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["甘肃省注册会计师资产评估行业\n专业委员会委员推荐表"]
["姓名",null,"性别",null,"民族",null,"近期免冠\n一寸照片"]
["出生年月",null,"身份证号"]
["联系电话",null,"电子邮箱"]
["通讯地址",{"$nulls":3},"邮编"]
["会员类别","□执业会员□非执业会员□行业管理□其他（请注明）"]
["工作单位"]
["职务/职称",{"$nulls":3},"从业年限",null,"       年"]
["教育背景","起止时间","毕业院校",null,"所学专业",null,"学历/学位"]
[]
[]
[]
[]
[]
[]
["工作经历","起止时间","工作单位",null,"职务",null,"主要工作内容"]
[]
[]
[]
[]
[]
["申报委员会（可多选，按优先级排序）","□会员管理与服务委员会\n□行业人才工作委员会\n□职业道德委员会\n□专业咨询委员会\n□惩戒委员会\n□申诉与法律维权委员会\n□中小事务所发展委员会\n□资产评估专业委员会\n□行业信息化委员会"]
["申报身份","□主任委员□副主任委员□普通委员"]
["符合任职条件说明（对应目标委员会工作规则第四条/第五条）","1.从事注册会计师/资产评估行业工作5年以上□是□否"]
[null,"2.担任会计师事务所/资产评估机构合伙人（股东）□是□否"]
[null,"3.未受到刑事处罚、行政处罚或行业惩戒□是□否"]
[null,"4.其他符合该委员会任职条件的情况："]
[]
["回避声明","本人不存在下列需回避情形：\n1.与其他申报人同属一家会计师事务所（含分所）/资产评估机构且超过1人；\n2.拟申报惩戒委员会与申诉与法律维权委员会双重职务；\n3.其他可能影响履职公正的利害关系；\n\n\n                   声明人签字：          日期："]
[]
[]
[]
[]
["专业资质","证书名称","颁发机构","取得时间",null,"证书编号"]
[]
[]
[]
[]
["专业成果","\n1.论文/著作（名称、发表/出版时间、刊物/出版社）："]
[null,"\n2.研究课题/项目（名称、参与角色、完成时间、成果）："]
[null,"\n3.行业表彰/荣誉（名称、颁发机构、取得时间）："]
[null,"\n4.其他专业成果（请详细说明）："]
["履职能力\n承诺","本人承诺：自觉遵守各专业委员会工作规则，按时参加会议，保守工作秘密，积极履行委员职责，维护行业合法权益。\n\n\n\n                    承诺人签字：         日期："]
[]
["个人陈述（请结合申报委员会职责，说明自身优势、申报初衷及未来工作设想，限500字以内）"]
["推荐意见","\n（请说明推荐理由，需推荐人签字确认）"]
[null,"推荐人签1：",null,null,"日期："]
[null,"推荐人签2：",null,null,"日期："]
["所在单位\n意见","       \n\n （加盖单位公章）\n\n\n  \n   负责人签字：               日期："]
[]
["协会秘书处初审意见","□通过    □不通过"]
[null,"审核人签字：                     日期："]
["理事会\n审议意见","□通过    □不通过"]
[null,"签字：                             日期："]