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[]
["マイナンバーカード出張申請サポート申込書"]
[null,null,null,null,null,null,null,null,null,null,null,null,"申請日",null,"令和",null,"年",null,"月",null,"日"]
[null,null,null,null,null,null,"企業・団体名"]
[null,null,null,null,null,null,"所在地"]
[null,null,null,null,null,null,"担当者","所属"]
[null,null,null,null,null,null,null,"フリガナ"]
[null,null,null,null,null,null,null,"氏名"]
[null,null,null,null,null,null,null,"連絡先",null,null,"TEL：　　　　　　　　"]
[null,null,null,null,null,null,null,null,null,null,"FAX :"]
[null,null,null,null,null,null,null,null,null,null,"E-mail："]
[]
[]
["実施希望日時","第一希望",null,null,null,null,"令和",null,"年",null,null,"月",null,"日","（","午前","・","午後　",null,"）"]
[null,"第ニ希望",null,null,null,null,"令和",null,"年",null,null,"月",null,"日","（","午前","・","午後　",null,"）"]
[null,"第三希望",null,null,null,null,"令和",null,"年",null,null,"月",null,"日","（","午前","・","午後　",null,"）"]
["申請者人数（見込み）",null,null,null,null,null,null,"※    申請希望者が概ね5名以上見込めること"]
[null,null,null,null,null,null,null,"※    胎内市に住民登録があり、２カ月以内に市外への転出がないこと"]
[null,null,null,null,null,null,null,"※    既にマイナンバーカードの申請を行っていないこと"]
[null,null,null,null,null,null,"人","※    本人が会場に来ることができること（申請希望者が15歳未満の人及び成年被後見人の場合は法定代理人とともに来ることができること）"]
["実施予定会場","会場名：",null,null,"駐車場（　有　・　無　）",null,null,null,null,null,null,null,null,null,"駐車場",null,"（","有","・","無","）"]
[null,"□ 企業、団体所在地と同じ"]
[null,"所在地："]
["受取方法",null,"①","□","申請者の自宅へ郵送",null,null,null,null,null,null,null,"②","□","出張申請場所で直接受取"]
["受取希望日\n※②希望の場合のみ記入","申請からおおむね1か月以降の日付をご記入ください。"]
[null,"令和",null,null,null,null,"年",null,"月",null,null,null,"日","（","午前","・","午後","）",null,"時","～"]
["※注意事項","※②をご希望の場合は、受取時の会場の確保及び申請者ご本人への周知をお願いします。\n※①、②での受取を希望されない場合、市民生活課市民係（1番窓口）で受取っていただきます。"]
["備考"]
["◆業務等の関係上、ご希望に添えない場合もありますのであらかじめご了承ください。"]
["◆特定の政党、宗教または営利を目的とした催し等と合わせて実施することはできません。"]
["◆当日の会場、会場内の机・いす等の備品や、電源の確保等は申込者においてご準備いただきますようお願いします。"]
["◆申込者において、申請希望者に対する広報周知を行っていただきますようお願いします。"]
[]
["※市記入"]
["実施日","令和　　年　　月　　日（　　）　　時間：　　　時　　　分　　～　　　時　　　分　　"]
["備考"]

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[]
["マイナンバーカード出張申請者名簿"]
[null,null,null,"実施日"]
[null,null,null,"実施団体名"]
[null,null,null,"担当者名"]
["No","住      所","ふりがな",null,"生年月日","そ の 他"]
[null,null,"氏　　名"]
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