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{"sheet":"申込書","index":0,"n_rows":65,"n_cols":25,"rows_kept":65,"cut":false,"hidden":false,"merged":[[64,1,64,25],[57,2,58,2],[57,3,58,18],[51,2,52,2],[51,3,52,18],[52,22,52,24],[53,3,53,10],[53,11,53,19],[53,22,55,24],[54,3,54,10],[54,11,54,19],[55,3,55,10],[44,23,44,24],[45,3,45,11],[45,14,45,22],[46,3,46,11],[46,14,46,22],[47,3,47,11],[47,14,47,22],[38,3,38,10],[40,2,41,2],[40,3,41,18],[44,3,44,11],[44,12,44,13],[44,14,44,22],[31,3,31,15],[33,2,34,2],[33,3,34,18],[34,22,34,24],[35,3,35,10],[35,22,37,24],[36,3,36,10],[36,11,36,18],[37,3,37,10],[26,2,27,2],[26,3,27,18],[27,22,27,24],[28,3,28,15],[28,22,30,24],[29,3,29,15],[30,3,30,15],[18,19,19,23],[21,2,21,24],[23,2,24,2],[23,3,24,13],[23,15,24,16],[23,17,24,22],[23,23,24,24],[18,3,19,4],[18,5,19,9],[18,10,19,11],[18,12,19,16],[18,17,19,18],[11,3,14,4],[11,5,14,11],[11,12,14,12],[10,13,14,23],[15,3,17,4],[15,6,15,23],[16,6,17,23],[1,1,4,25],[6,2,7,15],[6,16,7,25],[9,14,9,23],[10,3,10,4],[10,5,10,12]]}
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[null,"みなかみ町 ふるさと納税 「寄附申込書」"]
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[null,null,"みなかみ町長　あて",null,null,null,null,null,null,null,null,null,null,null,null,null,"令和　 　年　　 月　 　日　　"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ワンストップ特例制度申請（どちらかに○を付けてください）"]
[null,null,null,"ふりがな",null,null,null,null,null,null,null,null,null,"１．希望する　　　　　　　２．希望しない\n（確定申告しない）    　　 （確定申告する）\n※希望する場合は生年月日を記入してください。\n（　　　　　　　年　　　　　月　　　　　日）"]
[null,null,null,"お名前",null,null,null,null,null,null,null,null,"様"]
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[]
[]
[null,null,null,"ご住所",null,"〒"]
[]
[]
[null,null,null,"電話番号",null,null,null,null,null,null,"ＦＡＸ",null,null,null,null,null,null,"メール"]
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[null,null,"みなかみ町を応援するため、次のとおり寄附を申し込みます。"]
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[null,null,"①","寄附金額（ご寄附いただける金額をご記入ください）　",null,null,null,null,null,null,null,null,null,null,null,"金",null,null,null,null,null,null,null,"円"]
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[null,null,"②","寄附金の払込方法（希望される払込方法の番号をご記入ください）　"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番　号"]
[null,null,null,"１．郵便振替（手数料は無料）　　"]
[null,null,null,"２．銀行振込（手数料は寄附者様がご負担）　　　　"]
[null,null,null,"３．現金書留（郵送料は寄附者様がご負担）"]
[null,null,null,"４．直接持参（みなかみ町役場観光商工課まで）"]
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[null,null,"③","寄附金の使途（希望される使途の番号をご記入ください）　"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番　号"]
[null,null,null,"１．産業振興に関する事業",null,null,null,null,null,null,null,"５．自然・環境に関する事業"]
[null,null,null,"２．子育て支援に関する事業",null,null,null,null,null,null,null,"６．町内にある高等学校等の教育支援"]
[null,null,null,"３．芸術・文化振興に関する事業",null,null,null,null,null,null,null,"７．町長にお任せ"]
[null,null,null,"４．観光振興に関する事業"]
[]
[null,null,"④","希望されるお礼の品（希望される返礼品の品名と数量をご記入ください）　"]
[]
[null,null,null,"　  ※感謝券の１口　⇔　1万円のご寄附で、 3千円分のMINAKAMI TICKETをお返し。"]
[null,null,null,"　　<例>1口＝1万円（3千円分返礼）、10口＝10万円（3万円分返礼）、100口＝100万円（30万円分返礼）"]
[null,null,null,"品　　　　名",null,null,null,null,null,null,null,null,"数量",null,"品　　　　名",null,null,null,null,null,null,null,null,"数量"]
[null,null,null,"感謝券「MINAKAMI HEART TICKET」",null,null,null,null,null,null,null,null,null,"口",null,null,null,null,null,null,null,null,null,null,"個"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"個",null,null,null,null,null,null,null,null,null,null,"個"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"個",null,null,null,null,null,null,null,null,null,null,"個"]
[]
[null,null,null,null,"　お礼の品を希望しない。（返礼品が不要な場合はチェックしてください）"]
[]
[null,null,"⑤","寄附情報の公表（希望される番号をご記入ください）　"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番　号"]
[null,null,null,"１．希望しない",null,null,null,null,null,null,null,"４．希望する（氏名・都道府県）"]
[null,null,null,"２．希望する（氏名のみ）",null,null,null,null,null,null,null,"５．希望する（氏名・都道府県・寄附金額）"]
[null,null,null,"３．希望する（氏名・寄附金額）"]
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[null,null,"⑥","備考"]
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[]
[]
[]
[]
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[null,"申込先：みなかみ町役場　観光商工課　　　FAX番号：０２７８－６２－３２１１"]