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1、Applicant signature: Public Security Department (sealed)The undertaker signature: Register date : xxxxxx ,20xx(sealed) (sealed)Nanjing Service Center for Human Resources Nanjing Public Security Bureau Household Special StampHousehold Special Stamp Police Station of xxxxxHousehold No.: xxxxxxType of
2、household Name of household RelationCorporateHousehold register xxxxxx Non-relativeName xxxxxx Gender MaleFormer name xxxxxx Ethnicity Han Date of birth xx xx,19xxGuardian Place of birth xxxx County, xxxx ProvinceCitizen birth certificateRelation Issued dateAddress No.xxx, xxxxx Road, Xuanwu Distric
3、t, Nanjing This cityOther addressPlace of origin xxxx County, xxxx Province Religion Non-religionID card No. xxxxxxxxxxxxxxxxxx Issued date Dec 30th ,20xxEducation Graduate studentMarital statusSingle Military serviceNon-militaryHeight 185cm Blood type x Occupation StaffEmployer Nanjing xxx xxxxxxx
4、Co.,LtdWhen & where move to this city Moved from No.x, xxxx Road xxx District,xxx,xxx Province on xxx 10th ,20xx When & why From where to hereWhen & why To this addressWhen & why Cancel householdMale oneMale twoMale threeUpdates of Members Information item After the change Date of change Applicant signature telephoneResident IDAPPLICANT REASONResident IDValid period Resident IDPayment & cancelName Relation to Address or work place Social relationrecordsFemale one Female two Female three
