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<table cellspacing="0" cellpadding="0" border="0" class="myTable" style="border-width:0;width:518pt">
<tbody><tr style="height:0px"><td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
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<td style="border-width:0;width:36pt"></td>
</tr><tr style="height:4pt">
<td style="border-width:0"><font style="font-size:32pt;font-weight:bold;"></font></td>
<td style="border-width:0"><font style="font-size:32pt;font-weight:bold;"></font></td>
<td style="border-width:0"><font style="font-size:32pt;"></font></td>
<td style="border-width:0"></td>
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</tr>
<tr style="height:18pt">
<td align="center" rowspan="2" colspan="14" style="border-width:0"><font style="font-size:22pt;font-weight:bold;">东莞市住宅专项维修资金业主书面确认
<br>情况登记表</font></td>
</tr>
<tr style="height:42pt">
</tr>
<tr style="height:7pt">
<td align="center" colspan="14" style="border-width:0"></td>
</tr>
<tr style="height:26pt">
<td align="center" colspan="6" style="border-width:0"><font style="font-size:12pt;">厚街镇</font></td>
<td align="center" style="border-width:0"><font style="font-size:12pt;">镇（街）</font></td>
<td align="center" colspan="6" style="border-width:0"><font style="font-size:12pt;">湖景壹号庄园</font></td>
<td style="border-width:0"><font style="font-size:12pt;">楼盘</font></td>
</tr>
<tr style="height:1pt">
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
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<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:0"></td>
</tr>
<tr style="height:26pt">
<td align="center" colspan="13" style="border-width:0"><font style="font-size:12pt;">湖景壹号庄园18栋电梯（编号：08KT110310)更换钢丝绳(182101140105)</font></td>
<td style="border-width:0"><font style="font-size:12pt;">项目</font></td>
</tr>
<tr style="height:1pt">
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:0"></td>
</tr>
<tr style="height:26pt">
<td align="center" colspan="2" style="border-width:0"><font style="font-size:12pt;">单位分摊：</font></td>
<td align="center" colspan="4" style="border-width:0"><font style="font-size:12pt;">3.45</font></td>
<td style="border-width:0"><font style="font-size:12pt;">元/㎡</font></td>
<td style="border-width:0"><font style="font-size:12pt;"></font></td>
<td style="border-width:0"><font style="font-size:12pt;"></font></td>
<td style="border-width:0"><font style="font-size:12pt;"></font></td>
<td style="border-width:0"><font style="font-size:12pt;"></font></td>
<td style="border-width:0"><font style="font-size:12pt;"></font></td>
<td style="border-width:0"><font style="font-size:12pt;"></font></td>
<td style="border-width:0"><font style="font-size:12pt;"></font></td>
</tr>
<tr style="height:9pt">
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
</tr>
<tr style="height:32pt">
<td align="center" bgcolor="#C0C0C0"><font style="font-weight:bold;">序号</font></td>
<td align="center" colspan="2" bgcolor="#C0C0C0"><font style="font-weight:bold;">幢号</font></td>
<td align="center" colspan="2" bgcolor="#C0C0C0"><font style="font-weight:bold;">房号</font></td>
<td align="center" colspan="2" bgcolor="#C0C0C0"><font style="font-weight:bold;">建筑面积
<br>（平方米）</font></td>
<td align="center" colspan="3" bgcolor="#C0C0C0"><font style="font-weight:bold;">分摊金额/备用金金额
<br>（元）</font></td>
<td align="center" colspan="4" bgcolor="#C0C0C0" style="border-width:1px 1px 0 1px"><font style="font-weight:bold;">业主意见
<br>（同意、不同意、弃权或未表决）</font></td>
</tr>
<tr style="height:14pt">
<td align="center">1</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋202</td>
<td align="center" colspan="2">177.7700</td>
<td align="center" colspan="3">613.05</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">2</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋802</td>
<td align="center" colspan="2">181.8500</td>
<td align="center" colspan="3">627.13</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">3</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋702</td>
<td align="center" colspan="2">181.8500</td>
<td align="center" colspan="3">627.13</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">4</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋901</td>
<td align="center" colspan="2">181.7600</td>
<td align="center" colspan="3">626.81</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">弃权</td>
</tr>
<tr style="height:14pt">
<td align="center">5</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋501</td>
<td align="center" colspan="2">181.7600</td>
<td align="center" colspan="3">626.81</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">弃权</td>
</tr>
<tr style="height:14pt">
<td align="center">6</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋1102</td>
<td align="center" colspan="2">182.4900</td>
<td align="center" colspan="3">629.33</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">弃权</td>
</tr>
<tr style="height:14pt">
<td align="center">7</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋301</td>
<td align="center" colspan="2">181.2500</td>
<td align="center" colspan="3">625.05</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">8</td>
<td align="center" colspan="2">香溪湾18栋</td>
<td align="center" colspan="2">902</td>
<td align="center" colspan="2">181.8500</td>
<td align="center" colspan="3">627.13</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">9</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋1001</td>
<td align="center" colspan="2">181.7600</td>
<td align="center" colspan="3">626.81</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">10</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋401</td>
<td align="center" colspan="2">181.7600</td>
<td align="center" colspan="3">626.81</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">11</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋302</td>
<td align="center" colspan="2">181.3500</td>
<td align="center" colspan="3">625.39</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">弃权</td>
</tr>
<tr style="height:14pt">
<td align="center">12</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋1101</td>
<td align="center" colspan="2">182.4800</td>
<td align="center" colspan="3">629.30</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">13</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋801</td>
<td align="center" colspan="2">181.7600</td>
<td align="center" colspan="3">626.81</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">14</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋502</td>
<td align="center" colspan="2">181.8500</td>
<td align="center" colspan="3">627.12</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">15</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋701</td>
<td align="center" colspan="2">181.7600</td>
<td align="center" colspan="3">626.81</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">16</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋1002</td>
<td align="center" colspan="2">181.8500</td>
<td align="center" colspan="3">627.12</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">17</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋601</td>
<td align="center" colspan="2">181.7600</td>
<td align="center" colspan="3">626.81</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">18</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋201</td>
<td align="center" colspan="2">174.0800</td>
<td align="center" colspan="3">600.32</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">弃权</td>
</tr>
<tr style="height:14pt">
<td align="center">19</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋402</td>
<td align="center" colspan="2">181.8500</td>
<td align="center" colspan="3">627.13</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">20</td>
<td align="center" colspan="2">香溪湾18栋19栋</td>
<td align="center" colspan="2">18栋602</td>
<td align="center" colspan="2">181.8500</td>
<td align="center" colspan="3">627.13</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px">同意</td>
</tr>
<tr style="height:14pt">
<td align="center">汇总</td>
<td align="center" colspan="2"></td>
<td align="center" colspan="2"></td>
<td align="center" colspan="2">3624.6900</td>
<td align="center" colspan="3">12,500.00</td>
<td align="center" colspan="4" style="border-width:1px 1px 0 1px"></td>
</tr>
<tr style="height:14pt">
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
</tr>
<tr style="height:103pt">
<td style="border-width:0" valign="top" colspan="14"><font style="font-size:12pt;">本《维修和更新、改造方案》/《电梯备用金设立方案》于 2021 年 3 月 23 日完成业主表决，表决结果如下：
<br>1、列支范围内涉及房屋总户数 20 户，总人数 20 人，专有部分面积 3624.69 平方米；
<br>2、参与表决的业主拥有专有部分面积 3624.6900 平方米，占列支范围的专有部分面积的比例 100.00 ％，同意的业主拥有专有部分面积 2723.2500 平方米，占参与表决专有部分面积的 75.13 ％；
<br>3、参与表决 20 人，占总人数 100 ％，同意表决的人数是 15 人，占参与表决人数的 75 ％。
<br>以上填报信息及提交材料全部真实有效，现予以确定，如有隐瞒或虚假，使用申请人（单位）承担由此引起的法律等责任。</font></td>
</tr>
<tr style="height:4pt">
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
</tr>
<tr style="height:20pt">
<td rowspan="3" valign="top" colspan="7" style="border-width:1px 0 1px 1px"><font style="font-size:12pt;">
<br> 业主委员会委员（签名）：
<br> （已成立业主委员会的由业委会半数以上成员签名，未成立的不用签名。）</font></td>
<td rowspan="3" valign="top" colspan="7" style="border-width:1px 1px 1px 1px"><font style="font-size:12pt;">
<br> 物业服务企业（签名）：
<br></font></td>
</tr>
<tr style="height:20pt">
</tr>
<tr style="height:20pt">
</tr>
</tbody></table>
<table cellspacing="0" cellpadding="0" border="0" class="myTable" style="border-width:0;width:518pt">
<tbody><tr style="height:0px"><td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
<td style="border-width:0;width:36pt"></td>
</tr><tr style="height:32pt">
<td align="center" bgcolor="#C0C0C0"><font style="font-weight:bold;">序号</font></td>
<td align="center" colspan="2" bgcolor="#C0C0C0"><font style="font-weight:bold;">幢号</font></td>
<td align="center" colspan="2" bgcolor="#C0C0C0"><font style="font-weight:bold;">房号</font></td>
<td align="center" colspan="2" bgcolor="#C0C0C0"><font style="font-weight:bold;">建筑面积
<br>（平方米）</font></td>
<td align="center" colspan="3" bgcolor="#C0C0C0"><font style="font-weight:bold;">分摊金额/备用金金额
<br>（元）</font></td>
<td align="center" colspan="4" bgcolor="#C0C0C0" style="border-width:1px 1px 0 1px"><font style="font-weight:bold;">业主意见
<br>（同意、不同意、弃权或未表决）</font></td>
</tr>
<tr style="height:100pt">
<td valign="top" colspan="7"><font style="font-size:12pt;"></font></td>
<td style="border-width:1px 1px 0 1px" valign="top" colspan="7"><font style="font-size:12pt;"></font></td>
</tr>
<tr style="height:20pt">
<td style="border-width:1px 0 0 0" colspan="14">说明：业主书面确认情况登记表若多余一页，需要在所有页面上盖章确认或盖骑缝章。</td>
</tr>
</tbody></table>
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