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["宁夏医科大学科研项目绩效支出申请表"]
["课题名称","*",{"$nulls":5},"经费编号",null,"*例如：109-20010101"]
[{"$nulls":7},"（部门-项目）"]
["资助总经费","*  万元",null,"间接费",null,"  *  万元",null,"绩效费",null,"*  万元",null,"设备费","*  万元"]
["主持人姓名",{"$nulls":6},"所在院部"]
["项目组成员人数数"," *   人",null,"其中校本部   人       外单位   人"]
["课题来源","□国家自然科学基金项目  □科技部项目 □公益性行业科研专项"]
[null,"□宁夏自然科学基金        □自治区科技重大专项（含支撑、惠民、国际合作等）"]
[null,"□其它预算有绩效支出的课题（请标明类别                    ）"]
["执行期限",{"$nulls":5},"本次申请发放金额（元）"]
["项目进度"," □中 期 评 估              □结 题 验 收"]
["到账经费","第一次","元",null,"提取绩效","第一次",null,"元","发放绩效","第一次","元"]
[null,"第二次","          /            元",null,null,"第二次","/","元",null,"第二次","          /            元"]
[null,"第三次","/","元",null,"第三次","/","元",null,"第三次","          /            元"]
[null,"合计",null,"元",null,"合计",null,"元",null,"合计","                      元"]
["发放方案","序号","姓名",null,"发放金额（元）","工作单位及所在部门",null,"序号","姓名",null,"发放金额（元）","所在部门"]
[null,1]
[null,2]
[null,3]
[null,4]
[null,5]
[null,6]
[null,7]
[null,8]
[null,9]
[null,10]
[null,null,"……（可增加）"]
["课题负责人意见","签    字：                 "]
[null,"                        年  月  日 "]
["学院审核  意见","考核等级：                         （公章）"]
[]
[null,"负责人（签字）：                                                      年    月    日"]
["学校管理部门审核意见","科技处负责人（签字）：                  （公章）"]
[null,"  "]
[null,"财务处负责人（签字）：                       （公章）"]
[null,"          年    月    日"]
["学校审核 意见"]
[null,"分管科研工作校领导（签字）                                                       年    月    日"]
[]
["注：1、此表一式4份，课题组、院级单位、科技处、财务处各1份（可复印，财务处留存原件，其余单位留存复印件）；"]
["        2、本校员工应在“开户行/卡号”栏填写本人工资卡号。"]
["        3、*为必填项目"]
["        4、表后需附任务书复印件（首页、参加人员页、经费预算页、签字盖章页即可）、本年度总结报告及学院考核结果"]
["        5、单次发放50000元（含）以上须有分管科研及财务校领导签字。"]