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["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        "]
["申请人基本信息","姓名"," ","性别",null,"出生日期",null,"身高"]
[null,"公民身份 号码 ",{"$nulls":3},"联系电话"]
[null,"原户籍地址",{"$nulls":3},"所属派出所"]
["监护人  信息","姓名","公民身份证号码",null,null,"联系电话"]
["父亲"]
["母亲"]
["拟落户地址",null,"□ 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"]
[" 就读学校院系",null,"武昌工学院             学院      级              专业"]
["个人\n申请\n（填写主要事实和理由）"," 本人申请在校就读期间，将户籍迁入所在高校学生集体户。"]
[]
[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,"      申请人签名（必须手写）：                     年    月    日"]
[]
["            受理人签名（盖章）：                         年    月    日"]

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