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[null,"(必ず記入してください)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(必ず記入してください)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(必ず記入してください)"]
["納　期　限",null,null,null,null,null,null,null,"令和",null,2,"年",12,"月",10,null,"日",null,"納　期　限",null,null,null,null,null,null,null,{"$f":"I22","v":"令和"},null,{"$f":"K22","v":2},"年",{"$f":"M22","v":12},"月",{"$f":"O22","v":10},null,"日",null,"納　期　限",null,null,null,null,null,null,null,{"$f":"I22","v":"令和"},null,{"$f":"K22","v":2},"年",{"$f":"M22","v":12},"月",{"$f":"O22","v":10},null,"日"]
["(特別徴収義務者)\n住所\n(所在地)",null,null,null,null,null,"あ",null,null,null,null,null,null,null,null,null,null,null,"(特別徴収義務者)\n住所\n(所在地)",null,null,null,null,null,{"$f":"G23","v":"あ"},null,null,null,null,null,null,null,null,null,null,null,"(特別徴収義務者)\n住所\n(所在地)",null,null,null,null,null,{"$f":"G23","v":"あ"}]
[]
[]
["氏名\n(名称)",null,null,null,null,null,"え",null,null,null,null,null,null,null,null,null,null,null,"氏名\n(名称)",null,null,null,null,null,{"$f":"G26","v":"え"},null,null,null,null,null,null,null,null,null,null,null,"氏名\n(名称)",null,null,null,null,null,{"$f":"G26","v":"え"}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"様",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"様",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"様"]
["上記のとおり領収しました。",null,null,null,null,null,null,null,null,"領収日付印",null,null,null,null,null,null,null,null,"上記のとおり納入します。",null,null,null,null,null,null,null,null,"領収日付印",null,null,null,null,null,null,null,null,"取りまとめ店舗",null,null,null,null,null,null,null,null,"領収日付印"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※日計",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ゆうちょ銀行横浜貯金事務センター"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"口",null,null,null,null,null,null,null,null,null,"〒224-8794"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"上記のとおり通知します。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※印はゆうちょ銀行･郵便局において使用する欄です。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"連絡欄"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"（納入者保管)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（金融機関保管)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"金融機関→藤沢市役所(保管)"]
[null,null,null,null,"市民税"]
[null,null,null,null,null,null,null,null,"納入申告書"]
[null,null,null,null,"県民税"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"(受付印)"]
[null,null,"藤沢市長"]
[]
[]
[null,"令和",null,null,"年",null,null,"月",null,null,"日提出"]
[]
["令和",null,null,null,"年",null,null,"月分",null,"人員",null,null,null,null,null,null,"人"]
[]
["退職手当等\n支 払 金 額",null,null,null,null,null,null,"十","億","千","百","十","万","千","百","十","円"]
[]
["特別徴収税額",null,null,"市民税"]
[null,null,null,"県民税"]
["(特別徴収義務者)\n住所又は\n所 在 地"]
[]
[]
[]
["氏名又は\n名　　称"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印"]
["法人番号"]
["　地方税法第50条の5及び第328条の5第2項の規定により上記のとおり分離課税に係る所得割の納入について申告します。"]
[]
[]
[]
[]
[]
["金融機関→藤沢市役所(保管)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(金融機関保管)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(納入者保管)"]

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