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[null,null,"(見舞金・祝金制度付)",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,"02","01","01"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"以下の情報をご入力ください。",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,"04","03","03"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"＊は必須項目になります。",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,"05","04","04"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,"入　　　力　　　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,"入　　力　　例",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"10","09","09"]
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[null,null,null,null,null,null,"共\n済\n契\n約\n者",null,"＊申込日\n(告知日)",null,null,null,null,"令和",null,null,null,null,"年",null,null,null,"月",null,null,null,"日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和07年09月01日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$12=\"\",$U$12=\"\",$Y$12=\"\")","v":true},null,null,null,null,null,null,null,null,null,null,null,null,"12","11","11"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$12=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,{"$f":"AND($BM$13=\"×\",OR(OR($BM$15=\"〇\",$BN$15=\"〇\"),$BM$17=\"〇\",$BM$21=\"〇\",$BM$23=\"〇\",$BM$25=\"〇\",$BM$27=\"〇\",$BM$29=\"〇\",$BM$31=\"〇\",$BM$33=\"〇\",$BM$35=\"〇\"))","v":false},null,null,null,null,null,null,null,null,"13","12"]
[null,null,null,null,null,null,null,null,"＊事業所\n申込区分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所として初めての加入の場合は「新規」、それ以外は「既加入」と入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"新規 または 既加入",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"14","13"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$14=\"新規\",\"〇\",\"×\")","v":"×"},{"$f":"IF($N$14=\"既加入\",\"〇\",\"×\")","v":"×"},null,null,{"$f":"AND(OR($BM$15=\"×\",$BN$15=\"×\"),OR($BM$17=\"〇\",$BM$21=\"〇\",$BM$23=\"〇\",$BM$25=\"〇\",$BM$27=\"〇\",$BM$29=\"〇\",$BM$31=\"〇\",$BM$33=\"〇\",$BM$35=\"〇\"))","v":false},null,null,null,null,null,null,null,null,"15","14"]
[null,null,null,null,null,null,null,null,"＊効力発生日",null,null,null,null,"令和",null,null,null,null,"年",null,null,null,"月",null,"01",null,"日",null,"担当生保に確認のうえ入力ください（締切スケジュールがあります）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和07年11月01日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$16=\"\",$U$16=\"\")","v":true},null,null,null,null,null,null,null,null,null,null,null,null,"16","15"]
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[null,null,null,null,null,null,null,null,"事業所番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所番号７桁を入力ください。不明な場合は担当生保に確認のうえ入力ください。\nまた、「新規」非会員事業所様は申込受理後事業所番号を附番させていただきます。","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","0012345",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"18","17"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください","７桁まで入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$18=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,null,null,null,null,null,null,"19","18"]
[null,null,null,null,null,null,null,null,"＊事業所名\n(半角カナ)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"\"後\"&20-LEN($N$20)&\"文字可\"","v":"後20文字可"},null,null,null,"事業所名の法人格は略せず入力ください。入力しきれない場合はできるところまでお願いします","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","20桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","ｶﾌﾞｼｷｶﾞｲ ｼｬ ｼｮｳｺｳｶｲｷﾞｼｮ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"20","19"]
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[null,null,null,null,null,null,null,null,"＊事業所名\n(漢字)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"\"後\"&20-LEN($N$22)&\"文字可\"","v":"後20文字可"},null,null,null,"事業所名の法人格は略せず入力ください","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","16桁まで入力してください(「　(全スペース)」も1カウントになります)","株式会社商工会議所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"22","21"]
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[null,null,null,null,null,null,null,null,"＊代表者氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","代表取締役　田中 太郎",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"24","23"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください","姓と名の間には、スペースを入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$24=\"\",\"×\",\"〇\")","v":"×"},null,null,null,{"$f":"AND($BM$25=\"×\",OR($BM$27=\"〇\",$BM$29=\"〇\",$BM$31=\"〇\",$BM$33=\"〇\",$BM$35=\"〇\"))","v":false},null,null,null,null,null,null,null,null,"25","24"]
[null,null,null,null,null,null,null,null,"＊市区町村\n(半角カナ)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ｼｸﾁｮｳｿﾝ ～ 〇〇ﾁｮｳﾒまで35桁で入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾄﾄﾞｳﾌｹﾝ ～ 〇〇ﾁｮｳﾒまで入力してください","ﾁﾖﾀﾞｸ ﾏﾙﾉｳﾁｷﾀ 1ﾁｮｳﾒ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"26","25"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","35桁まで(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$26=\"\",\"×\",\"〇\")","v":"×"},null,null,null,{"$f":"AND($BM$27=\"×\",OR($BM$29=\"〇\",$BM$31=\"〇\",$BM$33=\"〇\",$BM$35=\"〇\"))","v":false},null,null,null,null,null,null,null,null,"27","26"]
[null,null,null,null,null,null,null,null,"＊市区町村\n(漢字)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"市区町村 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","千代田区　丸の内北　1丁目",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"28","27"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください","都道府県 ～ 〇〇丁目まで入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$28=\"\",\"×\",\"〇\")","v":"×"},null,null,null,{"$f":"AND($BM$29=\"×\",OR($BM$31=\"〇\",$BM$33=\"〇\",$BM$35=\"〇\"))","v":false},null,null,null,null,null,null,null,null,"29","28"]
[null,null,null,null,null,null,null,null,"＊番地\n(半角カナ)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番地以降を31桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","2-3 ﾉｰｽﾋﾞﾙ5F",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30","29"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$30=\"\",\"×\",\"〇\")","v":"×"},null,null,null,{"$f":"AND($BM$31=\"×\",OR($BM$33=\"〇\",$BM$35=\"〇\"))","v":false},null,null,null,null,null,null,null,null,"31"]
[null,null,null,null,null,null,null,null,"＊番地\n(漢字)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番地以降を27桁まで入力してください(「　(全スペース)」も1カウントになります)","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","２－３　ノースビル５F",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"32"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください","番地以降を入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$32=\"\",\"×\",\"〇\")","v":"×"},null,null,null,{"$f":"AND($BM$33=\"×\",OR($BM$35=\"〇\"))","v":false},null,null,null,null,null,null,null,null,"33"]
[null,null,null,null,null,null,null,null,"＊電話番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「-(ハイフン)」なし12桁まで入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"0312345678",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"34"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$34=\"\",\"×\",\"〇\")","v":"×"},null,null,null,{"$f":"AND($BM$35=\"×\",OR($BM$33=\"〇\"))","v":false},null,null,null,null,null,null,null,null,"35"]
[null,null,null,null,null,null,null,null,"取扱者(1)\nコード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入不要です",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"36"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$36=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,null,null,null,null,null,null,"37"]
[null,null,null,null,null,null,null,null,"取扱者(2)\nコード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入不要です",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"38"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$38=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,null,null,null,null,null,null,"39"]
[null,null,null,null,null,null,null,null,"生保\nコード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記入不要です",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"40"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$40=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,null,null,null,null,null,null,"41"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"42"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"43"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"44"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"45"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"入　　　力　　　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,"入　　力　　例",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"46"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"47"]
[null,null,null,null,null,null,"預金口座振替",null,"＊金融機関名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指定の金融機関のみのお取り扱いとなります","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","東商銀行",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"みずほ銀行","0001",null,null,null,null,null,null,null,"48"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください","〇〇銀行、〇〇信用金庫、〇〇農業協同組合まで入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$48=\"\",\"×\",\"〇\")","v":"×"},null,null,null,"三菱ＵＦＪ銀行","0005",null,{"$f":"AND($BM$49=\"×\",OR($BM$53=\"〇\",$BM$55=\"〇\",$BM$57=\"〇\",$BM$59=\"〇\",$BM$61=\"〇\",$BM$63=\"〇\"))","v":false},null,null,null,null,null,"49"]
[null,null,null,null,null,null,null,null,"金融機関\nコード",null,null,null,null,{"$f":"IF($N$48=\"\",\"\",VLOOKUP($N$48,$BQ$48:$BR$77,2,FALSE))","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,"0009",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"三井住友銀行","0009",null,null,null,null,null,null,null,"50"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"りそな銀行","0010",null,null,null,null,null,null,null,"51"]
[null,null,null,null,null,null,null,null,"＊支店名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本店または〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","【〇】日本橋支店、【×】日本橋",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"きらぼし銀行","0137",null,null,null,null,null,null,null,"52"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください","本店 または 〇〇支店まで入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$52=\"\",\"×\",\"〇\")","v":"×"},{"$f":"IF(AND($N$52<>\"本店\",RIGHT($N$52,2)<>\"支店\",RIGHT($N$52,3)<>\"営業所\",RIGHT($N$52,3)<>\"営業部\"),FALSE,TRUE)","v":false},null,null,"横浜銀行","0138",null,{"$f":"AND($BM$53=\"×\",OR($BM$55=\"〇\",$BM$57=\"〇\",$BM$59=\"〇\",$BM$61=\"〇\",$BM$63=\"〇\"))","v":false},null,null,null,null,null,"53"]
[null,null,null,null,null,null,null,null,"＊支店\nコード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"010",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"東日本銀行","0525",null,null,null,null,null,null,null,"54"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$54=\"\",\"×\",\"〇\")","v":"×"},null,null,null,"東京スター銀行","0526",null,{"$f":"AND($BM$55=\"×\",OR($BM$57=\"〇\",$BM$59=\"〇\",$BM$61=\"〇\",$BM$63=\"〇\"))","v":false},null,null,null,null,null,"55"]
[null,null,null,null,null,null,null,null,"＊預金種目",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"普通 または 当座",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"朝日信用金庫","1303",null,null,null,null,null,null,null,"56"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$56=\"\",\"×\",\"〇\")","v":"×"},null,null,null,"興産信用金庫","1305",null,{"$f":"AND($BM$57=\"×\",OR($BM$59=\"〇\",$BM$61=\"〇\",$BM$63=\"〇\"))","v":false},null,null,null,null,null,"57"]
[null,null,null,null,null,null,null,null,"＊口座番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","0012345",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"さわやか信用金庫","1310",null,null,null,null,null,null,null,"58"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください","7桁まで入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$58=\"\",\"×\",\"〇\")","v":"×"},null,null,null,"東京シティ信用金庫","1311",null,{"$f":"AND($BM$59=\"×\",OR($BM$61=\"〇\",$BM$63=\"〇\"))","v":false},null,null,null,null,null,"59"]
[null,null,null,null,null,null,null,null,"＊預金者名\n(半角カナ)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"30桁まで入力してください(「゛(濁点)」、「゜(半濁点)」、「　(半スペース)」も1カウントになります)",null,null,null,null,null,null,null,"姓と名の間には、スペースを入力してください",null,null,null,null,null,null,"ｶ)ｼｮｳｺｳｶｲｷﾞｼｮ ﾀﾞｲﾋｮｳﾄﾘｼﾏﾘﾔｸ ﾀﾅｶﾀﾛｳ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"芝信用金庫","1319",null,null,null,null,null,null,null,"60"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$60=\"\",\"×\",\"〇\")","v":"×"},null,null,null,"東京東信用金庫","1320",null,{"$f":"AND($BM$61=\"×\",OR($BM$63=\"〇\"))","v":false},null,null,null,null,null,"61"]
[null,null,null,null,null,null,null,null,"＊預金者名\n(漢字)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"24桁まで入力してください\n(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","株式会社商工会議所　代表取締役　田中太郎",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"東栄信用金庫","1321",null,null,null,null,null,null,null,"62"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)","24桁まで入力してください(「　(全スペース)」も1カウントになります)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($N$62=\"\",\"×\",\"〇\")","v":"×"},null,null,null,"亀有信用金庫","1323",null,{"$f":"AND($BM$63=\"×\",OR($BM$61=\"〇\"))","v":false},null,null,null,null,null,"63"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND($BM$13=\"〇\",$BM$15=\"〇\",$BM$17=\"〇\",$BM$21=\"〇\",$BM$23=\"〇\",$BM$25=\"〇\",$BM$27=\"〇\",$BM$29=\"〇\",$BM$31=\"〇\",$BM$33=\"〇\",$BM$35=\"〇\")=TRUE,\"〇\",IF(AND($BM$13=\"×\",$BM$15=\"×\",$BM$17=\"×\",$BM$21=\"×\",$BM$23=\"×\",$BM$25=\"×\",$BM$27=\"×\",$BM$29=\"×\",$BM$31=\"×\",$BM$33=\"×\",$BM$35=\"×\")=TRUE,\"×\",\"△\"))","v":"×"},{"$f":"IF(AND($BM$13=\"〇\",$BN$15=\"〇\",$BM$21=\"〇\",$BM$23=\"〇\",$BM$25=\"〇\",$BM$17=\"〇\")=TRUE,\"〇\",IF(AND($BM$13=\"×\",$BN$15=\"×\",$BM$21=\"×\",$BM$23=\"×\",$BM$25=\"×\",$BM$17=\"×\")=TRUE,\"×\",\"△\"))","v":"×"},null,{"$f":"IF(OR($BM$64=\"〇\",$BN$64=\"〇\"),\"〇\",\"×\")","v":"×"},"小松川信用金庫","1326",null,null,null,null,null,null,null,"64"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"足立成和信用金庫","1327"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"東京三協信用金庫","1333"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西京信用金庫","1336"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"入　　　力　　　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,"入　　力　　例",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"西武信用金庫","1341"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"城南信用金庫","1344"]
[null,null,null,null,"本人",null,"＊申込書区分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"すでにご加入の方が増額・減額希望の場合は２保険金変更を選択ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1.新規 または 2.保険金変更",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"昭和信用金庫","1345"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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":"IF($O$70=\"\",\"×\",\"〇\")","v":"×"},null,null,null,"目黒信用金庫","1346",null,{"$f":"AND($BM$71=\"×\",OR($Q$74<>\"\",$Y$74<>\"\",$Q$76<>\"\",$Y$76<>\"\",$BM$79=\"〇\",$O$80<>\"\",$R$80<>\"\",$V$80<>\"\",$Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"加入者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"増額・減額の場合のみ入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"012345678",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"世田谷信用金庫","1348"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$72=\"\",\"×\",\"〇\")","v":"×"},null,null,null,"東京信用金庫","1349"]
[null,null,null,null,null,null,"＊加入者(被保険者)氏名\n(半角カナ)",null,null,null,null,null,null,null,"ｾｲ",null,null,null,null,null,null,null,"ﾒｲ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ﾀﾅｶ ﾀﾛｳ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$74=\"\",$Y$74=\"\")","v":true},null,null,null,"城北信用金庫","1351"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$74=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,"滝野川信用金庫","1352",null,{"$f":"AND($Q$74=\"\",OR($Y$74<>\"\",$Q$76<>\"\",$Y$76<>\"\",$BM$79=\"〇\",$O$80<>\"\",$R$80<>\"\",$V$80<>\"\",$Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false},{"$f":"AND($Y$74=\"\",OR($Q$74<>\"\",$Q$76<>\"\",$Y$76<>\"\",$BM$79=\"〇\",$O$80<>\"\",$R$80<>\"\",$V$80<>\"\",$Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊加入者(被保険者)氏名\n(漢字)",null,null,null,null,null,null,null,"姓",null,null,null,null,null,null,null,"名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"田中　太郎",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$76=\"\",$Y$76=\"\")","v":true},null,null,null,"巣鴨信用金庫","1356"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$76=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,"商工組合中央金庫","2004",null,{"$f":"AND($Q$76=\"\",OR($Y$76<>\"\",$BM$79=\"〇\",$O$80<>\"\",$R$80<>\"\",$V$80<>\"\",$Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false},{"$f":"AND($Y$76=\"\",OR($Q$76<>\"\",$BM$79=\"〇\",$O$80<>\"\",$R$80<>\"\",$V$80<>\"\",$Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊性別",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$78=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$79=\"×\",OR($O$80<>\"\",$R$80<>\"\",$V$80<>\"\",$Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊生年月日",null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,"月",null,null,null,"日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"昭和63年2月10日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($O$80=\"\",$R$80=\"\",$V$80=\"\",$Z$80=\"\")","v":true}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$80=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($O$80=\"\",OR($R$80<>\"\",$V$80<>\"\",$Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false},{"$f":"AND($R$80=\"\",OR($V$80<>\"\",$Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false},{"$f":"AND($V$80=\"\",OR($Z$80<>\"\",$BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false},{"$f":"AND($Z$80=\"\",OR($BM$83=\"〇\",$BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊(新)保険金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"00万円",null,null,null,"新規で申込みの保険金額、または、変更後の保険金額を入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2000万円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$82=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$83=\"×\",OR($BM$85=\"〇\",OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊掛金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,"パンフレットを確認いただき入力ください ⇒ こちら",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1000円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$84=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$85=\"×\",OR(OR($BM$91=\"〇\",$BN$91=\"〇\"),$BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"現在加入保険金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"00万円",null,null,null,"増額・減額の場合のみ入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2400万円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$86=\"\",\"×\",\"〇\")","v":"×"}]
[null,null,null,null,null,null,"＊保険金・給付金\n＊受取人コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３つのなかから選択ください\n→法人または事業主受取・加入者受取・受取人指定から選択ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5：加入者（死亡のときは約款第39条の者（注1））または\n6：法人または事業主 または\n3：受取人指定（下欄に指定ください）（注2）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5：加入者（死亡のときは約款第39条の者（注1））"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"6：法人または事業主"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$88=\"5：加入者（死亡のときは約款第39条の者（注1））\",\"（注1）約款第39条の者とは受取人の順位を指しており、配偶者、子（子が死亡している場合には、その直系卑属）、父母、祖父母、兄弟姉妹の順です。\",IF($O$88=\"3：受取人指定（下欄に指定ください）（注2）\",\"（注2）受取人コード「3」を選択される場合は、高度障害保険金および諸給付金の受取人は加入者（被保険者）となります。\",\"\"))","v":""},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3：受取人指定（下欄に指定ください）（注2）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$88=\"3：受取人指定（下欄に指定ください）（注2）\",\"〇\",\"×\")","v":"×"},{"$f":"IF($O$88=\"\",\"×\",IF($O$88<>\"3：受取人指定（下欄に指定ください）（注2）\",\"〇\",\"×\"))","v":"×"},null,null,null,null,null,{"$f":"AND(OR($BM$91=\"×\",$BN$91=\"×\"),OR($BM$93=\"〇\",$Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊続柄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"受取人指定を選択した場合の入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"子"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$92=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$93=\"×\",OR($Q$94<>\"\",$Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊指定保険金受取人\n(半角カナ)",null,null,null,null,null,null,null,"ｾｲ",null,null,null,null,null,null,null,"ﾒｲ",null,null,null,null,null,null,"受取人指定を選択した場合の入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ﾀﾅｶ ｲﾁﾛｳ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$94=\"\",$Y$94=\"\")","v":true}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$94=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($Q$94=\"\",OR($Y$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false},{"$f":"AND($Y$94=\"\",OR($Q$94<>\"\",$Q$96<>\"\",$Y$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊指定保険金受取人\n(漢字)",null,null,null,null,null,null,null,"姓",null,null,null,null,null,null,null,"名",null,null,null,null,null,null,"受取人指定を選択した場合の入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"田中　一郎",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$96=\"\",$Y$96=\"\")","v":true}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$96=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($Q$96=\"\",OR($Y$96<>\"\",$BM$99=\"〇\"))","v":false},{"$f":"AND($Y$96=\"\",OR($Q$96<>\"\",$BM$99=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊告知欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"下記の【告知にあたっての留意事項】を確認いただき告知蘭の「いいえ」「はい」にて告知してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"いいえ または はい"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$98=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$99=\"×\",OR($Q$96<>\"\",$Y$96<>\"\"))","v":false}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【告知にあたっての留意事項】\n　新規加入または増額を申込まれる方は、申込日（告知日）現在、 ご本人の場合は正常に就業している方に限ります。下記の【告知事項】 をご確認いただき、上の「告知欄」の「いいえ」「はい」にて告知してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND($BM$71=\"〇\",$BM$75=\"〇\",$BM$77=\"〇\",$BM$79=\"〇\",$BM$81=\"〇\",$BM$83=\"〇\",$BM$85=\"〇\",$BM$91=\"〇\",$BM$93=\"〇\",$BM$95=\"〇\",$BM$97=\"〇\",$BM$99=\"〇\")=TRUE,\"〇\",IF(AND($BM$71=\"×\",$BM$75=\"×\",$BM$77=\"×\",$BM$79=\"×\",$BM$81=\"×\",$BM$83=\"×\",$BM$85=\"×\",$BM$91=\"×\",$BM$93=\"×\",$BM$95=\"×\",$BM$97=\"×\",$BM$99=\"×\")=TRUE,\"×\",\"△\"))","v":"×"},{"$f":"IF(AND($BM$71=\"〇\",$BM$75=\"〇\",$BM$77=\"〇\",$BM$79=\"〇\",$BM$81=\"〇\",$BM$83=\"〇\",$BM$85=\"〇\",$BN$91=\"〇\",$BM$99=\"〇\")=TRUE,\"〇\",IF(AND($BM$71=\"×\",$BM$75=\"×\",$BM$77=\"×\",$BM$79=\"×\",$BM$81=\"×\",$BM$83=\"×\",$BM$85=\"×\",$BN$91=\"×\",$BM$99=\"×\")=TRUE,\"×\",\"△\"))","v":"×"},null,{"$f":"IF(OR($BM$100=\"〇\",$BN$100=\"〇\"),\"〇\",\"×\")","v":"×"}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入者（被保険者）の告知事項"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"①申込日（告知日）から過去1年以内に、下表の病気で、手術を受けたことまたは継続して14日以上の入院をしたことがありますか。\n②申込日(告知日）から過去1年以内に、下表の病気で、14日以上の期間にわたり、医師の治療・投薬を受けたことがありますか。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"心臓病（心筋こうそく・心臓弁膜症・先天性心臓病・心筋症・狭心症）、高血圧症（※1）、脳卒中（脳出血・脳こうそく・くも膜下出血）、精神疾患（うつ病・双極性障がい（躁うつ病）・パニック障がい・不安障がい・神経症・統合失調症・心因反応）、てんかん、肺気腫、肺結核、すい臓炎、肝臓病（肝炎・肝硬変）、腎臓病（腎炎・ネフローゼ・腎不全）、緑内障、がん・悪性新生物（肉腫・白血病・悪性リンパ腫・多発性骨髄腫を含みます）、上皮内新生物、糖尿病（※2）、リウマチ\n\n（※1）高血圧症については、直近の血圧値が最大値150mmHgかつ最小値90mmHg以上に限り告知事項に該当します。\n（※2）糖尿病については、「インスリンを使用」「HbA1c（NGSP)が6.5％以上」「空腹時血糖値が126mg/dl以上」のいずれかの場合に限り告知事項に該当します。"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※告知について、別添の「パンフレット」および",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「重要事項説明書」を必ずお読みのうえ、その意義や重要性をご確認ください。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※この事実に相違した場合は、契約の一部または全部が解除されたり、保険金等をお支払できないことがあります。"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"配偶者の方もお申込みの場合は入力ください"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"入　　　力　　　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,"入　　力　　例"]
[]
[null,null,null,null,"配偶者",null,"＊申込書区分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"すでにご加入の方が増額・減額希望の場合は２保険金変更を選択ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1.新規 または 2.保険金変更"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$123=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$124=\"×\",OR($Q$127<>\"\",$Y$127<>\"\",$Q$129<>\"\",$Y$129<>\"\",$BM$132=\"〇\",$O$133<>\"\",$R$133<>\"\",$V$133<>\"\",$Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"加入者番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"増額・減額の場合のみ入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"012345678"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$125=\"\",\"×\",\"〇\")","v":"×"}]
[null,null,null,null,null,null,"＊加入者(被保険者)氏名\n(半角カナ)",null,null,null,null,null,null,null,"ｾｲ",null,null,null,null,null,null,null,"ﾒｲ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ﾀﾅｶ ﾀﾛｳ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$127=\"\",$Y$127=\"\")","v":true}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$127=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($Q$127=\"\",OR($Y$127<>\"\",$Q$129<>\"\",$Y$129<>\"\",$BM$132=\"〇\",$O$133<>\"\",$R$133<>\"\",$V$133<>\"\",$Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false},{"$f":"AND($Y$127=\"\",OR($Q$127<>\"\",$Q$129<>\"\",$Y$129<>\"\",$BM$132=\"〇\",$O$133<>\"\",$R$133<>\"\",$V$133<>\"\",$Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊加入者(被保険者)氏名\n(漢字)",null,null,null,null,null,null,null,"姓",null,null,null,null,null,null,null,"名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"田中　太郎",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$129=\"\",$Y$129=\"\")","v":true}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$129=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($Q$129=\"\",OR($Y$129<>\"\",$BM$132=\"〇\",$O$133<>\"\",$R$133<>\"\",$V$133<>\"\",$Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false},{"$f":"AND($Y$129=\"\",OR($Q$129<>\"\",$BM$132=\"〇\",$O$133<>\"\",$R$133<>\"\",$V$133<>\"\",$Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊性別",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$131=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$132=\"×\",OR($O$133<>\"\",$R$133<>\"\",$V$133<>\"\",$Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊生年月日",null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,null,"月",null,null,null,"日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"昭和63年2月10日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($O$133=\"\",$R$133=\"\",$V$133=\"\",$Z$133=\"\")","v":true}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$133=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($O$133=\"\",OR($R$133<>\"\",$V$133<>\"\",$Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false},{"$f":"AND($R$133=\"\",OR($V$133<>\"\",$Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false},{"$f":"AND($V$133=\"\",OR($Z$133<>\"\",$BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false},{"$f":"AND($Z$133=\"\",OR($BM$136=\"〇\",$BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊(新)保険金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"00万円",null,null,null,"新規で申込みの保険金額、または、変更後の保険金額を入力ください\n保険金額（500万円、300万円）は本人の加入口数と同等か、それ以下とします",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"500万円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$135=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$136=\"×\",OR($BM$138=\"〇\",OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊掛金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,"パンフレットを確認いただき入力ください ⇒ こちら",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1000円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$137=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$138=\"×\",OR(OR($BM$144=\"〇\",$BN$144=\"〇\"),$BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"現在加入保険金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"00万円",null,null,null,"増額・減額の場合のみ入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"300万円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$139=\"\",\"×\",\"〇\")","v":"×"}]
[null,null,null,null,null,null,"＊保険金・給付金\n＊受取人コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３つのなかから選択ください\n→法人または事業主受取・加入者受取・受取人指定から選択ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5：加入者（死亡のときは約款第39条の者（注1））または\n6：法人または事業主 または\n3：受取人指定（下欄に指定ください）（注2）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$141=\"5：加入者（死亡のときは約款第39条の者（注1））\",\"（注1）約款第39条の者とは受取人の順位を指しており、配偶者、子（子が死亡している場合には、その直系卑属）、父母、祖父母、兄弟姉妹の順です。\",IF($O$141=\"3：受取人指定（下欄に指定ください）（注2）\",\"（注2）受取人コード「3」を選択される場合は、高度障害保険金および諸給付金の受取人は加入者（被保険者）となります。\",\"\"))","v":""}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$141=\"3：受取人指定（下欄に指定ください）（注2）\",\"〇\",\"×\")","v":"×"},{"$f":"IF($O$141=\"\",\"×\",IF($O$141<>\"3：受取人指定（下欄に指定ください）（注2）\",\"〇\",\"×\"))","v":"×"},null,null,null,null,null,{"$f":"AND(OR($BM$144=\"×\",$BN$144=\"×\"),OR($BM$146=\"〇\",$Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊続柄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"受取人指定を選択した場合の入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"妻"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$145=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$146=\"×\",OR($Q$147<>\"\",$Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊指定保険金受取人\n(半角カナ)",null,null,null,null,null,null,null,"ｾｲ",null,null,null,null,null,null,null,"ﾒｲ",null,null,null,null,null,null,"受取人指定を選択した場合の入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ﾀﾅｶ ﾊﾅｺ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$147=\"\",$Y$147=\"\")","v":true}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$147=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($Q$147=\"\",OR($Y$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false},{"$f":"AND($Y$147=\"\",OR($Q$147<>\"\",$Q$149<>\"\",$Y$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊指定保険金受取人\n(漢字)",null,null,null,null,null,null,null,"姓",null,null,null,null,null,null,null,"名",null,null,null,null,null,null,"受取人指定を選択した場合の入力ください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"田中　花子",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"OR($Q$149=\"\",$Y$149=\"\")","v":true}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$149=TRUE,\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($Q$149=\"\",OR($Y$149<>\"\",$BM$152=\"〇\"))","v":false},{"$f":"AND($Y$149=\"\",OR($S$149<>\"\",$BM$152=\"〇\"))","v":false}]
[null,null,null,null,null,null,"＊告知欄",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"下記の【告知にあたっての留意事項】を確認いただき告知蘭の「いいえ」「はい」にて告知してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"いいえ または はい"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($O$151=\"\",\"×\",\"〇\")","v":"×"},null,null,null,null,null,null,{"$f":"AND($BM$152=\"×\",OR($S$149<>\"\",$Y$149<>\"\"))","v":false}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【告知にあたっての留意事項】\n　新規加入または増額を申込まれる方は、申込日（告知日）現在、 ご本人の場合は正常に就業している方に限ります。下記の【告知事項】 をご確認いただき、上の「告知欄」の「いいえ」「はい」にて告知してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND($BM$124=\"〇\",$BM$128=\"〇\",$BM$130=\"〇\",$BM$132=\"〇\",$BM$134=\"〇\",$BM$136=\"〇\",$BM$138=\"〇\",$BM$144=\"〇\",$BM$146=\"〇\",$BM$148=\"〇\",$BM$150=\"〇\",$BM$152=\"〇\")=TRUE,\"〇\",IF(AND($BM$124=\"×\",$BM$128=\"×\",$BM$130=\"×\",$BM$132=\"×\",$BM$134=\"×\",$BM$136=\"×\",$BM$138=\"×\",$BM$144=\"×\",$BM$146=\"×\",$BM$148=\"×\",$BM$150=\"×\",$BM$152=\"×\")=TRUE,\"×\",\"△\"))","v":"×"},{"$f":"IF(AND($BM$124=\"〇\",$BM$128=\"〇\",$BM$130=\"〇\",$BM$132=\"〇\",$BM$134=\"〇\",$BM$136=\"〇\",$BM$138=\"〇\",$BN$144=\"〇\",$BM$152=\"〇\")=TRUE,\"〇\",IF(AND($BM$124=\"×\",$BM$128=\"×\",$BM$130=\"×\",$BM$132=\"×\",$BM$134=\"×\",$BM$136=\"×\",$BM$138=\"×\",$BN$144=\"×\",$BM$152=\"×\")=TRUE,\"×\",\"△\"))","v":"×"},null,{"$f":"IF(OR($BM$153=\"〇\",$BN$153=\"〇\"),\"〇\",\"×\")","v":"×"}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入者（被保険者）の告知事項"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"①申込日（告知日）から過去1年以内に、下表の病気で、手術を受けたことまたは継続して14日以上の入院をしたことがありますか。\n②申込日(告知日）から過去1年以内に、下表の病気で、14日以上の期間にわたり、医師の治療・投薬を受けたことがありますか。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"心臓病（心筋こうそく・心臓弁膜症・先天性心臓病・心筋症・狭心症）、高血圧症（※1）、脳卒中（脳出血・脳こうそく・くも膜下出血）、精神疾患（うつ病・双極性障がい（躁うつ病）・パニック障がい・不安障がい・神経症・統合失調症・心因反応）、てんかん、肺気腫、肺結核、すい臓炎、肝臓病（肝炎・肝硬変）、腎臓病（腎炎・ネフローゼ・腎不全）、緑内障、がん・悪性新生物（肉腫・白血病・悪性リンパ腫・多発性骨髄腫を含みます）、上皮内新生物、糖尿病（※2）、リウマチ\n\n（※1）高血圧症については、直近の血圧値が最大値150mmHgかつ最小値90mmHg以上に限り告知事項に該当します。\n（※2）糖尿病については、「インスリンを使用」「HbA1c（NGSP)が6.5％以上」「空腹時血糖値が126mg/dl以上」のいずれかの場合に限り告知事項に該当します。"]
[]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※告知について、別添の「パンフレット」および",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「重要事項説明書」を必ずお読みのうえ、その意義や重要性をご確認ください。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※この事実に相違した場合は、契約の一部または全部が解除されたり、保険金等をお支払できないことがあります。"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF($BM$170=\"×\",\"未入力項目があります。\"&CHAR(10)&\"赤色の項目をご確認ください。\",\"\")","v":"未入力項目があります。\n赤色の項目をご確認ください。"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AND($BP$64=\"〇\",OR($BP$100=\"〇\",$BP$153=\"〇\"))=TRUE,\"〇\",\"×\")","v":"×"}]

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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,"生命共済制度"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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・保険金額変更 申込書兼告知書"]
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[]
[null,null,null,null,null,"東　京　商　工　会　議　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"御中"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(見舞金・祝金制度付)"]
[]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,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\n申込区分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$N$14=\"\",\"\",入力!$N$14)","v":""}]
[]
[]
[null,null,null,null,null,"貴団体と生命保険会社との間に締結された福祉団体定期保険契約並びに貴団体が運営する見舞金・祝金制度に加入（保険金額変更）をいたしたく、所定の手続きをとられるよう依頼いたします。申込みにあたり、加入者（被保険者）全員は、「パンフレット」記載の各事項（貴団体が別に定めた規約等がある場合はその約定事項を含む）・重要事項（「契約概要」・「注意喚起情報」）を了知し、「個人情報の取扱について」の内容に同意しています。また、申込書および告知欄の記載事項は事実と相違ありません。併せて、申込内容（保障内容・保険金額等）が意向に沿っていることを確認しました。\nなお、本申込が加入資格範囲外であった場合には、本申込が無効となることを了解しております。"]
[]
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[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"共済契約者",null,null,null,"事業所名",null,null,null,null,null,"カタカナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$N$52=\"\",\"\",入力!$N$52)","v":""}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"効力発生日/変更日となります。\n取扱生保にて記入します。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"MID(入力!$N$20,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,12,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,13,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,14,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,15,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,16,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,17,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,18,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,19,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,20,1)","v":""}]
[]
[]
[null,null,null,null,null,null,"【告知にあたっての留意事項】\n新規加入または増額を申込まれる方は、申込日（告知日）現在、 ご本人の場合は正常に就業している方に限ります。下記の【告知事項】 をご確認いただき、「告知欄」の該当項目に○をつける方法で告知してください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"漢字"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※\n\n\n\n",null,null,null,"告知について、別添の「パンフレット」および「重要事項説明書」を必ずお読みのうえ、その意義や重要性をご確認ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"MID(入力!$N$22,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,12,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,13,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,14,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,15,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,16,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,17,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,18,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,19,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,20,1)","v":""}]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者\n氏　 名",null,null,null,null,null,{"$f":"IF(入力!$N$24=\"\",\"\",入力!$N$24)","v":""}]
[]
[]
[]
[null,null,null,null,null,null,"加入者（被保険者）の告知事項"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電　話\n番　号",null,null,null,null,null,null,null,null,null,"「- (ブランク)」なし12桁まで入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会員番号",null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$N$18=\"\",\"\",入力!$N$18)","v":""}]
[]
[null,null,null,null,null,null,"①申込日（告知日）から過去1年以内に、下表の病気で、手術を受けたことまたは継続して\n　 14日以上の入院をしたことがありますか。\n②申込日(告知日）から過去1年以内に、下表の病気で、14日以上の期間にわたり、医師\n　 の治療・投薬を受けたことがありますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"MID(入力!$N$34,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,12,1)","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,null,null,null,null,null,null,null,null,null,null,null,null,"※\n\n\n\n",null,null,null,"この事実に相違した場合は、契約の一部または全部が解除されたり、保険金等をお支払できないことがあります。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"通信先住所",null,null,null,"地区町村カナ",null,null,null,null,null,"丁目までご記入ください｡（番地からは下段にご記入ください｡）"]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"漢\n字",null,null,null,null,null,"丁目までご記入ください｡（番地からは下段にご記入ください｡）"]
[null,null,null,null,null,null,null,"心臓病（心筋こうそく・心臓弁膜症・先天性心臓病・心筋症・狭心症）、高血圧症（※1）、脳卒中（脳出血・脳こうそく・くも膜下出血）、精神疾患（うつ病・双極性障がい（躁うつ病）・パニック障がい・不安障がい・神経症・統合失調症・心因反応）、てんかん、肺気腫、肺結核、すい臓炎、肝臓病（肝炎・肝硬変）、腎臓病（腎炎・ネフローゼ・腎不全）、緑内障、がん・悪性新生物（肉腫・白血病・悪性リンパ腫・多発性骨髄腫を含みます）、上皮内新生物、糖尿病（※2）、リウマチ\n（※1）高血圧症については、直近の血圧値が最大値150mmHgかつ最小値90mmHg以上に\n（※1）限り告知事項に該当します。\n（※2）糖尿病については、「インスリンを使用」「HbA1c（NGSP)が6.5％以上」「空腹時血糖\n（※1）値が126mg/dl以上」のいずれかの場合に限り告知事項に該当します。"]
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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,"番地\nカナ",null,null,null,null,null,{"$f":"MID(入力!$N$30,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,12,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,13,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,14,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,15,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,16,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,17,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,18,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,19,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,20,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,21,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,22,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,23,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,24,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,25,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,26,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,27,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,28,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,29,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,30,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,31,1)","v":""}]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"漢\n字",null,null,null,null,null,{"$f":"MID(入力!$N$32,1,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,2,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,3,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,4,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,5,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,6,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,7,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,8,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,9,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,10,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,11,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,12,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,13,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,14,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,15,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,16,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,17,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,18,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,19,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,20,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,21,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,22,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,23,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,24,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,25,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,26,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,27,1)","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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"パンフレット記載の保険契約内容、重要事項、本申込書の内容を了知のうえ、また、別紙「個人情報の取扱について」の内容について保険金受取人とともに承知し、この保険契約の被保険者となることに同意します。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"."]
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[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄が「はい」の方は新規加入または増額できません。"]
[]
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[null,null,null,null,null,"該当箇所に\n○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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"被保険者\n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,"区分　1：本人　2：配偶者（新規で本人、配偶者セット加入の場合は連記でご記入ください）"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"新　規　加　入　時　記　入　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,"【告知事項】\n①②のいずれか又は両方に該当していますか？"]
[]
[]
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[null,null,null,null,null,"保\n険\n会\n社\n処\n理\n欄",null,null,null,null,"取扱者(１)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,"取扱者(２)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,"生保コード",null,null,null,null,null,null,null,"取扱者印",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"既に本人が加入されており、今回\n配偶者のみを追加で加入させる\n場合に限りご記入ください。",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,"預金口座振替依頼書を受理の上、確認印をお願いします。"]
["EAA12L-220602",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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・給付金受取人コード\n5：加入者（死亡のときは約款第39条の者（注1）\n6：法人または事業主\n3：受取人指定（右欄に指定ください）（注2）"]
[]
[]
[]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金融機関確認印",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（注1）\n\n（注2）\n",null,null,null,null,null,null,"約款の順位とは、配偶者、子（子が死亡している場合には、その直系卑属）、父母、祖父母、兄弟姉妹の順です。\n受取人コード「3」を選択される場合は、高度障害保険金および諸給付金の受取人は加入者（被保険者）となります。"]
[null,null,null,null,null,null,null,null,null,null,"取扱者（1）氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生保会社名　 生命"]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"月度",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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・保険金額変更 申込書兼告知書"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"枚目",null,null,null,null,null,null,"/",null,null,null,null,null,null,null,null,null,"枚のうち"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"福祉団体定期保険"]
[]
[null,null,null,null,null,"アクサ生命保険株式会社[事務幹事会社]",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,"御中"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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\n申込区分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$N$14=\"\",\"\",入力!$N$14)","v":""}]
[]
[]
[]
[null,null,null,null,null,"貴社と締結しています福祉団体定期保険契約への加入（保険金額変更）を申込みます。加入者(被保険者)全員は、パンフレット記載の各事項、重要事項(「契約概要」・「注意喚起情報」)を了知し、「個人情報の取扱について」の内容に同意していることを確認しました。また、申込書および告知欄の記載事項は事実と相違ないこと、併せて、申込内容(保障内容・保険金額等)は事業主の意向に沿っていることを確認しました。\nなお、本申込時に、被保険者が加入資格範囲外であった場合には本申込が無効になることを了解しております。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申込日(告知日)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$BM$13=\"×\",\"\",入力!$N$12&入力!$Q$12&入力!$S$12&入力!$U$12&入力!$W$12&入力!$Y$12&入力!$AA$12)","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,"金融機関届出印",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"預　\n　\n金　\n　\n口　\n　\n座　\n　\n振　\n　\n替"]
[]
[]
[]
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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,"共済契約者",null,null,null,"事業所名",null,null,null,null,null,"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,null,null,null,null,null,null,null,null,null,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,{"$f":"IF(入力!$N$52=\"\",\"\",入力!$N$52)","v":""}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"効力発生日/変更日となります。\n取扱生保にて記入します。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"MID(入力!$N$20,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,12,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,13,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,14,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,15,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,16,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,17,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,18,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,19,1)","v":""},null,null,null,{"$f":"MID(入力!$N$20,20,1)","v":""}]
[]
[]
[null,null,null,null,null,null,"【告知にあたっての留意事項】\n新規加入または増額を申込まれる方は、申込日（告知日）現在、 ご本人の場合は正常に就業している方に限ります。下記の【告知事項】 をご確認いただき、「告知欄」の該当項目に○をつける方法で告知してください。"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"漢字"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※\n\n\n\n",null,null,null,"告知について、別添の「パンフレット」および「重要事項説明書」を必ずお読みのうえ、その意義や重要性をご確認ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"MID(入力!$N$22,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,12,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,13,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,14,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,15,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,16,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,17,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,18,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,19,1)","v":""},null,null,null,{"$f":"MID(入力!$N$22,20,1)","v":""}]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者\n氏　 名",null,null,null,null,null,{"$f":"IF(入力!$N$24=\"\",\"\",入力!$N$24)","v":""}]
[]
[]
[]
[null,null,null,null,null,null,"加入者（被保険者）の告知事項"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電　話\n番　号",null,null,null,null,null,null,null,null,null,"「- (ブランク」なし12桁まで入力してください",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"会員番号",null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$N$18=\"\",\"\",入力!$N$18)","v":""}]
[]
[null,null,null,null,null,null,"①申込日（告知日）から過去1年以内に、下表の病気で、手術を受けたことまたは継続して\n　 14日以上の入院をしたことがありますか。\n②申込日(告知日）から過去1年以内に、下表の病気で、14日以上の期間にわたり、医師\n　 の治療・投薬を受けたことがありますか。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"MID(入力!$N$34,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,12,1)","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,null,null,null,null,null,null,null,null,null,null,null,null,"※\n\n\n\n",null,null,null,"この事実に相違した場合は、契約の一部または全部が解除されたり、保険金等をお支払できないことがあります。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"通信先住所",null,null,null,"地区町村カナ",null,null,null,null,null,"丁目までご記入ください｡（番地からは下段にご記入ください｡）"]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"漢\n字",null,null,null,null,null,"丁目までご記入ください｡（番地からは下段にご記入ください｡）"]
[null,null,null,null,null,null,null,"心臓病（心筋こうそく・心臓弁膜症・先天性心臓病・心筋症・狭心症）、高血圧症（※1）、脳卒中（脳出血・脳こうそく・くも膜下出血）、精神疾患（うつ病・双極性障がい（躁うつ病）・パニック障がい・不安障がい・神経症・統合失調症・心因反応）、てんかん、肺気腫、肺結核、すい臓炎、肝臓病（肝炎・肝硬変）、腎臓病（腎炎・ネフローゼ・腎不全）、緑内障、がん・悪性新生物（肉腫・白血病・悪性リンパ腫・多発性骨髄腫を含みます）、上皮内新生物、糖尿病（※2）、リウマチ\n（※1）高血圧症については、直近の血圧値が最大値150mmHgかつ最小値90mmHg以上に\n（※1）限り告知事項に該当します。\n（※2）糖尿病については、「インスリンを使用」「HbA1c（NGSP)が6.5％以上」「空腹時血糖\n（※1）値が126mg/dl以上」のいずれかの場合に限り告知事項に該当します。"]
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[]
[]
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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,"漢\n字",null,null,null,null,null,{"$f":"MID(入力!$N$32,1,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,2,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,3,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,4,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,5,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,6,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,7,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,8,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,9,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,10,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,11,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,12,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,13,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,14,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,15,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,16,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,17,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,18,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,19,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,20,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,21,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,22,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,23,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,24,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,25,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,26,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,27,1)","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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"パンフレット記載の保険契約内容、重要事項、本申込書の内容を了知のうえ、また、別紙「個人情報の取扱について」の内容について保険金受取人とともに承知し、この保険契約の被保険者となることに同意します。"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"."]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"告知欄が「はい」の方は新規加入または増額できません。"]
[]
[]
[null,null,null,null,null,"該当箇所に\n○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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"被保険者\n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,"区分　1：本人　2：配偶者（新規で本人、配偶者セット加入の場合は連記でご記入ください）"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"新　規　加　入　時　記　入　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,"【告知事項】\n①②のいずれか又は両方に該当していますか？"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"申込書\n区分",null,null,null,null,null,null,null,null,null,"加 入 者 番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入者(被保険者)氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,null,null,"生　年　月　日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(新)保険金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現在加入\n保険金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険金\n給付金\n受取人",null,null,null,null,null,null,"続\n柄",null,null,null,null,"指定保険金受取人",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,"その他\n人数"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"区分"]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(漢字)",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":"IF(入力!$Y$149=\"\",\"\",入力!$Y$149)","v":""}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$Q$149=\"\",\"\",入力!$Q$149)","v":""}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(漢字)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$Y$129=\"\",\"\",入力!$Y$129)","v":""}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"既加入者被保険者番号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$Q$129=\"\",\"\",入力!$Q$129)","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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"既加入者被保険者氏名"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"【保険会社押印欄】"]
[]
[]
[null,null,null,null,null,"保\n険\n会\n社\n処\n理\n欄",null,null,null,null,"取扱者(１)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,"取扱者(２)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,"生保コード",null,null,null,null,null,null,null,"取扱者印",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"幹事会社所管長印",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"既に本人が加入されており、今回\n配偶者のみを追加で加入させる\n場合に限りご記入ください。"]
["EAA12L-220602",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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・給付金受取人コード\n5：加入者（死亡のときは約款第39条の者（注1）\n6：法人または事業主\n3：受取人指定（右欄に指定ください）（注2）"]
[]
[]
[]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険契約者(団体名)"]
[]
[]
[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,"印",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"東京商工会議所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"届出印"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（注1）\n\n（注2）\n",null,null,null,null,null,null,"約款の順位とは、配偶者、子（子が死亡している場合には、その直系卑属）、父母、祖父母、兄弟姉妹の順です。\n受取人コード「3」を選択される場合は、高度障害保険金および諸給付金の受取人は加入者（被保険者）となります。"]
[null,null,null,null,null,null,null,null,null,null,"取扱者（1）氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生保会社名　 生命"]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"月度",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,"この保険契約が共同取扱契約の場合、引受保険会社はそれぞれの引受割合による保険契約上の責任を負います。事務幹事会社は各引受保険会社の委任を受けて事務を行います。"]
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[]
[null,null,null,null,null,"アクサ生命保険株式会社[事務幹事会社]",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,"御中"]
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[]
[null,null,null,null,null,"貴社と締結しています福祉団体定期保険契約への加入（保険金額変更）を申込みます。加入者(被保険者)全員は、パンフレット記載の各事項、重要事項(「契約概要」・「注意喚起情報」)を了知し、「個人情報の取扱について」の内容に同意していることを確認しました。また、申込書および告知欄の記載事項は事実と相違ないこと、併せて、申込内容(保障内容・保険金額等)は事業主の意向に沿っていることを確認しました。\nなお、本申込時に、被保険者が加入資格範囲外であった場合には本申込が無効になることを了解しております。"]
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[]
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[]
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[]
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[]
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[]
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[]
[]
[null,null,null,null,null,null,"【告知にあたっての留意事項】\n新規加入または増額を申込まれる方は、申込日（告知日）現在、 ご本人の場合は正常に就業している方に限ります。下記の【告知事項】 をご確認いただき、「告知欄」の該当項目に○をつける方法で告知してください。"]
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[]
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[]
[]
[]
[null,null,null,null,null,null,"加入者（被保険者）の告知事項"]
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[null,null,null,null,null,null,"①申込日（告知日）から過去1年以内に、下表の病気で、手術を受けたことまたは継続して\n　 14日以上の入院をしたことがありますか。\n②申込日(告知日）から過去1年以内に、下表の病気で、14日以上の期間にわたり、医師\n　 の治療・投薬を受けたことがありますか。",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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":"MID(入力!$N$34,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$34,12,1)","v":""}]
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[null,null,null,null,null,null,null,"心臓病（心筋こうそく・心臓弁膜症・先天性心臓病・心筋症・狭心症）、高血圧症（※1）、脳卒中（脳出血・脳こうそく・くも膜下出血）、精神疾患（うつ病・双極性障がい（躁うつ病）・パニック障がい・不安障がい・神経症・統合失調症・心因反応）、てんかん、肺気腫、肺結核、すい臓炎、肝臓病（肝炎・肝硬変）、腎臓病（腎炎・ネフローゼ・腎不全）、緑内障、がん・悪性新生物（肉腫・白血病・悪性リンパ腫・多発性骨髄腫を含みます）、上皮内新生物、糖尿病（※2）、リウマチ\n（※1）高血圧症については、直近の血圧値が最大値150mmHgかつ最小値90mmHg以上に\n（※1）限り告知事項に該当します。\n（※2）糖尿病については、「インスリンを使用」「HbA1c（NGSP)が6.5％以上」「空腹時血糖\n（※1）値が126mg/dl以上」のいずれかの場合に限り告知事項に該当します。"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番地\nカナ",null,null,null,null,null,{"$f":"MID(入力!$N$30,1,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,2,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,3,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,4,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,5,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,6,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,7,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,8,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,9,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,10,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,11,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,12,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,13,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,14,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,15,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,16,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,17,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,18,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,19,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,20,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,21,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,22,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,23,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,24,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,25,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,26,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,27,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,28,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,29,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,30,1)","v":""},null,null,null,{"$f":"MID(入力!$N$30,31,1)","v":""}]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"漢\n字",null,null,null,null,null,{"$f":"MID(入力!$N$32,1,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,2,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,3,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,4,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,5,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,6,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,7,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,8,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,9,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,10,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,11,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,12,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,13,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,14,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,15,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,16,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,17,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,18,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,19,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,20,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,21,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,22,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,23,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,24,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,25,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,26,1)","v":""},null,null,null,null,{"$f":"MID(入力!$N$32,27,1)","v":""}]
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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,"パンフレット記載の保険契約内容、重要事項、本申込書の内容を了知のうえ、また、別紙「個人情報の取扱について」の内容について保険金受取人とともに承知し、この保険契約の被保険者となることに同意します。"]
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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,"告知欄が「はい」の方は新規加入または増額できません。"]
[]
[]
[null,null,null,null,null,"該当箇所に\n○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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"被保険者\n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,"区分　1：本人　2：配偶者（新規で本人、配偶者セット加入の場合は連記でご記入ください）"]
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[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,"申込書\n区　 分",null,null,null,null,null,null,null,null,null,"加 入 者 番 号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"加入者(被保険者)氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,null,null,"生　年　月　日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(新)保険金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"掛　金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現在加入\n保険金",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険金\n給付金\n受取人",null,null,null,null,null,null,"続\n柄",null,null,null,null,"指定保険金受取人",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,"その他\n人数"]
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[null,null,null,null,null,"保\n険\n会\n社\n処\n理\n欄",null,null,null,null,"取扱者(１)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,"取扱者(２)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,"生保コード",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"既に本人が加入されており、今回\n配偶者のみを追加で加入させる\n場合に限りご記入ください。"]
["EAA12L-220602",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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・給付金受取人コード\n5：加入者（死亡のときは約款第39条の者（注1）\n6：法人または事業主\n3：受取人指定（右欄に指定ください）（注2）"]
[]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険契約者(団体名)"]
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[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"東京商工会議所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"届出印"]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（注1）\n\n（注2）\n",null,null,null,null,null,null,"約款の順位とは、配偶者、子（子が死亡している場合には、その直系卑属）、父母、祖父母、兄弟姉妹の順です。\n受取人コード「3」を選択される場合は、高度障害保険金および諸給付金の受取人は加入者（被保険者）となります。"]
[null,null,null,null,null,null,null,null,null,null,"取扱者（1）氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生保会社名　 生命"]
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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,null,null,null,null,null,null,null,"月度",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,"この保険契約が共同取扱契約の場合、引受保険会社はそれぞれの引受割合による保険契約上の責任を負います。事務幹事会社は各引受保険会社の委任を受けて事務を行います。"]
[]
[]
["　　　　　　　　　　　　　　　　　　　　　　　　　個人情報の取扱いについて\n\n　　　　　生命共済制度におきましては、事業主、ご加入者および保険金受取人の個人情報を次のとおり取扱いますので、\n　　　　　ご同意のうえ、お申込みください。\n　　　　　①ご加入者の個人情報（氏名、性別、生年月日、健康状態等）および事業主の個人情報（氏名、住所、口座番\n　　　　　　号等）は、ご加入者の同意に基づき、会員事業所（事業主）から東京商工会議所（以下、「商工会議所」と\n　　　　　　いう。）に提供されます\n　　　　　②商工会議所は会員事業所（事業主）から提供された事業主、ご加入者および保険金受取人の個人情報を、生\n　　　　　　命共済制度の事務手続き、各種サービスのご案内・ご提供のために使用するとともに、事業主およびご加入\n　　　　　　者の同意に基づき、商工会議所が本制度運営のために福祉団体定期保険契約を締結している生命保険会社（共\n　　　　　　同取扱会社を含みます。以下同じ。）に提供します。\n　　　　　③生命保険会社は受領した個人情報を各種保険契約の引受け、継続・維持管理、保険金・給付金の支払、その\n　　　　　　他保険に関連・付随する業務のために利用し、またこの目的の範囲内で、商工会議所、他の共同取扱会社、\n　　　　　　再保険会社および本人が所属する加入事業所に提供します。\n　　　　　④個人情報に変更等が発生した際にも、引き続き商工会議所および生命保険会社においてそれぞれ上記②③に\n　　　　　　準じ個人情報が取り扱われます。\n　　　　　⑤福祉団体定期保険契約の引受生命保険会社が変更された場合、個人情報は変更後の引受生命保険会社へ提供\n　　　　　　されます。\n　　　　　⑥指定された死亡保険金受取人の個人情報については、上記のご加入者の個人情報と同様に取り扱われます。"]
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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,"|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\nき\n|\nり\n|\nと\n|\nり\n|\n線\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n|\n"]
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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,null,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 日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(入力!$BM$13=\"×\",\"\",入力!$N$12&入力!$Q$12&入力!$S$12&入力!$U$12&入力!$W$12&入力!$Y$12&入力!$AA$12)","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,"金\n融\n機\n関\n届\n出\n印",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"東京商工会議所　共済制度　預金口座振替依頼書"]
[]
[]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"預　金\n者　名",null,null,null,null,null,null,null,null,null,"カタカナ"]
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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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"御　 中"]
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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,"　私（当社）は、上記収納団体から請求された金額を、私名義の上記指定預金口座から口座振替\nによって支払うことに致しますので、預金口座振替規程を了知のうえ依頼いたします。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"———預　金　口　座　振　替　規　定———"]
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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,"お取扱上のご注意\n新規加入事業所の場合は、",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,"金融機関に請求書が送付されたときは、私に通知することなく、請求書に記載された金額を預金\n口座から引落しのうえ支払ってください。この場合、預金規程または当座勘定規程にかかわらず、\n預金通帳・同払戻請求書または小切手の振出しはしません。"]
[]
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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,"(1)",null,null,null,null,null,null,"預金者のご印鑑は、必ず金融機関届出印をご使用ください。"]
[]
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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,"(2)",null,null,null,null,null,null,"預金口座振替依頼書は、金融機関窓口にご提出ください。\n加入・保険金額変更申込書兼告知書の１枚目（東京商工会議所用）に、金融機関確認印をお取寄せください。",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,2,null,null,null,null,"振替日において請求書に記載された金額が預金口座から払戻することのできる金額（当座貸越を\n利用できる範囲内の金額を含む｡）をこえるときは、私に通知することなく、請求書を返却して\nも差支えありません。"]
[]
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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,3,null,null,null,null,"この契約を解約するときは、私から金融機関に書面により届出ます。なお、この届出がないまま\n長期間にわたり収納団体から請求がない等相当の事由があるときは、とくに申し出をしない限り、\n金融機関はこの契約が終了したものとして取扱っても差支えありません。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,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,null,null,null,null,"この預金口座振替について、かりに紛議が生じても、金融機関の責による場合を除き、金融機関\nには迷惑をかけません。"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金融機関使用欄",null,null,null,null,"不備返却事由",null,null,null,null,"　1．預金取引なし\n　2．記載事項等の相違",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"検印"]
[]
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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,"店　名 ・ 預　金　種　目\n口 座 番 号 ・ 口 座 名 義",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"〕"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印鑑照合"]
[]
[]
[]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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．印鑑相違\n　4．その他"]
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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,"備考",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"受付印"]
[]
[]
[]
[]
["EAA12L-220602"]