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["附件1"]
["中南大学教职工及配偶福利房情况调查表"]
["基本情况",null,"姓名","性别","身份证号",null,null,"工作单位及部门",{"$nulls":3},"职称职务","参加工作时间\n（年/月）","备注"]
["本人","本人"]
["配偶","配偶"]
["本人是否有或有过单位（含原工作单位）或政府部门的福利房：是（ 　） 否（　 ）；是否领取住房补贴：是（ 　） 否（　 ）"]
["福利房基本情况","序号","房屋地址",null,"建筑面积","房产类别","房屋所有权人","房屋所有权证号","获得时间","处置情形","处置时间","售房单位意见（加盖公章）"]
[null,1,{"$nulls":9},"               签字：      年  月   日"]
[null,2,{"$nulls":9},"               签字：      年  月   日"]
["配偶是否有或有过单位（含原工作单位）或政府部门的福利房：是（ 　） 否（　 ）；是否领取住房补贴：是（ 　） 否（　 ）"]
["福利房基本情况","序号","房屋地址",null,"建筑面积","房产类别","房屋所有权人","房屋所有权证号","获得时间","处置情形","处置时间","售房单位意见（加盖公章）"]
[null,1,{"$nulls":9},"               签字：      年  月   日"]
[null,2,{"$nulls":9},"               签字：      年  月   日"]
["说明：1.房产类别指房改房、集资房、经济适用房。\n      2.处置情形指已出售、继承、赠与、退还单位。\n      3.售房单位指原售房单位或政府住房保障部门。\n      4.有或有过中南大学（含各校区）出售的福利房的暂不用单位盖章，待二级单位统一收齐报送房产处后，由房产处一并审核盖章。"]
[" 本人承诺：上述信息本人已认真核实，承诺所填内容真实、准确、完整。\n"]
["                                                                                 本人签名：                        日期：         年   月   日   "]