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["普宁市公共租赁住房申请表\n（适用于城镇中低收入家庭申请对象）"]
["                                                档案编号："]
["申请人姓名",null,"性别",null,"身份证号码"]
["工作单位",null,null,"单位地址"]
["家庭（个人）基本情况"]
["家庭人数",null,"就业人数",null,"家庭电话"]
["年总收入",null,"年人均收入",null,"联系电话"]
["车辆情况",null,null,"存款和有价证券价值"]
["户籍地址",null,null,"现住址"]
["家庭（个人）住房状况"]
["□自有  □租住 □借住 \n□其他                        ",null,"总居住\n建筑面积",null,"人均居住\n建筑面积"]
["登记对象（只勾选一项）","□城镇低收入家庭（廉租对象）     □城镇中等收入家庭     "]
["申请意向（只勾选一项）","□池尾新寮点     □莲花山公园点"]
["是否持有□《广东省城乡居民最低生活保障证》 □《广东省城乡特困人员救助供养证》"]
["持证人",null,"发证日期",null,"证书编号"]
["共同申请家庭成员情况（表格不够可另附页）"]
["姓  名","性  别","申请人关系","身 份 证 号 码",null,"备    注"]
[]
[]
[]
[]
["                                 承诺书\n  本申请人由家庭成员一致推荐产生，并且有完全民事行为能力。本人对申请材料的真实性负责，同意住房保障主管部门核实本人申报信息，并承诺若以欺骗等不正手段进行申请的，愿意承担一切法律后果。"]
["                                              承诺人签名：                "]
["年    月    日  "]
["申请人从业单位意见（若申请人及其家庭成员无固定工作的，请在此栏作出说明）\n "]
[]
[" "]
[" "," ",null,null,"负责人：","          "]
[" ",null,null,"年    月    日"]
["初审意见"]
[]
[]
[]
[]
["             "]
[{"$nulls":3},"经办人：",null,"（公章）"]
[{"$nulls":5},"年    月    日"]
[]
["民政部门复核意见(仅申请廉租房对象需要)"]
[]
[]
[{"$nulls":5},"          （公章）"]
[{"$nulls":3},"  经办人：",null,"年   月   日"]
[]
["复审意见"]
["公示情况：",null,null,"意见："]
["    经公示，对申请人基本情况"]
["□有异议  "]
["□无异议"]
["    经调查，异议  "]
["             □成立    ",null,null,"经办人："]
["             □不成立"]
["              ",null,null,"负责人：",null,"         （公章）"]
["年    月    日",null,null,"年    月    日"]
["   备注：    1、此表适用于城镇中低收入家庭申请对象（含廉租房申请对象），新就\n                业人员和外来务工人员对象不适用于此表；"]
[null,"2、“申请人从业单位意见”栏，若申请人及其家庭成员均为无固定工作状\n   态，则申请人在该栏填写相关说明，并在“负责人”处签名；"]
["             3、“民政局复核意见”栏仅城镇低收入家庭（廉租房）对象需要填写；"]
["             4、本表须双面打印。"]

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