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["附件一："]
["外商投资创业投资企业情况备案表"]
[]
["企业名称"]
["英文名称"]
["注册地址"]
["股东及出资情况"]
["资金总额"]
["其中：中方投资者"]
["名称","认缴出资额","实际出资额",null,"占资金总额比重"]
[]
[]
[]
["（中方出资如涉及国有资产、民营资产，应予说明）"]
["外方投资者"]
["名称及注册地国别/地区","认缴出资额","实际出资额",null,"占资金总额比重"]
[]
[]
[]
["（外方应说明实际控制人及其注册地）"]
["创投企业管理资本情况"]
["管理资本总额",null,null,"同比"]
["经营情况"]
["股权投资行业情况"]
["投资行业","项目数","同比","投资金额","同比"]
["农、林、牧、渔业"]
["采矿业"]
["制造业"]
["   医药制造业"]
["   设备制造业"]
["   新材料工业"]
["   化工产业"]
["   计算机硬件产业"]
["   通讯设备制造业"]
["   软件产业"]
["   环保工程产业"]
["   其他制造业(请说明)"]
["交通运输业"]
["批发和零售业"]
["   一般商品的配送"]
["   现代物流"]
["科研、技术服务业"]
["公共设施业"]
["商业服务业"]
["   服务外包"]
["媒体和娱乐业"]
["其他（请说明）"]
["股权投资地区分布情况"]
["省份（请列出）","项目数","同比","投资金额","同比"]
[]
[]
[]
["所投资企业发展阶段"]
[null,"项目数","同比","投资金额 ","同比"]
["初创期"]
["种子期"]
["成长（扩张）期"]
["成熟期"]
["重建期"]
["在所投资企业持股情况"]
[null,"项目数",null,null,"同比"]
["10%以下"]
["10%-20%"]
["20%-30%"]
["30%-40%"]
["40%-50%"]
["50%以上"]
["在所投资企业投资阶段情况"]
[null,"项目数","同比","投资金额","同比"]
["首轮投资"]
["后续投资"]
["所投资企业雇员人数情况"]
[null,"项目数",null,null,"同比"]
["10人以下"]
["10人-50人"]
["50人-100人"]
["100人-150人"]
["150人-200人"]
["200人以上"]
["退出情况"]
["退出方式"]
["退出方式","收益情况","增值情况",null,"增值幅度（%）"]
["首次上市"]
["上市减持"]
["股权转让"]
["回购"]
["并购"]
["重组"]
["清算"]
["其他（可说明）"]
["退出行业情况"]
["投资行业","退出项目数","同比","涉及金额","同比"]
["农、林、牧、渔业"]
["采矿业"]
["制造业"]
["   医药制造业"]
["   设备制造业"]
["   新材料工业"]
["   化工产业"]
["   计算机硬件产业"]
["   通讯设备制造业"]
["   软件产业"]
["   环保工程产业"]
["   其他制造业(请说明)"]
["交通运输业"]
["批发和零售业"]
["   一般商品的配送"]
["   现代物流"]
["科研、技术服务业"]
["公共设施业"]
["商业服务业"]
["   服务外包"]
["媒体和娱乐业"]
["其他（请说明）"]
["退出分地区情况"]
["省份（请列出）","项目数","同比","投资金额","同比"]
[]
[]
[]
["是否享受税收优惠政策的情况"]
["享受政策种类",null,null,"享受额度"]
[]
[]
[]
["意见、建议，以及其他创投企业认为需要说明的情况"]
["对市场前景的评价"]
["对法律环境的评价"]
["对政策环境的评价"]
["对所投资企业管理水平的评价"]
["其他"]
[]
[]
[]
[]
["说明：新批准设立的创投企业应填写股东及出资情况。经营情况等内容可填写投资计划。"]
[]
[]
[]
["填表人：",null,null,"填表日期："]
[]
["企业负责人签字（盖公司印章）："]

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