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["一般社団法人香川県中小企業退職金共済会　御中"]
[]
[]
["事業所変更事項届出書"]
[]
[]
[null,null,"次の事項が変更になりましたので届出いたします。"]
[]
[]
[null,null,null,"共済契約番号",null,null,null,null,null,null,null,"-"]
[]
[]
[]
[null,null,null,null,null,null,null,null,"住　　所"]
[]
[]
[null,null,null,"共済契約者",null,null,null,null,"事業所名"]
[]
[]
[null,null,null,null,null,null,null,null,"代表者名",null,null,null,null,null,null,null,null,null,null,null,null,"㊞"]
[]
[]
[null,"変更年月日",null,null,null,null,null,null,"年",null,"月",null,"日"]
[null,"項　　目",null,null,null,"変　更　前",null,null,null,null,null,null,null,"変　更　後"]
[null,"住　　所",null,null,null,"〒",null,"－",null,null,null,null,null,"〒",null,"－"]
[]
[null,"電話番号",null,null,null,"☎",null,"－",null,null,"－",null,null,"☎",null,"－",null,null,"－"]
[null,"フリガナ"]
[null,"事業所名※1"]
[null,"フリガナ"]
[null,"代表者名"]
[null,"印　　鑑"]
[null,"E-mail"]
[null,"引落口座※2",null,null,null,"引落金融機関（口座名義）変更の場合は、口座振替依頼書が別途必要になります。お手数ではございますが、お電話又はメールにて当会にご依頼下さい。"]
[]
[null,"※1）","事業所名が変更になった場合は、共済加入者様全員分の退職金共済証をご提出下さい。"]
[null,"※2）","代表者名のみの変更の場合は、口座振替依頼書の提出は不要です。"]
[]
[]
[null,null,null,null,null,"会　長",null,"副　会　長",null,null,null,"事務局長",null,"課　長",null,null,null,"担　当",null,"庶　務"]

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