This is to certify that ×× province ×× city ×× county (district) ×× town (township, sub-district office) ×× village (or neighborhood committee) ×× group member (citizen) ×× Comrade ××.

State the reasons for the difficulties (family population, location in remote mountainous areas, family per capita annual income, family suffering from natural disasters, family suffering from unexpected accidents, family members having weak working ability due to disability or old age) , family members’ unemployment situation, debt situation and other difficulties, etc.)

Extended information

Filling instructions:

1. Please handwrite according to the given template. Or print out the certification materials, please do not alter them and make sure the elements are complete and the handwriting is clear.

2. The information filled in is true and consistent with relevant certificates, originals and copies of certificates.

3. The certification unit is at least the neighborhood committee (administrative village committee), sub-district office or town government where the applicant’s family is located, the civil affairs department at or above the district or county level (including county level) or equivalent functional departments.

4. Please certify the unit to carefully review the applicant’s family situation and ask the person in charge to write down the contact number and sign for confirmation to ensure that the content of this certificate is consistent with the actual situation.