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["北京市申领生育津贴人员信息登记表"]
["申领生育津贴次序号："]
["组织机构代码：","********","单位名称（章）：",null,"□□□□□□□□公司"]
["申领人公民身份号码","AAAAAAAAAAAAAAAAAA",null,"姓名","AAA","性别","女"]
["配偶证件类别","( ）公民身份证（ ）港澳台证（ ）护照"]
["配偶证件号码","BBBBBBBBBBBBBBBBBB",null,"配偶姓名","BBB"]
["配偶出生日期","****年**月**日","生育/引、流产日期","****年**月**日","终止妊娠前的怀孕周数","**周"]
["本次生育胎儿数","1（或2）","生育类别","( ）正常产（ ）难产（ ）引、流产"]
["产假终止原因","（  ）正常到期（  ）退休（  ）死亡（  ）其他"]
["是否为晚育","( √ )是   (  )否",null,"产假终止日期","不填"]
["申领晚育津贴人公民身份号码","AAAAAAAAAAAAAAAAAA或BBBBBBBBBBBBBBBBBB",null,"申领晚育津贴人员姓名","AAA或BBB"]
["产假包含产前15天","(   )是  (  )否",null,"申领人自愿选择(  )银行代发(  )单位发放 "]
["女方签字：","（女方手签）",null,"男方签字:","（男方手签）"]
["女方所在单位（盖章）    年   月   日",null,null,"男方所在单位（盖章）    年    月   日"]
["申请单位联系电话","400-8000-800",null,"申请单位邮编",100022]
["申请单位地址","北京市朝阳门南大街14号"]
["单位负责人:","（不填）","填报人:","（员工本人姓名）","填报日期:****年**月**日"]
["填表说明："]
["1. 在( )中划√进行选择；"]
["2. 在生育时采用产钳助产、胎吸、剖宫生育的,在生育类别中选难产；"]
["3. 申领晚育奖励津贴的，应夫妻双方签字确认，并加盖所在单位的公章。如果一方无单位，应在所在单位（盖章）处注明本人无单位；"]
["4.产假非正常到期的，应填写具体日期。"]
["5.女性生育时超过24周岁且为初育的属于晚育、"]
["6.申领生育津贴次序号由经（代）办机构填写。"]
["7.军人配偶应填写身份号码或军官证号。"]
["8.未登记个人银行账户信息的，默认为单位发放。"]
["9.此表一式二份，单位、社保经（代）办机构各一份"]

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["北京市申领生育津贴人员信息登记表"]
["申领生育津贴次序号："]
["组织机构代码：","********","单位名称（章）：",null,"□□□□□□□□公司"]
["申领人公民身份号码","AAAAAAAAAAAAAAAAAA",null,"姓名","AAA","性别","女"]
["配偶证件类别","( ）公民身份证（ ）港澳台证（ ）护照"]
["配偶证件号码","BBBBBBBBBBBBBBBBBB",null,"配偶姓名","BBB"]
["配偶出生日期","****年**月**日","生育/引、流产日期","****年**月**日","终止妊娠前的怀孕周数","**周"]
["本次生育胎儿数","1（或2）","生育类别","( ）正常产（ ）难产（ ）引、流产"]
["产假终止原因","（  ）正常到期（  ）退休（  ）死亡（  ）其他"]
["是否为晚育","(  )是   ( √ )否",null,"产假终止日期","不填"]
["申领晚育津贴人公民身份号码","不填",null,"申领晚育津贴人员姓名","不填"]
["产假包含产前15天","(   )是  (  )否",null,"申领人自愿选择(  )银行代发(  )单位发放 "]
["女方签字：","（女方手签）",null,"男方签字:","（男方手签）"]
["女方所在单位（盖章）    年   月   日",null,null,"男方所在单位（盖章）    年    月   日"]
["申请单位联系电话","400-8000-800",null,"申请单位邮编",100022]
["申请单位地址","北京市朝阳门南大街14号"]
["单位负责人:","（不填）","填报人:","（员工本人姓名）","填报日期:****年**月**日"]
["填表说明："]
["1. 在( )中划√进行选择；"]
["2. 在生育时采用产钳助产、胎吸、剖宫生育的,在生育类别中选难产；"]
["3. 申领晚育奖励津贴的，应夫妻双方签字确认，并加盖所在单位的公章。如果一方无单位，应在所在单位（盖章）处注明本人无单位；"]
["4.产假非正常到期的，应填写具体日期。"]
["5.女性生育时超过24周岁且为初育的属于晚育、"]
["6.申领生育津贴次序号由经（代）办机构填写。"]
["7.军人配偶应填写身份号码或军官证号。"]
["8.未登记个人银行账户信息的，默认为单位发放。"]
["9.此表一式二份，单位、社保经（代）办机构各一份"]

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["北京市申领生育津贴人员信息登记表"]
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["组织机构代码：","********","单位名称（章）：",null,"□□□□□□□□公司"]
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["配偶证件号码","AAAAAAAAAAAAAAAAAA",null,"配偶姓名","AAA"]
["配偶出生日期","****年**月**日","生育/引、流产日期","****年**月**日","终止妊娠前的怀孕周数","**周"]
["本次生育胎儿数","1（或2）","生育类别","( ）正常产（ ）难产（ ）引、流产"]
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["女方签字：","（女方手签）",null,"男方签字:","（男方手签）"]
["女方所在单位（盖章）    年   月   日",null,null,"男方所在单位（盖章）    年    月   日"]
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["申请单位地址","北京市朝阳门南大街14号"]
["单位负责人:","（不填）","填报人:","（员工本人姓名）","填报日期:****年**月**日"]
["填表说明："]
["1. 在( )中划√进行选择；"]
["2. 在生育时采用产钳助产、胎吸、剖宫生育的,在生育类别中选难产；"]
["3. 申领晚育奖励津贴的，应夫妻双方签字确认，并加盖所在单位的公章。如果一方无单位，应在所在单位（盖章）处注明本人无单位；"]
["4.产假非正常到期的，应填写具体日期。"]
["5.女性生育时超过24周岁且为初育的属于晚育、"]
["6.申领生育津贴次序号由经（代）办机构填写。"]
["7.军人配偶应填写身份号码或军官证号。"]
["8.未登记个人银行账户信息的，默认为单位发放。"]
["9.此表一式二份，单位、社保经（代）办机构各一份"]

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["北京市申领生育津贴人员信息登记表"]
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["组织机构代码：",null,"单位名称（章）："]
["申领人公民身份号码",null,null,"姓名",null,"性别"]
["配偶证件类别","( ）公民身份证（ ）港澳台证（ ）护照"]
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["配偶出生日期",null,"生育/引、流产日期",null,"终止妊娠前的怀孕周数"]
["本次生育胎儿数",null,"生育类别","( ）正常产（ ）难产（ ）引、流产"]
["产假终止原因","（  ）正常到期（  ）退休（  ）死亡（  ）其他"]
["是否为晚育","(   )是   (  )否",null,"产假终止日期"]
["申领晚育津贴人公民身份号码",null,null,"申领晚育津贴人员姓名"]
["产假包含产前15天","(   )是  (  )否",null,"申领人自愿选择(  )银行代发(  )单位发放 "]
["女方签字：",null,null,"男方签字:"]
["女方所在单位（盖章）    年   月   日",null,null,"男方所在单位（盖章）    年    月   日"]
["申请单位联系电话",null,null,"申请单位邮编"]
["申请单位地址"]
["单位负责人:",null,"填报人:",null,"填报日期:  年  月  日"]
["填表说明："]
["1. 在( )中划√进行选择；"]
["2. 在生育时采用产钳助产、胎吸、剖宫生育的,在生育类别中选难产；"]
["3. 申领晚育奖励津贴的，应夫妻双方签字确认，并加盖所在单位的公章。如果一方无单位，应在所在单位（盖章）处注明本人无单位；"]
["4.产假非正常到期的，应填写具体日期。"]
["5.女性生育时超过24周岁且为初育的属于晚育、"]
["6.申领生育津贴次序号由经（代）办机构填写。"]
["7.军人配偶应填写身份号码或军官证号。"]
["8.未登记个人银行账户信息的，默认为单位发放。"]
["9.此表一式二份，单位、社保经（代）办机构各一份"]