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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"部　　長",null,null,null,null,null,null,null,null,null,null,null,"課　　長",null,null,null,null,null,null,null,null,null,null,null,"係　　長",null,null,null,null,null,null,null,null,null,null,null,"主　　任",null,null,null,null,null,null,null,null,null,null,null,"係"]
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[null,null,null,null,null,null,"健康保険 被扶養者（異動）届"]
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[null,null,"被保険者情報",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"資格取得年月日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"標準報酬月額"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"元号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,null,null,null,null,null,null,"月",null,null,null,null,null,null,null,null,null,null,null,"日"]
[null,null,null,null,null,null,null,null,"被保険者等\n記号・番号\n(右づめ)"]
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[null,null,null,null,null,null,null,null,"氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(ﾌﾘｶﾞﾅ)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,"生年\n月日",null,null,null,null,null,null,null,null,null,"元号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,null,null,null,null,null,null,"月",null,null,null,null,null,null,null,null,null,null,null,"日"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(氏)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(名)"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女"]
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[null,null,null,null,null,null,null,null,"住民票住所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(〒",null,null,null,null,null,null,null,null,null,null,null,"-",null,null,null,null,null,null,null,null,null,null,null,")",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考"]
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[null,null,"被扶養者情報１",null,null,null,null,null,"氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"続柄",null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,null,null,null,null,"生年月日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"職業",null,null,null,null,null,null,null,null,null,null,null,null,"年間収入"]
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[]
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[null,null,null,null,null,null,null,null,"(ﾌﾘｶﾞﾅ)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,"元号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,null,null,null,null,null,null,"月",null,null,null,null,null,null,null,null,null,null,null,"日"]
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[]
[]
[]
[null,null,null,null,null,null,null,null,"(氏)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(名)"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女"]
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[]
[]
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[]
[]
[null,null,null,null,null,null,null,null,"扶養になった(でなくなる)日"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"出生",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"婚姻",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"退職",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"雇用保険の受給"]
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[null,null,null,null,null,null,null,null,null,null,"元号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,null,null,null,null,null,null,"月",null,null,null,null,null,null,null,null,null,null,null,"日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,"開始",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,"）"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"就職",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"収入超過"]
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[]
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[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"その他"]
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[]
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[]
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[null,null,null,null,null,null,null,null,"資格確認書\n発行要否"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人番号\n※扶養を削除する場合\n　の記入は不要です。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"発行が必要",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□"]
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[]
[]
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[]
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[null,null,null,null,null,null,null,null,null,null,"※健保処理欄"]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所（住民票住所）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(〒",null,null,null,null,null,null,null,null,null,null,null,"-",null,null,null,null,null,null,null,null,null,null,null,")"]
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[]
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[null,null,null,null,null,null,null,null,"同居別居の別",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"同居"]
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[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"別居",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"同上"]
[]
[]
[]
[]
[]
[]
[null,null,"被扶養者情報２",null,null,null,null,null,"氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"続柄",null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,null,null,null,null,"生年月日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"職業",null,null,null,null,null,null,null,null,null,null,null,null,"年間収入"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,"(ﾌﾘｶﾞﾅ)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,"元号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,null,null,null,null,null,null,"月",null,null,null,null,null,null,null,null,null,null,null,"日"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,"(氏)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(名)"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女"]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,"扶養になった(でなくなる)日"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"出生",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"婚姻",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"退職",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"雇用保険の受給"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,"元号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,null,null,null,null,null,null,"月",null,null,null,null,null,null,null,null,null,null,null,"日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,"開始",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,"）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"就職",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"収入超過"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"その他"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,"資格確認書\n発行要否"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人番号\n※扶養を削除する場合\n　の記入は不要です。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"発行が必要",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□"]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,"※健保処理欄"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所（住民票住所）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(〒",null,null,null,null,null,null,null,null,null,null,null,"-",null,null,null,null,null,null,null,null,null,null,null,")"]
[]
[]
[]
[null,null,null,null,null,null,null,null,"同居別居の別",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"同居"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"別居",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"同上"]
[]
[]
[]
[]
[]
[null,null,"【被保険者記載欄】日本国内に被扶養者の住民票がない場合は、裏面の要件を確認いただき、該当する番号を備考欄に記載してください。"]
[]
[]
[]
[]
[null,null,"社会保険労務士の\n提出代行者名記載欄"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"【事業主記載欄】事業主の確認により本人押印・署名を省略した場合は、下記にチェックをしてください。"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"本人押印・署名の省略にあたり、被保険者に届出意思を確認しました。"]
[]
[]
[]
[]
[null,null,"事業主証明欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"受付日付印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"確認日付印"]
[null,null,null,null,null,null,null,null,null,"上記のとおり被保険者から被扶養者の届出がありましたので提出します。"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,null,null,null,null,null,null,"月",null,null,null,null,null,null,null,null,null,"日",null,null,null,null,"提出"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"〒",null,null,null,null,null,null,null,null,null,null,null,"-"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"事業所所在地"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"事業所名称"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"事業主氏名"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"電話番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(",null,null,null,null,null,null,null,null,null,null,null,null,")"]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"愛知県農協健康保険組合"]

{"sheet":"異動届（裏面）","index":1,"n_rows":153,"n_cols":94,"rows_kept":153,"cut":false,"hidden":false,"merged":[[72,15,79,90],[72,93,94,168],[81,15,94,90],[95,2,117,13],[95,15,102,90],[95,93,117,168],[10,2,13,169],[14,2,17,169],[20,2,25,13],[20,14,25,91],[20,92,25,169],[144,2,147,169],[148,2,151,169],[152,2,163,169],[104,15,117,90],[26,93,48,168],[26,2,48,13],[118,2,140,13],[118,15,125,90],[118,93,140,168],[127,15,140,90],[26,15,48,90],[49,2,71,13],[49,15,56,90],[49,93,71,168],[58,15,71,90],[72,2,94,13]]}
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"日本国内に被扶養者の住民票がない場合、被扶養者が以下いずれかの要件に該当するか確認いただき、該当する番号を備考欄に"]
[]
[]
[]
[null,null,"記載してください。"]
[]
[]
[]
[]
[]
[null,null,"番号",null,null,null,null,null,null,null,null,null,null,null,"要件",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"添付書類"]
[]
[]
[]
[]
[]
[null,null,"①",null,null,null,null,null,null,null,null,null,null,null,null,"外国において留学をする学生",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"査証、学生証、在学証明書・入学証明書等の写し"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"②",null,null,null,null,null,null,null,null,null,null,null,null,"外国に赴任する被保険者に同行する者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"査証、海外赴任辞令、海外の公的機関が発行する居住証明書等の写し"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【具体例】\n家族帯同ビザが発行されるもの"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"③",null,null,null,null,null,null,null,null,null,null,null,null,"観光、保養又はボランティア活動その他就労以外の目的で一時的に海外に渡航するもの",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"査証、ボランティア派遣機関の証明、ボランティアの参加同意書等の写し"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【具体例】\nワーキングホリデー制度を利用して渡航するもの、外国において留学する学生に同行する家族等、原則としてビザに有効期限があるもの"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"④",null,null,null,null,null,null,null,null,null,null,null,null,"被保険者が外国に赴任している間に当該被保険者との身分関係が生じた者であって、②と同等と認められるもの",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"出生や婚姻等を証明する書類等の写し"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【具体例】\n・海外赴任中に生まれた被保険者の子供\n・海外赴任中に現地で結婚した配偶者\n・海外赴任中に縁組を結んだ特別養子"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"⑤",null,null,null,null,null,null,null,null,null,null,null,null,"①から④までに掲げるもののほか、渡航目的その他事情を考慮して日本国内に生活の基礎があると認められる者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"出生や婚姻等を証明する書類等の写し等"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【具体例】\n留学等の理由で渡航する被扶養者の海外在住中に生まれた子供等"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,"  資格確認書の発行が必要な場合（※）は「□発行が必要」にチェックを入れてください。"]
[]
[]
[]
[null,null," 　※以下に該当する場合に限ります。"]
[]
[]
[]
[null,null,"  ・マイナンバーカードを取得していない者、マイナンバーカードの返納者\n  ・マイナンバーカードを保有しているが健康保険証利用登録を行っていない者、利用登録解除を申請した者、利用登録解除者\n　・マイナンバーカードの電子証明書の有効期限切れの者"]