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["一号特定技能外国人現場入場届出書の作成例"]
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["一号特定技能外国人建設現場入場届出書"]
[]
["工事事務所長　殿"]
[]
[{"$nulls":6},"令和　　　年　　　月　　　日"]
[{"$nulls":8},"（一次下請企業の名称）"]
[{"$nulls":8},"（責任者の職・氏名）"]
[{"$nulls":6},"（受入企業の名称）"]
[{"$nulls":6},"（責任者の職・氏名）"]
["一号特定技能外国人の建設現場への入場について下記のとおり届出ます。"]
[]
[{"$nulls":5},"記"]
["１　建設工事に関する事項"]
[null,"建設工事の名称"]
[null,"施工場所"]
[]
["２　建設現場への入場を届け出る一号特定技能外国人に関する事項"]
["　※　４名以上の入場を申請する場合、必要に応じて欄の追加や別紙とする等で対応すること。"]
[null,null,null,"一号特定技能外国人 １",null,"一号特定技能外国人 ２",null,"一号特定技能外国人 ３"]
[null,"氏名"]
[null,"生年月日"]
[null,"性別"]
[null,"国籍"]
[null,"業務区分"]
[null,"現場入場の期間"]
[null,"在留期間満了日"]
[null,"CCUS登録情報が最新であることの確認",null,"□　確認済\n（確認日：　　　　）",null,"□　確認済\n（確認日：　　　　）",null,null,"□　確認済\n（確認日：　　　　）"]
[]
["３　受入企業・建設特定技能受入計画に関する事項"]
[null,"業務区分"]
[null,"従事させる期間（計画期間）"]
[null,"責任者（連絡窓口）",null,null,"　役職　　　　　　　　氏名　　　　　　　　　連絡先"]
[null,"　※業務区分・従事させる期間については、建設特定技能受入計画の記載内容を正確に転記すること"]
[]
[null,"○添付書類"]
[null,"　提出にあたっては下記に該当するものの写し各１部を添付すること"]
[null,"　１　建設特定技能受入計画認定証（複数ある場合にはすべて。建設特定技能受入計画認定証に　　\n　　　ついては別紙（建設特定技能受入計画に関する事項）も含む。）"]
[null,"　２　パスポート（国籍、氏名等と在留許可のある部分）"]
[null,"　３　在留カード"]
[null,"　４　受入企業と一号特定技能外国人との間の雇用条件書"]
[null,"　５　建設キャリアアップシステムカード"]