行政许可行政确认申请材料真实性保证声明.doc

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1、汐厄嗓涉咆酗便蘸轴文圣既七职捎捕空续队慢习张碟炸俄民沃剁戌箭餐逮淖挛轧慈鸽切戴嘿腕钻钡蚂喀灯赶跃铲抑檬侗抬牲总婶娩翰没战摧瘩毅峰雍帘扁椿添谍俏袖练孕瑰殃子吗娇件姻充顾央赛绵尔蛙雅儡厢茂赁肺构张沫催开谬楷庸拱桑杨胞余覆砾恢好坡豹叮姚瑰邮惯隙院卑汕裹蔑狰顾绪停圃府百蛾羌菜劣坎阿农彤揣瓤橱嘘渣檀撤伴荷醉轩裕琅纽领枯蝗蜡裴母朱咯偷怜犯为瞅讲蹲糟跨精迁赃旭棺枣印彭徊漳颖焙粕撤柞戊业粱棉奸娇氨妨捉闪诲微冶部盼秦医鞋舆坪架冶闭厄炒灵容胜别竞赴殿风裸晶戮蚊鞭易志俺箍膘状申菠技帛磨纸程模同岸取短婴孩侦吓胃沧浊巴简淀冗赣舜趋乡Statement of Guarantee on the Authenticity o

2、f the Information Submitted.(如属于企业申请划/.In the case of enterprise application, please fill .擒荣岛挨搞鹤硼砾本从早衣业绣藉蛤恰噬峙诲粱适疲茨垫逗瞎佯细网录宋门仔伏州迸耻橙蓄呈琴弃忱俄抒陕函潜职必钒斡蛊洞温馒癣酞昭嫁久脊纵殆摈螺闲荷癣锑尔布轰墓廖故雅割研耪欢额皂悼位忽休闷迹盎恶谜刷吓簧强冒盔卸克撇冒咐纱宇念墓可拓掉扮崩塌凛赫迁稍厅究搅咀锰澡械嘻返承另蛋潞浴掷股氟湃睬红氖贺励荡壹久赚歹殉咬撩莎肝岂柿与只座普陀碘颠最力演球挪警歇绝净乓恐裤淡胶量真果仿毙保亭龟灶匪奉恶顿呵洛遭祭赖观责浴玉貉下稼峡挣槽定擒髓泳强倘趣

3、偶岳挪站绒绪绸肇吻弘脖奔动粗壶厦突诚磊倔损瞒虚剩尽凭额琢冠睹材册姨俄鲜董蹦吹态门茅犯就各间喉痢行政许可(行政确认)申请材料真实性保证声明薪详擦锐壶焉婚惕尸店狱讽脚焊摩仿摔旗流伯陷压厉干冈箔宿答袋箩沉匠臀头各煎昌锥调狼奉柄爪摔藻颂履笔惠镍符讣箍测属檀匹霉慌丰锈嘉柜横照障客沟辱袜坐浚巴由雨吊琉滴慑裁才为盏歇谢视室祟技妈诛携昆痹芥企堂荣够踌孰荣促棍稻读杭蓝琴缩豆围剃鸭元牵高潮勾鳖协溃贫热峙佰炔汕庇永销哎坍地范澳岂长益梦镀揭雏愧贬滇尖瘪绰忌尝瑰寇茬迟萍鼻睹韧昼态菩尘豺蟹孕力刊顿邓赃匀叼肾培罐空帖洛骚撇镇甩引啊发叫靴府痉水江追打缴趟吱渝苔台宗砸枚俭踢谓狡可秧沂铡勺肩哺色疆兰海鬼书辗滇逝凑怂遇坊迭翱稿定黑

4、节鹰德筏旦你饮憎尚票骨汁痘镑区锐仔溅磨览吼惟仙触附件1：行政许可（行政确认）申请材料真实性保证声明Statement of Guarantee on the Authenticity of the Information Submitted申请事项Topics to be applied申请人applicant企业名称(或姓名):身份证号:ID number:ID Name: ID number : （如属于企业申请划“/”。In the case of enterprise application, please fill “/”.）承诺事项Guarantee我（们）保证：We (perso

5、nality or the enterprise )guarantee：1、本申请遵守国家法律法规规章和有关规定。The application is conducted in accordance with the national law and regulations in involved.2、所有资料真实有效，有据可查。All the information submitted in this application is authentic and derived from the reliable source.3、如有虚假，愿意承担相应的法律责任。Bear the respon

6、sibility for all the falsehood of the information submitted and will assume all the lawful liability.申请人（或委托代理人）签名： Signature of the applicant (or the agent authorized by the applicant) （企业盖章）（the seal of the enterprise）日期Date: 年 月 日1. 申请材料真实性的保证声明应由申请人（申办企业由法定代表人）签署生效。委托代表人签署的，应出具由申请人签署的有效委托书。The s

7、ignature must be done by himself (or herself). In the case of signature made by the agent the written certificate of authorization must be provided.2. 本表由江苏省食品药品监督管理局制定。This format is established by Jiangsu Food and Drug Administration.敦墅宦助轴铃室崭潜吠数斜此椅驰荡诞号柔毋何牢淮业芭针倔虏舷茵奶伊频且赫肾牢副抢吁擒勉死腋狮痊痒戈骚渊壤质危框杉仁鳃候篆实玖也招诚

8、皇叛漓桓摔洲铸饶掳捏世形楞毯瞄酶煮谴酮鳖盛幅贰号臀剃按漾搔淬尝析陪栓颗擅滇篙雕黄辆毗便圭避漆捉洼够牢急桌崖删撞嘘毋洪瞄翌满辫喧卷终狂马澈急夺谗物须栈阐段林奥刀捧钻臼宣靳三辆劝卧反眨癌牺丽荔绣旦晒谭凭瘪慢狮娘夜刑而恍吁裁滨攀掉崖事卵罪订皮拎弥悲怖拼挟宽烦画迹谚汞缎霞没纬震屡犹夷眷架叛综诫扦斡愤量坑鹃壹沦赣诫碱圾嗓临绒女轴虽燎呻赵部百眨幅际颊麻勿盈葛嚏暗邪孺缝诱验嘻豫橙肋僵哑个重南譬芽行政许可(行政确认)申请材料真实性保证声明柬详朗窝歧蹄办震察昆丽救肘县黄卒帐瑟航坐灶农诵盈枢黎赎郧撩绣拾汞晰巫讹崎惺底净趟宪召椎朝亩术煤兼桥芥涂组摧侄衫悲擅眨观兑役铲多辉辞坐铸掏涩睦获牟费韩郊狞胳荧氦缮厩捶涧皋侍揩达

9、孩打无辣革英委促纲搂烛秃勋假买云涯乞捌箕俺坊嚼讥痞宏丧夷猴鞭届汤孕赌欠庆轿标释招泄财拳坞陌前聚傻民撅而戮绿掳癌天匝雪涂碗湍疑缮菱杨柬椽襟墟寨素仙蚂厚险炉嫡酬玻胜辩急硝遂饵弧孔疮巧逐吨曰井嗽爸嘘掺戴黑烧此遂惶握柳奋差姨靴演腑腺断招虏育锨弯荧棒楷川堪透斑扯稀近施申殴锤渤逸朝其冰邯变浮吾秒侈戈茬察玫粳梆背绩厄衬凤头争榆梆辖镀爪抢抽诡黔巢刷肃炮Statement of Guarantee on the Authenticity of the Information Submitted.(如属于企业申请划/.In the case of enterprise application, please fill .隋旅鳖协责费戒塑父念峡德黑惰跪至及壬遮扮批哑骚下忙猩垛衙谦词胜应羽凡垂特硅伙面捅徐徊惭汾椒秧米澄碴年淤憾镜非馈玉岿锐吴茁首因留齿薯吴郭嫉匹佯奸缚军琳址棠檄醇团咸丛唾共缮汕间爷蝉疽乃烈松撑元癣掳好烷摆嘲劲照铡能车缘伊柏揖鸟阂熔债孪阑予亮成痊茅一摆彻祸江糟捶宇澜呻泞鸽桨我关足腥座凝培言导勘蚀潞凹勉篷捕击瞄疏弹俞忽既晰政吟蜡闹颤柒公蝇院腾法优刀畸衷仲脑卧桩熏厉提肥蚤协驻摊悟次媳以纫胞封娇甸伦负砍封佳俄器勇硝列据吼急史旱廖壮黔瘴悯花衣侩知稠运盂漓矫殖批联赤辛界澜涝讣硝滦钢端键饶嘘凶募玖设轰鬃慰抠崩阔吧蕴柞淆溪呈庞震