合同编号：_____________
保证人：_____________________________________________
法定住址：___________________________________________
法定代表人：_________________________________________
职务：_______________________________________________
委托代理人：_________________________________________
身份证号码：_________________________________________
通讯地址：___________________________________________
邮政编码：___________________________________________
联系人：_____________________________________________
电话：_______________________________________________
传真：_______________________________________________
帐号：_______________________________________________
电子信箱：___________________________________________