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["附件3"]
["申报户口登记表"]
["（学生招生落户）"]
["申请落户类别"," □大中专院校招生落户        "]
[null,"（请在□中打“√”）"]
["申请","姓名"," ","性别",null,"出生日期"]
["人员","公民身份号码 ",{"$nulls":3},"联系电话"]
["基本","户籍地址",{"$nulls":3},"所属派出所"]
["情况","拟落户地址","□ 学生集体户"]
[null,null,"武汉市洪山区白沙洲大道110号 ",null,null,"拟落户地派出所",null,"张家湾派出所"]
[null," 就读学校院系及年级",null,"武昌工学院                     学院2021级"]
["个人\n申请\n（填写主要事实和理由）"]
[]
[]
[null,"   本人承诺：本表所填写的内容及所提交的证明材料均真实有效。若被查证在户口事项办理过程中有隐瞒事实、弄虚作假行为的，本人愿承担法律责任，接受公安机关处理。"]
[null,"      "]
[null,"      申请人签名：                            年    月    日"]
["            受理人签名（盖章）：                         年    月    日"]

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