탄소포인트제 참여 신청서

<TABLE style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; BORDER-BOTTOM: #000000 0.28pt solid; BORDER-COLLAPSE: collapse"> <TBODY> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 346.43pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 52.44pt" vAlign=center colSpan=7 rowSpan=2> 『탄소포인트제』참여 신청서</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 129.69pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 23.2pt" vAlign=center colSpan=3> 등록번호</TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 43.23pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 29.24pt" vAlign=center> </TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 43.23pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 29.24pt" vAlign=center> </TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 43.23pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 29.24pt" vAlign=center> </TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63.43pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center> 성 명</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 180.29pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center colSpan=2> </TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 47.67pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 80.46pt" vAlign=center colSpan=2 rowSpan=3> 고객 번호</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 33.57pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center> 전기</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 151.16pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center colSpan=4> </TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63.43pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center> (세대주)</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 180.29pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center colSpan=2> </TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 33.57pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center> 수도</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 151.16pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center colSpan=4> </TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63.43pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center> 가족 구성원 수</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 180.29pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center colSpan=2> </TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 33.57pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center> 도시가스</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 151.16pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 26.82pt" vAlign=center colSpan=4> </TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63.43pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 42.51pt" vAlign=center rowSpan=2> 주 소</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 198.27pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 42.51pt" vAlign=center colSpan=3 rowSpan=2> </TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63.26pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 21.23pt" vAlign=center colSpan=2> 전화번호</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 151.16pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 21.23pt" vAlign=center colSpan=4> </TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63.26pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 21.28pt" vAlign=center colSpan=2> 휴대폰</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 151.16pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 21.28pt" vAlign=center colSpan=4> </TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 117.2pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 23.31pt" vAlign=center colSpan=2> 세대주(신청자) 통장계좌번호</TD> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 358.92pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 23.31pt" vAlign=center colSpan=8> 은행, 계좌번호 : </TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 476.12pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 40.45pt" vAlign=center colSpan=10> 온실가스 줄이기를 위한 탄소포인트제 참여를 신청합니다.</TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 476.12pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 38.29pt" vAlign=center colSpan=10> 변동사항 기재란</TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 476.12pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 66.59pt" vAlign=center colSpan=10> *2005년 이후의 주소 및 구성원 수 변동 사항 기재 </TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 476.12pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 35.46pt" vAlign=center colSpan=10> 개인정보 제공 및 활용 동의서</TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 476.12pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 94.89pt" vAlign=center colSpan=10> 본인의 성명, 주소, 전화번호 등 본인의 식별을 위하여 필요한 정보를 한국전력공사, 수도사업소, 아파트 관리사무소 등에서 에너지 사용량 자료를 수집하기 위한 업무에 활용하는데 동의합니다.</TD></TR> <TR> <TD style="BORDER-RIGHT: #000000 0.28pt solid; BORDER-TOP: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 476.12pt; BORDER-BOTTOM: #000000 0.28pt solid; HEIGHT: 65.88pt" vAlign=center colSpan=10> 년 월 일 신청인 (인 또는 서명) 청주시장 귀하</TD></TR></TBODY></TABLE> ※ 고객번호는 사용료 납부고지서의 번호를 기재하시기 바랍니다. ※ 등록번호는 기재하지 마시기 바랍니다. ※ 작성하신 신청서는 팩스(254-0128) 또는 우편으로 제출하시면 됩니다. <a href='javascript:fileFilterViewer("http://cfile262.uf.daum.net/attach/113B28234A16A3B9CF568F", "/cfile262/11/3B28234A16A3B9CF568F", "청주시탄소포인트신청서[1].hwp", "grpid%3D1HM0s%26fldid%3D9ytC%26dataid%3D27%26fileid%3D1%26regdt%3D20090522220816&url=http%3A%2F%2Fcfile262.uf.daum.net%2Fattach%2F113B28234A16A3B9CF568F")'><img src="https://t1.daumcdn.net/daumtop_deco/icon/icon.hanmail.net/editor/p_hwp_s.gif" border="0" alt="첨부파일" class="vam"/> 청주시탄소포인트신청서[1].hwp</a>