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[null,null,null,"(樣    式)"]
["財團法人金融聯合徵信中心"]
["所屬單位：8888888  xxx銀行xxx分行",{"$nulls":5},"查詢日期：xxx/xx/xx      09：09：09            "]
["查詢對象：8888888   "]
["查詢項目：W01                           不定期性指定項目會員自行查核工作底稿"]
["(A)類--查詢當事人衍生性金融商品資料之查詢紀錄"]
["編號","查詢日期","查詢對象",null,"使用者代號","查詢資格要件\n是否符合(註A1)","符合查詢資格要件\n但有下列缺失(註A2)","不符合查詢資格   \n要件之原因(註A3)","備註"]
[1,"xxx/xx/xx","11XXXXXX",null,"888WS001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[2,"xxx/xx/xx","2XXXXXX2",null,"888WS001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[3,"xxx/xx/xx","46XXXXXX",null,"888WS001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[4,"xxx/xx/xx","3XXXXXX5",null,"888WS001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[5,"xxx/xx/xx","18XXXXXX",null,"888WS001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[null,"註A1：符合查詢資格要件，係指符合聯徵中心會員規約第12條第1項之規定者。"]
[null,"註A2：符合查詢資格要件但有下列缺失者，請續勾選缺失項目，其代號為："]
[null,"          (1)證明文件無填寫日期； (2)證明文件日期後於查詢日；(3)其他(請說明於備註)。"]
[null,"註A3：不符合查詢資格要件者，請續勾選原因，其代號為：(1)未具辦理衍生性金融商品業務目的；"]
[null,"          (2)未取得足資證明文件；(3)ID誤鍵；(4)其他(請說明於備註)。"]
["      (A)類-應查核總筆數共5筆"]
["(B)類--查詢當事人勞工退休準備金相關資訊之查詢紀錄"]
["編號","查詢日期","查詢對象",null,"使用者代號","查詢資格要件\n是否符合(註B1)","符合查詢資格要件\n但有下列缺失(註B2)","不符合查詢資格   \n要件之原因(註B3)","備註"]
[1,"xxx/xx/xx","12XXXXXX",null,"888ET001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[2,"xxx/xx/xx","1XXXXXX2",null,"888ET001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[3,"xxx/xx/xx","35XXXXXX",null,"888ET001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[4,"xxx/xx/xx","3XXXXXX5",null,"888ET001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[5,"xxx/xx/xx","68XXXXXX",null,"888ET001","□1.是□2.否","□1 □2  □3","□1 □2 □3 □4"]
[null,"註B1：符合查詢資格要件者，係指取得當事人書面同意，於同意書內向當事人明示查詢項目「R08」，"]
[null,"          且符合授信之特定目的。        "]
[null,"註B2：符合查詢資格要件但有下列缺失者，請續勾選缺失項目，其代號為："]
[null,"          (1)證明文件無填寫日期； (2)證明文件日期後於查詢日；(3)其他(請說明於備註)。"]
[null,"註B3：不符合查詢資格要件者，請續勾選原因，其代號為：(1)未具備授信之特定目的；"]
[null,"          (2)未取得足資證明文件；(3)ID誤鍵；(4)其他(請說明於備註)。"]
["     (B)類-應查核總筆數共5筆"]
["(C)類--查詢中小企業融資服務平台資料(T類產品項目)之發查紀錄"]
["編號","發查日期","查詢對象",null,"使用者代號","查詢資格要件\n是否符合(註C1)","缺失改善辦理\n情形(註C2)","備註"]
[1,"xxx/xx/xx","13XXXXXX",null,"888SM530","□1.是□2.否"]
[2,"xxx/xx/xx","1XXXXXX3",null,"888SM530","□1.是□2.否"]
[3,"xxx/xx/xx","58XXXXXX",null,"888SM530","□1.是□2.否"]
[4,"xxx/xx/xx","5XXXXXX8",null,"888SM530","□1.是□2.否"]
[5,"xxx/xx/xx","86XXXXXX",null,"888SM530","□1.是□2.否"]
[null,"註C1：符合查詢資格要件，係指取得當事人查詢中小業融資服務平台之專用授權書，且符合融資"]
[null,"         之特定目的。"]
[null,"註C2：查詢資格要件不符合者，請於本欄位填寫改善辦理情形。\n\n"]
["     (C)類-應查核總筆數共5筆"]
["(D)類--查詢當事人不動產逆向抵押借款人遷籍、死亡資訊之查詢紀錄"]
["編號","發查日期","查詢對象",null,"使用者代號","查詢資格要件\n是否符合(註D1)","缺失改善辦理\n情形(註D2)","備註"]
[1,"xxx/xx/xx","A1XXXXXXX0",null,"888WA002","□1.是□2.否"]
[2,"xxx/xx/xx","B2XXXXXXX3",null,"888WA002","□1.是□2.否"]
[3,"xxx/xx/xx","F2XXXXXXX9",null,"888WA002","□1.是□2.否"]
[4,"xxx/xx/xx","E1XXXXXXX8",null,"888WA002","□1.是□2.否"]
[5,"xxx/xx/xx","S1XXXXXXX6",null,"888WA002","□1.是□2.否"]
[null,"註D1：符合查詢資格要件，係指符合聯徵中心會員規約第12條第1項之規定者。"]
[null,"註D2：查詢資格要件不符合者，請於本欄位填寫改善辦理情形。"]
["     (D)類-應查核總筆數共5筆"]
[]
["主管：",null," ",null,null,"覆核人：",null,"查核人："]
[]
["注意事項："]
["(A)類查核資料"]
[null,"(一)查核資料來源"]
[null,"      1、為108年1月查詢衍生性金融相關產品(C05~C07)之查詢紀錄。(含特約產品查詢紀錄)"]
["        ","      2、請逐筆查核是否符合查詢資格要件者，若符合查詢資格要件但有缺失者，請續勾選缺失項目；"]
[null,"            若不符合查詢資格要件者，請續勾選不符合原因；如不符合原因屬其他者，請說明於備註欄。"]
[null,"      3、請逐筆查核。本類查核不須檢附證明文件影本予本中心。"]
[null,"(二)依據本中心103年12月2日金徵(信)字第1030009754號函說明二：衍生性金融相關產品僅提供會員金融"]
[null,"       機構於辦理衍生性金融商品業務，並取得受查企業書面同意後查詢，不提供會員金融機構為辦理授"]
[null,"       信等其他業務目的之查詢。"]
[null,"(三)查核資料來源之查詢紀錄，於本中心產品代號為「Z50」。"]
["(B)類查核資料"]
[null,"(一)查核資料來源 "]
[null,"      1、為107年11月查詢「R08勞工退休準備金相關資訊」之查詢紀錄。(含特約產品查詢紀錄)"]
["        ","      2、請逐筆查核是否符合查詢資格要件者，若符合查詢資格要件但有缺失者，請續勾選缺失項目；"]
[null,"            若不符合查詢資格要件者，請續勾選不符合原因；如不符合原因屬其他者，請說明於備註欄。"]
[null,"      3、請逐筆查核。本類查核不須檢附證明文件影本予本中心。"]
[null,"(二)依據本中心104年8月27日金徵(信)字第1040006990號函說明三：會員機構因辦理核貸業務而有"]
[null,"       查詢R08產品之需要時，應先取得受查企業客戶之書面同意後查詢。"]
[null,"(三)查核資料來源之查詢紀錄，於本中心產品代號為「Z50」。"]
["(C)類查核資料 "]
[null,"(一)查核資料來源"]
[null,"       1、為有加入經濟部中小企業處中小企業融資服務平台之會員金融機構，107年12月查詢T類產品"]
[null,"             項目(T10~T19、T91~T95等)之發查紀錄  。"]
[null,"      2、請逐筆查核。本類查核不須檢附證明文件影本予本中心。"]
[null,"(二)依據「經濟部中小企業處中小企業融資服務平台介接公務及非公務機關電子資料使用管理規範」"]
[null,"       及「財團法人金融聯合徵信中心及其會員透過中小企業融資服務平台介接公務及非公務機關"]
[null,"       電子資料使用管理辦法」規定，“本中心會員需徵得個別企業之授權書後，始得使用介接資料，"]
["        ","       並以融資目的所需之徵審查調為限。”"]
[null,"(三)查核資料來源之查詢紀錄，於本中心產品代號為「Z51」。"]
["(D)類查核資料 "]
[null,"(一)查核資料來源"]
[null,"       1、為108年1月至108年2月查詢不動產逆向抵押借款人遷籍、死亡產品(B46)之查詢紀錄。(含特約產"]
[null,"            品查詢紀錄)"]
[null,"      2、請逐筆查核。本類查核不須檢附證明文件影本予本中心。"]
[null,"(二)依據「財團法人金融聯合徵信中心及金融機構辦理逆向抵押貸款業務使用戶役政資訊管理規定」，"]
[null,"      “金融機構將辦理不動產逆向抵押貸款借款人名單提供聯徵中心向內政部查詢其戶籍資料時，應先"]
[null,"      於借款契約中取得借款人書面同意。”"]
[null,"(三)查核資料來源之查詢紀錄，於本中心產品代號為「Z50」。"]