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Э鷶

ڣ

_________޹˾(׷)һλй_________ҵһרṩϽƽ̨ĵ˾

_________˹ɷ޹˾(ҷ)ӪййڰСҵۺ񡣼׷ѾͬҷΪϽṩͷͻΪ˫ͬǩһսԺЭ顣

ˣ˫ƽȻƻԭ򣬾ͽɳڡȫĵսԻϵʵԴͬչΪԺĿϵĺһʵĻѺЭ˫Э

1.

Ʒָڼ׷ϵͳ-_________Ͻн׵ĸֲƷ

ͬЭƷĶ塣

Ӧָ̣_________Ͻн׵ĹȻˡ˺֯

ͻϵָͨ_________ϵͳƷȻ˺ͷԼ֯

۸ϵָ_________˹ɷ޹˾ṩ_________ͻļ۸

ҷϵָ_________˹ɷ޹˾з֧

ϵָҷƷʹͻеĹ̡

Ժл񹲺͹ڵķԺ

ɣл񹲺͹ķɡ

2.ʽ

(1)ҷΪͨ׷_________ϵͳƷĿͻṩ(յɿͻָ)

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(2)׷Ϊҷʵ_________ṩӦ֧ƵԱҷ˾Ϻͷ۸ͱ׼Լϵʽṩ_________Ŀͻѡ

(3)ͻѡҷҷչӦṩķҪ͡ (4)гֵ˻⣬ҷʵг

(5)˫ĺʽûԣ˫ںͬʱԺӦĺк

(6)˫ɾȺʽнһ̽֡

3.׷Ȩ

(1)׷ȨѡΪԼչҵĺ顣

(2)׷ȨҷںΧڵпˡ

(3)׷Ȩϸߡ

(4)׷Ȩ_________ƽ̨Ͻн׵ĹӦ̽й

(5)׷յ׹򽫿ͻĶʱ֪ͨӦ̡

(6)׷ײƷıա

(7)ҷṩļ۸ͷ׼ǹҹı׼׷ӦýҷṩӦʵʽͻʾ

(8)׷֤ҷӦõ棬Ϊ_________׼Ϳͻ빩Ӧ̵Ľ׾׶Ӱҷʱõõõ档

(9)׷ҷṩݺ벢رܹ

(10)׷Խ׵ĺϷԺͲƷĺϷԸ

4.ҷȨ

ҷΪ׷ĺ飬ΪеĶṩ̣ںӦȨ

(1)ҷȨҪ_________н׵ĹӦ̽͵ҷָĵص㡣Ҫҷṩȡ۸ҷ빩Ӧ̽Э̡ (2)ҷ밴չ_________ϵļ۸ͷ׼ṩ

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(3)ҷֹܾͣݣҲܸIJƷȨʡ

(4)ҷṩļ۸Ǵӷصͻϵļ۸񡣵Ӧ̴ȡļ۸

(5)ҷֻԹӦṩƷװ𣬼װõ£Ѿ֤ҷʵı׼

(6)ҷȨܾӦṩװѾIJƷ߾鷢Ʒ

(7)ҷֻչӦ̵ҪзԹӦҪķصĶԴ

(8)ҷԻʹԭɵ𻵺ʹʧ𣬶ԲƷͺŵĶԴ

(9)ͻ˻ɼ׷͹Ӧ̸ҪҷʱܺṩģɹӦ̳е׷Ҫ֤üʱҷʻ

(10)ҷڲ֪£ԲƷĺϷԺͽ׵ĺϷԲ

5.Լ

(1)׷ҷṩݺ롣׷֤ӵĽǶȶҷӦʵһʽһתͻ빩Ӧ̻׷ľףܹӰ˸Լ

(2)˫Э̣˫ͬ⵱ҷڴУÿµ泬_________ʱڳIJ֣ҷ׷_________%ĸлѡ

6.Ʒչ

˫ϿɽԼзյĴڣ׷ӦøײƷķչ

ʹͻеĻﱣգ׷аҲίҷУշӦɼ׷ȫ֧׷ﱣգڲƷʹͻзķҷԭɵIJƷʧ𻵱Ӧɱչ˾⸶ģҷΡ 7.⸶

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ΪҷԭɻͶʧģҷҪ⳥⳥ʽǼ׷ͻ߹Ӧ⳥Ȼ˫Э⳥ˡ

8.Ч

(1)۵Чڣҷṩ۸Ч___________________________ա

(2)ЭЧڣЭǩ֮ЧЭЧ___________________________ա

(3)Эκ޸Ч

9.ͱ֤

סҷ໥ͱ֤

(1)סҷǰڿչľӪл񹲺͹عҵ÷ɷ棬ûзͥδĻԤڵĵ顣

(2)סҷҵ񼰷зҪ󣬲ÿչҵṩκɼ׼ҲκΥΪԸõҪɼ׼ĹԤڵΥ򳷻ء

10./й

ЭаϢǻܵġ

ڱЭЧڼֹ󣬼׷ҷýЭеκϢй¶κεκβϼϢϸܡ

׷Ӧϸҷ_________idܣ׷Ӧ⳥ɴ˸ҷɵľʧ

ҷָӦ֤Աó׽бرЭУ׷ۡҵ񡢿ͻгϢĻܡ

˫ͬмͬҷӦѼ׷ԼϵͳеĸݺϢҷԱʹá¶ϢҷӦʹ׷еӦΥԼ⳥(⳥ͨ˫Эȷ)ɼ׷شʧģ׷ͨ;Ȩ

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