행복바라미 신청서 양식

<a href='javascript:fileFilterViewer("http://cfile287.uf.daum.net/attach/270EEB3C548A550C309D7B", "/cfile287/27/0EEB3C548A550C309D7B", "행복바라미 지원대상자 신청서.hwp", "grpid%3D1HTRP%26fldid%3DKiV7%26dataid%3D559%26fileid%3D1%26regdt%3D20141212113139&url=http%3A%2F%2Fcfile287.uf.daum.net%2Fattach%2F270EEB3C548A550C309D7B")'><img src="https://t1.daumcdn.net/daumtop_deco/icon/icon.hanmail.net/editor/p_hwp_s.gif" border="0" alt="첨부파일" class="vam"/> 행복바라미 지원대상자 신청서.hwp</a>     행복바라미 지원대상자 신청서 (서식1)   ○ 추천기관 <TABLE style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; BORDER-COLLAPSE: collapse; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid"> <TBODY> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 70.76pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 추천기관</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 112.76pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 109.93pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 신청(추천)금액 </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 190.94pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 원 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 70.76pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 담당자명</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 112.76pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 109.93pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 담당자연락처</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 190.94pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> Tel) 032 - 00 H.P) 010-</TD></TR></TBODY></TABLE>     ○ 신청자 현황 <TABLE style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; BORDER-COLLAPSE: collapse; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid"> <TBODY> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 13.8pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 신청 구분 (해당부분 √)</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 13.8pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12>   ○ 소년소녀가장( ) ○ 무의탁 노인( ) ○ 빈곤노인 가장( ) ○ 무의탁 청소년( ) ○ 극빈 및 저소득 가정( ) ○ 저소득 다문화 가정( ) ○ 빈곤 이주민 가정( ) </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 지원 대상자명</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 83.28pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 75.72pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 성별</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 106.3pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=4> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 42.27pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 나이</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 96.51pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 주민등록번호</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 265.3pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=8> -</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 42.27pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 종교</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 96.51pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 주 소</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 212.62pt; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=6> - </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 69.99pt; BACKGROUND: #d8d8d8; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 전화번호</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 121.47pt; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> Tel) H.P)</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 30.78pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 보호구분</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 30.78pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 국민기초생활수급자( ) 차상위계층( ) 그 외 저소득층( ) </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 세대구분</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 한부모가정( ) 조손가정( ) 다문화가정( ) 장애인가정( ) 무의탁, 홀몸 어르신( ) 기타( )</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 월평균소득</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 159pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=4> 원</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 123.61pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=5> 월평균 필요 최저생활비</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 121.47pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 원</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 지원금 사용처</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 교육비( ) 의료비( ) 생활비( ) </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 137.27pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle rowSpan=6> 가족사항</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 관계</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 성명</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 주민번호(앞6자리)</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 직업</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 월소득</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 동거여부</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 건강상태</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 본인</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 343.13pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle rowSpan=5> 생활실태 (간략히 작성)</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 87.15pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 1. 건강상태 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 75.06pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 2. 경제상황 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 66.8pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 3. 주거환경 및 생활실태 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 57.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 4. 타 사회복지 기관의 지원 여부 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 56.83pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 5. 기타사항 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 56.5pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 추천사유</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 56.5pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 추천기관 의견 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 27.72pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 신청자 계좌번호 </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 27.72pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 은행명 : 계좌번호 : </TD></TR></TBODY></TABLE> ○ 첨부서류 1: 국민기초생활수급권증명서 또는 차상위계층증명서 ○ 첨부서류 2: (1)의 서류가 구비되지 않을 경우 건강보험료 납부확인서 또는 의료급여증 사본, 소득금액증명서 ○ 첨부서류 3: (해당자에 한함) 한부모가족증명서, 장애수당지급대상확인서, 장애인등록증명서 가족관계증명원, 장애인등록증명서, 외국인등록증 사본 ○ 첨부서류 4: (공통사항) 주민등록등본, 지원금을 수령할 통장 사본(수령대상자와 신청자 일치) ○ 대학생의 경우 : 한국장학재단의 국가장학금(Ⅰ유형, Ⅱ유형)에 해당하는 서류제출 2014년 월 일 신청자 (인) 상기와 같이 행복바라미 지원대상자로 추천합니다. 추천기관 : 추천자 (인)       (작성예)행복바라미 지원대상자 신청서 ○ 추천기관 <TABLE style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; BORDER-COLLAPSE: collapse; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid"> <TBODY> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 59.44pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 추천기관</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 172.19pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 포교 서울지단 / 영통복지관</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 78.8pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 신청(추천)금액</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 173.96pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 800,000 원 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 59.44pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 담당자명</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 172.19pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 홍길동</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 78.8pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 담당자연락처</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 173.96pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> Tel) 032 - 00 H.P) 010-</TD></TR></TBODY></TABLE>     ○ 신청자 현황 <TABLE style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; BORDER-COLLAPSE: collapse; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid"> <TBODY> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 13.8pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 신청 구분 (해당부분 √ )</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 13.8pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12>   ○ 소년소녀가장( ) ○ 무의탁 노인( ) ○ 빈곤노인 가장( ) ○ 무의탁 청소년( ) ○ 극빈 및 저소득 가정( √ ) ○ 저소득 다문화 가정( ) ○ 빈곤 이주민 가정( ) </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 지원 대상자명</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 105.92pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 김협동</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 70.06pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 성 별</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.32pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=4> 남</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 42.27pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 나이</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 96.51pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 46세</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 주민등록번호</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 265.3pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=8> 680802- 0000000</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 42.27pt; BACKGROUND: #d8d8d8; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 종교</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 96.51pt; HEIGHT: 26.54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 불교</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 주 소</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 212.62pt; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=6> 110 - 170 서울 종로구 우정국로 67(견지동 13) </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 69.99pt; BACKGROUND: #d8d8d8; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 전화번호</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 121.47pt; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> Tel) 020- 732-7272 H.P) 010-2064-****</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 30.78pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 보호구분</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 30.78pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 국민기초생활수급자( √ ) 차상위계층( ) 그 외 저소득층( ) </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 세대구분</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 37.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 한부모가정( ) 조손가정( ) 다문화가정( ) 장애인가정( √ ) 무의탁, 홀몸 어르신( ) 기타( )</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 월평균소득</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 175.98pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=4> 82 만원</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 106.63pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=5> 월평균 필요 최저생활비</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 121.47pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 177 만원</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 지원금 사용처</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 22.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 교육비( ) 의료비( ) 생활비( √ ) </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 137.27pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle rowSpan=6> 가족사항</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 관계</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 성명</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 주민번호(앞6자리)</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 직업</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 월소득</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 동거여부</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; BACKGROUND: #d8d8d8; HEIGHT: 25.12pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 건강상태</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 본인</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 김00</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 680802</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 무직</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> -</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 동거</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 장애2급</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 배우자</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 한00</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 700318</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 미화원</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 82만원</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 동거</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 양호</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 자</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 김민주</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> 970723</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 학생</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> - </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> 동거</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 양호</TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 31.31pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 57.53pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 89.19pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=3> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 64.35pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 40.23pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 63pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=2> </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 58.47pt; HEIGHT: 22.43pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 340.3pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle rowSpan=5> 생활실태 (간략히 작성)</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 81.49pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 1. 건강상태 장애2급으로서 무릎 관절 이상 및 보행 불편 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 80.72pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 2. 경제상황 배우자가 공장 미화원으로 근무하며 생계 유지 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 66.8pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 3. 주거환경 및 생활실태 13평 다세대 주택에 전세 월세 20만원으로 거주 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 57.29pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 4. 타 사회복지 기관의 지원 여부 타 복지기관의 지원없음 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 54pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 5. 기타사항 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 53.19pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 추천사유</TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 53.19pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 추천기관 의견 신심 깊은 불자로서 사찰 신행활동 및 봉사활동 참여 </TD></TR> <TR> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 82.08pt; BACKGROUND: #d8d8d8; HEIGHT: 30.8pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle> 신청자 계좌번호 </TD> <TD style="BORDER-BOTTOM: #000000 0.28pt solid; BORDER-LEFT: #000000 0.28pt solid; WIDTH: 404.08pt; HEIGHT: 30.8pt; BORDER-TOP: #000000 0.28pt solid; BORDER-RIGHT: #000000 0.28pt solid" vAlign=middle colSpan=12> 은행명 : 계좌번호 : </TD></TR></TBODY></TABLE> ○ 첨부서류 1: 국민기초생활수급권증명서 또는 차상위계층증명서 ○ 첨부서류 2: (1)의 서류가 구비되지 않을 경우 건강보험료 납부확인서 또는 의료급여증 사본, 소득금액증명서 ○ 첨부서류 3: (해당자에 한함) 한부모가족증명서, 장애수당지급대상확인서, 장애인등록증명서 가족관계증명원, 외국인등록증 사본 ○ 첨부서류 4: (공통사항) 주민등록등본, 지원금을 수령할 통장 사본(수령대상자와 신청자 일치) ※ 수령자가 무자력자(통장을 개설할 수 없는 자의 경우) : 가족관계 증명원을 첨부하여 가족관계 입증 및 가족 통장 사본 제출) ○ 대학생의 경우 : 한국장학재단의 국가장학금(Ⅰ유형, Ⅱ유형)에 해당하는 서류제출 2014년 12 월 24 일 신청자 김 협 동 서명(인) 상기와 같이 행복바라미 지원대상자로 추천합니다. 추천기관 : 포교사단 서울지단 / 영통복지관 추천자 지단장 / 관장 0 0 0 서명 (인)