XLS《附件3达到法定退休年龄人员基础资料明细表》

"附件3:",,

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"达到法定退休年龄人员基础资料明细表",,

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"参保单位(印章)",,

"序号","姓名","身份证号码","达到法定退休年龄年月","参保人确认签名" "1",,

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"2",,

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"3",,

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"4",,

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"5",,

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"6",,

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"7",,

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"8",,

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"9",,

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"10",,

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"11",,

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"12",,

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"13",,

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"14",,

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"15",,

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"16",,

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"17",,

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"18",,

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"19",,

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"20",,

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"21",,

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"22",,

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"23",,

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"24",,

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"25",,

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"参保单位经办人:",,

,"申报日期:","年月日" ,,

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"说明:",,

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1、本表由参保单位及参保人填写;

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2、本表适用于按潮府[2011]33号文件规定,达到法定退休年龄后参保个人不再申报缴纳职工住院医疗保险个人部分的依据;

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3、本表一式二份,一份参保单位留存,一份地税机关存档;

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4、对应本表姓名,附送身份证复印件.

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