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[]
["給与支払報告"]
[null,null,null,null,null,null,null,null,"に係る給与所得者異動届出書",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※太枠の徴収月等に誤りがないか提出前に再度確認してください。\n※異動があった場合は、速やかに提出してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※同封の手引きの記入例を参考に必要事項を記入してください。\n※特別徴収税額が0円の場合も提出してください。"]
["特 別 徴 収"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"給与支払者","（特別徴収義務者）","所在地\n\n（住　所）",null,null,null,null,"〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特別徴収義務者\n指　定　番　号"]
[]
["令和",null,null,null,"年",null,null,"月",null,null,"日","提出",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"宛　名　番　号"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"名　称　\n\n（氏　名）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"担当者　\n　連絡先",null,"フリガナ",null,null,null,null,null,null,null,null,null,null,null,null,"係"]
[null,null,"（宛先）　福 井 市 長",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏 名"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"法人番号又は\n個人番号 ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※個人番号および法人番号（法人番号の指定を受けていない場合は事業主の個人番号）を記載してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,"電 話",null,null,null,"（　　　　）",null,null,null,null,null,null,"－"]
[]
["給 与 所 得 者","個人番号 ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生年月日",null,null,null,null,"（ア）",null,null,null,null,null,null,"（イ）",null,null,null,null,null,"（ウ）",null,null,null,null,null,"異動\n年月日",null,null,null,"異動の事由",null,null,null,null,null,"異動後の未徴収税額の徴収方法"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特別徴収税額",null,null,null,null,null,null,"徴収済税額",null,null,null,null,null,"未徴収税額"]
[null,"フリガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（年税額）",null,null,null,null,null,null,null,null,null,null,null,null,"（ア）－（イ）"]
[]
[null,"氏　名",null,null,null,null,null,null,null,null,null,null,null,null,null,"(旧姓",null,null,null,null,null,"）",null,null,null,null,null,null,null,null,null,null,"月分から"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ｒ",null,null,"年","1.","退職",null,null,null,null,"Ａ．一括徴収",null,null,null,null,null,"下欄【A】へ"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"月分まで",null,null,null,null,null,null,null,null,null,null,null,null,"2.","転勤・転職"]
[null,"現住所",null,null,null,"（給与の支払を受けなくなった後の住所）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3.","休職・長休",null,null,null,null,"Ｂ．普通徴収",null,null,null,null,null,"下欄【B】へ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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","4.","産休・育休"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"5.","死亡",null,null,null,null,"Ｃ．特別徴収継続",null,null,null,null,null,"下欄【C】へ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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.","会社解散"]
[null,null,null,null,null,"電話",null,null,null,"（　　　　　）　    　-",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,"円",null,null,null,null,null,"円",null,null,null,"日","7.","特別徴収不可"]
[]
["異動者の未徴収税額については、一括徴収にご協力ください。(1月1日から4月30日までの異動は一括徴収が義務付けられています。)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"異動の事由が「7.特別徴収不可」の場合は、以下より理由を選択してください。（必須）",null,null,null,null,null,null,null,null,null,null,null,null,"１月１日以後退職時\nまでの給与支払額"]
["【Ａ】一括徴収","一括徴収の理由",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給与又は退職手当等の\n支払予定月日",null,null,null,null,null,null,null,"一括徴収予定額\n上記（ウ）の金額"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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Ａ",null,"従業員が2名以下"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[null,null,null,null,"1.",null," 異動が12月31日以前で、本人の申出があったため。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　年　　　月　　　日　"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"普Ｂ",null,"他事業所で特別徴収を行っている（乙欄適用者を含む）"]
[null,null,null,null,"2.",null," 異動が1月1日以降で、特別徴収継続の希望がないため。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,"普Ｃ",null,"給与が少なく、税額が引けない",null,null,null,null,null,null,null,null,null,null,"控除社会保険料額"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"一括徴収した税額は"]
[null,"一括徴収しない理由（該当するものに〇をつけてください。）"]
[null,1,null,"異動の日が6月1日から12月31日までの間で本人から一括徴収の申出がないため。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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Ｄ",null,"給与の支払いが不定期"]
[null,2,null,"特別徴収の継続の希望があるため。(転勤の場合も含む。)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"月分で納入します。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[null,3,null,"異動の日が1月1日から4月30日までの間で上記(ウ)の金額を超える給与又は退職手当等の支払がないため。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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Ｅ",null,"事業専従者（個人事業主のみ）"]
[null,4,null,"死亡による退職のため。（一括徴収する場合はご遺族の了承が必要です。）",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,"（　　　　月　　　　日納期限）"]
[]
["転勤等により引き続き特別徴収を行う場合は、新勤務先で下枠内に記入し、福井市に提出してください。"]
["【Ｃ】特別徴収継続",null,"月割額",null,null,null,null,null,null,null,"給 与 支 払 者","（特別徴収義務者）","所在地",null,null,"〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"法人番号又は\n個人番号 ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0,null,"※市町村記入欄",null,null,null,null,null,null,null,null,"賦課年度"]
[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,"個人コード",null,null,null,null,null,null,null,null,"1.","R７"]
[null,null,null,null,null,null,null,null,"円を",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特別徴収義務者\n指　定　番　号",null,null,null,null,null,null,null,null,null,null,null,null,null,"新規",null,null,null,null,null,null,null,null,null,null,null,null,null,"2.","R８"]
[null,null,null,null,null,null,null,null,null,null,null,null,"フリガナ",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,"3.","R９"]
[null,null,null,null,null,null,null,null,null,null,null,null,"名　称",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"担当者　\n　連絡先",null,"フリガナ",null,null,null,null,null,null,null,null,null,null,null,"係",null,null,null,null,"月割",null,null,null,"期割",null,null,null,null,"4."]
[null,null,null,null,null,null,"月分から",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏 名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"済月",null,"開始",null,"済期",null,"開始"]
[]
[null,null,"(  　月　　日納期限）",null,null,null,null,null,null,null,null,null,"送付先\n住 所",null,null,"〒",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ｒ 　普給年 併"]
[null,null,null,null,null,null,null,null,null,null,null,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",null,null,"　（　　　　　　）　　 　　-",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ｒ 　普給年 併"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メモ","無"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"納入書\n（及び各種様式）\n要否",null,null,null,null,"要",null,"不要",null,"※銀行サービスをご利用の場合や独自様式の納入書をお持ちの場合は「不要」に丸をつけてください。\n（新規の場合のみ要・不要を選択）"]
[null,null,"徴収し納入します。",null,null,null,null,null,null,null,"受給者番号",null,null,null,null,"※eLTAXで税額通知を希望する場合は必ず記入してください。（左詰め）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"＊複写してご使用ください。"]