[Boutique] University Students' Poverty Certificate

Part 1: Proof of College Students' Poverty

School: College: Professional class: Student number:

Student's basic situation, name, gender, date of birth, nation

ID card number political appearance before entering school

Account □ town □ rural

family

Graduation of population

School individual

Specialty

Orphans and □ Is it a single parent? Is it a martyr or a child of a special care? Yes □ No

Family communication information detailed communication address

Postal code contact phone -

Family member status name age and student

Relationship work unit occupational annual income health status

Affect the family economy

Status related information family per capita annual income. Students have been funded this school year.

The family suffered from natural disasters: The family suffered a sudden accident:

Family members are weak due to disability and old age:

Unemployment of family members: Family debt situation:

Other cases: .

Signature student's parent or guardian student's hometown or street civil affairs department

Signature of the handler:

company name:

year month day

PART 2: Proof of College Students' Poverty

I have the son of my hometown ××××××, who was admitted to your school in the year of ×××××. Due to the XX×, the family’s economic difficulties are caused. I hope that the school and the bank can provide national student loans to help them. Successful completion of school.

××× Township People's Government or ××× Neighborhood Committee, etc.

××年××月××

Part 3: Proof of College Students' Poverty

Xxxx:

Your home visit record " target="_blank" class="hotkey" > Student xxx whose parents are local residents, the basic situation of the family is as follows:

First, the family population x people, family members:

Family annual income of about 000 yuan

Second, the main source of income: xxxxxxxxxxx

Third, the main difficulties of the family at present:

It is indeed a poor family. Hereby prove.

Village committee township, town or county government civil affairs department

Or the civil affairs department above the street where the family contact is located.

Sealed by the unit

Year, month, year, month, day, day, month, day

Sealed unit contact number: 000