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ڝ΁ 1-1
ڝ΁
ࣨ೯ୌ՘ᛇڎ̨ਠΫ̨ҳ༟Бਗ˙ࣩ™༟ࣸႩ֛͡ሗࣣ
€͉͡ሗࣣɓ຾෩ҷу̰ࣖ ͡ሗɛ͡ሗ ϋ ˜ ˚

຾᏶௅ҳ༟ၽᝄԫਕה̨ᛡj ˚ಂʿο໮
( ɓ ) ͡ሗԫධʿΤ၈ Աኽ˜ᛇڎ̨ਠΫ̨ҳ༟Бਗ˙ࣩ™͡ሗࣨ೯༟ࣸႩ֛֛ࣨՌ

ʮ ̡ Τ ၈
( ɚ )
͡ ᐄлԫุ୕ɓᇜ໮ ࠋபɛ ᑌഖɛ
ሗ ཥ ༑ Email
ɛ
ᐼʮ̡ήѧ
΍Ν༟ࣸj( ඲Ό௅ୌΥ )
½ߕʕ൱׸኷աላᏘุ٫
½ࠌʕ਷ɽ௔ҳ༟༺ 2 ϋ˸ɪ
½Ϋ̨ҳ༟ / ᓒᅀʘ௅ʱପᇞ඲Ո௪౽ᅆҦஔʩ९א౽ᅆʷ̌ঐʘΆุ
त֛༟ࣸj( ඲ୌΥЇˇɓධ )
( ɧ ) ቇ͜༟ࣸ
½᙮ 5+2 ପุ௴อჯਹ
½᙮৷ڝ̋ᄆ࠽ପۜʿᗫᒟཧଡ଼΁޴ᗫପุ
½਷ყԶᏐᗡ֢׵ᗫᒟήЗ
½ІϞۜ೐਷ყБቖ
½຾Ⴉ֛Ϋ̨ҳ༟ධͦၾ਷࢕ࠠᓃପุ݁ഄ޴ᗫ
½ ৷߅Ҧପุ ( ҳ༟੽ԫጐ᜗ཥ༩౺˪Ⴁிe૰౺ᜑͪኜ€TFT Ñ LCDאጐ᜗ཥ༩Ⴁ೻͜
( ̬ ) ʮ̡Бุᗳй Έ໅ഃɧ၇Ⴁ೻אႡۜʘႡிุ )
½Չ˼ପุ ( Ⴍ׼ :____________________)
͉ʮ̡ҳ༟ࠇ೥ᐼږᕘjอ̨࿆ _________ ʩdՉʕj
1. ᒅໄɺήjอ̨࿆ _____________ ʩi 2. อ ( ᓒ ) ܔᅀגjอ̨࿆ _________ ʩd
( ʞ ) ཫࠇҳ༟ږᕘ
3. ᒅໄዚኜண௪jอ̨࿆ _________ ʩi4. ᐄ༶༟ږjอ̨࿆ ______________ ʩ
( ৷߅Ҧପุҳ༟ږᕘ༺อ̨࿆ _________ ʩ˸ɪiՉ˼ପุҳ༟ږᕘ༺อ̨࿆ _________ ʩ˸ɪ )
͉ʮ̡ତϞ྇͜ࡰʈᐼɛᅰj_______ ɛdՉʕj
͉਷ࡰʈɛᅰj_______ ɛiႡிุ̮ᘬࡰʈɛᅰ ( ᔝჯ )j_______ ɛ
( ʬ ) ཫࠇอᄣ྇͜ࡰʈᅰ ͉ʮ̡อᄣ྇͜ࡰʈᐼɛᅰj_______ ɛdՉʕj
อᄣ͉਷ࡰʈɛᅰj_______ ɛ ( ᑚ༟༺อ̨࿆ 3 ຬʩ )iอᄣႡிุ̮ᘬࡰʈɛᅰ ( ᔝჯ )j
_______ ɛ ( Չʕत֛Ⴁ೻ 5 ॴՓj_______ ɛiڝࣩ̋j_______ ɛiΎڝ̋j_______ ɛ )
อ( ᓒ )ܔᅀגήᓃ
( ɖ )
ண௪τༀήᓃ
( ɞ ) ཫࠇҳ༟ࠇ೥ҁϓ˚ ͏਷ _______ ϋ _______ ˜ _______ ˚

( ɘ ) Ꮸڝ˖΁j( ᅂ͉˖΁Ꮠ̋ႊ˜ၾ͍͉޴ୌ™Ι௝ ) ( ɤ ) ɪකҳ༟ࠇ೥ࣣʘᜊһd˸ɓϣމࠢd˲Ꮠ׵ҳ༟ࠇ
1. ʮ̡ணͭ೮াڌᅂ͉ɓ΅ ೥ҁϓۃ౤̈͡ሗf
2. ҳᄲึࣨࡘא௪ݟՌᅂ͉ ( ͉ʮ̡א͎ʮ̡ࠌʕ਷ɽ௔ҳ༟ ) ( ɤɓ ) וፕࣣj
3. ҳ༟ࠇ೥ࣣ 10 ΅ ͡ሗɛڭᗇ͡ሗࣣʿՉהڝ༟ࣘѩ᙮͍ᆽdνϞൈ
4. ቇ͜༟ࣸ޴ᗫᗇ׼˖΁j ৽ʔྼdᗴࠋجܛப΂f
(1) ߕʕ൱׸኷աላᏘุ٫jᏐІБႭ׼޴ᗫᗇ׼˖΁ ( ɤɚ ) ਖ਼ɛਖ਼ࣩ܄Ⴁʷ؂ਕj
(2) ପᇞՈ௪౽ᅆҦஔʩ९א౽ᅆʷ̌ঐjᏐІБႭ׼ୌΥʘ މл̋஺͡ሗɛ˖΁๟௪d͡ሗɛሗ΋ݻ༔ҳ༟ၽ
Ҧஔא̌ঐ ᝄԫਕהd͟ਖ਼ɛආБႾኬf( νϞ͡ሗᎴ౉ცӋd
(3) ᙮ 5+2 ପุ௴อჯਹjᏐІБႭ׼ୌΥʘପุ ሗ෬ᄳܝڝʘ͡ሗ˜ᛇڎ̨ਠΫ̨ҳ༟Бਗ˙ࣩ™
(4) ᙮৷ڝ̋ᄆ࠽ପۜʿᗫᒟཧଡ଼΁޴ᗫପุjᏐІБႭ׼ୌ Ꮄ౉ცӋڌ )
Υପุאପۜධͦ ( ɤɧ ) ධϣ ( ʬ ) อᄣᔝჯ̮ᘬࡰʈɛᅰdස΋˸΢ॴй༊
(5) ਷ყԶᏐᗡ֢׵ᗫᒟήЗ : νમᒅΥߒࣣഃᗇ׼˖΁ Бࠇၑf͍ό͡ሗ໌྇Ⴁிุ̮ᘬ௶ʈdც˸຾᏶
(6) ІϞۜ೐਷ყБቖ : ᏐϞۜ೐ਠᅺ೮াʿ̈஬ ( મᒅeቖ ௅ʈุ֛҅ࣨБุйʿॴйΐࠇ໌྇ɛᅰf
஬ഃ ) ˖΁eΥߒࣣഃԑ༟ᗇ׼˖΁
(7) ຾Ⴉ֛Ϋ̨ҳ༟ධͦၾ਷࢕ࠠᓃପุ݁ഄ޴ᗫjᏐІБႭ
׼޴ᗫᗇ׼˖΁
( ሗႊʮ̡೮াΙᛠ௝ʿࠋபɛ೮াΙᛠ௝ )

৔΁ήѧj10046 ̨̹̏ᑳජ༩ 1 ໮ 8 ᅽ ҳ༟ၽᝄԫਕה ؂ਕཥ༑j(02)2311-2031 ၣѧ : https://investtaiwan.nat.gov.tw/
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