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["正",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"常務理事",null,null,"事務長",null,null,"課　長",null,null,"課長補佐",null,null,"係　長",null,null,"係　員"]
[null,null,"健康保険　被保険者資格取得届"]
[]
[]
[]
[null,null,"令和",null,null,"年",null,"月",null,"日提出"]
[]
[null,"提出者記入欄","事業所記号"]
[]
[]
[null,null,"\n事業所\n所在地",null,null,"　届書記入の個人番号に誤りがないことを確認しました。"]
[null,null,null,null,null,"〒"]
[]
[]
[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,"社会保険労務士記載欄"]
[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,"　　氏　　名　　等"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
[null,null,"電話番号"]
[]
[]
[null,"被保険者 １","①",null,null,null,null,null,"②",null,null,{"$f":"PHONETIC(K23)","v":""},null,null,null,null,{"$f":"PHONETIC(Q23)","v":""},null,null,null,null,null,"③",null,{"$f":"IF(K23=0,\"\",IF(Z22=0,\"→\",(IF(Z22<$Q$150,\"5.\",(IF(Z22<$Q$151,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,"④"]
[null,null,"被保険者\n整理番号",null,null,null,null,null,"\n氏 名",null,null,null,null,null,null,null,null,null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"種 別"]
[]
[null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,null,null,null,null,null,null,null,null,null,null,null,null,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,{"$f":"IF(K23=0,\"\",IF(Z25=0,\"→\",(IF(Z25<$Q$150,\"5.\",(IF(Z25<$Q$151,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,"⑧"]
[null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,null,null,null,null,null,null,null,null,null,"マイナンバーの記載は義務化されています"]
[null,null,"⑨\n 　　報 酬\n 　　月 額",null,"㋐(通貨)",null,null,null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,{"$f":"IF(L29=\"\",\"\",(IF($E$149>=1355,1390,VLOOKUP($E$149,$C$149:$D$1446,2,0))))","v":""},null,null,null,"⑪\n  備 考"]
[null,null,null,null,"㋑(現物)",null,null,null,null,null,"円",{"$f":"IF(G28=\"\",\"\",(G28+G29))","v":""},null,null,null,"円",null,null,null,null,"千円",null,null,null,null,null,"(",null,null,null,null,null,null,null,null,null,"）"]
[null,null,"⑫　",null,"住民票\n住 所",null,"〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否"]
[null,null,"　 　住 所",null,"居 所\n住所",null,"〒"]
[]
[null,"被保険者 2","①",null,null,null,null,null,"②",null,null,{"$f":"PHONETIC(K34)","v":""},null,null,null,null,{"$f":"PHONETIC(Q34)","v":""},null,null,null,null,null,"③",null,{"$f":"IF(K34=0,\"\",IF(Z33=0,\"→\",(IF(Z33<$Q$150,\"5.\",(IF(Z33<$Q$151,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,"④"]
[null,null,"被保険者\n整理番号",null,null,null,null,null,"\n氏 名",null,null,null,null,null,null,null,null,null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"種 別"]
[]
[null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,null,null,null,null,null,null,null,null,null,null,null,null,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,{"$f":"IF(K34=0,\"\",IF(Z36=0,\"→\",(IF(Z36<$Q$150,\"5.\",(IF(Z36<$Q$151,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,"⑧"]
[null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,null,null,null,null,null,null,null,null,null,"マイナンバーの記載は義務化されています"]
[null,null,"⑨\n 　　報 酬\n 　　月 額",null,"㋐(通貨)",null,null,null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,{"$f":"IF(L40=\"\",\"\",(IF($E$150>=1355,1390,VLOOKUP($E$150,$C$149:$D$1446,2,0))))","v":""},null,null,null,"⑪\n  備 考"]
[null,null,null,null,"㋑(現物)",null,null,null,null,null,"円",{"$f":"IF(G39=\"\",\"\",(G39+G40))","v":""},null,null,null,"円",null,null,null,null,"千円",null,null,null,null,null,"(",null,null,null,null,null,null,null,null,null,"）"]
[null,null,"⑫　",null,"住民票\n住 所",null,"〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否"]
[null,null,"　 　住 所",null,"居 所\n住所",null,"〒"]
[]
[null,"被保険者 3","①",null,null,null,null,null,"②",null,null,{"$f":"PHONETIC(K45)","v":""},null,null,null,null,{"$f":"PHONETIC(Q45)","v":""},null,null,null,null,null,"③",null,{"$f":"IF(K45=0,\"\",IF(Z44=0,\"→\",(IF(Z44<$Q$150,\"5.\",(IF(Z44<$Q$151,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,"④"]
[null,null,"被保険者\n整理番号",null,null,null,null,null,"\n氏 名",null,null,null,null,null,null,null,null,null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"種 別"]
[]
[null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,null,null,null,null,null,null,null,null,null,null,null,null,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,{"$f":"IF(K45=0,\"\",IF(Z47=0,\"→\",(IF(Z47<$Q$150,\"5.\",(IF(Z47<$Q$151,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,"⑧"]
[null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,null,null,null,null,null,null,null,null,null,"マイナンバーの記載は義務化されています"]
[null,null,"⑨\n 　　報 酬\n 　　月 額",null,"㋐(通貨)",null,null,null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,{"$f":"IF(L51=\"\",\"\",(IF($E$151>=1355,1390,VLOOKUP($E$151,$C$149:$D$1446,2,0))))","v":""},null,null,null,"⑪\n  備 考"]
[null,null,null,null,"㋑(現物)",null,null,null,null,null,"円",{"$f":"IF(G50=\"\",\"\",(G50+G51))","v":""},null,null,null,"円",null,null,null,null,"千円",null,null,null,null,null,"("]
[null,null,"⑫　",null,"住民票\n住 所",null,"〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否"]
[null,null,"　 　住 所",null,"居 所\n住所",null,"〒"]
[]
[null,"被保険者 4","①",null,null,null,null,null,"②",null,null,{"$f":"PHONETIC(K56)","v":""},null,null,null,null,{"$f":"PHONETIC(Q56)","v":""},null,null,null,null,null,"③",null,{"$f":"IF(K56=0,\"\",IF(Z55=0,\"→\",(IF(Z55<$Q$150,\"5.\",(IF(Z55<$Q$151,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,"④"]
[null,null,"被保険者\n整理番号",null,null,null,null,null,"\n氏 名",null,null,null,null,null,null,null,null,null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"種 別"]
[]
[null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,null,null,null,null,null,null,null,null,null,null,null,null,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,{"$f":"IF(K56=0,\"\",IF(Z58=0,\"→\",(IF(Z58<$Q$150,\"5.\",(IF(Z58<$Q$151,\"7.\",\"9.\"))))))","v":""},null,null,null,null,null,null,"⑧"]
[null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,null,null,null,null,null,null,null,null,null,"マイナンバーの記載は義務化されています"]
[null,null,"⑨\n 　　報 酬\n 　　月 額",null,"㋐(通貨)",null,null,null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,{"$f":"IF(L62=\"\",\"\",(IF($E$152>=1355,1390,VLOOKUP($E$152,$C$149:$D$1446,2,0))))","v":""},null,null,null,"⑪\n  備 考"]
[null,null,null,null,"㋑(現物)",null,null,null,null,null,"円",{"$f":"IF(G61=\"\",\"\",(G61+G62))","v":""},null,null,null,"円",null,null,null,null,"千円",null,null,null,null,null,"(",null,null,null,null,null,null,null,null,null,"）"]
[null,null,"⑫　",null,"住民票\n住 所",null,"〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否"]
[null,null,"　 　住 所",null,"居 所\n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,"観光産業健康保険組合（250401）"]
["副",null,null,null,"健康保険",null,null,null,"被保険者資格取得確認および標準報酬決定通知書"]
[]
[null,null,"下記のとおり資格取得の確認および標準報酬月額を決定したので通知します。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和　　　年　　　月　　　日"]
[]
[null,null,"（令和",null,{"$f":"IF(E6=\"\",\"\",E6)","v":""},"年",{"$f":"IF(G6=\"\",\"\",G6)","v":""},"月",{"$f":"IF(I6=\"\",\"\",I6)","v":""},"日提出分）",null,null,null,null,null,null,null,null,null,null,null,null,null,"観光産業健康保険組合理事長"]
[]
[null,null,"事業所番号\n（健康保険被保険者証の記号）",null,null,null,null,null,null,{"$f":"IF(J8=\"\",\"\",J8)","v":""}]
[]
[]
[null,null,"\n事業所\n所在地",null,null,"　届書記入の個人番号に誤りがないことを確認しました。"]
[null,null,null,null,null,"〒",{"$f":"IF(G12=\"\",\"\",G12)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　この通知書を受け取りましたら、すみやかに確認された資格取得年月日および決定された標準報酬を、それぞれの被保険者に通知しなければなりません。また、健康保険被保険者証を本人に渡した際は、裏面の住所欄に直ちに現住所を明確に自筆させてください。"]
[null,null,null,null,null,{"$f":"IF(F13=\"\",\"\",F13)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　この通知書の確認および決定に不服があるときは、確認および決定を知った日の翌日から起算して３か月以内に文書又は口頭で社会保険審査官（地方厚生（支）局内）に対して審査請求をすることができます。また、審査請求の決定に不服があるときは、再審査請求又は処分の取消しの訴えを提起することができます。 再審査請求は、審査官の決定書の謄本が送付された日の翌日から起算して２か月以内に文書又は口頭で社会保険審査会（厚生労働省内）に対して行うことができ、処分の取消しの訴えは、審査請求の決定があったことを知った日から６か月以内（再審査請求があったときは、その裁決があったことを知った日から６か月以内）に、健康保険組合を被告として提起することができます。（ただし、原則として、決定又は裁決の日から１年を経過したときは、提起することができなくなります。）\n　なお、審査請求があった日から２か月を経過しても決定がないときや、処分の執行等による著しい損害を避けるため緊急の必要があるとき、その他正当な理由があるときは、審査請求の決定を経なくても提起することができます。"]
[null,null,"事業所\n名　称",null,null,{"$f":"IF(F15=\"\",\"\",F15)","v":""}]
[]
[null,null,"事業主\n氏　名",null,null,{"$f":"IF(F17=\"\",\"\",F17)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
[null,null,"電話番号",null,null,{"$f":"IF(F19=\"\",\"\",F19)","v":""}]
[]
[]
[null,"被保険者　１","①",null,{"$f":"IF(E22=\"\",\"\",E22)","v":""},null,null,null,"②",null,null,{"$f":"IF(L22=\"\",\"\",L22)","v":""},null,null,null,null,{"$f":"IF(Q22=\"\",\"\",Q22)","v":""},null,null,null,null,null,"③",null,{"$f":"IF(Y22=\"\",\"\",Y22)","v":""},{"$f":"IF(Z22=\"\",\"\",Z22)","v":""},null,null,null,null,null,"④",null,{"$f":"IF(AH22=\"\",\"\",AH22)","v":""}]
[null,null,"被保険者\n整理番号",null,null,null,null,null,"\n氏 名",null,{"$f":"IF(K23=\"\",\"\",K23)","v":""},null,null,null,null,null,{"$f":"IF(Q23=\"\",\"\",Q23)","v":""},null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"種 別"]
[]
[null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,{"$f":"IF($K$23=\"\",\"\",(IF(K25=\"\",\"速\",\"届\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(L25=\"\",\"や\",\"出\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(M25=\"\",\"か\",\"済\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(N25=\"\",\"に\",\"\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(O25=\"\",\"届\",\"\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(P25=\"\",\"け\",\"\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(Q25=\"\",\"出\",\"\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(R25=\"\",\"く\",\"\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(S25=\"\",\"だ\",\"\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(T25=\"\",\"さ\",\"\")))","v":""},{"$f":"IF($K$23=\"\",\"\",(IF(U25=\"\",\"い\",\"\")))","v":""},null,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,{"$f":"IF(Y25=\"\",\"\",Y25)","v":""},{"$f":"IF(Z25=\"\",\"\",Z25)","v":""},null,null,null,null,null,"⑧",null,{"$f":"IF(AH25=\"\",\"\",AH25)","v":""}]
[null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,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,"⑨\n 　　報 酬\n 　　月 額",null,"㋐(通貨)",null,{"$f":"IF(G28=\"\",\"\",G28)","v":""},null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,{"$f":"IF(S28=\"\",\"\",S28)","v":""},null,null,null,"⑪\n  備 考"]
[null,null,null,null,"㋑(現物)",null,{"$f":"IF(G29=\"\",\"\",G29)","v":""},null,null,null,"円",{"$f":"IF(L29=\"\",\"\",L29)","v":""},null,null,null,"円",null,null,null,null,"千円",null,null,null,null,null,"(",{"$f":"IF(AB29=\"\",\"\",AB29)","v":""},null,null,null,null,null,null,null,null,"）"]
[null,null,"⑫　",null,"住民票\n住 所",null,"〒",{"$f":"IF(H30=\"\",\"\",H30)","v":""},null,{"$f":"IF(J30=\"\",\"\",J30)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否"]
[null,null,"　 　住 所",null,"居 所\n住所",null,"〒",{"$f":"IF(H31=\"\",\"\",H31)","v":""},null,{"$f":"IF(J31=\"\",\"\",J31)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(Y31=\"\",\"\",Y31)","v":""}]
[]
[null,"被保険者　２","①",null,{"$f":"IF(E33=\"\",\"\",E33)","v":""},null,null,null,"②",null,null,{"$f":"IF(L33=\"\",\"\",L33)","v":""},null,null,null,null,{"$f":"IF(Q33=\"\",\"\",Q33)","v":""},null,null,null,null,null,"③",null,{"$f":"IF(Y33=\"\",\"\",Y33)","v":""},{"$f":"IF(Z33=\"\",\"\",Z33)","v":""},null,null,null,null,null,"④",null,{"$f":"IF(AH33=\"\",\"\",AH33)","v":""}]
[null,null,"被保険者\n整理番号",null,null,null,null,null,"\n氏 名",null,{"$f":"IF(K34=\"\",\"\",K34)","v":""},null,null,null,null,null,{"$f":"IF(Q34=\"\",\"\",Q34)","v":""},null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"種 別"]
[]
[null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,{"$f":"IF($K$34=\"\",\"\",(IF(K36=\"\",\"速\",\"届\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(L36=\"\",\"や\",\"出\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(M36=\"\",\"か\",\"済\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(N36=\"\",\"に\",\"\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(O36=\"\",\"届\",\"\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(P36=\"\",\"け\",\"\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(Q36=\"\",\"出\",\"\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(R36=\"\",\"く\",\"\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(S36=\"\",\"だ\",\"\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(T36=\"\",\"さ\",\"\")))","v":""},{"$f":"IF($K$34=\"\",\"\",(IF(U36=\"\",\"い\",\"\")))","v":""},null,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,{"$f":"IF(Y36=\"\",\"\",Y36)","v":""},{"$f":"IF(Z36=\"\",\"\",Z36)","v":""},null,null,null,null,null,"⑧",null,{"$f":"IF(AH36=\"\",\"\",AH36)","v":""}]
[null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,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,"⑨\n 　　報 酬\n 　　月 額",null,"㋐(通貨)",null,{"$f":"IF(G39=\"\",\"\",G39)","v":""},null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,{"$f":"IF(S39=\"\",\"\",S39)","v":""},null,null,null,"⑪\n  備 考"]
[null,null,null,null,"㋑(現物)",null,{"$f":"IF(G40=\"\",\"\",G40)","v":""},null,null,null,"円",{"$f":"IF(L40=\"\",\"\",L40)","v":""},null,null,null,"円",null,null,null,null,"千円",null,null,null,null,null,"(",null,null,null,null,null,null,null,null,null,"）"]
[null,null,"⑫　",null,"住民票\n住 所",null,"〒",{"$f":"IF(H41=\"\",\"\",H41)","v":""},null,{"$f":"IF(J41=\"\",\"\",J41)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否"]
[null,null,"　 　住 所",null,"居 所\n住所",null,"〒",{"$f":"IF(H42=\"\",\"\",H42)","v":""},null,{"$f":"IF(J42=\"\",\"\",J42)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(Y42=\"\",\"\",Y42)","v":""}]
[]
[null,"被保険者　３","①",null,{"$f":"IF(E44=\"\",\"\",E44)","v":""},null,null,null,"②",null,null,{"$f":"IF(L44=\"\",\"\",L44)","v":""},null,null,null,null,{"$f":"IF(Q44=\"\",\"\",Q44)","v":""},null,null,null,null,null,"③",null,{"$f":"IF(Y44=\"\",\"\",Y44)","v":""},{"$f":"IF(Z44=\"\",\"\",Z44)","v":""},null,null,null,null,null,"④",null,{"$f":"IF(AH44=\"\",\"\",AH44)","v":""}]
[null,null,"被保険者\n整理番号",null,null,null,null,null,"\n氏 名",null,{"$f":"IF(K45=\"\",\"\",K45)","v":""},null,null,null,null,null,{"$f":"IF(Q45=\"\",\"\",Q45)","v":""},null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"種 別"]
[]
[null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,{"$f":"IF($K$45=\"\",\"\",(IF(K47=\"\",\"速\",\"届\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(L47=\"\",\"や\",\"出\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(M47=\"\",\"か\",\"済\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(N47=\"\",\"に\",\"\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(O47=\"\",\"届\",\"\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(P47=\"\",\"け\",\"\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(Q47=\"\",\"出\",\"\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(R47=\"\",\"く\",\"\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(S47=\"\",\"だ\",\"\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(T47=\"\",\"さ\",\"\")))","v":""},{"$f":"IF($K$45=\"\",\"\",(IF(U47=\"\",\"い\",\"\")))","v":""},null,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,{"$f":"IF(Y47=\"\",\"\",Y47)","v":""},{"$f":"IF(Z47=\"\",\"\",Z47)","v":""},null,null,null,null,null,"⑧",null,{"$f":"IF(AH47=\"\",\"\",AH47)","v":""}]
[null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,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,"⑨\n 　　報 酬\n 　　月 額",null,"㋐(通貨)",null,{"$f":"IF(G50=\"\",\"\",G50)","v":""},null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,{"$f":"IF(S50=\"\",\"\",S50)","v":""},null,null,null,"⑪\n  備 考"]
[null,null,null,null,"㋑(現物)",null,{"$f":"IF(G51=\"\",\"\",G51)","v":""},null,null,null,"円",{"$f":"IF(L51=\"\",\"\",L51)","v":""},null,null,null,"円",null,null,null,null,"千円",null,null,null,null,null,"(",null,null,null,null,null,null,null,null,null,"）"]
[null,null,"⑫　",null,"住民票\n住 所",null,"〒",{"$f":"IF(H52=\"\",\"\",H52)","v":""},null,{"$f":"IF(J52=\"\",\"\",J52)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否"]
[null,null,"　 　住 所",null,"居 所\n住所",null,"〒",{"$f":"IF(H53=\"\",\"\",H53)","v":""},null,{"$f":"IF(J53=\"\",\"\",J53)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(Y53=\"\",\"\",Y53)","v":""}]
[]
[null,"被保険者　４","①",null,{"$f":"IF(E55=\"\",\"\",E55)","v":""},null,null,null,"②",null,null,{"$f":"IF(L55=\"\",\"\",L55)","v":""},null,null,null,null,{"$f":"IF(Q55=\"\",\"\",Q55)","v":""},null,null,null,null,null,"③",null,{"$f":"IF(Y55=\"\",\"\",Y55)","v":""},{"$f":"IF(Z55=\"\",\"\",Z55)","v":""},null,null,null,null,null,"④",null,{"$f":"IF(AH55=\"\",\"\",AH55)","v":""}]
[null,null,"被保険者\n整理番号",null,null,null,null,null,"\n氏 名",null,{"$f":"IF(K56=\"\",\"\",K56)","v":""},null,null,null,null,null,{"$f":"IF(Q56=\"\",\"\",Q56)","v":""},null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"種 別"]
[]
[null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,{"$f":"IF($K$56=\"\",\"\",(IF(K58=\"\",\"速\",\"届\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(L58=\"\",\"や\",\"出\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(M58=\"\",\"か\",\"済\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(N58=\"\",\"に\",\"\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(O58=\"\",\"届\",\"\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(P58=\"\",\"け\",\"\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(Q58=\"\",\"出\",\"\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(R58=\"\",\"く\",\"\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(S58=\"\",\"だ\",\"\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(T58=\"\",\"さ\",\"\")))","v":""},{"$f":"IF($K$56=\"\",\"\",(IF(U58=\"\",\"い\",\"\")))","v":""},null,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,{"$f":"IF(Y58=\"\",\"\",Y58)","v":""},{"$f":"IF(Z58=\"\",\"\",Z58)","v":""},null,null,null,null,null,"⑧",null,{"$f":"IF(AH58=\"\",\"\",AH58)","v":""}]
[null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,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,"⑨\n 　　報 酬\n 　　月 額",null,"㋐(通貨)",null,{"$f":"IF(G61=\"\",\"\",G61)","v":""},null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,{"$f":"IF(S61=\"\",\"\",S61)","v":""},null,null,null,"⑪\n  備 考"]
[null,null,null,null,"㋑(現物)",null,{"$f":"IF(G62=\"\",\"\",G62)","v":""},null,null,null,"円",{"$f":"IF(L62=\"\",\"\",L62)","v":""},null,null,null,"円",null,null,null,null,"千円",null,null,null,null,null,"(",null,null,null,null,null,null,null,null,null,"）"]
[null,null,"⑫　",null,"住民票\n住 所",null,"〒",{"$f":"IF(H63=\"\",\"\",H63)","v":""},null,{"$f":"IF(J63=\"\",\"\",J63)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否"]
[null,null,"　 　住 所",null,"居 所\n住所",null,"〒",{"$f":"IF(H64=\"\",\"\",H64)","v":""},null,{"$f":"IF(J64=\"\",\"\",J64)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(Y64=\"\",\"\",Y64)","v":""}]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,58,58,{"$f":"IF(L29=\"\",\"\",(ROUNDDOWN(L29/1000,0)))","v":""}]
[null,null,59,58,{"$f":"IF(L40=\"\",\"\",(ROUNDDOWN(L40/1000,0)))","v":""},null,null,null,null,null,null,null,"5.昭和",null,null,null,"1989-01-08"]
[null,null,60,58,{"$f":"IF(L51=\"\",\"\",(ROUNDDOWN(L51/1000,0)))","v":""},null,null,null,null,null,null,null,"7.平成",null,null,null,"2019-05-01"]
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[null,null,66,68,null,null,null,null,null,null,null,null,"5．男(基金)"]
[null,null,67,68,null,null,null,null,null,null,null,null,"6．女(基金)"]
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[null,null,69,68,null,null,null,false,false]
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[null,null,75,78,null,null,null,null,null,null,null,null,"1.海外在住"]
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{"sheet":"記入例","index":1,"n_rows":162,"n_cols":38,"rows_kept":162,"cut":false,"hidden":false,"merged":[[56,10,56,37],[57,10,57,37],[58,10,58,37],[59,10,59,37],[0,3,0,8],[1,3,1,37],[2,3,2,37],[3,3,3,37],[5,3,5,36],[7,3,7,8],[7,10,7,36],[10,32,10,33],[10,34,12,37],[11,3,12,4],[11,9,12,10],[11,11,12,16],[11,17,12,22],[11,23,12,24],[11,32,12,33],[8,3,8,8],[8,10,8,36],[10,3,10,4],[10,5,12,8],[10,9,10,10],[14,3,15,4],[14,9,15,10],[14,32,15,33],[13,20,14,20],[13,21,14,21],[13,22,14,22],[13,23,15,24],[13,14,14,14],[13,15,14,15],[13,16,14,16],[13,17,14,17],[13,18,14,18],[13,19,14,19],[13,3,13,4],[13,5,15,8],[13,9,13,10],[15,11,15,22],[10,12,10,16],[10,17,10,22],[10,23,10,24],[13,32,13,33],[13,34,15,37],[18,10,18,24],[18,25,18,29],[19,10,19,24],[19,25,19,29],[19,44,19,72],[18,5,18,6],[19,5,19,6],[26,3,26,8],[26,10,26,37],[20,44,20,72],[27,3,27,8],[28,3,28,8],[13,11,14,11],[13,12,14,12],[13,13,14,13],[17,21,17,22],[17,23,17,24],[17,28,17,36],[18,3,18,4],[16,3,17,4],[16,5,16,6],[16,7,16,10],[16,17,17,18],[16,19,17,20],[17,5,17,6],[17,7,17,10],[17,12,17,15],[18,8,18,9],[29,3,29,8],[19,3,19,4],[20,3,20,8],[21,3,21,8],[21,10,21,36],[24,3,24,8],[24,10,24,36],[32,3,32,8],[32,11,32,16],[32,17,32,18],[32,19,32,20],[32,21,32,22],[18,30,19,33],[18,34,19,37],[19,8,19,9],[33,3,33,8],[37,10,37,37],[30,3,30,8],[30,17,30,18],[30,19,30,20],[30,21,30,22],[31,3,31,8],[31,11,31,16],[31,17,31,18],[31,19,31,20],[31,21,31,22],[38,10,38,36],[39,3,39,8],[40,3,40,8],[40,10,41,36],[41,3,41,8],[43,10,43,37],[34,3,34,8],[34,10,34,36],[35,10,35,36],[36,10,36,36],[37,3,37,8],[47,3,47,8],[48,3,48,8],[48,10,48,36],[47,10,47,37],[49,10,49,37],[51,10,51,37],[42,3,42,8],[43,3,43,8],[44,3,44,8],[44,10,44,36],[45,3,45,8],[45,10,45,36],[73,3,73,8],[74,3,74,8],[75,3,75,8],[10,25,12,31],[13,25,15,31],[67,3,67,8],[68,3,68,8],[69,3,69,8],[70,3,70,8],[71,3,71,8],[72,3,72,8],[60,3,60,8],[61,3,61,8],[65,3,65,8],[66,3,66,8],[55,3,55,8],[56,3,56,8],[58,3,58,8],[49,3,49,8],[50,10,50,36],[51,3,51,8],[52,10,52,36],[46,3,46,8],[46,10,46,36]]}
[]
[null,null,null," ■　この届書は、資格取得の日（⑦欄の日）から５日以内に、当健康保険組合に提出してください。"]
[null,null,null," ■ 「正」に入力した事項は、「副」に転記されます。「正」「副」２枚とも提出してください。"]
[null,null,null," ■　この届書の提出が、資格取得日より２か月を経過している場合は、「遅延理由書」を作成のうえ、併せて提出してください。"]
[]
[]
[]
[null,null,null,"提出者記入欄",null,null,null,null,null,"：","事業所番号（被保険者証の記号）は、新規適用時に付された番号（被保険者証の記号）を記入してください。"]
[null,null,null,null,null,null,null,null,null,null,"事業主の押印は、署名（自筆）の場合は必要ありません。"]
[]
[null,null,null,"①",null,1234,null,null,null,"②",null,null,"　　　　ケン　　ポ",null,null,null,null,"　　　　　　　　タ　　ロウ",null,null,null,null,null,"③",null,"7．平成13年12月13日",null,null,null,null,null,null,"④",null,"1．男"]
[null,null,null,"  被保険\n  者証の\n番 号",null,null,null,null,null,"\n氏 名",null,"健　保",null,null,null,null,null,"太　郎",null,null,null,null,null,"生 年\n月 日",null,null,null,null,null,null,null,null,"\n種 別"]
[]
[null,null,null,"⑤",null,"1．健保",null,null,null,"⑥\n\n",null,0,1,2,3,4,5,6,7,8,9,0,1,"⑦　　　　　　\n　 取 得\n  （該当）\n  年月日",null,"9．令和6年12月1日",null,null,null,null,null,null,"⑧",null,"0．無"]
[null,null,null,"取 得\n区 分",null,null,null,null,null,"個 人\n番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被 扶\n養 者"]
[null,null,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,"⑨\n   報 酬\n   月 額",null,"㋐(通貨)",null,367893,null,null,null,"円","㋒（合計㋐＋㋑）",null,null,null,null,"⑩　　　　　\n  標準報\n  酬月額",null,360,null,null,null,"⑪"]
[null,null,null,null,null,"㋑(現物)",null,0,null,null,null,"円",{"$f":"H17+H18","v":367893},null,null,null,"円",null,null,null,null,"千円",null,"備考",null,null,null,"(","○○○○○○○○○○○○○○○",null,null,null,null,null,null,null,null,"）"]
[null,null,null,"⑫　",null,"住民票\n住 所",null,"〒","101-0051",null,"東京都千代田区神田神保町１－４４－２",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所が空欄の場合は、下記よりを選んでください。",null,null,null,null,"⑬\n　 資格確認書\n     発行要否",null,null,null,"発行が必要"]
[null,null,null,"　住 所",null,"居 所",null,"〒"]
[]
[null,null,null,"①被保険者証の番号",null,null,null,null,null,"：","提出順に被保険者番号を払い出ししますので、記入する必要はありません。"]
[null,null,null,null,null,null,null,null,null,null,"記入する場合は、取得日順に追番号を記入してください。（年金の整理番号と同じ番号）"]
[]
[null,null,null,"②氏名",null,null,null,null,null,"：","氏名を記入してください。フリガナはカタカナで正確に記入してください。"]
[]
[null,null,null,"③生年月日",null,null,null,null,null,"：","年号は該当する番号を○で囲んでください。"]
[]
[null,null,null,"④種別",null,null,null,null,null,"：","下図を参照し、該当する番号を○で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男子",null,"女子"]
[null,null,null,null,null,null,null,null,null,null,null,"一般（基金未加入）",null,null,null,null,null,1,null,2]
[null,null,null,null,null,null,null,null,null,null,null,"厚生年金基金加入員",null,null,null,null,null,5,null,6]
[]
[null,null,null,"⑥個人番号",null,null,null,null,null,"：","マイナンバーの提出が義務化されています。本人確認を行ったうえで、個人番号を必ず記入してください。"]
[null,null,null,null,null,null,null,null,null,null,"記載がない場合は処理ができませんので書類をお戻しいたします。マイナンバーを記入の上再度申請してください。"]
[]
[null,null,null,"⑦取得（該当）年月日",null,null,null,null,null,"：","適用事業所に使用されるに至った日（事実上の使用関係が発生した日）、その使用される事業所が適用事"]
[null,null,null,null,null,null,null,null,null,null,"業所となった日等を記入してください。"]
[]
[null,null,null,"⑧被扶養者",null,null,null,null,null,"：","健康保険の被扶養者がある場合は「1．有」を、ない場合は「0．無」を○で囲んでください。\n「1．有」の場合は『被扶養者（異動）届』の届出が別途必要です。"]
[]
[]
[null,null,null,"⑨報酬月額",null,null,null,null,null,"：","「㋐（通貨）」は給料・手当等、名称を問わず労働の対償として金銭（通貨）で支払われるすべての合計金額を記入"]
[null,null,null,null,null,null,null,null,null,null,"を記入してください。"]
[null,null,null,null,null,null,null,null,null,null,"※1　臨時に支払うものや、３月を超える期間ごとに支払う賞与等は対象となりません。"]
[null,null,null,null,null,null,null,null,null,null,"※2　週給の場合は、報酬額を7で割って得た額の30倍に相当する金額を記入してください。"]
[null,null,null,null,null,null,null,null,null,null,"※3　実績によって報酬が変わる場合は、資格取得月の前１ヵ月間に、同事業所内で同様の業務に携わっ"]
[null,null,null,null,null,null,null,null,null,null,"　　　ている従業員の報酬の平均額を記入してください。"]
[null,null,null,null,null,null,null,null,null,null,"「㋑（現物）」は、報酬のうち食事・住宅・被服・定期券等、金銭（通貨）以外で支払われるものについて記入し"]
[null,null,null,null,null,null,null,null,null,null,"てください。"]
[null,null,null,null,null,null,null,null,null,null,"現物によるものの額は、厚生労働大臣によって定められた額（食事・住宅については都道府県ごとに定めら"]
[null,null,null,null,null,null,null,null,null,null,"れた価格、その他被服等は時価により算定した額）を記入してください。"]
[]
[null,null,null,"⑩標準報酬月額",null,null,null,null,null,"：","健康保険法第４０条の標準報酬等級区分にあてはめて得られた標準報酬月額を記入してください。"]
[]
[null,null,null,"⑪備考",null,null,null,null,null,"：","「二以上事業所勤務者」は、2ヵ所以上の適用事業所で勤務している被保険者が取得する場合に☑し、資格"]
[null,null,null,null,null,null,null,null,null,null,"取得日から10日以内に、被保険者が「被保険者所属選択・二以上事業所勤務届」を提出してください。"]
[null,null,null,null,null,null,null,null,null,null,"「退職後の継続再雇用者」は、60歳以上の者が退職し1日の空白もなく引き続き再雇用された場合に☑し、"]
[null,null,null,null,null,null,null,null,null,null,"併せて「被保険者資格喪失届」を提出してください。また、「その他」は、（　）内に内容を記入してください。"]
[]
[null,null,null,"⑫住所",null,null,null,null,null,"：","住所は住民票住所を正確にご記入ください。居所住所が住民票と異なる場合は居所住所も記入してください。"]
[null,null,null,null,null,null,null,null,null,null,"なお、日本国内に住民票（個人番号）を有していない等、住民票住所を記入できない場合は、「1.海外在住」"]
[null,null,null,null,null,null,null,null,null,null,"「2.短期在留」「3.その他」のいずれか該当する理由を選択し、「3.その他」の場合は、その理由をご記入ください。"]
[]
[null,null,null,"⑬資格確認書発行要否",null,null,null,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,null,null,null,null,null,null,null,null,"※以下に該当する場合に限ります。"]
[null,null,null,null,null,null,null,null,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"]
[null,null,null,null,null,null,null,null,null,null,"　・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"]
[null,null,null,null,null,null,null,null,null,null,"　・マイナンバーカードの電子証明書の有効期限切れの者"]
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