Place and date, signature of authorized

申报地点、日期及授权签字人的签字

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Hand written amendment in place together with approved signature by authorized personnel or department.

手写修改（当）份并有指定负责人或部门签字认可。

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Hand written amendment in place together with approved signature by authorized personnel or department.

手写修改（当）份并有指定负责人或部门签字认可。

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