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["附件2"]
["广西城市（农村）低保申请审批表（适用审批权下放乡镇试点）"]
["受理时间：    年    月    日"]
["申请人家庭基本信息"]
["申请人",null,"户籍地址",{"$nulls":4},"现住地址",{"$nulls":3},"联系电话",null,null,"是否建档立卡贫困户",null,"入户调查情况"]
["家庭人口",null,"申请享受人口",null,"房屋套数（套）",null,"房屋面积（平方米）",null,"房屋性质",null,"房屋结构",null,"耕地面积（亩）",null,"林地面积（亩）"]
["申请前一日家庭存款现金总额",null,null,"手机数（台）",null,"电脑（台）",null,"冰箱（台）",null,"彩电（台）",null,"空调（台）",null,"其他家电"]
["船只数（辆）",null,"大车数（辆）",null,"小车数（辆）",null,"农用车数（辆）",null,"摩托车数（辆）",null,"其他（如收割机）"]
["年总收入",null,"年工资性收入",null,"年经营纯收入",null,null,"年转移性收入",null,null,"年财产性收入",null,null,"年其他收入"]
["低保领取人",null,null,"开户银行",{"$nulls":4},"银行账号",{"$nulls":4},"联系电话"]
["共同生活家庭成员","家庭成员","与申请人关系","身份证号",null,"性别","民族","婚姻状况","工作单位 （就业情况）","残疾等级","重病","常见病或慢性病",null,"上月水电费","上月通讯费","是否与申请人户口在一起"]
[]
[]
[]
[]
["非共同生活家庭成员","家庭成员","与申请人关系","身份证号",null,"性别","民族","婚姻状况","工作单位 （就业情况）","是否低保对象",null,"非共同生活原因"]
[]
[{"$nulls":16},"调查员（不少于2人，至少1名乡镇、街道干部）（签名）："]
["以上情况完全真实，如有虚假，本人愿承担一切法律责任。如有骗取社会救助资金行为的，本人退回非法获取的救助资金，并接受乡镇人民政府（街道办事处）1倍以上3倍以下的罚款"]
["申请人签名并按指印：                                                           年    月    日",{"$nulls":15},"年  月  日"]
["是否经办人员和村（居）民委员会成员近亲属享受低保需备案对象及备案情况"]
["民主评议意见",null,null,"委托核对信息反馈情况",null,null,"乡镇（街道）民政办初审意见",null,null,"乡镇人民政府（街道办事处）分管领导审核意见",null,null,"拟保障对象家庭情况公示（7天）",null,null,"乡(镇）人民政府主要领导审批意见"]
["（入户调查后经公示群众有异议的召开民主评议发，否则不需评议）"]
["经本民主评议小组评议（评议申请人申报情况及入户调查情况真实性、完整性）：\n                               。",null,null,"核对信息平台数据情况有（无）差异（如有差异的请列出具体差异情况）：\n                                。",null,null,"经审核，该申请人家庭符合城市（农村）低保条件，建议     （A、B、C）类低保家庭，每人每月补助    元。",null,null,"拟统一民政办意见，该申请家庭共\n    人，从    年    月起享受城市（农村）低保",null,null,"从    年    月    日至    年\n    月    日公示。群众无异议。",null,null,"同意分管意见"]
[{"$nulls":15},"乡镇人民政府（街道办事处）负责人（签名）："]
["评议小组：",null,null,"信息查询员：",null,null,"民政助理员：",null,null,"乡镇人民政府（街道办事处）分管领导（签名）：",null,null,"公示记录员：",null,null,"乡镇人民政府（街道办事处）（公章）："]
["年  月   日",null,null,"年  月   日",null,null,"年  月   日",null,null,"年  月   日",null,null,"年  月   日",null,null,"年   月   日"]