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[]
[{"$nulls":4},"給与支払報告・特別徴収に係る異動届出書"]
[{"$nulls":18},"※市町村処理欄"]
[null,"小平町長　様",null,null,null,"（特別徴収義務者）\n給与支払者","氏名又は名称",null,"㊞　　　",{"$nulls":9},"特別徴収義務者指定番号"]
[{"$nulls":18},"連絡者の係及び指名並びにその電話番号",null,null,"係"]
[null,"令和　　年　　月　　日提出"]
[{"$nulls":6},"住所地"]
[{"$nulls":21},"氏名"]
[{"$nulls":21},"電話","（　　　　　　　）　　　　　　　－"]
[null,"給与所得者",{"$nulls":8},"（ア）\n特別徴収税額（年税額）",null,"（イ）\n徴収済税額　　　　　",null,"（ウ）\n未徴収税額\n（ア）－（イ）",null,"異動\n年月日","異動の事由",null,null,"異動後の未徴収税額の徴収方法",{"$nulls":7},"退職時までの\n給与支払額"]
[null,"受給者番号",null,null,"氏名"]
[null,"(整理番号)",{"$nulls":10},"　月分から\n月分まで",null,"月分以降",null,"･　　・","１．退　　　職\n２．転　　　勤\n３．休　　　職\n４．長　　　欠\n５．死　　　亡\n６．そ  の  他　　\n　　　（　　　　 　）　　　　",null,null,"１・特別徴収継続",null,null,null,"一括徴収した税額は、　　　月分で納入します。",null,null,null,"円"]
[null,"給与の支払を受けなくなった後の住所",{"$nulls":18},"２・一括徴収"]
[{"$nulls":28},"控除社会保険料額"]
[]
[null,"新しい勤務先の名称及び\n所在地",{"$nulls":18},"３・普通徴収",{"$nulls":7},"円"]
[null,"◎給与の支払を受けなくなった後の月割額（未徴収税額）について一括徴収する場合等は、次の欄に記入してください。",{"$nulls":26},"退職手当等の支払い額（支払予定額）"]
[null,"一括徴収の理由",{"$nulls":5},"異動者印",null,null,"給与又は退職手当等の支払予定月日",null,null,"一括徴収予定額",null,null,null,"\n　　　　　お願い\n<一括徴収について>\n　\n退職者の未徴収税額は本人の了解を得て、なるべく一括徴収し納入いただくようお願いします。",null,null,null,"※市町村処理欄","処理年月日",null,"・　　・"]
[null,"１．異動が　　　年12月31日までで、申し出があったため（　　月　　日申出）\n２．異動が　　　年１月１日以後で特別徴収の継続の希望がないため",{"$nulls":11},"支払予定日毎の徴収予定額",null,"合　　　　　　　　　計\n〔上記（ウ）と同額〕",{"$nulls":12},"円"]
[]
[{"$nulls":10},"・"]
[{"$nulls":28},"勤続年数"]
[null,"一括徴収できない理由",{"$nulls":8},"・"]
[{"$nulls":28},"年"]
[null,"１．５月31日まで支払われる給与若しくは退職手当がないため又は未徴収税額より少ないため\n２．その他　理由（　　　　　　　　　　　　　　　　　　）",{"$nulls":8},"・"]
[]
[null,"転勤等による特別徴収届出書"]
[null,"\n\n＿＿月分から徴収し納入する。",{"$nulls":4},"（特別徴収義務者）\n新しい給与支払者","所在地",{"$nulls":10},"特別徴収義務者指定番号"]
[{"$nulls":18},"連絡者の係及び指名並びにその電話番号",null,null,"係"]
[{"$nulls":7},"フリガナ",{"$nulls":13},"氏名"]
[null,"給与支払方法\n及びその期日",{"$nulls":5},"名　称\n（代表者の職氏名印）"]
[{"$nulls":21},"電話","（　　　　　　　）　　　　　　　－"]
[{"$nulls":18},"＜備考＞"]