农村特困人员申请书怎么写

样本一：

农村特困人员救助供养申请书

申请人：

• 姓名：________
• 性别：________
• 民族：________
• 出生日期：______年______月______日
• 身份证号码：____________________________
• 家庭住址：______省______市______县______乡（镇）______村______组
• 联系电话：________________（如有）
• 健康状况：________________（如：患有________疾病，丧失劳动能力等）
• 家庭成员情况：（如有共同生活的家庭成员，请填写）

申请事由：

本人________，现居住于______省______市______县______乡（镇）______村______组。因_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(878) 878-9808

申请事由：

我叫______，是_____省_____市_____县_____乡（镇）_____村_____组村民，身份证号码是____________________。我今年_____岁，身体状况_____（详细说明具体健康问题，例如：患有_____病多年，无法从事体力劳动；因_____原因导致残疾，残疾等级为____级等），且_____（说明是否无配偶、无子女或其他家庭情况，例如：无配偶，无子女；配偶已故，子女均在外地无法照顾；配偶/子女患有____疾病，需要长期照料等）。

我家现有____口人，分别是_____（列出所有家庭成员姓名、与申请人关系、年龄、健康状况、收入情况等）。主要收入来源是_____（例如：务农、低保、养老金等），年收入约为_____元。由于_____（详细说明导致生活困难的具体原因，例如：长期患病导致医疗费用巨大，且无力承担；因自然灾害导致房屋倒塌，无家可归；因年龄过大，失去劳动能力，无经济来源等），家庭生活十分困难，无力维持基本生活，符合农村特困人员的认定标准。

特此向贵村（居）委会、乡（镇）人民政府申请特困人员救助供养，希望能够得到政府的帮助，解决基本生活困难。

附件材料：

1. 本人身份证复印件
2. 户口簿复印件
3. _____（其他相关证明材料，如：残疾证复印件、疾病诊断证明、低保证复印件、房屋受损照片等）

承诺：

本人承诺以上所填信息及提供的材料真实有效，如有虚假，愿承担一切法律责任。

申请人（签字、捺印）：________

_____年____月_____日

村（居）委会意见：

（盖章）

_____年____月____日

乡（镇）人民政府意见：

（盖章）

_____年____月_____日

样本二：

农村特困人员申请书

尊敬的_____乡（镇）人民政府、_____村（居）委会：

我叫________，性别_____，_____族，_____年____月____日出生，身份证号码：____________________，现居住在_____省_____市_____县_____乡（镇）_____村_____组。

家庭基本情况：

• 家庭人口：_____人
• 家庭成员：
  • 姓名：________，关系：________，年龄：_____，健康状况：________，劳动能力：________，收入情况：________。
  • （如有其他家庭成员，请依次列出）
• 主要收入来源：____________________________________（如：务农、低保、养老金、残疾补助等）
• 年总收入：约______元
• 主要支出：____________________________________（如：医疗费用、生活费用、子女教育费用等）

申请特困救助供养的理由：

本人因_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________\