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<DIV align=center><FONT size=6><SPAN style="FONT-SIZE: 26px"><BR></SPAN></FONT><STRONG><FONT size=6><SPAN style="FONT-SIZE: 26px">支出证明单</SPAN><BR></FONT></STRONG></DIV>
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<DIV style="LINE-HEIGHT: 1.5" align=left><FONT size=3>科目{DATA_103}帐页（{DATA_104}）<FONT size=1> </FONT></FONT></DIV></TD>
<TD style="BORDER-BOTTOM: #000000 1.5pt solid; BORDER-LEFT: #000000 1pt; BORDER-TOP: #000000 1pt; BORDER-RIGHT: #000000 1pt" vAlign=middle colSpan=6><FONT size=3>日期{DATA_105}</FONT></TD></TR>
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<DIV style="LINE-HEIGHT: 1.5" align=center><FONT size=3>摘 要 及 用 途</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5">{DATA_113}</DIV></TD></TR>
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<DIV style="LINE-HEIGHT: 1.5" align=center><FONT size=3>金 额</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5" align=left><FONT style="FONT-SIZE: 12pt"><FONT style="FONT-SIZE: 12pt">{DATA_106}</FONT></FONT></DIV></TD></TR>
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<DIV style="LINE-HEIGHT: 1.5" align=center><FONT size=3>不 能 取 得</FONT></DIV>
<DIV style="LINE-HEIGHT: 1.5" align=center><FONT size=3>单 据 原 因</FONT></DIV></TD>
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<DIV>{DATA_114}</DIV></TD></TR>
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<DIV style="LINE-HEIGHT: 1.5" align=center><FONT size=3>签 署</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT size=3>会计</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT style="FONT-SIZE: 12pt">{DATA_107}</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT size=3>出纳</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT style="FONT-SIZE: 12pt">{DATA_108}</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT size=3>主管</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT size=3>{DATA_109}</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT size=3>验收</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT size=3>{DATA_110}</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT size=3>经手</FONT></DIV></TD>
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<DIV style="LINE-HEIGHT: 1.5"><FONT size=3>{DATA_111}</FONT></DIV></TD></TR>
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<DIV style="LINE-HEIGHT: 1.5" align=right><FONT size=3>第</FONT>{DATA_112}<FONT size=3>号</FONT></DIV></TD></TR></TBODY></TABLE></DIV></DIV></DIV></DIV></DIV></DIV></DIV>