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["附1-3"]
["江门市外贸高质量创新发展资金\n短期进出口信用保险资金申请表"]
[{"$nulls":4},"填报时间："]
["企业名称",null,null,"联系人","姓名："]
[{"$nulls":3},"联系电话","固话/分机："]
[{"$nulls":4},"手机："]
["统一社会信用代码"]
["企业实际经营地址"]
["企业海关编码",null,null,"保单号"]
["工商登记机关",null,null,"区属"]
["投保时间","      年     月至       年     月"]
["上一年出口额",null,"万美元","当年出口额",null,null,"万美元"]
["投保金额",null,"美元","应缴保费",null,null,"元人民币"]
["保险公司垫付保费",null,"元人民币","已缴保费",null,null,"元人民币"]
["申请资助金额",null,"                 元人民币"]
["开户银行名称：                                 银行行号："]
["人民币开户银行帐号："]
["兹声明以上填报内容无讹并承担法律责任。"]
[]
["企业法定代表人（签名）                                         "]
[]
["                                    （ 企业公章）"]
["                                       年     月      日"]
["说明：1、企业名称需填单位全称；开户银行名称要填到地市级名称，如：XX银行江门城区支行；"]
["      2、银行帐号应为申请企业接收资助资金的人民币开户银行帐号；"]
["      3、固话如有分机，请提供分机号；"]
["      4、企业填报区属时请按照营业执照的登记机关所属地区填写；"]
["      5、联系人为申报该项目的经办人。"]

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