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[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[]
[]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
[]
[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
["留"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹"]
[]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
["点"]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[]
[]
[]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"IF(入力シート!$K$8=\"\",\"\",入力シート!$K$8)","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
["（",null,"人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
["ゴ",null,"名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[]
["印",null,"施",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"健康上の理由で勤務に制限を加える必要のある方で、勤務先または医師等の"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１表の提出が複数枚となる"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指示により労働時間（日数）短縮の特別扱を受けている場合をいいます。"]
["可",null,"設"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"場合、必ずすべての１表に"]
[]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
["）",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,"施設印を押印してください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項（項目番号「２」「３」）を確認のうえ、以下の告知欄（＊）",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,"してください。"]
[]
["県コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設種類コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に記入してください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて提出してください。"]
[]
[]
[]
["申込コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お届記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会社処理欄"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　条件となります。",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,"団定",null,null,null,"医療"]
[]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●申込コード「8．死亡」の場合"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者の",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,"現在の加入",null,null,null,null,null,null,null,null,"申込保険",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現在の",null,null,null,null,null,null,null,null,null,null,null,"申込入院",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有無",null,"内容"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　のみ死亡日を記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項「2」「3」",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄を確認"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に該当する場合は",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"のうえ、記入"]
[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1.男性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3.昭和",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入してください。",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,"してください。"]
[null,null,null,"入」の方は記入不要）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2.女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和",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,"4.平成"]
[]
[{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$U,8,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$U,8,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$U,10,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$U,11,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,4,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$T,4,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$T,13,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$T,14,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$T,15,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$T,16,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$T,17,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$T,18,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ81,入力シート!$B:$T,19,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$I$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$J$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$K$9)","v":""},null,null,"無",null,null,"項目番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$L$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$M$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$N$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ81,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$O$9)","v":""},null,null,null,"無",null,null,null,"有",null,null,null,5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,null,3]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
["申",null,null,"１．新規加入　２．脱退　３．転出※　４．転入※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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　１．男性　２．女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★【同意印鑑】新規加入（転入時の新規加入を含む）・増額時のみ必要"]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
[]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"－"]
[null,"記号証券番号　932-5595／900-95235"]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"K23-385"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[]
[]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
[]
[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
["留"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
[]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
["点"]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[]
[]
[]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
["（",null,"人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
["ゴ",null,"名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[]
["印",null,"施",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"健康上の理由で勤務に制限を加える必要のある方で、勤務先または医師等の"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１表の提出が複数枚となる"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指示により労働時間（日数）短縮の特別扱を受けている場合をいいます。"]
["可",null,"設"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"場合、必ずすべての１表に"]
[]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
["）",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,"施設印を押印してください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項（項目番号「２」「３」）を確認のうえ、以下の告知欄（＊）",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,"してください。"]
[]
["県コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設種類コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に記入してください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて提出してください。"]
[]
[]
[]
["申込コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お届記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会社処理欄"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　条件となります。",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,"団定",null,null,null,"医療"]
[]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●申込コード「8．死亡」の場合"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者の",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,"現在の加入",null,null,null,null,null,null,null,null,"申込保険",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現在の",null,null,null,null,null,null,null,null,null,null,null,"申込入院",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有無",null,"内容"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　のみ死亡日を記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項「2」「3」",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄を確認"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
["申",null,null,"１．新規加入　２．脱退　３．転出※　４．転入※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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　１．男性　２．女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★【同意印鑑】新規加入（転入時の新規加入を含む）・増額時のみ必要"]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
[]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"－"]
[null,"記号証券番号　932-5595／900-95235"]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"K23-385"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[]
[]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
[]
[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
["留"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
[]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
["点"]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[]
[]
[]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
["（",null,"人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
["ゴ",null,"名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[]
["印",null,"施",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"健康上の理由で勤務に制限を加える必要のある方で、勤務先または医師等の"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１表の提出が複数枚となる"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指示により労働時間（日数）短縮の特別扱を受けている場合をいいます。"]
["可",null,"設"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"場合、必ずすべての１表に"]
[]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
["）",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,"施設印を押印してください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項（項目番号「２」「３」）を確認のうえ、以下の告知欄（＊）",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,"してください。"]
[]
["県コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設種類コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に記入してください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて提出してください。"]
[]
[]
[]
["申込コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お届記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会社処理欄"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　条件となります。",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,"団定",null,null,null,"医療"]
[]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●申込コード「8．死亡」の場合"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者の",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,"現在の加入",null,null,null,null,null,null,null,null,"申込保険",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現在の",null,null,null,null,null,null,null,null,null,null,null,"申込入院",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有無",null,"内容"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　のみ死亡日を記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項「2」「3」",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄を確認"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に該当する場合は",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"のうえ、記入"]
[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1.男性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3.昭和",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入してください。",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,"してください。"]
[null,null,null,"入」の方は記入不要）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2.女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和",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,"4.平成"]
[]
[{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$U,8,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$U,8,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$U,10,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$U,11,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,4,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$T,4,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$T,13,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$T,14,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$T,15,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$T,16,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$T,17,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$T,18,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ313,入力シート!$B:$T,19,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$I$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$J$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$K$9)","v":""},null,null,"無",null,null,"項目番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$L$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$M$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$N$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ313,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$O$9)","v":""},null,null,null,"無",null,null,null,"有",null,null,null,5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"GJ213+1","v":11}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,null,3]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
["申",null,null,"１．新規加入　２．脱退　３．転出※　４．転入※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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　１．男性　２．女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★【同意印鑑】新規加入（転入時の新規加入を含む）・増額時のみ必要"]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
[]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"－"]
[null,"記号証券番号　932-5595／900-95235"]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"K23-385"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[]
[]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
[]
[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
["留"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
[]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
["点"]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[]
[]
[]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
["（",null,"人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
["ゴ",null,"名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[]
["印",null,"施",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"健康上の理由で勤務に制限を加える必要のある方で、勤務先または医師等の"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１表の提出が複数枚となる"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指示により労働時間（日数）短縮の特別扱を受けている場合をいいます。"]
["可",null,"設"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"場合、必ずすべての１表に"]
[]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
["）",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,"施設印を押印してください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項（項目番号「２」「３」）を確認のうえ、以下の告知欄（＊）",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,"してください。"]
[]
["県コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設種類コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に記入してください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて提出してください。"]
[]
[]
[]
["申込コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お届記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会社処理欄"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　条件となります。",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,"団定",null,null,null,"医療"]
[]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●申込コード「8．死亡」の場合"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者の",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,"現在の加入",null,null,null,null,null,null,null,null,"申込保険",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現在の",null,null,null,null,null,null,null,null,null,null,null,"申込入院",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有無",null,"内容"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　のみ死亡日を記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項「2」「3」",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄を確認"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
["申",null,null,"１．新規加入　２．脱退　３．転出※　４．転入※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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　１．男性　２．女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★【同意印鑑】新規加入（転入時の新規加入を含む）・増額時のみ必要"]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
[]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"－"]
[null,"記号証券番号　932-5595／900-95235"]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"K23-385"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[]
[]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
[]
[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
["留"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
[]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
["点"]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[]
[]
[]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
["（",null,"人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
["ゴ",null,"名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考",null,null,"・",null,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項（項目番号「２」「３」）を確認のうえ、以下の告知欄（＊）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"してください。"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に該当する場合は",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"のうえ、記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1.男性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,null,3]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
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[]
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[]
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[]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
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[]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
[]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
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[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
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[]
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["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
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[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"届出印"]
["点"]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
["）",null,"名"]
[]
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[]
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["申",null,null,"１．新規加入　２．脱退　３．転出※　４．転入※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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　１．男性　２．女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★【同意印鑑】新規加入（転入時の新規加入を含む）・増額時のみ必要"]
[]
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[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
["留"]
[]
[]
["（",null,"人"]
["印",null,"施",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"健康上の理由で勤務に制限を加える必要のある方で、勤務先または医師等の"]
["可",null,"設"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設印を押印してください。"]
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[]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
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["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
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["留"]
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[]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
["ゴ",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,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"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,null,"指示により労働時間（日数）短縮の特別扱を受けている場合をいいます。"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　のみ死亡日を記入"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4.平成"]
[]
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[{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$U,8,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$U,8,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$U,10,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$U,11,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,4,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$T,4,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$T,13,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$T,14,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$T,15,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$T,16,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$T,17,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$T,18,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1257,入力シート!$B:$T,19,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$I$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$J$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$K$9)","v":""},null,null,"無",null,null,"項目番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$L$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$M$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$N$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1257,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$O$9)","v":""},null,null,null,"無",null,null,null,"有",null,null,null,5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"GJ1253+1","v":55}]
[]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[]
[]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
["点"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設印を押印してください。"]
[]
["申込コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お届記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会社処理欄"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
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[{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$U,8,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$U,8,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$U,10,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$U,11,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,4,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$T,4,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$T,13,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$T,14,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$T,15,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$T,16,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$T,17,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$T,18,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1373,入力シート!$B:$T,19,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$I$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$J$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$K$9)","v":""},null,null,"無",null,null,"項目番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$L$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$M$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$N$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1373,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$O$9)","v":""},null,null,null,"無",null,null,null,"有",null,null,null,5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"GJ1369+1","v":60}]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
["留"]
[]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
["（",null,"人"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
["印",null,"施",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"健康上の理由で勤務に制限を加える必要のある方で、勤務先または医師等の"]
[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,"施設印を押印してください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●申込コード「8．死亡」の場合"]
[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
[]
[{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$U,8,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$U,8,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$U,10,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$U,11,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,4,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$T,4,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$T,13,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$T,14,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$T,15,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$T,16,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$T,17,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$T,18,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1477,入力シート!$B:$T,19,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$I$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$J$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$K$9)","v":""},null,null,"無",null,null,"項目番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$L$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$M$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$N$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1477,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$O$9)","v":""},null,null,null,"無",null,null,null,"有",null,null,null,5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"GJ1473+1","v":62}]
[]
[]
["申",null,null,"１．新規加入　２．脱退　３．転出※　４．転入※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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　１．男性　２．女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★【同意印鑑】新規加入（転入時の新規加入を含む）・増額時のみ必要"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
["（",null,"人"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１表の提出が複数枚となる"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設印を押印してください。"]
["県コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設種類コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に記入してください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
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[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
[null,null,null,"入」の方は記入不要）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2.女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和",null,null,"年",null,null,null,null,null,"月",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
["申",null,null,"１．新規加入　２．脱退　３．転出※　４．転入※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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　１．男性　２．女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★【同意印鑑】新規加入（転入時の新規加入を含む）・増額時のみ必要"]
[]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
[]
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["ゴ",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,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
["印",null,"施",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"健康上の理由で勤務に制限を加える必要のある方で、勤務先または医師等の"]
[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,"場合、必ずすべての１表に"]
["県コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設種類コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に記入してください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者の",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,"現在の加入",null,null,null,null,null,null,null,null,"申込保険",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現在の",null,null,null,null,null,null,null,null,null,null,null,"申込入院",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有無",null,"内容"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3.昭和",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入してください。",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,"してください。"]
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[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
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[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
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["）",null,"名"]
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[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
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[]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
[]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"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,null,"指示により労働時間（日数）短縮の特別扱を受けている場合をいいます。"]
["）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
[]
[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4.平成"]
[]
[{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$U,8,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$U,8,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$U,10,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$U,11,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,4,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$T,4,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$T,13,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$T,14,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$T,15,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$T,16,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$T,17,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$T,18,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ1949,入力シート!$B:$T,19,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$I$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$J$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$K$9)","v":""},null,null,"無",null,null,"項目番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$L$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$M$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$N$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ1949,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$O$9)","v":""},null,null,null,"無",null,null,null,"有",null,null,null,5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"GJ1945+1","v":84}]
[]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[]
[]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１表の提出が複数枚となる"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"場合、必ずすべての１表に"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●申込コード「8．死亡」の場合"]
[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
[null,null,null,"入」の方は記入不要）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2.女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,null,3]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
[]
[]
["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
[null,"記号証券番号　932-5595／900-95235"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[]
[]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"場合、必ずすべての１表に"]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項「2」「3」",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄を確認"]
[null,null,null,"入」の方は記入不要）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2.女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和",null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日"]
[{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$U,8,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$U,8,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$U,10,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$U,11,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,4,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$T,4,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$T,13,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$T,14,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$T,15,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$T,16,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$T,17,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$T,18,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2169,入力シート!$B:$T,19,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$I$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$J$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$K$9)","v":""},null,null,"無",null,null,"項目番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$L$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$M$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$N$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2169,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$O$9)","v":""},null,null,null,"無",null,null,null,"有",null,null,null,5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"GJ2069+1","v":91}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
[]
[]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
[]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考",null,null,"・",null,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
["申込コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お届記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会社処理欄"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項「2」「3」",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄を確認"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に該当する場合は",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"のうえ、記入"]
[{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$U,8,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$U,8,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$U,10,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$U,3,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$U,11,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,4,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$T,4,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$T,13,0))","v":""},null,null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$T,14,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$T,15,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$T,16,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$T,17,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$T,18,0))","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,5,0)=\"\",\"\",VLOOKUP($GJ2285,入力シート!$B:$T,19,0))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$I$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$J$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$K$9)","v":""},null,null,"無",null,null,"項目番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$L$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$M$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$N$9)","v":""},null,null,{"$f":"IF(VLOOKUP($GJ2285,入力シート!$B:$T,3,0)=\"\",\"\",入力シート!$O$9)","v":""},null,null,null,"無",null,null,null,"有",null,null,null,5,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"GJ2185+1","v":96}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
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[]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
[]
["）",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,"施設印を押印してください。"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて提出してください。"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3.昭和",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入してください。",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,"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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",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,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１表の提出が複数枚となる"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて提出してください。"]
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["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
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[null,"記号証券番号　932-5595／900-95235"]
[]
[]
[]
[]
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["ゴ",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,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
["可",null,"設"]
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["県コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設種類コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に記入してください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。"]
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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,null,null,null,null,null,"告知事項「2」「3」",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄を確認"]
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["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"－"]
[]
[]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
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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,null,null,null,null,null,"に該当する場合は",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"のうえ、記入"]
[null,null,null,"入」の方は記入不要）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2.女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項（項目番号「２」「３」）を確認のうえ、以下の告知欄（＊）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"してください。"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
[]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に該当する場合は",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"のうえ、記入"]
[null,null,null,"入」の方は記入不要）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2.女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
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["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"K23-385"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",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,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
["可",null,"設"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項（項目番号「２」「３」）を確認のうえ、以下の告知欄（＊）",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,"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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて提出してください。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●申込コード「8．死亡」の場合"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3.昭和",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入してください。",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,"してください。"]
[]
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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,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,null,3]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
[null,"記号証券番号　932-5595／900-95235"]
[]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
[]
[]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
["申込コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お届記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会社処理欄"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　のみ死亡日を記入"]
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[]
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[]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"K23-385"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
["留"]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
["（",null,"人"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　条件となります。",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,"団定",null,null,null,"医療"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設名"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
["留"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
["）",null,"名"]
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[]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　"]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"－"]
[null,"記号証券番号　932-5595／900-95235"]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"K23-385"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）・総合医療保険（団体型）　加入申込書兼告知書・異動報告書（１表）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"日本生命保険相互会社　行"]
[null,null,null,null,null,null,null,null,null,null,null,"以下の「効力発生日」から効力が発生することを承知のうえ、以下被保険者について加入（増額）の申込みをします。なお、加入申込書兼告知書に記載の内容が事実に相違した場合は、契約（特約が付加されている場合は、特約を含みます。）の"]
[null,null,null,null,null,null,null,null,null,null,null,"全部または一部を解除されても異議を申しません。この申込みについては、被保険者の加入同意印をもって同意確認を行いました。なお、契約者にて、社会福祉施設従事者相互保険（団体定期保険）および総合医療保険（団体型）の告知事項を確認し、"]
[null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）については、以下の告知事項の１項に該当しないことを確認しました。"]
[]
[]
["ご",null,null,null,null,null,"１．",null,null,"被保険者同意の重要性を十分にご理解いただき、中途加入者、増減額者全員に対して契約内容の通知を行い、同意確認を実施していただきますようお願いいたします。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"契約者",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,"届出印"]
[]
[null,null,null,null,null,null,"２．",null,null,"生命保険会社の職員・代理店がお客様の告知に際し、事実を告知することを妨げたり、あるいは事実と違うことを告知するよう勧めることはありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"団体名：公益財団法人　社会福祉振興・試験センター"]
["留"]
[null,null,null,null,null,null,"３．",null,null,"社会福祉施設従事者相互保険（団体定期保険）について、次の方の新規加入・保険金増額等の際には、以下告知事項２項、３項に該当しない場合でも「被保険者の告知書」"]
[]
["意",null,null,null,null,null,null,null,null,"をご提出ください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名：",null,null,null,null,null,null,null,null,null," 理事長　臼井　正樹                                                                                                                                                                                   "]
[]
[null,null,null,null,null,null,null,null,null,"・非常勤役員等の加入が認められた制度で、常勤ではない等の理由で、以下告知事項に該当するかどうかの判断が困難な方"]
["点"]
[null,null,null,null,null,null,"４．",null,null,"「加入申込書兼告知書」等への記入の有無にかかわらず、当社で保有するお客様情報により、ご加入もしくは増額等をお断りすることがあります。"]
[]
[]
[]
["効　力",null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$8","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$8","v":""},null,null,null,"月",null,null,1,null,null,null,"日",null,null,"申込（告知）日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,null,null,null,null,null,{"$f":"入力シート!$K$6","v":""},null,null,null,"年",null,null,{"$f":"入力シート!$L$6","v":""},null,null,null,"月",null,null,{"$f":"入力シート!$M$6","v":""},null,null,null,"日",null,null,null,"施設の管理者の方が告知事項をご確認ください"]
["発生日",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,"（記入日）",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,"制度",null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄"]
[null,null,"法",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項",null,null,"１.",null,"告知日現在、病気やけがにより欠勤中の方がいますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知日から過去５年以内に、病気またはけがにより、継続"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$2=\"\",\"\",入力シート!$D$2)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤している方を含む）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７日以上にわたり、欠勤された方はいますか。"]
["（",null,"人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施",null,null,"施設印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"２.",null,"告知日から過去１年以内に、病気やけがにより継続して２週間以上欠勤",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（病気やけがの治療のため公休・普通休暇等で欠勤した"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$D$3=\"\",\"\",入力シート!$D$3)","v":""}]
["ゴ",null,"名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"された方がいますか。（病気やけがの治療のため公休・普通休暇等で",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　方を含む）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"押印要"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"欠勤した方を含む）"]
["ム",null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"設"]
[null,null,null,null,null,null,"所在地",null,null,null,null,null,{"$f":"IF(入力シート!$D$4=\"\",\"\",入力シート!$D$4)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３.",null,"告知日現在、健康上の理由で勤務の特別扱（※）を受けている方がいますか。"]
[]
["印",null,"施",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"健康上の理由で勤務に制限を加える必要のある方で、勤務先または医師等の"]
[null,null,null,null,null,null,{"$f":"IF(入力シート!$F$4=\"\",\"\",入力シート!$F$4)","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"１表の提出が複数枚となる"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指示により労働時間（日数）短縮の特別扱を受けている場合をいいます。"]
["可",null,"設"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"場合、必ずすべての１表に"]
[]
[null,null,null,null,null,"代表者役職名・氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$D$5=\"\",\"\",入力シート!$D$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力シート!$F$5=\"\",\"\",入力シート!$F$5)","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"上記、告知事項（項目番号「１」）に該当する場合は、加入（増額）できません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項を確認のうえ、以下の告知欄（＊）に記入"]
["）",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,"施設印を押印してください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"上記、告知事項（項目番号「２」「３」）を確認のうえ、以下の告知欄（＊）",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,"してください。"]
[]
["県コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"施設種類コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に記入してください。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当しない場合・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「無」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,"該当する場合　・・・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「有」を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて"]
[0,null,null,null,null,0,null,null,null,null,0,null,null,null,null,{"$f":"入力シート!$J$10","v":""},null,null,null,null,{"$f":"入力シート!$K$10","v":""},null,null,null,null,{"$f":"入力シート!$J$11","v":""},null,null,null,null,{"$f":"入力シート!$K$11","v":""},null,null,null,null,{"$f":"入力シート!$L$11","v":""},null,null,null,null,{"$f":"入力シート!$M$11","v":""},null,null,null,null,{"$f":"入力シート!$N$11","v":""},null,null,null,null,9,null,null,null,null,9]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当の項目番号を〇印で囲んでください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"提出してください。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「被保険者の告知書」をあわせて提出してください。"]
[]
[]
[]
["申込コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"社会福祉施設従事者相互保険（団体定期保険）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合医療保険（団体型）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"お届記入欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会社処理欄"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※従事者相互保険の加入が"]
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[]
[null,null,null,"被保険者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者氏名（カタカナ）",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,"性別",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,"告知欄（＊）",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,"告知欄(＊)",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,"個別",null,null,null,"告知"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●申込コード「8．死亡」の場合"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"被保険者の",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,"現在の加入",null,null,null,null,null,null,null,null,"申込保険",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現在の",null,null,null,null,null,null,null,null,null,null,null,"申込入院",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有無",null,"内容"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　のみ死亡日を記入"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知事項「2」「3」",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄を確認"]
[null,null,null,"【右づめ記入／前「0」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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入同意印",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,null,"保険金額",null,null,null,null,null,null,null,null,"金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入金額",null,null,null,null,null,null,null,null,null,null,null,"給付金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"●転出元・転入先の施設名を記入"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に該当する場合は",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"のうえ、記入"]
[null,null,null,"（申込コード「１．新規加",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"セイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メイ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★参照",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号",null,null,null,"年",null,null,null,null,null,"月",null,null,null,null,null,"日",null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,"（万円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（円）",null,null,null,null,null,null,null,null,null,null,null,"日額（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（死亡日を記入）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1.男性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
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[null,null,null,"入」の方は記入不要）",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2.女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"和",null,null,"年",null,null,null,null,null,"月",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
["申",null,null,"１．新規加入　２．脱退　３．転出※　４．転入※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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　１．男性　２．女性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"★【同意印鑑】新規加入（転入時の新規加入を含む）・増額時のみ必要"]
["込",null,null,"５．氏名の変更・訂正　６．生年月日訂正　７．性別訂正　８．死亡",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年号　３．昭和　４．平成",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この保険制度および保険契約の内容・医療保障保険契約内容登録制度ならびに、この保険にかかわる個人情報の取扱いについて、"]
["コ",null,null,"９．総合医療保険（団体型）のみ新規加入（従事者相互保険加入者のみ選択可）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入勧奨時に説明資料等を通知・配付され、了解したうえで、この保険契約の被保険者となること、および社会福祉施設従事者相互"]
[]
["ー",null,null,"※［施設間での転出入発生時に使用］「３．転出」は制度の脱退のお手続き、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険（団体定期保険）の死亡保険金・災害保険金・障がい給付金・入院給付金受取人は事業主となり、総合医療保険（団体型）の"]
["ド",null,null,"　「４．転入」は制度への新規加入のお手続きとなります。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給付金受取人は被保険者本人となることに同意し押印します。"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社支部コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支社名",null,null,null,null,null,null,null,null,null,null,null,null,null,"営業部名",null,null,null,null,null,null,null,null,null,null,null,null,"氏名コード",null,null,null,null,null,null,null,null,null,null,"取扱者"]
[null,"申込書提出締切日については、募集パンフレットをご確認ください。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"－"]
[null,"記号証券番号　932-5595／900-95235"]
[null,"複数の保険会社による共同取扱契約の場合、幹事会社が他の引受保険会社から委任を受けて事務を行いますが、引受保険会社は引受割合に応じて保険契約上の権利を有し義務を負うものであり、相互に連帯して責任を負うものではありません。また、将来に向かって、引受保険会社および引受割合の変更もあり得ます。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（幹事会社）日本生命保険相互会社"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"K23-385"]

{"sheet":"施設コードのプルダウン","index":2,"n_rows":79,"n_cols":4,"rows_kept":79,"cut":false,"hidden":true,"merged":[[1,1,2,1],[1,2,2,2]]}
[null,"施設種類コード"]
["施設種類","区分","加入対象施設・事業"]
["コード",null,null,"プルダウン"]
[11001," (生保)"," 救護施設",{"$f":"CONCATENATE(A4,B4,C4)","v":"11001 (生保) 救護施設"}]
[11002," (生保)"," 更生施設",{"$f":"CONCATENATE(A5,B5,C5)","v":"11002 (生保) 更生施設"}]
[11003," (生保)"," 医療保護施設","11003 (生保) 医療保護施設"]
[11004," (生保)"," 授産施設（生活保護）","11004 (生保) 授産施設（生活保護）"]
[11005," (生保)"," 宿所提供施設","11005 (生保) 宿所提供施設"]
[11006," (生保)"," 葬祭扶助","11006 (生保) 葬祭扶助"]
[21001," (高齢)"," 養護老人ホーム","21001 (高齢) 養護老人ホーム"]
[21002," (高齢)"," 特別養護老人ホーム（介護老人福祉施設）","21002 (高齢) 特別養護老人ホーム（介護老人福祉施設）"]
[21003," (高齢)"," 軽費老人ホーム","21003 (高齢) 軽費老人ホーム"]
[22001," (高齢)"," 介護老人保健施設","22001 (高齢) 介護老人保健施設"]
[22002," (高齢)"," 介護医療院","22002 (高齢) 介護医療院"]
[23001," (高齢)"," 訪問介護、夜間対応型訪問介護","23001 (高齢) 訪問介護、夜間対応型訪問介護"]
[23002," (高齢)"," 訪問入浴介護、介護予防訪問入浴介護","23002 (高齢) 訪問入浴介護、介護予防訪問入浴介護"]
[23003," (高齢)"," 通所介護（デイサービス）","23003 (高齢) 通所介護（デイサービス）"]
[23004," (高齢)"," 短期入所生活介護、介護予防短期入所生活介護（ショートステイ）","23004 (高齢) 短期入所生活介護、介護予防短期入所生活介護（ショートステイ）"]
[23005," (高齢)"," 小規模多機能型居宅介護、介護予防小規模多機能型居宅介護","23005 (高齢) 小規模多機能型居宅介護、介護予防小規模多機能型居宅介護"]
[23006," (高齢)"," 認知症対応型共同生活介護、介護予防認知症対応型共同生活介護（グループホーム）","23006 (高齢) 認知症対応型共同生活介護、介護予防認知症対応型共同生活介護（グループホーム）"]
[23007," (高齢)"," 特定施設入居者生活介護、介護予防特定施設入居者生活介護","23007 (高齢) 特定施設入居者生活介護、介護予防特定施設入居者生活介護"]
[23008," (高齢)"," 地域密着型通所介護","23008 (高齢) 地域密着型通所介護"]
[23009," (高齢)"," 認知症対応型通所介護、介護予防認知症対応型通所介護","23009 (高齢) 認知症対応型通所介護、介護予防認知症対応型通所介護"]
[23010," (高齢)"," 小規模多機能型居宅介護、介護予防小規模多機能型居宅介護","23010 (高齢) 小規模多機能型居宅介護、介護予防小規模多機能型居宅介護"]
[23011," (高齢)"," 地域密着型特定施設入居者生活介護","23011 (高齢) 地域密着型特定施設入居者生活介護"]
[23012," (高齢)"," 地域密着型介護老人福祉施設入所者生活介護","23012 (高齢) 地域密着型介護老人福祉施設入所者生活介護"]
[23013," (高齢)"," 福祉用具貸与、特定福祉用具販売","23013 (高齢) 福祉用具貸与、特定福祉用具販売"]
[23101," (高齢)"," 訪問看護、介護予防訪問看護","23101 (高齢) 訪問看護、介護予防訪問看護"]
[23102," (高齢)"," 訪問リハビリテーション、介護予防訪問リハビリテーション","23102 (高齢) 訪問リハビリテーション、介護予防訪問リハビリテーション"]
[23103," (高齢)"," 居宅療養管理指導、介護予防居宅療養管理指導","23103 (高齢) 居宅療養管理指導、介護予防居宅療養管理指導"]
[23104," (高齢)"," 通所リハビリテーション、介護予防通所リハビリテーション","23104 (高齢) 通所リハビリテーション、介護予防通所リハビリテーション"]
[23105," (高齢)"," 短期入所療養介護、介護予防短期入所療養介護","23105 (高齢) 短期入所療養介護、介護予防短期入所療養介護"]
[23106," (高齢)"," 定期巡回・随時対応型訪問介護看護","23106 (高齢) 定期巡回・随時対応型訪問介護看護"]
[23107," (高齢)"," 複合型サービス（看護小規模多機能型居宅介護）","23107 (高齢) 複合型サービス（看護小規模多機能型居宅介護）"]
[24001," (高齢)"," 居宅介護支援、介護予防支援","24001 (高齢) 居宅介護支援、介護予防支援"]
[25001," (高齢)"," 老人福祉センター","25001 (高齢) 老人福祉センター"]
[25002," (高齢)"," 老人介護支援センター","25002 (高齢) 老人介護支援センター"]
[26001," (高齢)"," 有料老人ホーム","26001 (高齢) 有料老人ホーム"]
[31001," (児童)"," 乳児院","31001 (児童) 乳児院"]
[31002," (児童)"," 母子生活支援施設","31002 (児童) 母子生活支援施設"]
[31003," (児童)"," 児童養護施設","31003 (児童) 児童養護施設"]
[31004," (児童)"," 障害児入所施設",{"$f":"CONCATENATE(A42,B42,C42)","v":"31004 (児童) 障害児入所施設"}]
[31005," (児童)"," 児童心理治療施設","31005 (児童) 児童心理治療施設"]
[31006," (児童)"," 児童自立支援施設","31006 (児童) 児童自立支援施設"]
[32001," (児童)"," 障害児通所支援事業（放課後等デイサービスほか）","32001 (児童) 障害児通所支援事業（放課後等デイサービスほか）"]
[32002," (児童)"," 放課後児童健全育成事業（放課後児童クラブ）","32002 (児童) 放課後児童健全育成事業（放課後児童クラブ）"]
[32003," (児童)"," 助産施設","32003 (児童) 助産施設"]
[32004," (児童)"," 保育所（保育所型認定こども園を含む）","32004 (児童) 保育所（保育所型認定こども園を含む）"]
[32005," (児童)"," 児童厚生施設（児童遊園、児童館）","32005 (児童) 児童厚生施設（児童遊園、児童館）"]
[32006," (児童)"," 児童家庭支援センター","32006 (児童) 児童家庭支援センター"]
[32007," (児童)"," その他の社会福祉法第２条第３項第２号の事業","32007 (児童) その他の社会福祉法第２条第３項第２号の事業"]
[33001," (児童)"," 幼保連携型認定こども園","33001 (児童) 幼保連携型認定こども園"]
[34001," (児童)"," 母子・父子福祉施設","34001 (児童) 母子・父子福祉施設"]
[34002," (児童)"," その他の社会福祉法第２条第３項第３号の事業","34002 (児童) その他の社会福祉法第２条第３項第３号の事業"]
[41001," (障害)"," 障害者支援施設","41001 (障害) 障害者支援施設"]
[42001," (障害)"," 居宅介護、重度訪問介護、同行援護、行動援護、重度障害者等包括支援","42001 (障害) 居宅介護、重度訪問介護、同行援護、行動援護、重度障害者等包括支援"]
[42002," (障害)"," 療養介護、生活介護、短期入所","42002 (障害) 療養介護、生活介護、短期入所"]
[42003," (障害)"," 自立訓練、就労選択支援、就労移行支援、就労継続支援、就労定着支援、自立生活援助","42003 (障害) 自立訓練、就労選択支援、就労移行支援、就労継続支援、就労定着支援、自立生活援助"]
[42004," (障害)"," 共同生活援助（グループホーム）","42004 (障害) 共同生活援助（グループホーム）"]
[42005," (障害)"," 移動支援事業、地域活動支援センター、福祉ホーム","42005 (障害) 移動支援事業、地域活動支援センター、福祉ホーム"]
[42006," (障害)"," 一般相談支援事業、特定相談支援事業","42006 (障害) 一般相談支援事業、特定相談支援事業"]
[43001," (障害)"," 身体障害者生活訓練等事業","43001 (障害) 身体障害者生活訓練等事業"]
[43002," (障害)"," 手話通訳事業","43002 (障害) 手話通訳事業"]
[43003," (障害)"," 介助犬訓練事業、聴導犬訓練事業、盲導犬訓練事業","43003 (障害) 介助犬訓練事業、聴導犬訓練事業、盲導犬訓練事業"]
[43004," (障害)"," 身体障害者福祉センター","43004 (障害) 身体障害者福祉センター"]
[43005," (障害)"," 補装具製作施設","43005 (障害) 補装具製作施設"]
[43006," (障害)"," 視覚障害者情報提供施設","43006 (障害) 視覚障害者情報提供施設"]
[43007," (障害)"," 身体障害者更生相談所","43007 (障害) 身体障害者更生相談所"]
[44001," (障害)"," 知的障害者更生相談所","44001 (障害) 知的障害者更生相談所"]
[51001," (その他)"," 女性自立支援施設","51001 (その他) 女性自立支援施設"]
[51002," (その他)"," 授産施設（社会事業授産施設）","51002 (その他) 授産施設（社会事業授産施設）"]
[51003," (その他)"," 生活福祉資金貸付事業","51003 (その他) 生活福祉資金貸付事業"]
[52001," (その他)"," 生活困窮者に対する相談事業","52001 (その他) 生活困窮者に対する相談事業"]
[52002," (その他)"," 認定生活困窮者就労訓練事業","52002 (その他) 認定生活困窮者就労訓練事業"]
[52003," (その他)"," 養子縁組あっせん事業","52003 (その他) 養子縁組あっせん事業"]
[52004," (その他)"," 無料低額宿泊（診療）事業","52004 (その他) 無料低額宿泊（診療）事業"]
[52005," (その他)"," 隣保事業、福祉サービス利用援助事業","52005 (その他) 隣保事業、福祉サービス利用援助事業"]
[52006," (その他)"," 社会福祉事業に関する連絡・助成事業","52006 (その他) 社会福祉事業に関する連絡・助成事業"]
[61001," 法人一括",null,"61001 法人一括"]

{"sheet":"加入コース","index":3,"n_rows":25,"n_cols":1,"rows_kept":25,"cut":false,"hidden":true,"merged":[]}
["加入コース"]
["A1コース　150万円　病気入院1000円"]
["B1コース　200万円　病気入院1000円"]
["C1コース　250万円　病気入院1000円"]
["D1コース　300万円　病気入院1000円"]
["E1コース　400万円　病気入院1000円"]
["F1コース　500万円　病気入院1000円"]
["A2コース　150万円　病気入院2000円"]
["B2コース　200万円　病気入院2000円"]
["C2コース　250万円　病気入院2000円"]
["D2コース　300万円　病気入院2000円"]
["E2コース　400万円　病気入院2000円"]
["F2コース　500万円　病気入院2000円"]
["A3コース　150万円　病気入院3000円"]
["B3コース　200万円　病気入院3000円"]
["C3コース　250万円　病気入院3000円"]
["D3コース　300万円　病気入院3000円"]
["E3コース　400万円　病気入院3000円"]
["F3コース　500万円　病気入院3000円"]
["A0コース　150万円"]
["B0コース　200万円　"]
["C0コース　250万円　"]
["D0コース　300万円　"]
["E0コース　400万円　"]
["F0コース　500万円　"]

{"sheet":"県コード","index":4,"n_rows":48,"n_cols":1,"rows_kept":48,"cut":false,"hidden":true,"merged":[[0,1,0,25]]}
["県コード"]
["01北海道"]
["02青森"]
["03岩手"]
["04宮城"]
["05秋田"]
["06山形"]
["07福島"]
["08茨城"]
["09栃木"]
["10群馬"]
["11埼玉"]
["12千葉"]
["13東京"]
["14神奈川"]
["15新潟"]
["16富山"]
["17石川"]
["18福井"]
["19山梨"]
["20長野"]
["21岐阜"]
["22静岡"]
["23愛知"]
["24三重"]
["25滋賀"]
["26京都"]
["27大阪"]
["28兵庫"]
["29奈良"]
["30和歌山"]
["31鳥取"]
["32島根"]
["33岡山"]
["34広島"]
["35山口"]
["36徳島"]
["37香川"]
["38愛媛"]
["39高知"]
["40福岡"]
["41佐賀"]
["42長崎"]
["43熊本"]
["44大分"]
["45宮崎"]
["46鹿児島"]
["47沖縄"]

{"sheet":"施設種類コード","index":5,"n_rows":67,"n_cols":4,"rows_kept":67,"cut":false,"hidden":true,"merged":[[2,1,2,3],[3,1,4,1],[3,2,4,2]]}
[]
[null,"施設種類コード（2023年新体系）"]
[null,"(注）このコードは2023年7月以降に加入する場合に使用します。\n2023年6月時点の加入施設は現在使用しているコードをそのまま使用します。"]
[null,"区分","加入対象施設・事業","施設種類"]
[null,null,null,"コード"]
[null," 生活保護関係"," 救護施設",11001]
[null,null," 更生施設",11002]
[null,null," 医療保護施設",11003]
[null,null," 授産施設（生活保護）",11004]
[null,null," 宿所提供施設",11005]
[null,null," 葬祭扶助",11006]
[null," 高齢者関係"," 養護老人ホーム",21001]
[null,null," 特別養護老人ホーム（介護老人福祉施設）",21002]
[null,null," 軽費老人ホーム",21003]
[null,null," 老人保健施設（社会福祉法人が経営する場合に限る）",22001]
[null,null," 老人居宅介護等事業（訪問介護）",23001]
[null,null," 老人デイサービスセンター（通所介護）",23002]
[null,null," 老人短期入所施設（短期入所生活介護）",23003]
[null,null," 小規模多機能型居宅介護事業（小規模多機能型居宅介護）",23004]
[null,null," 認知症対応型老人共同生活援助事業（認知症対応型共同生活介護）グループホーム",23005]
[null,null," 複合型サービス福祉事業（看護小規模多機能型居宅介護）",23006]
[null,null," 老人福祉センター",25001]
[null,null," 老人介護支援センター",25002]
[null,null," 有料老人ホーム",26001]
[null," 児童関係"," 乳児院",31001]
[null,null," 母子生活支援施設",31002]
[null,null," 児童養護施設",31003]
[null,null," 障害児入所施設",31004]
[null,null," 児童心理治療施設",31005]
[null,null," 児童自立支援施設",31006]
[null,null," 障害児通所支援事業（放課後等デイサービスほか）",32001]
[null,null," 放課後児童健全育成事業（放課後児童クラブ）",32002]
[null,null," 助産施設",32003]
[null,null," 保育所（保育所型認定こども園を含む）",32004]
[null,null," 児童厚生施設（児童遊園、児童館）",32005]
[null,null," 児童家庭支援センター",32006]
[null,null," その他の社会福祉法第２条第３項第２号の事業",32007]
[null,null," 幼保連携型認定こども園",33001]
[null,null," 母子・父子福祉施設",34001]
[null,null," その他の社会福祉法第２条第３項第３号の事業",34002]
[null," 障害者関係"," 障害者支援施設",41001]
[null,null," 居宅介護、重度訪問介護、同行援護、行動援護、重度障害者等包括支援",42001]
[null,null," 療養介護、生活介護、短期入所",42002]
[null,null," 自立訓練、就労移行支援、就労継続支援、就労定着支援、自立生活援助",42003]
[null,null," 共同生活援助（グループホーム）",42004]
[null,null," 移動支援事業、地域活動支援センター、福祉ホーム",42005]
[null,null," 一般相談支援事業、特定相談支援事業",42006]
[null,null," 身体障害者生活訓練等事業",43001]
[null,null," 手話通訳事業",43002]
[null,null," 介助犬訓練事業、聴導犬訓練事業、盲導犬訓練事業",43003]
[null,null," 身体障害者福祉センター",43004]
[null,null," 補装具製作施設",43005]
[null,null," 視覚障害者情報提供施設",43006]
[null,null," 身体障害者更生相談所",43007]
[null,null," 知的障害者更生相談所",44001]
[null," その他"," 婦人保護施設",51001]
[null,null," 授産施設（社会事業授産施設）",51002]
[null,null," 生活福祉資金貸付事業",51003]
[null,null," 生活困窮者に対する相談事業",52001]
[null,null," 認定生活困窮者就労訓練事業",52002]
[null,null," 養子縁組あっせん事業",52003]
[null,null," 無料低額宿泊（診療）事業、無料低額介護老人保健施設（介護医療院）利用事業",52004]
[null,null," 隣保事業、福祉サービス利用援助事業",52005]
[null,null," 社会福祉事業に関する連絡・助成事業",52006]
[null," 法人一括",null,61001]
[]
[null,"（注）加入単位の施設・事業所において複数の事業を経営する場合は、その主たる事業のコードを登録する。"]