系统填报号：

高新技术企业认定申请书

企业名称：

企业所在地区： 省 市(区、自治州)

认定机构： 上海市高新技术企业认定办公室

申请日期： 年 月 日

声明：本申请书上填写的有关内容和提交的资料均准确、真实、合法、有效、无涉密信息，本企业愿为此承担有关法律责任。

法定代表人（签名）: （企业公章）

科技部、财政部、国家税务总局编制

二O一六年六月

企业注册登记表

企业名称		注册时间
注册类型		外资来源地
注册资金		所属行业
企业规模		行政区域
组织机构代码/统一社会信用代码		税务登记号/统一社会信用代码
企业所得税主管税务机关	□国税 □地税	企业所得税 征收方式	□查账征收 □核定征收
通信地址		邮政编码
企业法定 代表人	姓名		手机		身份证号/护照号
电话		传真		E-mail
联系人	姓名		手机
电话		传真		E-mail
企业是否上市	□是 □否	上市时间
股票代码		上市类型
是否属于国家级高新区内企业	□是 □否	高新区名称

填 报 说 明

企业应参照《高新技术企业认定管理办法》、《国家重点支持的高新技术领域》（国科发火〔2016〕32号）和《高新技术企业认定管理工作指引》（国科发火〔2016〕195号）的要求填报。

本表内的所有财务数据须出自专项报告、财务会计报告或纳税申报表。

1. 企业应如实填报所附各表。要求文字简洁，数据准确、详实。

2. 各栏目不得空缺，无内容填写“0”；数据有小数时，保留小数点后2位。

3. 对企业知识产权情况采用分类评价方式，其中：发明专利（含国防专利）、植物新品种、国家级农作物品种、国家新药、国家一级中药保护品种、集成电路布图设计专有权等按Ⅰ类评价；实用新型专利、外观设计专利、软件著作权等（不含商标）按Ⅱ类评价。

4. “基础研究投入费用总额”是指：企业研究开发费用总额中，为获得科学与技术（不包括社会科学、艺术或人文学）新知识等基础研究活动支出的费用总额。

5. 销售收入 = 主营业务收入 + 其他业务收入

企业总收入 = 收入总额 - 不征税收入

净资产 = 资产总额 - 负债总额

6. “近三年”、“近一年”和“申请认定前一年内”：详见《工作指引》三（一）“年限”中的说明，“近三年”即“年限”中的“近三个会计年度”。

7. “研发活动”：详见《工作指引》三（六）1中“研究开发活动确定”。

8. “高新技术产品（服务）收入”：详见《工作指引》三（四）1中“高新技术产品（服务）收入”的定义。

9. IP代表知识产权编号；RD代表研究开发活动编号；PS代表高新技术产品（服务）编号。IP、RD、PS后取两位数（01、02、……）。

10.为了了解上海科技企业发展情况，申请高新技术企业时将企业基本情况填写完整，否则无法提交高新技术企业申报表。

一、主要情况

技术领域
获得知识产权 数量(件)	Ⅰ类		Ⅱ类
人力资源 情况（人）	职工总数		科技人员数
近三年 经营情况 （万元）	年度 种类	净资产	销售收入	利润总额
2018年
2017年
2016年
近三年研究开发费用总额 （万元）		其 中	在中国境内 研发费用 总额（万元）
基础研究投入费用总额 （万元）
2018年企业总收入（万元）
2018年高新技术产品（服务）收入（万元）
申请认定前一年内是否发生过重大安全、 重大质量事故或严重环境违法行为	□是 □否

二、知识产权汇总表

获得 知识产权 数量(件)	发明专利		其中：国防专利
植物新品种		国家级农作物品种
国家新药		国家一级中药保护品种
集成电路布图 设计专有权		实用新型
外观设计		软件著作权

知识产权编号	知识产权名称	类别	授权日期	授权号	获得方式
IP…

三、人力资源情况表

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（一）总体情况
	企业职工	科技人员
总 数（人）
其中：在职人员
兼职人员
临时聘用人员
外籍人员
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{placeholder tag=td i=2379}{placeholder tag=p i=482}{placeholder tag=span i=1561}合计{placeholder tag=span i=1562}

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{placeholder tag=p i=496}{placeholder tag=span i=1576}企业填报人签字： 日 期： {placeholder tag=span i=1577} {placeholder tag=span i=1578}

{placeholder tag=p i=497}{placeholder tag=span i=1579}

{placeholder tag=span i=1580}{placeholder tag=br i=17} {placeholder tag=p i=33}{placeholder tag=p i=498}{placeholder tag=span i=1581}六、上年度高新技术产品（服务）情况表（按单一产品（服务）填报）{placeholder tag=span i=1582}

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{placeholder tag=td i=2393}{placeholder tag=p i=502}{placeholder tag=span i=1588}技术领域{placeholder tag=span i=1589}

{placeholder tag=td i=2394}{placeholder tag=p i=503}{placeholder tag=span i=1590}

{placeholder tag=td i=2395}{placeholder tag=p i=504}{placeholder tag=span i=1591}技术来源{placeholder tag=span i=1592}

{placeholder tag=td i=2396}{placeholder tag=p i=505}{placeholder tag=span i=1593}

{placeholder tag=td i=2397}{placeholder tag=p i=506}{placeholder tag=span i=1594}上年度销售收入{placeholder tag=span i=1595}

{placeholder tag=p i=507}{placeholder tag=span i=1596}（万元）{placeholder tag=span i=1597}

{placeholder tag=td i=2398}{placeholder tag=p i=508}{placeholder tag=span i=1598}

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{placeholder tag=td i=2402}{placeholder tag=p i=513}{placeholder tag=span i=1610}

{placeholder tag=td i=2403}{placeholder tag=p i=514}{placeholder tag=span i=1611}关键技术{placeholder tag=span i=1612}

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{placeholder tag=p i=516}{placeholder tag=span i=1615}技术指标{placeholder tag=span i=1616}

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{placeholder tag=p i=528}{placeholder tag=span i=1631}竞争优势{placeholder tag=span i=1632}

{placeholder tag=p i=529}{placeholder tag=span i=1633}（限400字）{placeholder tag=span i=1634}

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{placeholder tag=td i=2407}{placeholder tag=p i=531}{placeholder tag=span i=1636}知识产权获得情况及其对产品（服务）在技术上发挥的支持作用{placeholder tag=span i=1637}

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{placeholder tag=p i=541}{placeholder tag=span i=1648}{placeholder tag=br i=18}{placeholder tag=span i=1649}七、企业创新能力{placeholder tag=span i=1650}

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{placeholder tag=td i=2412}{placeholder tag=p i=548}{placeholder tag=span i=1662}

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{placeholder tag=td i=2423}{placeholder tag=p i=567}{placeholder tag=span i=1693}

{placeholder tag=td i=2424}{placeholder tag=p i=568}{placeholder tag=span i=1694}□国家{placeholder tag=span i=1695} {placeholder tag=span i=1696}□行业{placeholder tag=span i=1697}

{placeholder tag=td i=2425}{placeholder tag=p i=569}{placeholder tag=span i=1698}

{placeholder tag=td i=2426}{placeholder tag=p i=570}{placeholder tag=span i=1699}□{placeholder tag=span i=1700}主持 {placeholder tag=span i=1701}□{placeholder tag=span i=1702}参与{placeholder tag=span i=1703}

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{placeholder tag=td i=2436}{placeholder tag=p i=580}{placeholder tag=span i=1723}□{placeholder tag=span i=1724}主持 {placeholder tag=span i=1725}□{placeholder tag=span i=1726}参与{placeholder tag=span i=1727}

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{placeholder tag=td i=2440}{placeholder tag=p i=586}{placeholder tag=span i=1737}

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{placeholder tag=td i=2442}{placeholder tag=p i=588}{placeholder tag=span i=1740}

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{placeholder tag=td i=2444}{placeholder tag=p i=590}{placeholder tag=span i=1743}

{placeholder tag=td i=2445}{placeholder tag=p i=591}{placeholder tag=span i=1744}专项审计报告审计人{placeholder tag=span i=1745}1{placeholder tag=span i=1746}

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{placeholder tag=td i=2456}{placeholder tag=p i=602}{placeholder tag=span i=1767}

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{placeholder tag=td i=2460}{placeholder tag=p i=606}{placeholder tag=span i=1774}（包括：企业经营范围、主营业务、经营状况以及公司网址，限500字以内）{placeholder tag=span i=1775}

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{placeholder tag=td i=2466}{placeholder tag=p i=612}{placeholder tag=span i=1785}

{placeholder tag=td i=2467}{placeholder tag=p i=613}{placeholder tag=span i=1786}开户银行{placeholder tag=span i=1787}

{placeholder tag=td i=2468}{placeholder tag=p i=614}{placeholder tag=span i=1788}

{placeholder tag=td i=2469}{placeholder tag=p i=615}{placeholder tag=span i=1789}开户名{placeholder tag=span i=1790}

{placeholder tag=td i=2470}{placeholder tag=p i=616}{placeholder tag=span i=1791}

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{placeholder tag=td i=2472}{placeholder tag=p i=618}{placeholder tag=span i=1794}

{placeholder tag=td i=2473}{placeholder tag=p i=619}{placeholder tag=span i=1795}经营{placeholder tag=span i=1796}

{placeholder tag=p i=620}{placeholder tag=span i=1797}情况{placeholder tag=span i=1798}

{placeholder tag=p i=621}{placeholder tag=span i=1799}（万元）{placeholder tag=span i=1800}

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{placeholder tag=td i=2475}{placeholder tag=p i=623}{placeholder tag=span i=1803}总产值{placeholder tag=span i=1804}

{placeholder tag=td i=2476}{placeholder tag=p i=624}{placeholder tag=span i=1805}利润{placeholder tag=span i=1806}

{placeholder tag=p i=625}{placeholder tag=span i=1807}总额{placeholder tag=span i=1808}

{placeholder tag=td i=2477}{placeholder tag=p i=626}{placeholder tag=span i=1809}销售额{placeholder tag=span i=1810}

{placeholder tag=td i=2478}{placeholder tag=p i=627}{placeholder tag=span i=1811}科技开发经费支出{placeholder tag=span i=1812}

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{placeholder tag=td i=2480}{placeholder tag=p i=629}{placeholder tag=span i=1815}占销售额{placeholder tag=span i=1816}

{placeholder tag=p i=630}{placeholder tag=span i=1817}（％）{placeholder tag=span i=1818}

{placeholder tag=td i=2481}{placeholder tag=p i=631}{placeholder tag=span i=1819}201{placeholder tag=span i=1820}8{placeholder tag=span i=1821}年{placeholder tag=span i=1822}

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{placeholder tag=td i=2483}{placeholder tag=p i=633}{placeholder tag=span i=1824}

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{placeholder tag=td i=2485}{placeholder tag=p i=635}{placeholder tag=span i=1826}

{placeholder tag=td i=2486}{placeholder tag=p i=636}{placeholder tag=span i=1827}

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{placeholder tag=td i=2488}{placeholder tag=p i=638}{placeholder tag=span i=1830}出口创汇额{placeholder tag=span i=1831}

{placeholder tag=p i=639}{placeholder tag=span i=1832}（美元）{placeholder tag=span i=1833}

{placeholder tag=td i=2489}{placeholder tag=p i=640}{placeholder tag=span i=1834}应交所得税{placeholder tag=span i=1835}

{placeholder tag=td i=2490}{placeholder tag=p i=641}{placeholder tag=span i=1836}享受高新技术企业减免所得税{placeholder tag=span i=1837}

{placeholder tag=td i=2491}{placeholder tag=p i=642}{placeholder tag=span i=1838}

{placeholder tag=td i=2492}{placeholder tag=p i=643}{placeholder tag=span i=1839}

{placeholder tag=td i=2493}{placeholder tag=p i=644}{placeholder tag=span i=1840}

{placeholder tag=td i=2494}{placeholder tag=p i=645}{placeholder tag=span i=1841}

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{placeholder tag=br i=21}

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{placeholder tag=p i=647}{placeholder tag=span i=1844}（万元）{placeholder tag=span i=1845}

{placeholder tag=td i=2497}{placeholder tag=p i=648}{placeholder tag=span i=1846}

{placeholder tag=td i=2498}{placeholder tag=p i=649}{placeholder tag=span i=1847}中方{placeholder tag=span i=1848}

{placeholder tag=p i=650}{placeholder tag=span i=1849}投资额{placeholder tag=span i=1850}

{placeholder tag=td i=2499}{placeholder tag=p i=651}{placeholder tag=span i=1851}

{placeholder tag=td i=2500}{placeholder tag=p i=652}{placeholder tag=span i=1852}中方 占比{placeholder tag=span i=1853}

{placeholder tag=td i=2501}{placeholder tag=p i=653}{placeholder tag=span i=1854}

{placeholder tag=td i=2502}{placeholder tag=p i=654}{placeholder tag=span i=1855}外方{placeholder tag=span i=1856}

{placeholder tag=p i=655}{placeholder tag=span i=1857}投资额{placeholder tag=span i=1858}

{placeholder tag=td i=2503}{placeholder tag=p i=656}{placeholder tag=span i=1859}

{placeholder tag=p i=657}{placeholder tag=span i=1860}

{placeholder tag=td i=2504}{placeholder tag=p i=658}{placeholder tag=span i=1861}外方占比{placeholder tag=span i=1862}

{placeholder tag=td i=2505}{placeholder tag=p i=659}{placeholder tag=span i=1863}

{placeholder tag=p i=660}{placeholder tag=span i=1864}

{placeholder tag=p i=661}{placeholder tag=span i=1865}

{placeholder tag=p i=662}{placeholder tag=span i=1866}注：1、主管部门选择依据：企业税收由区县税务局征管的请选择所属区县，注册在高新区内的企业请选择高新区所属分园；2、税务征管单位是指企业所在区税务局。 {placeholder tag=span i=1867}

{placeholder tag=p i=663}{placeholder tag=span i=1868}

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{placeholder tag=p i=665}{placeholder tag=span i=1871}十、企业研究开发组织管理情况{placeholder tag=span i=1872}

{placeholder tag=p i=666}{placeholder tag=span i=1873}内容包括：（1）制定了企业研究开发的组织管理制度，建立了研发投入核算体系，编制了研发费用辅助账；（2）设立了内部科学技术研究开发机构并具备相应的科研条件，与国内外研究开发机构开展多种形式产学研合作；（3）建立了科技成果转化的组织实施与激励奖励制度，建立开放式的创新创业平台；（4）建立了科技人员的培养进修、职工技能培训、优秀人才引进，以及人才绩效评价奖励制度。{placeholder tag=span i=1874}

{placeholder tag=table i=2039}{placeholder tag=td i=2506}{placeholder tag=p i=667}{placeholder tag=span i=1875}

{placeholder tag=p i=668}{placeholder tag=span i=1876}注：1、提供企业研究开发的组织管理制度、企业关于研发投入核算财务管理制度，如研发投入投资管理办法等，以及近三年的研发费用明细台账等；2、研究开发机构指：具备各级工程中心、研发中心、研发部门等，提供各级政府关于建立研究开发机构的批文、或企业建立相关部门的文件等；具备相应的科研条件可以提供包含中试车间、设备等，列出清单或附照片等；开展多种形式产学研合作必须提供产学研合作协议、与高校院所共建研发中心、共同申报项目协议等合作文件以及相应的经济往来的有效凭证；3、各类绩效考核奖励制度是指：必须提供研发部门绩效考评制度等；提供建立创新平台的相关资料等。4、建立了科技人员的培养进修、职工技能培训、优秀人才引进，以及人才绩效评价奖励制度等需提供相关资料。{placeholder tag=span i=1877}{placeholder tag=br i=23}{placeholder tag=span i=1878}十一、近三年科技成果转化能力情况汇总表{placeholder tag=span i=1879}

{placeholder tag=table i=2040}{placeholder tag=td i=2507}{placeholder tag=p i=669}{placeholder tag=span i=1880}序号{placeholder tag=span i=1881}

{placeholder tag=td i=2508}{placeholder tag=p i=670}{placeholder tag=span i=1882}科技成果年份{placeholder tag=span i=1883}

{placeholder tag=p i=671}{placeholder tag=span i=1884}（按标下注释1要求填写）{placeholder tag=span i=1885}

{placeholder tag=td i=2509}{placeholder tag=p i=672}{placeholder tag=span i=1886}科技成果名称{placeholder tag=span i=1887}

{placeholder tag=p i=673}{placeholder tag=span i=1888}（按表下注释2要求填写）{placeholder tag=span i=1889}

{placeholder tag=td i=2510}{placeholder tag=p i=674}{placeholder tag=span i=1890}科技成果转化结果{placeholder tag=span i=1891}

{placeholder tag=p i=675}{placeholder tag=span i=1892}（按表下注释3要求填写产品、服务、样品、样机等具体项目名称）{placeholder tag=span i=1893}

{placeholder tag=td i=2511}{placeholder tag=p i=676}{placeholder tag=span i=1894}转化年份{placeholder tag=span i=1895}

{placeholder tag=p i=677}{placeholder tag=span i=1896}（按表下注释4要求填写）{placeholder tag=span i=1897}

{placeholder tag=td i=2512}{placeholder tag=p i=678}{placeholder tag=span i=1898}转化形式{placeholder tag=span i=1899}

{placeholder tag=td i=2513}{placeholder tag=p i=679}{placeholder tag=span i=1900}科技成果转化证明材料（按表下注释5要求填写）{placeholder tag=span i=1901}

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{placeholder tag=td i=2576}{placeholder tag=p i=742}{placeholder tag=span i=1964}

{placeholder tag=p i=743}{placeholder tag=span i=1965}注：1、科技成果可以不在近三年，但转化一定要在近三年。一个科技成果只能转化一个产品（服务）或样品、样机。{placeholder tag=span i=1966}

{placeholder tag=p i=744}{placeholder tag=span i=1967}2、科技成果是指：通过科学研究与技术开发所产生的具有实用价值的成果（专利、版权、集成电路布图设计等）。{placeholder tag=span i=1968}

{placeholder tag=p i=745}{placeholder tag=span i=1969}3、科技成果转化结果是指：为提高生产力水平而对科技成果进行的后续试验、开发、应用、推广直至形成新产品、新工艺、新材料，发展新产业等活动；以及技术成果形成产品、服务、样品、样机等。{placeholder tag=span i=1970}

{placeholder tag=p i=746}{placeholder tag=span i=1971}4、转化时间是指：201{placeholder tag=span i=1972}6{placeholder tag=span i=1973}年至201{placeholder tag=span i=1974}8{placeholder tag=span i=1975}年期间。{placeholder tag=span i=1976}

{placeholder tag=p i=747}{placeholder tag=span i=1977}5、转化形式包括：自行投资实施转化；向他人转让该技术成果；许可他人使用该科技成果；以该科技成果作为合作条件，与他人共同实施转化；以该科技成果作价投资、折算股份或者出资比例；以及其他协商确定的方式。{placeholder tag=span i=1978}

{placeholder tag=p i=748}{placeholder tag=span i=1979}6、科技成果转化证明材料是指：{placeholder tag=span i=1980}

{placeholder tag=p i=749}{placeholder tag=span i=1981}■ 科技成果形成的产品可提供下列材料：如新产品证书、新产品检测报告、新产品新技术鉴定验收证书、新产品查新报告、生产登记批准书等；新产品销售证明则为必须提供的材料。{placeholder tag=span i=1982}

{placeholder tag=p i=750}{placeholder tag=span i=1983}■ 科技成果形成服务可提供的材料：如销售合同、正能量、用户意见、收入证明等；{placeholder tag=span i=1984}

{placeholder tag=p i=751}{placeholder tag=span i=1985}■ 科技成果形成样品、样机可提供的材料：如检测报告、实物照片等。

{placeholder tag=span i=1986}{placeholder tag=br i=24} {placeholder tag=p i=752}{placeholder tag=span i=1987}十二、本申请所附材料清单{placeholder tag=span i=1988}

{placeholder tag=table i=2041}{placeholder tag=td i=2577}{placeholder tag=p i=38}{placeholder tag=table i=2042}{placeholder tag=td i=2578}{placeholder tag=p i=753}{placeholder tag=span i=1989}序号{placeholder tag=span i=1990}

{placeholder tag=td i=2579}{placeholder tag=p i=754}{placeholder tag=span i=1991}附件名称{placeholder tag=span i=1992}

{placeholder tag=td i=2580}{placeholder tag=p i=755}{placeholder tag=span i=1993}1{placeholder tag=span i=1994}

{placeholder tag=td i=2581}{placeholder tag=p i=756}{placeholder tag=span i=1995}知识产权相关材料（已授权的发明专利、实用新型、外观设计、软件著作权、集成电路布图设计、植物新品种可直接获取，勿须上传证书；其他知识产权需上传相关知识产权证书或授权通知书及缴费收据、参与制定标准情况等）、科研项目立项证明（已验收或结题项目需附验收或结题报告）、科技成果转化（总体情况与转化形式、应用成效的逐项说明）、研究开发组织管理（总体情况与四项指标符合情况的具体说明）等相关材料；{placeholder tag=span i=1996}

{placeholder tag=td i=2582}{placeholder tag=p i=757}{placeholder tag=span i=1997}2{placeholder tag=span i=1998}

{placeholder tag=td i=2583}{placeholder tag=p i=758}{placeholder tag=span i=1999}企业高新技术产品（服务）的关键技术和技术指标的具体说明，相关的生产批文、认证认可和资质证书、产品质量检验报告等材料；{placeholder tag=span i=2000}

{placeholder tag=td i=2584}{placeholder tag=p i=759}{placeholder tag=span i=2001}3{placeholder tag=span i=2002}

{placeholder tag=td i=2585}{placeholder tag=p i=760}{placeholder tag=span i=2003}企业职工和科技人员情况说明材料，包括在职、兼职和临时聘用人员人数、人员学历结构、科技人员名单及其工作岗位等{placeholder tag=span i=2004}

{placeholder tag=td i=2586}{placeholder tag=p i=761}{placeholder tag=span i=2005}4{placeholder tag=span i=2006}

{placeholder tag=td i=2587}{placeholder tag=p i=762}{placeholder tag=span i=2007}具有资质并符合本《工作指引》相关条件的中介机构出具的企业近三个会计年度（实际年限不足三年的按实际经营年限，下同）研究开发费用、近一个会计年度高新技术产品（服务）收入专项审计或鉴证报告，并附研究开发活动说明材料{placeholder tag=span i=2008}

{placeholder tag=td i=2588}{placeholder tag=p i=763}{placeholder tag=span i=2009}5{placeholder tag=span i=2010}

{placeholder tag=td i=2589}{placeholder tag=p i=764}{placeholder tag=span i=2011}经具有资质的中介机构鉴证的企业近三个会计年度的财务会计报告（包括会计报表、会计报表附注和财务情况说明书）{placeholder tag=span i=2012}

{placeholder tag=td i=2590}{placeholder tag=p i=765}{placeholder tag=span i=2013}6{placeholder tag=span i=2014}

{placeholder tag=td i=2591}{placeholder tag=p i=766}{placeholder tag=span i=2015}近三个会计年度企业所得税年度纳税申报表（包括主表及附表）{placeholder tag=span i=2016}

{placeholder tag=td i=2592}{placeholder tag=p i=767}{placeholder tag=span i=2017}7{placeholder tag=span i=2018}

{placeholder tag=td i=2593}{placeholder tag=p i=768}{placeholder tag=span i=2019}其他证明材料{placeholder tag=span i=2020}

{placeholder tag=td i=2594}{placeholder tag=p i=769}{placeholder tag=span i=2021}其他说明{placeholder tag=span i=2022}

{placeholder tag=td i=2595}{placeholder tag=p i=770}{placeholder tag=span i=2023}

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