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[null,"神戸市営住宅（令和元年5月募集）入居申込書",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,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,null,null,null,null,null,null,null,null,null,"※",null,"この入居申込書に記入された事項は、神戸市個人情報保護条例に基づいて、"]
[]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,"この市営住宅の申込みの目的以外には、使用いたしません。"]
[]
[]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"平成２１年度から新優遇制度の導入により抽選番号を付与して抽選するため、特に下記"]
[null,"入居申込案内書の記載事項を了承のうえ、以下のとおり申込みます。"]
[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,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,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,"１．２．３については記入内容に誤りがあれば「失格」になりますのでご注意ください。"]
[null,"なお、この申込書の記入内容が事実と相違するときは、申込みを無効とされても異議のないことを誓約します。",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,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,"令和元年 5 月",null,null,null,null,null,null,null,null,null,null,null,null,null,"日"]
[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,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,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,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,null,null,null,null,null,null,null,null,null,null,null,null,"（抽選結果通知用）"]
[]
[null,null,null,null,null,"一般住宅に申込希望の方",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,"特定目的住宅に申込希望の方",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,null,null,null,null,null,null,null,null,"１．被災者資格について、次の（1，2）のいずれかに必ず○をつけてください。"]
[]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　（○印の記入がない場合は、「1 一般」とさせていただきます。）"]
[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,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,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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,62]
[null,null,null,null,null,null,null,"一般住宅",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,"特定目的住宅"]
[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,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,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,"資格確認には、Ａ・Ｂ両方の証明が必要です。 （※Ａのみの記入は、「1 一般」となります。)"]
[null,null,null,null,null,null,null,"申込番号",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,"申込番号",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,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,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,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,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,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,"申込資格",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A. り災証明の内容",null,null,null,null,null,null,null,null,null,null,"　B. 家屋解体を証明するもの（A欄に○を付けた方は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,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,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,"  1",null,null," 一　般",null,null,null,null,null,null,null,null,null,null,null,null,"      1.　",null,null,null,"全壊（焼）",null,null,null,null,null,null,"       1.　",null,null," 家屋解体証明書",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,null,null,null,"切手を必ず貼ってください"]
[]
[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,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,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,"      2.　",null,null,null,"半壊（焼）",null,null,null,null,null,null,"       2.　",null,null," 閉鎖事項証明書（閉鎖登記簿謄本）"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"  2",null,null," 被災者"]
[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,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,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,"被災時の住所"]
[null,null,null,null,null,"※住宅の申込番号は、申込資格等をよく確認のうえご記入ください。"]
[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,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,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,"被災時の住居種別",null,null,null,null,null,null,null,null,null,null,null,"  1.",null,"持家",null,null,"2.",null,"公営住宅（市営・県営）",null,null,null,null,null,null,null,null,null,null,"3.",null,"公社・UR（旧公団）住宅　"]
[null,null,null,null,null,"　（一般住宅・特定目的住宅双方の申込資格がある方は、この用紙で両方申込みできます。）",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,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,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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（注）"]
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[]
[]
[null,null,null,"フリガナ",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,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,null,null,null,null,null,null,null,null,null,null,null,"２．落選回数について、１～７の該当する番号に必ず○をつけてください。（平成15年5月以降の定時募集が対象です。）",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,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,null,null,null,null,null,null,null,null,null,"切手を貼っていない場合は、結果を通知いたしかねますのでご了承ください。"]
[]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　（○印の記入がない場合は、「1.　０～４回落選者」とさせていただきます。）"]
[null,null,null,"氏　　名"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1.",null,"０～４回",null,null,null,null,null,null," 2．",null,"５～９回",null,null,null,null,null,null," 3．",null,"10～14回",null,null,null,null,null,null," 4．",null,"15～19回",null,null,null,null,null,null," 5．",null,"20～24回",null,null,null,null,null,null," 6．",null,"25～29回",null,null,null,null,null,null," 7．",null,"30回以上"]
[null,"申　込　者　⑴"]
[]
[null,null,null,"現住宅種別",null,null,null,null,null,null,null,null,"   　　  　 　  　 　　　　　　　　　　　　　　 　  　その他（　　　　　　　　　　　　　　　　　　　　　　　　","  １．",null,"民間借家",null,null,null,null,null,"    ２．",null,null,"公社・ＵＲ（旧公団）住宅",null,null,null,null,null,null,null,null,null,null,null,null," ３．",null,"市営住宅",null,null,null,null,null," ４．",null,"県営住宅",null,null,null,null,null,null,null,null,null,"・親子の近居申込みですか （ ",null,null,null,null,null,null,null,null,null,null,null,null,null,"はい",null,null,"・","いいえ",null,null,null,"）",null,null,null,null,null,null,null,"（注）",null,null,"・平成15年5月以降の定時募集のみ対象です。（ポイント方式・追加募集・再募集・平成23年5月以降の特定目的住宅を除く）　　　　　　　　　　　　　　　　　　　　　　　　　　　　・2～7に○をされた方で、当選後の書類審査で該当する落選者でないことが判明した場合は失格となりますのでご注意ください。　　　　　　　　\n・平成21年5月募集以降の当選者及び補欠繰上者で辞退又は棄権された方は、落選回数の履歴が一旦「０回」になります。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"   ５．",null," 持家（親の持家を含む）",null,null,null,null,null,null,null,null,null,null,null,null,"  ９．",null,"その他（",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,"郵便番号",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,"電話番号",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,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,"携帯番号",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,"現住所",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,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,null,null,null,null,null,null,null,null,null,null,null,"３．世帯の状況について、ア～スのいずれかに必ず○をつけてください。"]
[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,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,null,null,null,null,null,"様方）"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　（○印の記入がない場合は、「ス　上記に当てはまらない世帯」とさせていただきます。）"]
[]
[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,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,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,"世　帯　区　分",null,1,null,"　ア　",null,null,"６５歳以上の方のみの世帯（単身者含む）"]
[]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　イ　",null,null,"いずれか一方が６５歳以上の夫婦のみの世帯（他に６５歳以上の方がいる世帯を含む）"]
[null,null,null,null,null,null,null,null,null,null,"郵便番号",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,"※　現住所以外の場所へ送付希望の場合は、ご記入ください。"]
[null,null,null,"送付先",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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　ウ　",null,null,"６５歳以上の方（いずれか一方が６５歳以上の夫婦を含む）と１８歳未満の児童のみの世帯"]
[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,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,null,null,null,null,null,"様方）"]
[null,null,null,"住　所",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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　エ　",null,null,"中度以上の障害者等がいる世帯（難病患者を含む）"]
[]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　オ　",null,null,"母子・父子世帯（配偶者がおらず、かつ２０歳未満の子を扶養している世帯）※離婚予定は申込不可"]
[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,null,null,null,null,null,null,"電話番号",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,"勤務先名称",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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　カ　",null,null,"夫婦（内縁を含む）または婚約者の合計年齢が７０歳以下の世帯"]
[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,null,null,null,null,null,null,"所 在 地",null,null,null,null,null,null,null,null,null,null,null,null,null,"市",null,null,null,null,null,null,null,null,"区"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　キ　",null,null,"１８歳未満の子が３人以上いる世帯"]
[]
[null,"※令和元年5月14日現在の家族構成を原則とします。",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,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,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,"　ク　",null,null,"ハンセン病療養所入所者等"]
[]
[null,"　（ただし、結婚予定での申込みは可）",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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　ケ　",null,null,"中学校（これに準ずる学校を含む）を卒業するまでの子（平成15年4月2日以後に生まれた方）がいる世帯"]
[]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　コ　",null,null,"ＤＶ（配偶者等からの暴力）被害者がいる世帯　　※１"]
[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,"接続コード",null,null,null,null,null,null,null,null,null,null,null,null,null,"職業コード",null,null,null,null,"収入・所得",null,null,null,null,null,null,null,null,null,null,"控除",null,null,null,null,null,null,"手帳等の種類（等級）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"指定難病該当"]
[null,null,null,null,null,null,"フ　リ　ガ　ナ",null,null,null,null,null,null,null,null,null,null,null,null,"性　別",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,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,"　サ　",null,null,"中国残留邦人等世帯　　※国が発行する本人の帰国証明書が必要"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"続柄",null,null,null,null,null,null,null,"生年月日",null,null,null,null,null,null,"年齢",null,null,null,null,null,null,null,null,null,"年間総収入金額（事業の場合は総所得金額）（円）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"精神障害者　　　保健福祉手帳　　　（精神障害）"]
[null,null,null,null,null,null,"氏　　　　　名",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,"所得　　　　種類",null,null,null,null,null,null,null,null,null,null,null,null,null,"寡フ",null,null,"身体障害者　　　　手　　　帳",null,null,null,null,null,null,"療育手帳　　　　（知的障害）",null,null,null,null,null,null,null,null,null,null,null,"障害年金",null,null,null,null,null,null,null,null,null,null,null,null,null,"　シ　",null,null,"警察の証明書等で確認できる犯罪被害者世帯"]
[]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,"　ス　",null,null,"上記に当てはまらない世帯"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,null,null,"Ｍ",null,"　Ｔ",null," Ｓ",null,"Ｈ",null,null,null,null,null,null,"給与",null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,null,"有",null,null,null,null,null,null,"※１",null,null,"「裁判所の保護命令」又は「保護施設あるいは母子支援施設に入所中又は退所」の証明書（５年以内のもの）が必要"]
[null,null,null,"①",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人",null,null,0,null,1,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,1,null,"・ 2 ・",null,null,3]
[null,"入居しようとする者⑵",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,null,"事業等",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A ・ ",null,"B1・",null,"B2",null," 1 ・",null,2,null,"・ 3"]
[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,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,null,null,null,"・",null,null,"・"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女",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,"無",null,null,4,null,"・ 5 ・",null,null,6,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,"無",null,null,null,null,null,null,"４．困窮理由について、１～１０のうち該当する番号全てに○をつけてください。"]
[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,null,null,null,null,null,"年金"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　下記の住宅困窮理由に該当しない方は申込みできません。（騒音・日当り等、生活環境による理由は該当しません。）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,null,null,"Ｍ",null,"　Ｔ",null," Ｓ",null,"Ｈ",null,null,null,null,null,null,"給与",null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,null,"有"]
[null,null,null,"②",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,"・ 2 ・",null,null,3,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,"　倉庫・事務所など住宅でない建物に居住している"]
[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,null,null,null,"事業等",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A ・ ",null,"B1・",null,"B2",null," 1 ・",null,2,null,"・ 3"]
[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,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,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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,"　災害の危険があるような半壊住宅やバラックに住んでいる"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女",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,"無",null,null,4,null,"・ 5 ・",null,null,6,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,"無"]
[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,null,null,null,null,null,"年金"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,3,null,"　他の世帯と同居していて、便所又は炊事場が共同である"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,null,null,"Ｍ",null,"　Ｔ",null," Ｓ",null,"Ｈ",null,null,null,null,null,null,"給与",null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,null,"有"]
[null,null,null,"③",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,"・ 2 ・",null,null,3,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,4,null,"　住宅がないため、親族と別居している"]
[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,null,null,null,"事業等",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A ・ ",null,"B1・",null,"B2",null," 1 ・",null,2,null,"・ 3"]
[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,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,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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,5,null,"　部屋が狭い（１人あたり４．５畳以下又は最低居住面積以下）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女",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,"無",null,null,4,null,"・ 5 ・",null,null,6,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,"無"]
[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,null,null,null,null,null,"年金"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,6,null,"　正当な退去要求をうけているが、立退き先がない（自己の責めに帰する場合は除く）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,null,null,"Ｍ",null,"　Ｔ",null," Ｓ",null,"Ｈ",null,null,null,null,null,null,"給与",null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,null,"有"]
[null,null,null,"④",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,"・ 2 ・",null,null,3,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,7,null,"　通勤に片道１時間半以上かかる（電車等の待ち時間を除く）"]
[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,null,null,null,"事業等",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A ・ ",null,"B1・",null,"B2",null," 1 ・",null,2,null,"・ 3"]
[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,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,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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,8,null,"　収入と比較して家賃が高すぎる　　※生活保護受給中の方は自己負担額（住宅扶助額の差額）がある方"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女",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,"無",null,null,4,null,"・ 5 ・",null,null,6,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,"無"]
[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,null,null,null,null,null,"年金"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,9,null,"　婚約しているが、住宅がないため結婚がのびている（入籍予定日　",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,"  月",null,null,null,null,"日）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,null,null,"Ｍ",null,"　Ｔ",null," Ｓ",null,"Ｈ",null,null,null,null,null,null,"給与",null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,null,"有"]
[null,null,null,"⑤",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,"・ 2 ・",null,null,3,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,null,"　その他客観的にみて、上記のいずれかと同じような理由により住宅に非常に困っている"]
[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,null,null,null,"事業等",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A ・ ",null,"B1・",null,"B2",null," 1 ・",null,2,null,"・ 3"]
[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,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,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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　 理由："]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女",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,"無",null,null,4,null,"・ 5 ・",null,null,6,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,"無"]
[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,null,null,null,null,null,"年金"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,null,null,"Ｍ",null,"　Ｔ",null," Ｓ",null,"Ｈ",null,null,null,null,null,null,"給与",null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,null,"有"]
[null,null,null,"⑥",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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,1,null,"・ 2 ・",null,null,3,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"５．次の事項に必ず○をつけてください。",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,null,null,null,"裏面のアンケートに　　　　      ご協力ください"]
[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,null,null,null,"事業等",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"A ・ ",null,"B1・",null,"B2",null," 1 ・",null,2,null,"・ 3"]
[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,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,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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"     申込本人又は同居しようとする\n     者が暴力団員ではありません",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 1",null,null,null,"はい",null,null,null," 2",null,null,null,"いいえ"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"女",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,"無",null,null,4,null,"・ 5 ・",null,null,6,null,null,null,null,null,null,null,null,null,null,null,null,null,2,null,null,"無"]
[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,null,null,null,null,null,"年金"]
[]
[null,"別居　　　扶養　　　⑶",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"男",null,null,null,null,null,null,null,null,"Ｍ",null,"　Ｔ",null," Ｓ",null,"Ｈ",null,null,null,null,null,null,null,"※",null,"収入・所得の欄は空白にせず",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"障害のある方は、あてはまる手帳の",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生活保護受給の有無",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," 1",null,null,null,"あり",null,null,null," 2",null,null,null,"なし"]
[]
[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,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,"等級に必ず○をしてください。"]
[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,null,null,"女"]
[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,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"６．同意の有無について、次のいずれかに必ず○をつけてください。（該当しない場合、○印は不要です。）"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　職業コード　（下記の番号を記入してください）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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,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,"私が当選した場合、記入した生活保護受給情報及び障害手帳の交付情報を当選時点の情報で事前確認することについて",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,null,null,"   1",null,null,null,null,"同意する",null,null,null,null,null,null,null,"    2",null,null,null,"  同意しない"]
[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,null,null,null,null,null,null,null,null,"　１．会社員",null,null,null,null,null,null,null,null,"　４．団体職員",null,null,null,null,null,null,null,null,null,null,null,null,"　７．学生・生徒・児童"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"この欄には記入しないでください"]
[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,null,null,null,null,null,null,null,null,"　２．会社役員",null,null,null,null,null,null,null,null,"　５．自営業",null,null,null,null,null,null,null,null,null,null,null,null,"　８．無職"]
[]
[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,null,null,null,null,null,null,null,null,"　３．公務員",null,null,null,null,null,null,null,null,"　６．パート・アルバイト",null,null,null,null,null,null,null,null,null,null,null,null,"　９．その他",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※",null,"同意の有無に係らず、資格審査時の書類提出は必要です。"]