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<P class=HStyle0><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%">별지 </SPAN><SPAN style="FONT-SIZE: 10.8pt; LINE-HEIGHT: 160%">제1호 서식</SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%">】</SPAN></P>
<P class=HStyle0 style="MARGIN-TOP: 5.7pt; LINE-HEIGHT: 100%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 18pt; LINE-HEIGHT: 100%; FONT-FAMILY: -윤명조130,한컴돋움; LETTER-SPACING: 4.9pt">부양가족신고서</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 180%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 180%">󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲󰠲</SPAN></P>
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<P class=HStyle0 style="LINE-HEIGHT: 100%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 100%; LETTER-SPACING: 0.5pt">부양의무</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 200%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 200%; LETTER-SPACING: 0.5pt">공 무 원</SPAN></P></TD>
<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=center width=104 height=30>
<P class=HStyle0 style="TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt">성 명</SPAN></P></TD>
<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=center width=135 colSpan=3 height=30>
<P class=HStyle0 style="TEXT-ALIGN: center"> </P></TD>
<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=center width=127 colSpan=2 height=30>
<P class=HStyle0 style="TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt">주민등록번호</SPAN></P></TD>
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<P class=HStyle0 style="TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt">직 급</SPAN></P></TD>
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<P class=HStyle0 style="TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt"> 소속 / 행정전화</SPAN></P></TD>
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<P class=HStyle0 style="TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 13pt; LINE-HEIGHT: 160%"> /☎</SPAN></P></TD></TR>
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<P class=HStyle0 style="LINE-HEIGHT: 200%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 200%; LETTER-SPACING: 0.5pt">부</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 200%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 200%; LETTER-SPACING: 0.5pt">양</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 200%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 200%; LETTER-SPACING: 0.5pt">가</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 200%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 200%; LETTER-SPACING: 0.5pt">족</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 200%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 200%; LETTER-SPACING: 0.5pt">상</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 200%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 200%; LETTER-SPACING: 0.5pt">황</SPAN></P></TD>
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<P class=HStyle0 style="LINE-HEIGHT: 130%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 130%; LETTER-SPACING: 0.5pt">성 명</SPAN></P></TD>
<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=center width=56 height=41>
<P class=HStyle0 style="LINE-HEIGHT: 130%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 130%; LETTER-SPACING: 0.5pt">관계</SPAN></P></TD>
<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=center width=189 colSpan=2 height=41>
<P class=HStyle0 style="LINE-HEIGHT: 130%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 130%; LETTER-SPACING: 0.5pt">주민등록번호</SPAN></P></TD>
<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=center width=71 colSpan=2 height=41>
<P class=HStyle0 style="LINE-HEIGHT: 130%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 130%; LETTER-SPACING: 0.5pt">직 업</SPAN></P></TD>
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<P class=HStyle0 style="LINE-HEIGHT: 130%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 130%; LETTER-SPACING: 0.5pt">신고사유</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 130%; TEXT-ALIGN: center"><SPAN style="FONT-SIZE: 9.9pt; LINE-HEIGHT: 130%; LETTER-SPACING: -2pt">(혼인, 출생, 사망 등)</SPAN></P></TD></TR>
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<P class=HStyle0 style="TEXT-ALIGN: left"> </P></TD>
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<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=center width=643 colSpan=9 height=98>
<P class=HStyle0 style="TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt"> 특기사항 : </SPAN></P>
<P class=HStyle0 style="MARGIN-LEFT: 22.8pt; TEXT-INDENT: -22.8pt; TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt"> </SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; FONT-FAMILY: 한양중고딕,한컴돋움">* </SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; FONT-FAMILY: 한양중고딕,한컴돋움">본</SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; FONT-FAMILY: 한양중고딕,한컴돋움"> 란에는 장해진단서를 첨부한 가족성명, 공무원 또는 사립학교 교직원 및 별정</SPAN></P>
<P class=HStyle0 style="MARGIN-LEFT: 22.8pt; TEXT-INDENT: -22.8pt; TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; FONT-FAMILY: 한양중고딕,한컴돋움; LETTER-SPACING: -1.3pt"> </SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; FONT-FAMILY: 한양중고딕,한컴돋움"> 우</SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; FONT-FAMILY: 한양중고딕,한컴돋움; LETTER-SPACING: 0.4pt">체국 직원인 부양가족의 소속기관 및 연락처, 기타 특기사항을 반드시 기재하여야 함</SPAN></P></TD></TR>
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<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=top width=643 colSpan=9 height=361>
<P class=HStyle0 style="MARGIN: 15pt 3pt 9pt; LINE-HEIGHT: 180%"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 180%; LETTER-SPACING: 0.7pt">본인은 허위의 방법으로 가족수당을 지급받은 경우 이를 변상하고 일정기간 지급을 정지하는</SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 180%; LETTER-SPACING: 0.5pt"> 관련규정과 가족수당의 지급대상 및 부양가족의 기본요건 등을 숙지하고 지방공무원수당 </SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 180%; LETTER-SPACING: 0.4pt">등에 관한규정 제10조 제5항의 규정에 따라 관계서류를 첨부하여 위와 같이 부양가족</SPAN><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 180%; LETTER-SPACING: 0.5pt">을 신고합니다. </SPAN></P>
<P class=HStyle0 style="MARGIN-LEFT: 3pt; MARGIN-RIGHT: 3pt; TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt"> </SPAN></P>
<P class=HStyle0 style="MARGIN-LEFT: 3pt; MARGIN-RIGHT: 3pt; TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt"> 첨부 : 1. 주민등록등본(필요시 호적등본) 1부</SPAN></P>
<P class=HStyle0 style="MARGIN-LEFT: 3pt; MARGIN-RIGHT: 3pt; TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 160%; LETTER-SPACING: 0.5pt"> 2. 장해진단서 1부(해당자에 한함)</SPAN></P>
<P class=HStyle0 style="MARGIN-TOP: 10pt; MARGIN-LEFT: 3pt; LINE-HEIGHT: 210%; MARGIN-RIGHT: 3pt; TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 210%; LETTER-SPACING: 0.5pt"> 년 월 일</SPAN></P>
<P class=HStyle0 style="MARGIN-LEFT: 3pt; LINE-HEIGHT: 210%; MARGIN-RIGHT: 3pt; TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 210%; LETTER-SPACING: 0.5pt"> 신 고 인 성명 (인)</SPAN></P>
<P class=HStyle0 style="MARGIN-LEFT: 3pt; LINE-HEIGHT: 210%; MARGIN-RIGHT: 3pt; TEXT-ALIGN: left"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 210%; LETTER-SPACING: 0.5pt"> 대리신고인 성명 (인) 관계 (의)</SPAN></P></TD></TR>
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<TD style="BORDER-RIGHT: #000000 0.6pt solid; PADDING-RIGHT: 1.4pt; BORDER-TOP: #000000 0.6pt solid; PADDING-LEFT: 1.4pt; PADDING-BOTTOM: 1.4pt; BORDER-LEFT: #000000 0.6pt solid; PADDING-TOP: 1.4pt; BORDER-BOTTOM: #000000 0.6pt solid" vAlign=top width=643 colSpan=9 height=117>
<P class=HStyle0 style="MARGIN-TOP: 10pt; LINE-HEIGHT: 180%"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 180%; LETTER-SPACING: 0.5pt"> 위의 사실을 확인함</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 220%"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 220%; LETTER-SPACING: 0.5pt"> 년 월 일</SPAN></P>
<P class=HStyle0 style="LINE-HEIGHT: 220%"><SPAN style="FONT-SIZE: 11.7pt; LINE-HEIGHT: 220%; LETTER-SPACING: 0.5pt"> 소속기관장 (인)</SPAN></P></TD></TR></TBODY></TABLE></P>
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