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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"常務理事",null,null,null,"事務長",null,null,"課　長",null,"課長補佐",null,"係　長",null,"係　員",null,null,null,null,null,null,null,"1989-01-08","2019-05-01",null,null,false,false,false]
[null,null,null,"健康保険被扶養者（異動）届　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,false,false,false,false,false,null,false,false,true,false,false]
["被保険者が入力するところ",null,null,null,null,null,"認定",null,null,"削除",null,null,"訂正・氏名変更",null,null,null,null,null,null,null,null,null,"マイナンバーの記載は義務化されています",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,false,false,false,false,false]
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[null,null,null,"※ 住民票の住所が、被扶養者欄の住所（同居の場合は被保険者の住所）と同じ場合は、同上に☑してください。同じ場合は住所の記入は不要です。",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,null,null,null,null,null,null,null,null,"直接入力",null,null,null,142]
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[null,null,null,"削除\nする日",null,null,null,null,null,null,null,null,null,"認定・削除\nの理由",null,null,null,null,null,null,null,null,null,null,null,"資格確認書\n発行要否",null,null,"発行が必要",null,null,null,null,null,null,null,null,null,null,null,null,null,null,260]
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[null,null,"被扶養者欄 ３","氏名",null,{"$f":"PHONETIC(F40)","v":""},null,null,null,null,null,{"$f":"PHONETIC(L40)","v":""},null,null,null,null,null,"生年月日",null,{"$f":"IF(F40=\"\",\"\",(IF(X39=\"\",\"→\",(IF(X39<$AN$7,\"5.\",IF(X39<$AO$7,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,null,null,null,null,null,"母",null,null,null,320]
[null,null,null,null,"（氏）",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,"義父",null,null,null,340]
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[null,null,null,"続柄",null,null,"職業",null,null,null,"月収",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,"妻",null,null,null,410]
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[null,null,null,"認定\nする日",null,null,null,null,null,null,null,null,null,"住民票以外の居所住所",null,null,null,null,"〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"二男",null,null,null,470]
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[null,null,null,"削除\nする日",null,null,null,null,null,null,null,null,null,"認定・削除\nの理由",null,null,null,null,null,null,null,null,null,null,null,"資格確認書\n発行要否",null,null,"発行が必要",null,null,null,null,null,null,null,null,null,null,"四男",null,null,null,530]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"養子",null,null,null,560]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"長女",null,null,null,590]
["事業主が入力するところ",null,"事業主確認欄",null,"     この届書は被保険者が作成したものです。  　 　",null,null,null,null,null,null,null,null,null,null,"     記載内容について誤りがないか被保険者が確認しています。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"二女",null,null,null,620]
[null,null,null,"　扶養状況説明書（申立書）の添付書類の記号が「R」か「A」か「N」に該当し、事業主の確認により添付書類を省略した\n  場合は□に✓を付してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"三女",null,null,null,650]
[null,null,null,"　「R」に該当",null,null,"身分証明書 省略",null,null,null,"     被保険者と認定対象者の続柄を確認しました。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"四女",null,null,null,680]
[null,null,null,"　「A」　〃",null,null,"所得証明書  〃  ",null,null,null,"     認定対象者は所得税法上の控除対象配偶者又は控除対象扶養親族であることを確認しました。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"養女",null,null,null,710]
[null,null,null,"　「N」　〃",null,null,"世帯証明書  〃  ",null,null,null,"     被保険者と認定対象者が同一世帯であることを確認しました。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"姉",null,null,null,750]
[null,null,null,null,null,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,"弟",null,null,null,790]
[null,null,"事業所\n所在地",null,"〒",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,"年",null,null,null,"月",null,"日 提出",null,null,null,null,null,null,null,null,null,null,null,null,null,"妹",null,null,null,830]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"孫",null,null,null,880]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,930]
[null,null,"事業所\n名　称",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,980]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会保険労務士の代行者",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,1030]
[null,null,"事業主\n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,1090]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(250401)\n観光産業健康保険組合",null,null,null,null,null,null,null,null,null,null,null,null,null,1150]
[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,1210]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1270]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1330]
["　　　入　力　不　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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1390]
[null,null,"健康保険被扶養者（異動）届　"]
[null,null,null,null,null,null,"認定",null,null,"削除",null,null,"訂正・氏名変更"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,null,"被保険者","被保険者\n証の記号",null,{"$f":"IF(F11=\"\",\"\",F11)","v":""},null,null,"被保険者\n証の番号",null,{"$f":"IF(K11=\"\",\"\",K11)","v":""},null,null,"氏名",null,{"$f":"IF(P11=\"\",\"\",P11)","v":""},null,null,null,null,null,null,null,null,null,"標準報酬\n月額","標準報酬\n月額",null,null,{"$f":"IF(AD11=\"\",\"\",AD11)","v":""},null,null,"千円",null,null,null,null,null,null,null,null,null,null,false]
[null,null,null,"生年月日",null,{"$f":"F12","v":""},null,{"$f":"IF(H12=\"\",\"\",H12)","v":""},null,null,null,null,null,"取　得\n年月日",null,{"$f":"P12","v":""},null,{"$f":"IF(R12=\"\",\"\",R12)","v":""},null,null,null,null,null,null,null,"年間収入\n見込額",null,null,{"$f":"IF(AC12=\"\",\"\",AC12)","v":""},null,null,null,"万円",null,null,null,null,null,null,null,null,null,null,false]
[]
[null,null,null,"現住所",null,"〒",{"$f":"IF(G14=\"\",\"\",G14)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考",{"$f":"IF(Z14=\"\",\"\",Z14)","v":"備考"},{"$f":"IF(AA14=\"\",\"\",AA14)","v":""}]
[null,null,null,null,null,{"$f":"IF(F15=\"\",\"\",F15)","v":""}]
[]
[null,null,"被扶養者 1","氏名",null,{"$f":"F17","v":""},null,null,null,null,null,{"$f":"L17","v":""},null,null,null,null,null,"生年月日",null,{"$f":"T17","v":""},null,null,null,{"$f":"IF(X17=\"\",\"\",X17)","v":""},null,null,null,null,"性別",{"$f":"IF(AD17=\"\",\"\",AD17)","v":""}]
[null,null,null,null,"（氏）",{"$f":"IF(F18=\"\",\"\",F18)","v":""},null,null,null,null,"（名）",{"$f":"IF(L18=\"\",\"\",L18)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人番号",null,{"$f":"IF($G$23=\"\",\"\",IF(T19=\"\",\"速\",\"届\"))","v":""},null,{"$f":"IF($G$23=\"\",\"\",IF(V19=\"\",\"や\",\"出\"))","v":""},null,{"$f":"IF($G$23=\"\",\"\",IF(X19=\"\",\"か\",\"済\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(Y19=\"\",\"に\",\"\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(Z19=\"\",\"届\",\"\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(AA19=\"\",\"け\",\"\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(AB19=\"\",\"出\",\"\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(AC19=\"\",\"て\",\"\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(AD19=\"\",\"く\",\"\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(AE19=\"\",\"だ\",\"\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(AF19=\"\",\"さ\",\"\"))","v":""},{"$f":"IF($G$23=\"\",\"\",IF(AG19=\"\",\"い\",\"\"))","v":""}]
[]
[null,null,null,"続柄",{"$f":"IF(E21=\"\",\"\",E21)","v":""},null,"職業",{"$f":"IF(H21=\"\",\"\",H21)","v":""},null,null,"月収",{"$f":"IF(L21=\"\",\"\",L21)","v":""},null,null,null,"住民票住所",null,null,"　　　　　",null,null,null,null,"〒"]
[]
[null,null,null,"認定\nする日",null,{"$f":"IF(F23=\"\",\"\",F23)","v":""},null,null,null,null,null,null,null,"住民票以外の居所住所",null,null,null,null,"〒",{"$f":"IF(T23=\"\",\"\",T23)","v":""},null,null,null,{"$f":"IF(X23=\"\",\"\",X23)","v":""}]
[]
[null,null,null,"削除\nする日",null,{"$f":"IF(F25=\"\",\"\",F25)","v":""},null,null,null,null,null,null,null,"認定・削除\nの理由",null,null,null,null,null,null,null,null,null,null,null,"資格確認書\n発行要否",null,null,"発行が必要"]
[]
[]
[null,null,"被扶養者 ２","氏名",null,{"$f":"F28","v":""},null,null,null,null,null,{"$f":"L28","v":""},null,null,null,null,null,"生年月日",null,{"$f":"T28","v":""},null,null,null,{"$f":"IF(X28=\"\",\"\",X28)","v":""},null,null,null,null,"性別",{"$f":"IF(AD28=\"\",\"\",AD28)","v":""}]
[null,null,null,null,"（氏）",{"$f":"IF(F29=\"\",\"\",F29)","v":""},null,null,null,null,"（名）",{"$f":"IF(L29=\"\",\"\",L29)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人番号",null,{"$f":"IF($G$34=\"\",\"\",IF(T30=\"\",\"速\",\"届\"))","v":""},null,{"$f":"IF($G$34=\"\",\"\",IF(V30=\"\",\"や\",\"出\"))","v":""},null,{"$f":"IF($G$34=\"\",\"\",IF(X30=\"\",\"か\",\"済\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(Y30=\"\",\"に\",\"\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(Z30=\"\",\"届\",\"\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(AA30=\"\",\"け\",\"\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(AB30=\"\",\"出\",\"\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(AC30=\"\",\"て\",\"\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(AD30=\"\",\"く\",\"\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(AE30=\"\",\"だ\",\"\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(AF30=\"\",\"さ\",\"\"))","v":""},{"$f":"IF($G$34=\"\",\"\",IF(AG30=\"\",\"い\",\"\"))","v":""}]
[]
[null,null,null,"続柄",{"$f":"IF(E32=\"\",\"\",E32)","v":""},null,"職業",{"$f":"IF(H32=\"\",\"\",H32)","v":""},null,null,"月収",{"$f":"IF(L32=\"\",\"\",L32)","v":""},null,null,null,"住民票住所",null,null,"　　　　　",null,null,null,null,"〒"]
[]
[null,null,null,"認定\nする日",null,{"$f":"IF(F34=\"\",\"\",F34)","v":""},null,null,null,null,null,null,null,"住民票以外の居所住所",null,null,null,null,"〒",{"$f":"IF(T34=\"\",\"\",T34)","v":""},null,null,null,{"$f":"IF(X34=\"\",\"\",X34)","v":""}]
[]
[null,null,null,"削除\nする日",null,{"$f":"IF(F36=\"\",\"\",F36)","v":""},null,null,null,null,null,null,null,"認定・削除\nの理由",null,null,null,null,null,null,null,null,null,null,null,"資格確認書\n発行要否",null,null,"発行が必要"]
[]
[]
[null,null,"被扶養者 ３","氏名",null,{"$f":"F39","v":""},null,null,null,null,null,{"$f":"L39","v":""},null,null,null,null,null,"生年月日",null,{"$f":"T39","v":""},null,null,null,{"$f":"IF(X39=\"\",\"\",X39)","v":""},null,null,null,null,"性別",{"$f":"IF(AD39=\"\",\"\",AD39)","v":""}]
[null,null,null,null,"（氏）",{"$f":"IF(F40=\"\",\"\",F40)","v":""},null,null,null,null,"（名）",{"$f":"IF(L40=\"\",\"\",L40)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人番号",null,{"$f":"IF($G$45=\"\",\"\",IF(T41=\"\",\"速\",\"届\"))","v":""},null,{"$f":"IF($G$45=\"\",\"\",IF(V41=\"\",\"や\",\"出\"))","v":""},null,{"$f":"IF($G$45=\"\",\"\",IF(X41=\"\",\"か\",\"済\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(Y41=\"\",\"に\",\"\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(Z41=\"\",\"届\",\"\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(AA41=\"\",\"け\",\"\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(AB41=\"\",\"出\",\"\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(AC41=\"\",\"て\",\"\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(AD41=\"\",\"く\",\"\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(AE41=\"\",\"だ\",\"\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(AF41=\"\",\"さ\",\"\"))","v":""},{"$f":"IF($G$45=\"\",\"\",IF(AG41=\"\",\"い\",\"\"))","v":""}]
[]
[null,null,null,"続柄",{"$f":"IF(E43=\"\",\"\",E43)","v":""},null,"職業",{"$f":"IF(H43=\"\",\"\",H43)","v":""},null,null,"月収",{"$f":"IF(L43=\"\",\"\",L43)","v":""},null,null,null,"住民票住所",null,null,"　　　　　",null,null,null,null,"〒"]
[]
[null,null,null,"認定\nする日",null,{"$f":"IF(F45=\"\",\"\",F45)","v":""},null,null,null,null,null,null,null,"住民票以外の居所住所",null,null,null,null,"〒",{"$f":"IF(T45=\"\",\"\",T45)","v":""},null,null,null,{"$f":"IF(X45=\"\",\"\",X45)","v":""}]
[]
[null,null,null,"削除\nする日",null,{"$f":"IF(F47=\"\",\"\",F47)","v":""},null,null,null,null,null,null,null,"認定・削除\nの理由",null,null,null,null,null,null,null,null,null,null,null,"資格確認書\n発行要否",null,null,"発行が必要"]
[]
[]
[null,null,{"$f":"C50","v":"事業主確認欄"},null,"     この届書は被保険者が作成したものです。  　 　",null,null,null,null,null,null,null,null,null,null,"     記載内容について誤りがないか被保険者が確認しています。"]
[null,null,null,"　扶養状況説明書（申立書）の添付書類の記号が「R」か「A」か「N」に該当し、事業主の確認により添付書類を省略した\n  場合は□に✓を付してください。"]
[null,null,null,"　「R」に該当",null,null,"身分証明書 省略",null,null,null,"     被保険者と認定対象者の続柄を確認しました。"]
[null,null,null,"　「A」　〃",null,null,"所得証明書  〃  ",null,null,null,"     認定対象者は所得税法上の控除対象配偶者又は控除対象扶養親族であることを確認しました。"]
[null,null,null,"　「N」　〃",null,null,"世帯証明書  〃  ",null,null,null,"     被保険者と認定対象者が同一世帯であることを確認しました。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"   ",null,null,"上記のとおり認定（削除）となりましたので通知します。"]
[null,null,"事業所\n所在地",null,"〒",{"$f":"IF(F56=\"\",\"\",F56)","v":""},null,null,null,null,null,null,null,null,null,null,"令和　　　　年　　　　月　　　　日"]
[null,null,null,null,{"$f":"IF(E57=\"\",\"\",E57)","v":""},null,null,null,null,null,null,null,null,null,null,null,"観光産業健康保険組合理事長"]
[]
[null,null,"事業所\n名　称",null,{"$f":"IF(E59=\"\",\"\",E59)","v":""}]
[]
[null,null,"事業主\n氏　名",null,{"$f":"IF(E61=\"\",\"\",E61)","v":""}]
[]
[null,null,"電話番号",null,{"$f":"IF(E63=\"\",\"\",E63)","v":""}]
[]
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{"sheet":"認定基準","index":1,"n_rows":23,"n_cols":4,"rows_kept":23,"cut":false,"hidden":false,"merged":[[0,2,0,3],[7,2,7,3],[2,2,2,3],[18,2,18,3]]}
[]
[]
[null,null,"身分要件"]
[]
[null,null,"◎","被保険者と同居でも別居でもよい人・・・①配偶者（内縁でも可）　②子、孫　③兄弟姉妹　④父母などの直系尊属"]
[null,null,"◎","被保険者と同居が条件の人・・・①上記以外の三親等内の親族　②被保険者の内縁の配偶者の父母および子　③内縁の配偶者死亡後の父母および子"]
[]
[null,null,"生計維持要件"]
[]
[null,null,"◎","同居の場合は、認定対象者の年収（給与・給付金・年金等の総支給額）が、130万円（６０歳以上または障害厚生年金受給者は180万円）未満であって、\nかつ被保険者の年収の１／２未満であること。"]
[null,null,"◎","別居の場合は、認定対象者の年収（給与・給付金・年金等の総支給額）が、130万円（６０歳以上または障害厚生年金受給者は180万円）未満であって、\nかつ被保険者の仕送額より少ないこと。"]
[null,null,"◎","収入は、原則として、月単位・日単位でも基準額未満であること。\n収入基準額 ： 年額130万円 ＝ 平均月額108,334円 ＝ 平均日額3,612円、年額180万円 ＝ 平均月額15万円 ＝ 平均日額5,000円\n"]
[]
[]
[]
[]
[]
[]
[null,null,"居住地要件"]
[]
[null,null,"◎","日本国内に住所を有すること"]
[null,null,"◎","日本国内に住所を有しないが、渡航目的その他の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ものとして厚生労働省令で定めるものに該当すること\n・・・①外国において留学をする学生　②外国に赴任する被保険者に同行する者　③観光、保養また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\n　　　渡航する者　④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ものであって、②と同等と認められるもの　など"]
[null,null,"◎","上記に該当する場合でも、後期高齢者医療の被保険者等である者、その他特別の理由がある者として厚生労働省令で定める者は被扶養者にはなれません。\n・・・①日本国籍を有しない者であって、本邦に相当期間滞在し医療を受ける活動を行うもの、および医療活動を行う者の日常生活上の世話をする活動を行うもの\n　　　②日本国籍を有しない者であって、本邦において１年を超えない期間滞在し、観光、保養、その他これらに類似する活動を行うもの"]