解除就业协议证明范文参考
_______________,性别,身份证号,于______年______月______日与_____________结婚登记,初婚未育,特此证明。盖上单位公章和日期。
兹有________________性别:________________男,女;出生日期:________________年________________月________________日
属于(未婚、初婚、再婚、离婚、丧偶)。
配偶姓名:________________(性别:________________男,女;出生日期:_______________)。
子女姓名:________________(性别:________________男,女;出生日期:________________),
出生证号:________________
准生证号:________________;
特此证明。
负责人签字:________________
单位名称:________________
(盖章)
年月日
单位详细地址:________________
联系电话:________________
更多相似范文
篇1:关于护士英文求职信
dear mr. chamberlaine:
hello!
i am a 04 session of hubei medical college senior students, immediately facing the graduate work is about to embark on, which will have a bearing on my future, so i did a careful selection, your hospital has always been my first employment goals, so i decided to submit this self-recom#mendation and sincere leadership, as the hospital to express their determination! thank you to continue to read my self-recom#mendation !
as before admitted to the universities to determine their own goals in life to be a "white angel" , so do so as soon as i started to learn medical knowledge, the four-year period in school, i not only com#pleted the outstanding achievements the university of courses, but also other medical knowledge often expo, including nursing, pathology, or microbiology, bacteriology, surgery .... in a series of professional medical knowledge, in order to enrich themselves to faster access to social role, i also participated in a school sponsored organizations have served as chairman of the student experience as i set foot on these jobs provided an important experience, i believe i can unite colleague, and leadership, the patient ... live in harmony!
because i am a fresh graduate, i am well aware that their knowledge remains in the realm of theory, which is why i am even more urgent need for your hospital can give me the opportunity to practice, i have to play their professional for patients the most serious medical services, for your contribution to the development of the hospital my light and heat!
篇2:班长的英文自我评价
At work, I am an active, serious and responsible person. Whether it is done in the class squad leader, or captain of team practice, I willing to pay, and strict demands on themselves, seriously, promptly and responsibly as we do everything their own things to do. I am a serious and responsible attitude and spirit willing to pay to obtain the courtyard teachers and students unanimous recognition and praise.
Farewell University, Bachelor of clothes to wear, get rid of all the vulgar and shallow wound, the show is a new self. From the silly to the wise, from the "greenhouse flowers" to the community, we bid farewell to some of the things that some people do not take anything away, except for one empty bags. Hopes and anxious coexistence, joy and love intertwined, what a wonderful feeling ah!
Although never to the extent of academic scholarship, but I learned a lot in the process. The first is their own self-learning ability improved, university courses rely on classroom attendance is totally inadequate.Shall own research and often go to the library to find some relevant information, over time. Again it is to understand the application of learning to think independently while focusing on learning alone is not going to work hard at hard study, to learn "approach." As the old saying words "Give a man a fish, as delegate to fish", I just want to learn "fishing." All beginnings are hard. But I did not give up. In learning, always remind myself to think independently, over time, my mind has also been a qualitative leap.
We can say that the university is the loose and a good cultural atmosphere trained me, so I have a solid professional knowledge, with a wide range of capabilities and quality, for their own out of school, to the community was fully ready. I believe I am capable of performing a variety of work. Of course, due to the lack of social experience, I have the ability to deal with other aspects of the matter is not very strong, still we need to hone the actual work, you need to continue to find deficiencies in the work, continue to improve.
Process is memorable, the harvest is abundant. In the blink of an eye on the upcoming three years like the past, in this short but fulfilling day, I learned a lot. Of course, I also know there are many who shortcomings, I believe that I will inherit learning and training in the future work and social life.
篇3:家庭贫困证明样本_贫困证明_网
贫困证明范文一:
兹有我乡(镇)(居委会等)×××(父母亲姓名)之子(女)×××(学生姓名),于××年××月考 入贵校学习 ,家庭困难证明书。由于×××原因(每个家庭的具体原因),导致家庭经济困难,希望学校、银行能为其提供国家助学贷款,帮助其顺利完成学业。
×××乡(镇)人民政府(公章)或×××居委会等(公章)
××年××月××日
贫困证明范文二:
本人,家有三个人,爷爷、父亲和我,母亲与父亲已离婚,(可以的话也写下母亲是否给予固定生活或者教育费用),爷爷身体不好需要长期吃药才能保持身体健康,父亲是个油漆工工资很低,只能简单的维持家庭的生活。家庭负担全都靠父亲微薄的收入,我的学费对于我的家庭更是一个不轻的负担,所以请学校给予支持。
此致
敬礼
日期
篇4:2024年出生证明
时间:(20xx)年(02)月(17)日
兹证明赵(男)于x年xx月xx日在(江苏省盐)城市出生。
赵父亲是赵yy,赵母亲是李zz。
中华人民共和国(福建省福州)市公证处
公证员:卓
二x年七月三日
注意:需要贴照片,并在照片上盖钢章;在日期上盖公证处章。
内容扩展:出生证明填写内容
自填单一般有以下内容:父母姓名,身份证号,民族
,婴儿姓名,婴儿申报户口地址,母亲居住地址,床位号等。如果刚住院时还没想好宝宝的名字,可以先用小名代替(一般情况下医院多填写某某之子,之女字样)。出生3个月内,到生产的医院换取正式出生证明,正式的出生证明需要明确孩子的正式名字,并且一经打印就很难更改了。
1、填写《出生医学证明自填单》所在医院出具,有部分内容是医生填好的,个人填写部分(填错可以划掉重写),填写完毕后,可以去换正式出生证明。
2、当收到《出生医学证明》后要认真核对。如发现有填写错误时,应及时向医院申请换发。《出生证》全部机打,并且内容“原则上不能更改”(这句话是自填单里的原话,好像听起来还是有可以修改的余地,但是还是不建议冒险)。
3、《出生医学证明》是婴儿的有效法律凭证,要妥善保管。
篇5:注销股东出资证明书
编号:_________________
一、公司全称:_________________
二、公司住址:_________________
三、公司注册资本:_________________
四、公司股东:_________________于__________年向本公司缴纳货币出资__________元。(以上投入资金系本人自有资金,在其使用期间能以该资金承担企业的民事责任)
本出资证明经公司正式授权的法定代表人签字并加盖公司印鉴,方为有效,特此为证。
(公章)
法人代表(签章):_________________
_____年_____月_____日
篇6:单身证明委托书怎么写_委托书_网
委托人:
性别: 男
身份证号:
被委托人:
性别: 男
与委托人关系:
身份证号:
我委托人系单身,因购房需要办理单身证明,但是工作繁忙,不能亲自办理单身证明的相关手续,特委托 作为我的合法代理人,全权代表我办理相关事项,对委托人在办理上述事项过程中所签署的有关文件,我均予以认可,并承担相应的法律责任。
委托期限:至上述事宜办结为止
委托人:
x年x月x日
代办单身证明一般需要:公正处委托书,委托人身份证原件,两张照片,当事人户口本,身份证原件等。开具单身证明委托书应当载明:申请人姓名,出生日期、居住地、现婚姻状况、出证事由、授权“受委托人填写声明书”,受委托人姓名,身份证件号码。落款:签名,签署日期。涉外委托中,委托书为外文书写的,应同时提供中文译件。
篇7:单位证明书参考
兹证明,本单位___________同志,男/女,于_________年____月____日出生,身份证编号______________________。
于________年____月____至________年_____月,在____________________________单位从事_____________工作。
以上经历表明该同志已具有两年以上工作经验。
特此证明。
单位盖章:
填表人签名:
填表日期:
篇8:手机礼仪的英文对话
A:Hello,B!I read an article about western table manners.I found that there are many similarities and differences betwee western table manners and chinese table manners.
B:Yes.For example:When you are bidden to the feast,you are more interested in talking with people around you than having any dish.So when you have your meals,you should try your best to make less sound and action.
A:Yes.But in western countries before hostess pick up her spoon or fork,gests mustnt taste any dish.The hostess wont start her meal until all the guests get their dishes.She wont do it like chinese,want you have first.It means that everyone can have their own meals when the hostess pick up her spoon or fork.
B:And in China,people wear casual clothes when they have meals in the restaurant,even the T-shirt and jeans are available.Only in important banquet do they wear grandly.But it requires people wear formal dress.
A:And the people seat of traditional chinese food is not that exquisite like in western countries.Most of them are seated according to their own willings and without napkin.
B:However,its very exquisite in western countries.
A:Yes,we have a lot to learn.
B:Of course
篇9:异地居住证明格式
居住证明___________________先生/女士(身份证号:________________)自_________________年_____________月入住我居住区至今,地址为:______________市________________区___________________街道_________________楼_________________门_____________号(邮政编码________________),以上为其现在居住地址。特此证明。
派出所名称:_________________
或居民委员会名称:_________________
或物业管理公司名称:_________________(加盖证明单位公章)
________年_______月_____日
篇10:收入证明格式范文
兹证明___________(先生/女士)证件名称及号码_____________________,系本单位_______(1.正式工、2.合约工、3.临时工),已连续在本单位工作____年,目前在本单位担任_______职务。目前该职工的最高学历为_______,近一年内该职工的平均月收入(税后)为_______元人民币。
本单位承诺提供的以上情况真实,如因上述情况与事实不符而导致贵行经济损失,愿承担相应责任。
单位地址:______________
联系人:______________
联系电话:______________
单位公章或有权部门章:_______
单位或部门负责人签名:_______
_______年_______月_______日
篇11:英文合同
Contract No.:
Sales and Purchase ContractFOR
Manganese Ore
This contract is made and entered into on, Feb20xxunder terms and conditions as per the international chamber of commerce-600 (ICC UCP-600/20xx revision) by and between:
The Buyer:
Address:
Tel:
The Seller :
Address:
Tel:
Whereby seller agrees to sell to buyer and Buyer agrees to buy from seller Manganese Ore under following the terms and conditions stipulated below:
Article 1 Commodity
Concentrated manganese Ore
Article 2 Specifications
Concentrated Manganese Ore
Size: 0-5mm (90% min)
% Mn min. 40.0%
% Fe max. 15.0%
% Silica ( SiO2 ) max. 1.0%
% Aluminum ( Al ) max. 4.0%
% S max. 0.20%
% P max. 0.10%
Moisture max. 7%
Article 3 Quantity:
500 MT, partial shipment not allowed.
Article 4 Origin and Port of loading
4.1 Republic of ABC
4.2 Loading port:
Article 5 Packing/Delivery
5.1 In50 kg sack
5.2 Incontainer Shipment, more or less 20 tons.
Article 6 Shipment/Delivery
6.1 500MT(+/-5%)partial shipment not allowed
6.2 Shipment will be 90 days after signing of this contract and after the acceptance of the Letter of Credit by seller’s bank. L/C will be openedafter BuyerreceivingProforma Invoice from Sellerwith confirmation of the delivery schedule.
6.3 The Buyer has the right to appoint the independent surveyor or his representative to conduct the Pre-shipment Inspection and/or conduct the joint-inspection of the material with buyer for his own account.
Article 7 Contracted Price and Values
Price:Mn: 48% and above - USD0.00/%/DMTCFRCY Port, China
40% - 47.9% - USD 0.00 /%/DMTCFRCY Port, China
The Mn content will be average of the joint-inspection testing result at loading port.
Article 8 Payment
8.1 Payment shall be effected in full by an irrevocable Letter of Credit, which will be opened by 1stclass bank in Hong Kong or Singapore, 100% at sight upon presentation of shipping documents.
A. Seller’s Banking Details:
Bank Name :
Bank Address :
Account Name :
S.W.I.F.T. CODE SWIFT :
B. Buyer’s bank issues L/C to the Sellers bank via S.W.I.F.T. wire transfer.
Buyer’s Banking Details:
Bank Name : (will be advised)
Bank Address :
Account Name:
S.W.I.F.T. Address SWIFT :
Article 10 Inspection of Analysis & Weight
The shipmentinspection and analysis shall be done byCCICappointed by the Seller and one independent surveyor (i.e.: SGS or Geo-Chem, etc) appointed by the buyeras agreed by both parties at site before loading to container. While final weightand qualitydetermination shall be done atloadingportby the above joint-survey.Moisture content shall be deducted from the total weight shipped.
Article 11 Documents
Seller shall present the following documents to the buyer:
A. Signed Commercial Invoice for 100% of the total cargo value indicating, quantity, unit price and the total Amount of Value of the delivered commodity , 1 original and 3 copies.
B. Certificates of quantity, quality and weight issued byCCICand one independent surveyor appointed by the buyer.
C. Certificate of Origin issued by ABC Department Of Trade or concerned Government authorities, I original and 2 copies.
D. Weight List, showing total weight , 1 original and 3 copies.
E. Bill of Lading, 3 original copies and 3 non-negotiable copies.
Article 12 Force Majeure
The Seller shall not be responsible for the delay of shipment or non-delivery of the goods due to Force Majeureunder UCP 600. The seller shall advise the buyer immediately of the occurrence mentioned above and within 3 days thereafter the seller shall send a notice by courier to the buyer of their acceptance of a certificate of the accident issued by the local chamber of commerce under whose jurisdiction the accident occurs as evidence thereof. Under such circumstances the seller , however, are still under obligation to take all necessary measures to hasten the delivery of the goods. In case the accident lasts for more than 60 days the buyer shall have the right to cancel the Contract.
Article 13 Arbitration
All disputes arising out of or in connection with this Contract shall be finally resolved by arbitration in accordance with the Rules of Arbitration of the International Chamber of Commerce (UCP-600/20xx or Uniform Customs and Practice for Documentary Credits) by one or more arbitrators appointed in accordance with the said rules. The arbitration shall be conducted in ABCbythe English language.
Buyer Seller
篇12:职工生育保险公司证明
兹有我单位职工_______________,男/女,出生日期:______________年__________月__________日,身份证号码:_____________,系初婚,于_____________年__________月__________日在__________医院生育一男/女婴,第一胎,无保养小孩情况,符合计划生育且已参加生育保险。
单位名称(盖章)______
_______年__________月__________日
篇13:关于个人收入证明范文
兹证明 为本单位职工,已连续在我单位工作 年,学历为 毕业,目前在我单位担任 职务。近一年内该职工在我单位平均年/月收入为
致 行:
兹证明 先生/女士( 已婚 未婚 离婚)系我单位( 正式 临时 兼职)在职员工,其现在我单位担任 职务,职称 ;已在我单位工作 年,我单位性质为 。
其月均总收入为人民币 万 仟 佰 拾 元整(小写¥ )。
身份证号为:
对以上所提供资料的真实性我单位负法律责任。
特此证明。
单位地址:
人事劳资部门联系人:
联系电话:
单位盖章:
年 月 日
篇14:个人收入证明
借款单位:_____________(简称甲方)
贷款银行:_____________(简称乙方)
甲方为_____________需要,依据《单位住房贷款办法》,特向乙方申请借款,经乙方审查同意发放。为明确双方的权益和责任,特签订本合同,共同遵守。
一、甲方向乙方借款人民币(大写)________________,保证用于_____________。借款期限为_______________年___________个月,即从_______________年___________月_______________日至________________年_______________月_______________日。
二、乙方保证按以下用款计划供应资金:_________________
_____________年_____________月_____________日_____________元;
_____________年_____________月_____________日_____________元。
三、甲方保证按以下还款计划归还贷款本金:_____________年_______________月_______________日_____________元;________________年_______________月_______________日_____________元
四、贷款利息,自支用贷款之日起,以转入结算户数额按月利率_____________‰计算,按季结息。甲方不按期归还贷款,逾期部分加收利息_____________%,不按规定用途使用贷款,加收利息_____________%。
五、乙方未能按用款计划提供贷款,按违约数额和延期天数,每天付甲方万分之三的违约金。甲方不能按时付息,乙方有权从甲方账户中扣收或暂时停止支付贷款。
六、在本合同有效期内,如国家调整利率,从调整之日起,乙方即按调整后的贷款利率计算利息,同时书面通知甲方和担保单位。
七、借款到期后甲方如不能按期偿还,乙方有权从甲方存款账户中扣收或用其抵押物清偿。采取第三方担保的,由担保方代为偿还,担保单位在收到乙方还款通知一个月后仍未归还,乙方有权从其存款账户中扣收或通过法律手段维护自身的权益。
八、在本合同有效期内,甲方保证按季向乙方提供统计、会计、财务等方面的报表及其它有关资料。乙方有权了解甲方生产或项目的经营管理活动,检查贷款使用情况。
九、甲方法人变更时,应提前_____________天通知乙方,变更后的法人继续履行原法人所订合同规定的权利和义务。
十、甲方填报的借款申请书,抵押或担保协议书,均为本合同组成部分。变更合同条款,需经甲乙双方协商一致,并签订借款合同补充文本。
十一、本合同自签订之日起生效,贷款本息全部偿清后失效。
十二、本合同正本三份,甲方、乙方和担保方各执一份;副本_______________份,送_________________。
十三、补充条款:_______________________。
借款单位(盖章):_________________贷款银行(盖章):_________________
法定代表人(签字):_____________法定代表人(签字):_____________
签订地点:________________签订地点:________________
担保单位(盖章):_________________
法定代表人(签字):_____________
签订日期:________________年_____________月_____________日
篇15:出纳离职证明
Leavingcertificate
_______Sir/madam/miss,since____years__month__to____years__month__dayinourcompanyasa________(Department)ofthe_______position,dueto___personal______reasonsresignation,nowwiththecompanytoterminatethelaborrelationship.Herebycertifythat!
Companyname(seal)
Year,monthandday
篇16:法人身份证明书
现任我单位 职务,为法定代表人,特此证明。
附:法定代表人(主要负责人):
性别:
年龄:
民族:
住址:
联系电话:
邮政编码:
单位全称(印章) 年 月 日
法人委托授权书
_______________________________:
兹委派 (名称/职务)参加贵方组织 的竞价工作,全权代表我单位处理竞价的有关事宜。
代理人情况:
姓名:
性别:
年龄:
职务:
地址:
邮编:
电话:
传真:
授权单位: (盖章)
法定代表人签字:
日期:年 月 日
篇17:国际专利许可合同附英文译本[页5]_合同范本
甲方(盖章):_________ 乙方(盖章):_________
代表(签字):_________ 代表(签字):_________
签约地点:_________ 签约地点:_________
_________年____月____日 _________年____月____日
附件:patent license contract
附件一 专利资料的名称、内容和申请情况
附件二 合同产品的型号、规格和技术参数
附件三 提成资的起算时间和计算方法
附件四 出让方查帐的内容和方法
附件五 对甲方人员的培训计划
附件六 乙方派遣专家的技术服务计划
附件七 产品考核验收办法
party a :_________
party b:_________
whereas
the patent right which said in the contract os owned by party b.
party b has the right and agreed to grant paryt a the rights to use,manufac-ture and sell the contract products of the ppatented technology;whereas party a hope to use the patented technology of party b to manufacture and sellthecontract products;
both parties au thorized representatives, through friendly negotiation, have agreeto en-ter into this contract under the ertms as stipulated below;article 1 definitions
for the purpose of this contract, the following terms have the following meanings;
1.1 patented technologymeans those letters patent, and applications thereforpresently owned or hereafter acquired by party b and/or which party bhas or may have therigt to control or grant license thereof during the term hereof in any or all countriesof the world and which are applicable to or may be used in the manufacture of cotract products.
1.2 contract productsmians the products described in appendis2 annexed hereto,to-gether with all improvements and modifications thereof or developments with respectthere-to.
1.3 patty ameans_________. or his legal representative, agent and inhetitorto theproperty of the company.
1.4 party b means_________,or his legal representative,agent and inheritor,to the property of the company.
1.5 the contraet factory means the place which party party a manufactures thecontract products. that is_________.
1.6 spare p`menas replacement parts for contract products or for any part there-of.
1.7 componentsmeans those components and parts of contruct produets which par-tyb has agreed or may from time to time agree in writing to permit party a to manufactureor sell.
1.8 technical documentsmeane engineering, manufacturing and originatinginforna-tion relatiog to the manufacture and servicing of contract products, includingdrawings, blueprints,design sheets, material specifications, photographs, photostats and general da-ta, and designs and pecifications relating to manufacturing contract producdts, tools and fix-tures, but includes,however, onlysuch information as is available to party b and applicable to the operations of party aunder this contract which detaile as per appendis 1 to the con-tract.
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篇18:研究生英文求职信
To Whom It May Concern,
I have learnt fromyesterday’s newspaper that you are employing . I wish to be considered as anapplicant for the position, and beg to state my qualifications as follows:
I am years old, a major student of University / College. During my academic years,I have shown excellent performance and have been awarded first-classscholarship each year. In addition to my educational background, I have therich work experience in the fields of . Therefore, I believe I can be ofvalue to your company.
For furtherinformation please refer to my attached resume. I should be please to attendfor an interview at your convenience.
Yours sincerely,
LiMing
篇19:英文聘用合同聘用外国人_合同范本
Ⅰ Party A ___________wishes to engage the service of Party B______________ as______________. The two parties, in a spirit of friendly cooperation, agree to sign this contract and pledge to fulfill conscientiously all the obligations stipulated in it.
ⅡThe period of service will be from the______day of______,20__ to the ______day of______,20__
Ⅲ The duties of Party B (see attached pages)
Ⅳ Party Bs monthly salary will be ¥_______ yuan RMB,__ % of which can be converted into foreign currency monthly.
Ⅴ Party As Obligations
1. Party A shall introduce to Party B the laws, decrees and relevant regulations enacted by the Chinese government, the Party A work system and regulations concerning administration of foreign experts.
2. Party A shall conduct direction, supervision and evaluation of Party Bs work.
3. Party A shall provide Party B with necessary working and living conditions.
4. Party A shall provide co-workers.
5. Party A shall pay Party Bs salary regularly by the month.
Ⅵ Party Bs obligations
1. Party B shall observe the laws, decrees and relevant regulations enacted by the Chinese government and shall not interfere in Chinas internal affairs.
2. Party B shall observe Party As work system and regulations concerning administration of foreign experts and shall accept Party As arrangement, direction, supervision and evaluation in regard to his/her work. Without Party As consent, Party B shall not render service elsewhere or hold concurrently any post unrelated to the work agreed on with Party A.
3. Party B shall complete the tasks agreed on schedule and guarantee the quality of work.
4. Party B shall respect Chinas religious policy, and shall not conduct religious activities incompatible with the status of an expert.
5. Party B shall respect the Chinese peoples moral standards and customs.
Ⅶ Revision, Cancellation and Termination of the Contract
1. Both parties should abide by the contract and should refrain from revising, canceling, or terminating the contract without mutual consent.
2. The contract can be revised, canceled, or terminated with mutual consent. Before both parties have reached an agreement, the contract should be strictly observed.
3. Party A has the right to cancel the contract with a written notice to Party B under the following conditions;
(1) Party B does not fulfill the contract or does not fulfill the contract obligations according to the terms stipulated, and has failed to amend after Party A has pointed it out.
(2) According to the doctors diagnosis, Party B cannot resume normal work after a continued 30 day sick leave.
4. Party B has the right to cancel the contract with a written notice to party A under the following conditions:
(1) Party A has not provided Party B with necessary working and living conditions as stipulated in the contract.
(2) Party A has not paid Party B as scheduled.
Ⅷ Breach Penalty
When either of the two parties fails to fulfill the contract or fails to fulfill the contract obligations according to the terms stipulated, that is, breaks the contract, it must pay a breach penalty of US$500 to 2,000 (or the equivalent in RMB).
If Party B asks to cancel the contract due to events beyond control, it should produce certifications by the department concerned, obtain Party As consent, and pay its own return expenses; If Party B cancels the contract without valid reason, it should pay its own return expenses and pay breach penalty to Party A. If Party A asks to cancel the contract due to events beyond control, with the consent of Party B, it should pay Party Bs return expenses; if Party A cancels the contract without valid reason, it should pay Party Bs return expenses and pay a breach penalty to Party B.
Ⅸ The appendix of this contract is an inseparable part of the contract and has equal effect
Ⅹ This contract takes effect on the date signed by both parties and will automatically expire when the contract ends. If either of the two parties asks for a new contract, it should forward its request to another party 90 days prior to the expiration of the contract, and sign the new contract with mutual consent. Party B shall bear all expenses incurred when staying on after the contract expires.
Ⅺ Arbitration
The two parties shall consult with each other and mediate any disputes which may arise about the contract. If all attempts fail, the two parties can appeal to the organization of arbitration for foreign experts affairs in the State Administration of Foreign Experts Affairs and ask for a final arbitration.
This Contract is signed at_____________ , in duplicate, this_____ day of _______,20__, in the Chinese and _______ languages ,both texts being equally authentic.
Party A Party B
(Signature) (Signature)
篇20:独生子女证证明格式
兹有我辖区居民________,性别________,出生日期________年________月________日,身份证号码________,户籍地址________,该人属于我辖区居民,经查________的小孩,性别_____,出生日期________年________月________日,出生地_____________医院,出生证明编号________________号,未随_______________在我所落户。
特此小孩未上户口证明
________省________公安局________派出所
________年________月________日