬһʽݣ˫ǩ֮Чˮ_____֣____磺___ȡ
ǩ£ⷽ
ҷǩ£ⷽ
ڣ_______________
ⷿͬ 16
ⷽ_______________(Ƽ)
ַ_______________________
绰_______________________
ⷽ_______________(ҷ)
ַ________________________
绰________________________
Ϊ˷չľý裬ߵλ˷ݵʹʣָݹҺʡе`йط棬˫Э̣һͬǩͬͬ£
һ_____________________·()________()____ŵķݣ______(________)ҷ__________ʹá
___________________סլ________ŵķݡ_______(____________)ҷ______________ʹá
ڴ________________________ֹ(________)
ҷÿ()____Ԫڵ()____ڽ塣
ġͬЧҷӦ·____ԪΪԼ֤𣬺ͬ˻ҷ
塢ⷿݵķز˰˰ʹ÷ѡⷿݹ________ɣˮѡѡݹ____
ҷԼǷÿ찴20%ɽǷϣȨջطݣȨܾԼ֤
ߡҷԸı䷿ݵĽṹ;ҷʧ÷ݺ豸ĻӦָԭ״⳥ʧΡ
ˡӦⷿݵ``άޣίгⷽάޣά㣻άίάɷݻҷΣ⳥ҷľʧ
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
ʮġͬɾ֤֤ͬһʽ____ݣ˫ִһݣ֤һݣ˰һݣһݣͬȷЧ
ˣ(ǩ)______________
ˣ(ǩ)______________
_________________
쵥λ(ǩ)____________
______________
ⷿͬ£
ⷿͬ07-08
ⷿͬ08-02
ⷿͬ08-09
ⷿͬ02-07
ⷿͬѡ02-15
ⷿͬ02-22
ⷿͬ02-03
ѡⷿͬ07-11
ⷿͬ06-23
ⷿͬ07-21