<div style="text-align: center"><strong>
<div align="center"><span style="font-size: 26px"><strong>
<div style="layout-grid:  15.6pt 0pt; text-autospace: ideograph-alpha ideograph-numeric" align="center">
<div style="text-align: center; layout-grid:  15.6pt 0pt; text-autospace: ideograph-alpha ideograph-numeric"><font face="Calibri" style="font-size: 15pt"><span style="font-size: 32px"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 17pt"><strong>请款（借支）申请单</strong></font></font></span></font><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 15pt"><strong><br />
</strong></font></font></div>
</div>
<div align="center">
<div style="layout-grid:  15.6pt 0pt; text-autospace: ideograph-alpha ideograph-numeric">
<div style="layout-grid:  15.6pt 0pt; text-autospace: ideograph-alpha ideograph-numeric" align="center">
<div style="layout-grid:  15.6pt 0pt; text-autospace: ideograph-alpha ideograph-numeric" align="center"><font style="font-size: 14pt">
<table class="xdLayout" tabindex="65535" border="1" bordercolor="#ffffffffffffffffffffffff" style="border-bottom: medium none; border-left: medium none; width: 678px; border-collapse: collapse; word-wrap: break-word; table-layout: fixed; border-top: medium none; border-right: medium none">
    <colgroup><col style="width: 104px" /><col style="width: 238px" /><col style="width: 223px" /><col style="width: 113px" /></colgroup>
    <tbody valign="top">
        <tr style="min-height: 28px">
            <td style="border-bottom-color: ; border-top-color: ; border-left-color: ; border-right: black 1pt">
            <div><font style="font-size: 14pt">申请人：</font></div>
            </td>
            <td style="border-bottom-color: ; border-left: black 1pt; border-top-color: ; border-right: black 1pt">
            <div><font style="font-size: 14pt">{DATA_22}</font></div>
            </td>
            <td style="border-bottom-color: ; border-left: black 1pt; border-top-color: ; border-right: black 1pt">
            <div style="text-align: right"><font style="font-size: 14pt">申请日期：</font></div>
            </td>
            <td style="border-bottom-color: ; border-left: black 1pt; border-top-color: ; border-right-color: ">
            <div><font style="font-size: 14pt">{DATA_23}</font></div>
            </td>
        </tr>
    </tbody>
</table>
</font></div>
</div>
<div align="center">
<table class="xdLayout" tabindex="65535" border="1" bordercolor="#ffffff" style="border-bottom: medium none; border-left: medium none; width: 499.5pt; border-collapse: collapse; word-wrap: break-word; table-layout: fixed; border-top: medium none; border-right: medium none">
    <colgroup></colgroup>
    <tbody valign="top">
        <tr style="min-height: 32.25pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 1.5pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">请款金额</font></font></div>
            </td>
            <td width="232" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 1.5pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric">&#160;{DATA_71}</div>
            </td>
            <td width="110" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 1.5pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">请款用途</font></font></div>
            </td>
            <td width="180" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 1.5pt solid; border-right: #000000 1.5pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><u>
            <div style="line-height: 1.5; text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 12pt">{DATA_20}</font></div>
            </u></font></div>
            </td>
        </tr>
        <tr style="min-height: 32.25pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">请款方式</font></font></div>
            </td>
            <td width="232" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="line-height: 1.5; text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 12pt">{DATA_21}</font></div>
            </font></div>
            </td>
            <td width="110" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">货币币种</font></font></div>
            </td>
            <td width="180" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">{DATA_24}</font></div>
            </font></div>
            </td>
        </tr>
        <tr style="min-height: 32.25pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">请款金额</font></font></div>
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">（大写）</font></font></div>
            </td>
            <td width="232" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px">{DATA_25}</span></font></div>
            </font></div>
            </td>
            <td width="110" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">（小写）</font></font></div>
            </td>
            <td width="180" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="text-autospace: ideograph-alpha ideograph-numeric">&#160;{DATA_72}</div>
            </font></div>
            </td>
        </tr>
        <tr style="min-height: 32.25pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">请款部门</font></font></div>
            </td>
            <td width="232" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px">{DATA_29}</span></font></div>
            </font></div>
            </td>
            <td width="110" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">部门负责人</font></font></div>
            </td>
            <td width="180" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px">{DATA_28}</span></font></div>
            </font></div>
            </td>
        </tr>
        <tr style="min-height: 32.25pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">收款单位全称</font></font></div>
            </td>
            <td width="232" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px">{DATA_27}</span></font></div>
            </font></div>
            </td>
            <td width="110" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">合同号</font></font></div>
            </td>
            <td width="180" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px">{DATA_30}</span></font></div>
            </font></div>
            </td>
        </tr>
        <tr style="min-height: 31.5pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">收款单位账号</font></font></div>
            </td>
            <td width="522" colspan="3" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px">{DATA_32}</span></font></div>
            </td>
        </tr>
        <tr style="min-height: 44.25pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">备注</font></font></div>
            </td>
            <td width="522" colspan="3" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px">{DATA_31}</span></font></div>
            </td>
        </tr>
        <tr style="min-height: 56.25pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">部门主管审批</font></font></div>
            </td>
            <td width="522" colspan="3" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-align: center; text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px"><span style="font-size: 18px">{DATA_33}</span></span></font></div>
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt"><span style="font-size: 18px"><span style="font-size: 18px">
            <div style="text-align: right; line-height: 1.5; text-autospace: ideograph-alpha ideograph-numeric"><span style="font-size: 18px">{DATA_34}</span></div>
            </span></span></font></div>
            </td>
        </tr>
        <tr style="min-height: 57pt">
            <td width="139" style="border-bottom: #000000 0.75pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">财务主管审批</font></font></div>
            </td>
            <td width="522" colspan="3" style="border-bottom: #000000 0.75pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-align: center; text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">{DATA_36}</font></div>
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <p style="text-align: right">{DATA_38}</p>
            </font></div>
            </td>
        </tr>
        <tr style="min-height: 57.75pt">
            <td width="139" style="border-bottom: #000000 1.5pt solid; border-left: #000000 1.5pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 0.75pt solid">
            <div style="text-autospace: ideograph-alpha ideograph-numeric" align="center"><font face="Calibri" style="font-size: 10.5pt"><font face="宋体" style="font-size: 12pt">总经理审批</font></font></div>
            </td>
            <td width="522" colspan="3" style="border-bottom: #000000 1.5pt solid; border-left: #000000 0.75pt solid; layout-grid:  15.6pt 0pt; vertical-align: middle; border-top: #000000 0.75pt solid; border-right: #000000 1.5pt solid">
            <div style="text-align: center; text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">{DATA_37}</font></div>
            <div style="text-autospace: ideograph-alpha ideograph-numeric"><font face="Arial" style="font-size: 12pt">
            <div style="text-align: right; line-height: 1.5; text-autospace: ideograph-alpha ideograph-numeric"><span style="font-size: 18px">{DATA_39}</span></div>
            </font></div>
            </td>
        </tr>
    </tbody>
</table>
</div>
<div style="layout-grid:  15.6pt 0pt; text-autospace: ideograph-alpha ideograph-numeric">&#160;</div>
</div>
</div>
<div style="layout-grid:  15.6pt 0pt; text-autospace: ideograph-alpha ideograph-numeric" align="center">&#160;</div>
</strong></span></div>
</strong></div>