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[{"$nulls":32},"再　交　付"]
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[null,null,null,"建築物石綿含有建材調査者講習（一般）修了証明書",{"$nulls":36},"申込書"]
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[{"$nulls":32},"書　　　　替"]
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[null,null,null,"ふ　り　が　な",{"$nulls":36},"写真（のりづけ）\n縦3.0㎝×横2.4㎝\n正面、無帽、無背景\n(サングラス不可)\n6ヶ月以内に撮影\nされたもの。\n裏面に氏名を\n記入してください。"]
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[null,null,null,"氏　　　　　　名"]
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[{"$nulls":11},"※修了証明書に旧姓又は通称の併記を\n   希望する場合のみご記入ください。"]
[null,null,null,"旧姓・通称"]
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[null,null,null,"生年月日",{"$nulls":8},"昭和　・　平成",{"$nulls":9},"年",null,null,null,"月",null,null,null,"日"]
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[{"$nulls":12},"〒",null,null,null,"―"]
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[null,null,null,"住　　　　　　所"]
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[{"$nulls":36},"日中の連絡先☎（",{"$nulls":10},"）"]
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[null,null,null,"修了証明書番号",{"$nulls":21},"交付年月日"]
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[{"$nulls":11},"再交付",{"$nulls":5},"　1.　紛失　　4.　損傷\n　2.　盗難　　5.　その他\n　3.　焼失",{"$nulls":9},"裏面　修了証明書滅失事由書に再交付の理由を\nできるだけ詳しくご記入下さい。\n（4.損傷の場合は、旧修了証明書を添付のこと。）"]
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[null,null,null,"再交付または"]
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[null,null,null,"書替の理由",{"$nulls":7},"書　替",{"$nulls":5},"　6.　氏名変更\n　7.　その他",{"$nulls":9},"旧修了証明書及び変更を証する書面を添付してください。"]
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[null,null,null,"（該当する番号に〇印）"]
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[null,null,null,"所　属"]
[{"$nulls":5},"事業場名"]
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[{"$nulls":5},"代表者名"]
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[{"$nulls":12},"〒",null,null,null,"―"]
[{"$nulls":5},"所在地"]
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[null,null,null,"　建設業労働災害防止協会　奈良県支部長　殿"]
[{"$nulls":4},"記載事項に虚偽等があった場合、法律に基づく処罰があっても異議申し立ては致しません。"]
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[{"$nulls":4},"令和",{"$nulls":4},"年",null,null,null,"月",null,null,null,"日",{"$nulls":6},"申込者\n(修了者本人氏名)",{"$nulls":19},"㊞"]
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[null,null,null,"※　・この申込書に記載いただく氏名、生年月日等の各項目は、法律で記入することが定められています。\n　　　誤りのないよう正確に記入して下さい。\n　　 ・ご記入いただいた個人情報は、修了証明書再交付・書替業務以外には一切使用いたしません。"]
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[null,null,null,"(備考）\n１ 表題の「再交付」及び「書替」のうち、該当しない文字を抹消すること。\n２ 滅失の場合にあっては裏面　修了証明書滅失事由書に記入すること。損傷による再交付のみの場合にあっては旧修了証明書、\n　 また書替の場合にあっては旧修了証明書及び記載事項の異動を証する書面を添付すること。\n３ 滅失していた修了証明書が見つかった場合は、旧修了証明書を直ちに返却すること。"]
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[{"$nulls":26},"申込み先",null,null,null,"　〒630-8241",{"$nulls":5},"奈良市高天町５－１"]
[{"$nulls":30},"　建設業労働災害防止協会　奈良県支部"]
[{"$nulls":30},"　Tel　0742-22-3345 Fax　0742-22-3346"]
[{"$nulls":30},"奈良労働局技能講習登録教習機関（登録第２号）"]
[null,"本人確認方法",{"$nulls":7},"確認者",{"$nulls":4},"手数料支払方法",{"$nulls":9},"公布日",{"$nulls":8},"引渡方法",{"$nulls":4},"担当者",{"$nulls":4},"実施管理者"]
[null,"運転免許証／写",{"$nulls":12},"現金書留",{"$nulls":5},"No",null,null,null,"　　　年　　月　　日",{"$nulls":8},"窓口／郵送"]
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[null,"住民票 原本／写",{"$nulls":12},"窓",null,null,"口"]
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[null,"　その他(　　　　　　)",{"$nulls":12},"そ  の  他　"]

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[null,null,null,"修了証明書滅失事由書"]
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[null,null,null,"　　　このたび、下記の理由により修了証明書を滅失しました。\n　　　今後このようなことのないよう十分留意しますので、再交付をお願いします。\n　　　なお、旧修了証明書が見つかった場合は直ちに返納いたします。"]
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[{"$nulls":5},"理由　1.　滅失日（いつ）\t",{"$nulls":12},"平成・令和",{"$nulls":7},"年",null,null,"月",null,null,"日"]
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[{"$nulls":5},"　　　　2.　滅失場所（どこで）",{"$nulls":12},"作業場所 ・ 自宅 ・ その他（　　　　　　　　　　　　　　　　　）(該当に〇印)"]
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[{"$nulls":5},"　　　　3.　滅失理由",{"$nulls":12},"紛失 ・ 盗難 ・ その他　（　　　　　　　　　　　　　　　　　　　）(該当に〇印)"]
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[{"$nulls":13},"盗難の場合、以下に記入してください。"]
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[{"$nulls":14},"警察届出日",{"$nulls":7},"（","令和",{"$nulls":5},"年",null,null,"月",null,null,null,"日",null,"）"]
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[{"$nulls":14},"届出警察署",{"$nulls":7},"（",{"$nulls":15},"）"]
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[{"$nulls":14},"受理番号",{"$nulls":7},"（",{"$nulls":15},"）"]
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[null,null,null,"委　任　状"]
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[{"$nulls":5},"建設業労働災害防止協会　奈良県支部長　殿"]
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[{"$nulls":28},"令和",{"$nulls":4},"年",null,null,null,"月",null,null,null,"日"]
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[{"$nulls":23},"申請者氏名",{"$nulls":18},"㊞"]
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[{"$nulls":7},"建築物石綿含有建材調査者講習（一般）修了証明書再交付（書替）の申請及び受取りを"]
[{"$nulls":7},"下記の者に委任します。"]
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[{"$nulls":7},"代理人氏名"]
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[{"$nulls":7},"住　　　　　所"]
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[{"$nulls":7},"電 話 番 号"]
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[]
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[{"$nulls":7},"※代理人の方は、自動車運転免許証等の代理人本人であることを確認できる書類と印鑑をご持参下さい。"]
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[null,null,null,"受　領　証"]
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[]
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[{"$nulls":5},"建設業労働災害防止協会　奈良県支部長　殿"]
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[{"$nulls":7},"上記申請者の建築物石綿含有建材調査者講習（一般）修了証明書を受領いたしました。"]
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[{"$nulls":7},"受取人氏名",{"$nulls":10},"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　㊞"]
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[{"$nulls":7},"受領年月日",{"$nulls":10},"令和　　　年　　　月　　　日"]