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[null,"就労証明書"]
[null,null,null,null,null,null,null,null,null,"宛"]
[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,"西暦",null,null,null,"年",null,null,"月",null,null,"日"]
[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"]
[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"]
[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,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,"担当者名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記載者連絡先",null,null,null,null,null,"―",null,null,null,"―"]
[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,"※本証明書の内容について、就労先事業者等に無断で作成し又は改変を行ったときには、刑法上の罪に問われる場合があります。"]
[]
[null,"No.","項目",null,null,null,null,null,"記載欄"]
[null,1,"業種",null,null,null,null,null,"□","農業・林業",null,null,"□","漁業",null,null,"□","鉱業・採石業・砂利採取業",null,null,null,null,"□","建設業",null,"□","製造業",null,"□","電気・ガス・熱供給・水道業"]
[null,null,null,null,null,null,null,null,"□","情報通信業",null,null,"□","運輸業・郵便業",null,null,"□","卸売業・小売業",null,null,null,null,"□","金融業・保険業",null,null,null,null,"□","不動産業・物品賃貸業"]
[null,null,null,null,null,null,null,null,"□","学術研究・専門・技術サービス",null,null,null,null,null,null,"□","宿泊業・飲食サービス業",null,null,null,null,"□","生活関連サービス業・娯楽業",null,null,null,null,null,"□","医療・福祉"]
[null,null,null,null,null,null,null,null,"□","教育・学習支援業",null,null,null,"□","複合サービス事業",null,null,null,"□","公務",null,null,"□","その他（",null,null,null,null,null,null,null,null,"）"]
[null,2,"フリガナ"]
[null,null,"本人氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生年\n月日",null,null,null,"年",null,"月",null,"日"]
[null,3,"雇用(予定)期間等",null,null,null,null,null,"□","無期","□","有期","期間 \n （無期の場合は雇用開始日のみ）",null,null,null,null,null,null,null,null,"年",null,"月",null,"日","～",null,null,"年",null,"月",null,"日"]
[null,4,"本人就労先事業所",null,null,null,null,null,"名称"]
[null,null,null,null,null,null,null,null,"住所"]
[null,5,"雇用の形態",null,null,null,null,null,"□","正社員",null,"□","パート・アルバイト",null,null,null,"□","派遣社員",null,"□","契約社員",null,"□","会計年度任用職員",null,null,null,"□","非常勤・臨時職員",null,null,null,"□","役員"]
[null,null,null,null,null,null,null,null,"□","自営業主",null,"□","自営業専従者",null,null,null,"□","家族従業者",null,null,"□","内職","□","業務委託",null,null,"□","その他(",null,null,null,null,null,null,")"]
[null,6,"就労時間\n(固定就労の場合)",null,null,null,null,null,"月","火","水","木","金","土","日","祝日",null,null,"合計\n時間",null,"月間",null,null,null,"時間",null,null,null,"分","（うち休憩時間",null,null,null,null,"分）"]
[null,null,null,null,null,null,null,null,"□","□","□","□","□","□","□","□"]
[null,null,null,null,null,null,null,null,"一月当たりの就労日数",null,null,null,null,null,"月間",null,null,null,null,"日","一週当たりの就労日数",null,null,null,null,null,"週間",null,null,null,null,"日"]
[null,null,null,null,null,null,null,null,"平日",null,null,null,"時",null,null,"分",null,null,"～",null,null,"時",null,null,"分","（うち休憩時間",null,null,null,null,"分）"]
[null,null,null,null,null,null,null,null,"土曜",null,null,null,"時",null,null,"分",null,null,"～",null,null,"時",null,null,"分","（うち休憩時間",null,null,null,null,"分）"]
[null,null,null,null,null,null,null,null,"日祝",null,null,null,"時",null,null,"分",null,null,"～",null,null,"時",null,null,"分","（うち休憩時間",null,null,null,null,"分）"]
[null,null,"就労時間\n(変則就労の場合)",null,null,null,null,null,"合計時間",null,null,null,"□","月間",null,"□","週間",null,null,null,"時間",null,null,null,"分","（うち休憩時間",null,null,null,null,"分）"]
[null,null,null,null,null,null,null,null,"就労日数",null,null,null,"□","月間",null,"□","週間",null,null,null,"日"]
[null,null,null,null,null,null,null,null,"主な就労時間帯\n・シフト時間帯",null,null,null,null,null,"時",null,null,"分","～",null,null,"時",null,null,"分","（うち休憩時間",null,null,null,null,"分）"]
[null,7,"就労実績\n※日数に有給休暇を含み、\n時間数に休憩・残業時間を含む",null,null,null,null,null,"年月",null,null,null,"年",null,null,"月",null,"年月",null,null,null,"年",null,null,"月",null,"年月",null,null,null,"年",null,null,"月"]
[null,null,null,null,null,null,null,null,null,null,"日／月",null,null,null,"時間／月",null,null,null,null,"日／月",null,null,null,"時間／月",null,null,null,null,"日／月",null,null,null,"時間／月"]
[null,8,"産前･産後休業の取得\n※取得予定を含む",null,null,null,null,null,"□","取得予定",null,"□","取得中"]
[null,null,null,null,null,null,null,null,"期間",null,null,null,"年",null,null,"月",null,null,"日",null,"～",null,null,null,null,"年",null,null,"月",null,null,"日"]
[null,9,"育児休業の取得\n※取得予定を含む",null,null,null,null,null,"□","取得予定",null,"□","取得中",null,"□","取得済み"]
[null,null,null,null,null,null,null,null,"期間",null,null,null,"年",null,"月",null,"日","～",null,null,"年",null,"月",null,"日"]
[null,10,"産休・育休以外の休業の\n取得",null,null,null,null,null,"□","取得予定",null,"□","取得中",null,"□","取得済み",null,"理由"]
[null,null,null,null,null,null,null,null,"期間",null,null,null,"年",null,"月",null,"日","～",null,null,"年",null,"月",null,"日"]
[null,11,"復職（予定）年月日",null,null,null,null,null,"□","復職予定",null,"□","復職済み",null,null,null,null,"年",null,null,"月",null,null,"日"]
[null,12,"育児のための短時間\n勤務制度利用有無\n※取得予定を含む",null,null,null,null,null,"□","取得予定",null,"□","取得中",null,null,null,null,"期間",null,null,null,"年",null,"月",null,"日","～",null,null,"年",null,"月",null,"日"]
[null,null,null,null,null,null,null,null,"主な就労時間帯\n・シフト時間帯",null,null,null,null,null,"時",null,null,"分","～",null,null,"時",null,null,"分","（うち休憩時間",null,null,null,null,"分）"]
[null,13,"保育士等としての勤務実態の有無",null,null,null,null,null,"□","有","□","有（予定）",null,"□","無"]
[null,14,"備考欄"]
[]
[null,"追加的記載項目欄"]

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