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["附2"]
["蓝田县临时救助申请审批表"]
["编号：",{"$nulls":8},"申请日期："]
["申请人姓名",null,null,"性别",null,"年龄",null,"身份证号码"]
["家庭住址",{"$nulls":6},"联系电话"]
["救助对象类别（证号）",null,"城市“三无”",null,null,"城市低保",{"$nulls":3},"城市低收入",{"$nulls":3},"城市困难"]
[null,null,"农村五保",null,null,"农村低保",{"$nulls":3},"农村困难"]
["申请理由","                                                      申请人签字：                     年    月    日    "]
["家庭成员\n基本信息（此项特困供养、低保、低收入对象不再填写）","关系","姓名","性别","出生年月","婚姻状况","身份证号码",null,"户籍地",null,"实际居住地"]
{"$rows_empty":9}
["                                                                                                               -11-"]

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["核定本年度家庭人均收入",null,null,"              年   月   日",null,null,"村（居）意见",{"$nulls":3},"                    （盖章）"]
[{"$nulls":6},"村（居）主任签字",{"$nulls":3},"                     年   月   日"]
["评议意见",{"$nulls":5},"公示情况及反馈意见"]
["评议组长签字",null,null,"年   月   日",null,null,"公示负责人签字",{"$nulls":3},"                     年   月   日"]
["镇街拟救助金额",{"$nulls":5},"农行卡号"]
["货币财产\n认定情况",null,null,"房产认定\n情况",null,null,"机动车辆\n认定情况",null,null,"其他认定\n情况",null,"镇（街）核查人签字","   年  月  日 "]
["镇（街办）\n审核意见","镇长签字：",{"$nulls":4},"县民   政局\n审批\n意见","根据相关文件规定，经审核资料，并经   月   日局长办公会研究，同意救助。救助金额        元。                                                                                                                           "]
[null,"分管领导签字："]
[null,"民政干部签字：            （镇街政府盖章）       ",{"$nulls":5},"经办人：        审核人：                   民政局盖章"]
[null,"                          年   月   日",{"$nulls":5},"                                        年   月   日"]
["注： 1、此表一式三份，镇政府、县民政局、财政局各存一份。"]
["     2、此表应附个人申请、村（居）委会困难认定证明、个人身份证复印件、全家户口本复印件、个人农行卡复印件。"]
["     3、城市三无、城乡低保、农村五保、城市低收入家庭应提供证件复印件。"]
["     4、救助对象因病的附诊断证明（市级以上医院）、意外事故的附相关证明材料及照片、就学的附在校证明或录取通知书复印件。"]
[]
["  -12-"]

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