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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"証明日",null,null,null,null,null,null,"年",null,null,"月",null,null,"日"]
[null,"在　　職　　証　　明　　書"]
["（採用予定証明書）"]
[]
[]
[null,null,null,null,"八　幡　市　長　　様",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所住所"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業所名（屋号等）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"代表者名"]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"連絡先"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　※事実確認のため社印・ゴム印を使用してください。\n　※下記記載内容を訂正する場合は、訂正印として社印を押印してください。"]
[]
[]
[]
[null,"下記の内容について、事実であることを証明いたします。"]
[null,"勤務先事業者に関する事項"]
[null,null,"①","業種"]
[null,"就労者に関する事項"]
[null,null,"②","ふりがな"]
[null,null,null,"就労者氏名"]
[null,null,"③","就労者住所"]
[null,"就労状態等に関する事項"]
[null,null,"④","採用（予定）年月日",null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日"]
[null,null,"⑤","勤務先事業所名",null,null,null,null,"□","上記事業所名に同じ",null,null,null,null,null,null,null,"□","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,"⑥","勤務先住所",null,null,null,null,"□","上記事業所住所に同じ",null,null,null,null,null,null,null,"□","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,"⑦","勤務先電話番号",null,null,null,null,"□","上記事業所電話番号に同じ",null,null,null,null,null,null,null,null,null,null,null,"□","他","（",null,null,null,"-",null,null,null,"-",null,null,null,"）"]
[null,null,"⑧","雇用の形態",null,null,null,null,"□","正職",null,"□","非常勤",null,"□","パート",null,null,"□","自営",null,"□","内職",null,"□","他","（",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）"]
[null,null,"⑨","就労時間\n（固定勤務の場合）",null,null,null,null,"勤務日",null,null,null,"週",null,"日","（","□","月",null,"□","火",null,"□","水",null,"□","木",null,"□","金",null,"□","土","□","日","）","１ヶ月あたりの就労時間"]
[null,null,null,null,null,null,null,null,"勤務時間帯",null,null,null,null,null,"時",null,null,"分","～",null,null,null,"時",null,null,"分","（",null,null,"時間",null,null,null,"分",null,"）"]
[null,null,"⑩","就労時間\n（変則勤務の場合主なものを３つ）",null,null,null,null,"シフト①",null,null,null,null,"□","月",null,"□","火",null,"□","水",null,"□","木",null,"□","金",null,"□","土",null,"□","日"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"時",null,null,"分","～",null,null,null,"時",null,null,"分","（",null,null,"時間",null,null,null,"分",null,"）"]
[null,null,null,null,null,null,null,null,"シフト②",null,null,null,null,"□","月",null,"□","火",null,"□","水",null,"□","木",null,"□","金",null,"□","土",null,"□","日"]
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[null,null,null,null,null,null,null,null,"シフト③",null,null,null,null,"□","月",null,"□","火",null,"□","水",null,"□","木",null,"□","金",null,"□","土",null,"□","日"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"時",null,null,"分","～",null,null,null,"時",null,null,"分","（",null,null,"時間",null,null,null,"分",null,"）",null,null,null,null,null,null,null,null,"時間"]
[null,null,"⑪","就労実績",null,null,null,null,"直近３カ月の平均就労日数",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"日","前月の月収総額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[null,null,"⑫","産前産後休暇の期間（予定期間）",null,null,null,null,null,null,null,null,"年",null,null,null,"月",null,null,null,"日","～",null,null,null,null,null,null,"年",null,null,null,"月",null,null,null,"日"]
[null,null,"⑬","育児休業の取得\n（予定期間）",null,null,null,null,null,null,null,null,"年",null,null,null,"月",null,null,null,"日","～",null,null,null,null,null,null,"年",null,null,null,"月",null,null,null,"日"]
[null,null,"⑭","復職年月日",null,null,null,null,null,null,null,null,"年",null,null,null,"月",null,null,null,"日"]
[null,"その他"]
[null,null,"⑮","備考欄"]
[null,"※この証明書は、保育の認定及び利用調整の際の重要な資料となるため、代表者または人事担当者が事実のとおりにご記入ください。\n※記入漏れや不明な点がある場合は、八幡市から代表者または人事担当者にお問い合わせさせていただくことがあります。"]
[]
[null,"○以下は、保護者が記入してください。"]
[null,"施設名\n（第一希望）",null,null,null,null,null,null,null,null,null,null,null,null,null,"児童氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生年月日"]
[]
[]
[null,"通勤時間",null,null,null,null,null,"片道約　　　　",null,null,null,"分",null,null,null,"通勤手段",null,null,null,"□","電車",null,"□","バス",null,"□","自動車",null,null,"□","自転車",null,null,"□","徒歩",null,"□","その他",null,null,"（",null,null,null,null,null,"）"]
[null,"連絡先",null,null,null,null,null,"父携帯",null,null,null,"―",null,null,null,null,"―",null,null,null,null,"自宅",null,null,null,null,null,null,null,null,null,"―",null,null,null,null,"―"]
[null,null,null,null,null,null,null,"母携帯",null,null,null,"―",null,null,null,null,"―"]