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["附件6"]
["101年社區照顧關懷據點執行概況考核表(範例)"]
["機關（單位）名稱：   彰化縣花塘鄉中庄社區發展協會            "]
["接受內政部社會福利補助經費101年度執行概況考核表（A4格式）"]
["中華民國101年1月1日起至101年12月31日止",{"$nulls":18},"單位：新臺幣元"]
["計畫編號","受補助單位","補助計畫","申請時自籌經費\n","核定補助經費",null,"預定完成日期","實際完成日期","累計實支數",{"$nulls":6},"執行進度％\n","核銷情形\n\n","繳回經費",null,"備註\n(受益人次)"]
[{"$nulls":4},"經常門","資本門",null,null,"合計",null,"自籌經費支出",null,"補助經費支出",{"$nulls":4},"經常門","資本門","男","女"]
[{"$nulls":8},"經常門","資本門","經常門","資本門","縣市政府配合經費","內政部"]
[{"$nulls":13},"經常門","資本門"]
["101DG901z","彰化縣花壇鄉中庄社區發展協會","建立社區照顧關懷據點",50000,133000,0,"101.12.31","101.12.31",175000,0,35000,0,7000,133000,0,{"v":1,"d":"100%"},"已核銷",0,0,"關懷訪視30人次/月;電話問安10人次/月;健康促進250人次/月","關懷訪視30人次/月;電話問安10人次/月;健康促進250人次/月"]
[]
[]
[]
["合計"]
[]
["填表說明：\n1.「執行進度％」欄係指計畫工作執行進度，非為經費支出進度。\n2.「申請時自籌經費」欄所列係指申請單位申請時所列之自籌款，「核定補助經費」欄所列係指本部核定之補助金額。\n3.「核銷情形」欄請於計畫執行完成就地審計核銷後，填寫「已核銷」，如有賸餘款、其他收入請隨函繳回，本部據以備查建檔結案。\n4.「累計實支數」，如包含經常支出及資本支出，或經常支出內包含「專業服務費」，受補助單位應另以附件十三之一附表說明其「累計實支數」欄位內「自籌經費支出」及「補助經費支出」之「經常支出」、「資本支出」分配情形；「經常支出」內如包含「專業服務費」亦應分項說明。\n5.備註欄內請填報受益人次。"]
[]
["填表人：                                                    會計：                                                                   總幹事：                                                       理事長：                                                                                                              \n"]

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["101年社區照顧關懷據點執行概況考核表(範例)"]
["機關（單位）名稱：                       "]
["接受內政部社會福利補助經費　　　年度上/下半年執行概況考核表（A4格式）"]
["中華民國　　年　　月　　日起至　　年　　月　　日止",{"$nulls":18},"單位：新臺幣元"]
["計畫編號","受補助單位","補助計畫","申請時自籌經費\n","核定補助經費",null,"預定完成日期","實際完成日期","累計實支數",{"$nulls":6},"執行進度％\n","核銷情形\n\n","繳回經費",null,"備註\n(受益人次)"]
[{"$nulls":4},"經常門","資本門",null,null,"合計",null,"自籌經費支出",null,"補助經費支出",{"$nulls":4},"經常門","資本門","男","女"]
[{"$nulls":8},"經常門","資本門","經常門","資本門","縣市政府配合經費","內政部"]
[{"$nulls":13},"經常門","資本門"]
[{"$nulls":4},"E","F",null,null,"I","J","K","L","M","N","O",null,null,"R","S"]
[]
[]
[]
[]
["合計"]
[]
["填表說明：\n1.「執行進度％」欄係指計畫工作執行進度，非為經費支出進度。\n2.「申請時自籌經費」欄所列係指申請單位申請時所列之自籌款，「核定補助經費」欄所列係指本部核定之補助金額。\n3.「核銷情形」欄請於計畫執行完成就地審計核銷後，填寫「已核銷」，如有賸餘款、其他收入請隨函繳回，本部據以備查建檔結案。\n4.「累計實支數」，如包含經常支出及資本支出，或經常支出內包含「專業服務費」，受補助單位應另以附件十三之一附表說明其「累計實支數」欄位內「自籌經費支出」及「補助經費支出」之「經常支出」、「資本支出」分配情形；「經常支出」內如包含「專業服務費」亦應分項說明。\n5.備註欄內請填報受益人次。"]
[]
["填表人：                                   業務主管：                                                                   主辦會計：                                                       核轉機關首長：                                                                                                              \n"]