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["附件4："]
[{"$nulls":11},"编号："]
["基本养老保险关系转移接续信息表"]
[" 账户类别：一般账户[ ]  临时缴费账户[ ]",{"$nulls":12},"单位：元"]
["参保人员基本信息"]
["个人   编号",{"$nulls":3},"姓 名",{"$nulls":4},"性别",null,"出生日期"]
["公民身 份号码",{"$nulls":3},"户籍地    地  址",{"$nulls":6},"转出单位                       名   称"]
["参加工作时间",null,null,"首次参保地实行个人缴费时间",{"$nulls":4},"本人首次缴费时间",null,null,"本人建立个人账户时间"]
["在本地缴费起始时间",null,null,"在本地       缴费终    止时间",{"$nulls":4},"在本地实际缴费月数",null,null,"转移日期"]
["养老保险基金转移信息"]
["1998年1月1日前账户中个人缴费累计储存额",null,null,"1998年1月1日至调转上年末个人账户           累计储存额 ",{"$nulls":3},"调转当年       记入个人账户     本金金额",null,"个人账户          基金转移额",null,"统筹基金     转移额",null,null,"转移基金    总  额"]
[1,null,null,2,{"$nulls":3},3,null,4,null,5,null,null,6]
[]
["历年缴费及个人账户记账信息"]
["参保地区",null,"年份","缴费起止时间",null,"月缴费基数",null,"缴费比例",null,"当年记账       金   额",null,"当年记账           利   息",null,null,"至本年末账户累计储存额"]
["行政区  划代码"," 名称",{"$nulls":5},"单位","个人","小计","#个人　　　缴费","小计","#个人   缴费",null,"小计","#个人缴费"]
[7,8,9,10,null,11,null,12,13,14,"`15",16,17,null,18,19]
[]
[]
[]
["注：栏目关系：6=4+5；4=1+2+3"]
[]
["经办人(签章)：                联系电话：                    原参保地社保机构(章):"]
[]
[{"$nulls":12}," 年  月  日"]
["(本表一式两联，一联发给对方社保机构，一联留存)"]