<div align="center"><font size="5" face="方正小标宋简体"><br />
用印申请表</font></div>
<div>&#160;</div>
<div align="center">
<table class="xdLayout" tabindex="65535" border="1" bordercolor="#ffffff" style="border-bottom: medium none; border-left: medium none; width: 680px; border-collapse: collapse; word-wrap: break-word; table-layout: fixed; border-top: medium none; border-right: medium none">
    <colgroup><col style="width: 140px" /><col style="width: 200px" /><col style="width: 140px" /><col style="width: 200px" /></colgroup>
    <tbody valign="top">
        <tr>
            <td style="border-bottom: black 1pt solid; border-left: #000000 2.25pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 2.25pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">申请人</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 2.25pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center">{DATA_1}&#160;</div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 2.25pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">申请部门</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 2.25pt solid; border-right: #000000 2.25pt solid; padding-top: 1px">
            <div align="center">{DATA_2}&#160;</div>
            </td>
        </tr>
        <tr>
            <td rowspan="2" style="border-bottom: black 1pt solid; border-left: #000000 2.25pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">申请时间</font></div>
            </td>
            <td rowspan="2" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center">{DATA_3}&#160;</div>
            </td>
            <td rowspan="2" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">申请种类</font></div>
            </td>
            <td rowspan="2" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: #000000 2.25pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">{DATA_6}公章 {DATA_7}合同章</font></div>
            </td>
        </tr>
        <tr>
        </tr>
        <tr>
            <td style="border-bottom: black 1pt solid; border-left: #000000 2.25pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">用印次数</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center">{DATA_8}&#160;</div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">份数</font></div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: #000000 2.25pt solid; padding-top: 1px">
            <div align="center">{DATA_9}&#160;</div>
            </td>
        </tr>
        <tr>
            <td style="border-bottom: black 1pt solid; border-left: #000000 2.25pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">用印内容</font></div>
            </td>
            <td colspan="3" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: #000000 2.25pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_10}&#160;</div>
            </td>
        </tr>
        <tr>
            <td rowspan="2" style="border-bottom: black 1pt solid; border-left: #000000 2.25pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">综合管理部意见</font></div>
            </td>
            <td style="border-bottom: #000000 1pt; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_11}&#160;</div>
            </td>
            <td rowspan="2" style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: black 1pt solid; padding-top: 1px">
            <div align="center"><font size="4" face="宋体">CEO审批</font></div>
            </td>
            <td style="border-bottom: #000000 1pt; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: black 1pt solid; border-right: #000000 2.25pt solid; padding-top: 1px">
            <div style="text-align: left">{DATA_13}&#160;</div>
            </td>
        </tr>
        <tr>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 1pt; border-right: black 1pt solid; padding-top: 1px">
            <div style="text-align: right">&#160;{DATA_12}</div>
            </td>
            <td style="border-bottom: black 1pt solid; border-left: black 1pt solid; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 1pt; border-right: #000000 2.25pt solid; padding-top: 1px">
            <div style="text-align: right">{DATA_14}&#160;</div>
            </td>
        </tr>
        <tr>
            <td colspan="4" style="border-bottom: #000000 1pt; border-left: #000000 1pt; padding-bottom: 1px; padding-left: 1px; padding-right: 1px; vertical-align: middle; border-top: #000000 2.25pt solid; border-right: #000000 1pt; padding-top: 1px">
            <div align="left"><font size="4" face="宋体">注：此表由印章管理人保管，以备查询。</font></div>
            </td>
        </tr>
    </tbody>
</table>
</div>