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[{"$nulls":23},"平成　　年　　月　　日"]
["大学共同利用機関法人\n情報・システム研究機構　機構長　殿"]
[]
[]
["職員等マスタ登録依頼書（新規・変更・廃止）"]
[]
[{"$nulls":20},"機構職員　・　機構職員以外"]
[]
["債主コード",{"$nulls":16},"個人番号"]
["フリガナ",{"$nulls":15},"㊞",null,"（注1）生年月日（西暦）",{"$nulls":6},"男　・　女"]
["氏　　　名",{"$nulls":19},"年",null,"月",null,"日"]
["勤務先\n（所属）",{"$nulls":17},"官職\n（又は職業）　"]
[]
["勤務先住所"]
["〒",null,null,null,"－",{"$nulls":13},"電話番号"]
[]
["Ｅメールアドレス",null,null,null,"　※「支払明細通知」メールが必要な場合は記載してください。（PCの個人アドレスのみ）"]
[]
["受取人住所\n(機構教職員不要）",null,null,null,"　※住民登録地が受取人住所と異なる場合、備考欄へご記入下さい。\n"]
["〒",null,null,null,"－",{"$nulls":13},"電話番号"]
[]
[]
["金融機関名",{"$nulls":17},"金融機関コード"]
["支店名",{"$nulls":17},"支店コード"]
["預貯金種別",{"$nulls":5},"１：普通　　２：当座",{"$nulls":6},"口座番号"]
["フリガナ",{"$nulls":17},"支払\n方法",null,null,null,"1：国内振込　2：現金払\n3：外国送金　4：その他"]
["口座名義"]
["（注2）"]
[]
["依頼出張者\nの区分",null,null,null,"□","機構の委員等",{"$nulls":6},"1.「機構の委員等」とは、\n　①役員\n　②経営協議会委員\n　③教育研究協議会委員\n　④各研究所における委員会委員\n　⑤機構及び研究所の名誉教授\n　⑥国立大学法人及び大学共同利用機関法人の役員及び指定職相当\n　⑦その他上記に相当する者\n2.「大学院生」には、学生全般を含む。"]
[{"$nulls":4},"□","上記以外"]
[{"$nulls":4},"□","大学院生"]
["基本給表等",null,null,null,"□","一般職２級以下"]
[{"$nulls":4},"□","一般職３級～６級"]
[{"$nulls":4},"□","一般職７級以上"]
[{"$nulls":4},"□","指定職"]
["備　　考"]
[]
["　　　　　　　　　　　　　上記の内容で誤りがないことを確認しました。",{"$nulls":19},"担当係長：",{"$nulls":8},"㊞"]
[]
[{"$nulls":20},"研究所名：",null,null,"国立情報学研究所"]
[{"$nulls":20},"担当者名：",{"$nulls":8},"㊞"]
[]
["（注1）生年月日の欄は、謝金受給対象者は必ず記載してください。"]
["（注2）非居住者及び外国籍の方は口座名義確認のため、通帳の写し（表紙と1枚目）も添付してください。"]
[]
["《個人情報の利用目的》"]
["　ご記入いただいた個人情報は、旅費、謝金等の支払業務、支払調書の作成、電子メールによる振込\n　通知の送付のために利用します。"]

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[{"$nulls":23},"平成××年××月××日"]
["大学共同利用機関法人\n情報・システム研究機構　機構長　殿"]
[]
[]
[{"$nulls":6},"職員等マスタ登録依頼書（新規・変更・廃止）"]
[]
[{"$nulls":20},"機構職員　・　機構職員以外"]
[]
["債主コード",{"$nulls":16},"個人番号"]
["フリガナ",null,null,null,"ジヨウホウ　ケンタ",{"$nulls":11},"㊞",null,"（注1）生年月日（西暦）",{"$nulls":6},"男　・　女"]
["氏　　　名",null,null,null,"情報　研太",{"$nulls":13},1970,null,"年",5,"月",5,"日"]
["勤務先\n（所属）",null,null,null,"情報・システム(株)",{"$nulls":13},"官職\n（又は職業）　",null,null,null,"経理課長"]
[]
["勤務先住所"]
["〒",1,0,5,"－",0,0,0,1,{"$nulls":9},"電話番号",null,null,"03-6402-6219"]
["東京都港区虎ノ門4-3-13　神谷町セントラルプレイス2F"]
["Ｅメールアドレス",null,null,null,"　※「支払明細通知」メールが必要な場合は記載してください。（PCの個人アドレスのみ）"]
["k-jyouhou@rois.ac.jp"]
["受取人住所\n(機構教職員不要）",null,null,null,"　※住民登録地が受取人住所と異なる場合、備考欄へご記入下さい。\n"]
["〒",1,2,3,"－",4,5,6,7,{"$nulls":9},"電話番号",null,null,"03-1234-5678"]
["東京都港区港南1-2-3-456"]
[]
["金融機関名",null,null,null,"みずほ銀行",{"$nulls":13},"金融機関コード",null,null,null,"０００１"]
["支店名",null,null,null,"虎ノ門支店",{"$nulls":13},"支店コード",null,null,null,"０４６"]
["預貯金種別",null,null,null,1,null,"１：普通　　２：当座",{"$nulls":6},"口座番号",null,null,1,null,2,null,3,null,4,null,5,null,6,null,7]
["フリガナ",null,null,null,"ジヨウホウ　ケンタ",{"$nulls":13},"支払\n方法",null,1,null,"1：国内振込　2：現金払\n3：外国送金　4：その他"]
["口座名義",null,null,null,"情報　研太"]
["（注2）"]
[]
["依頼出張者\nの区分",null,null,null,"□","機構の委員等",{"$nulls":6},"1.「機構の委員等」とは、\n　①役員\n　②経営協議会委員\n　③教育研究協議会委員\n　④各研究所における委員会委員\n　⑤機構及び研究所の名誉教授\n　⑥国立大学法人及び大学共同利用機関法人の役員及び指定職相当\n　⑦その他上記に相当する者\n2.「大学院生」には、学生全般を含む。"]
[{"$nulls":4},"■","上記以外"]
[{"$nulls":4},"□","大学院生"]
["基本給表等",null,null,null,"□","一般職２級以下"]
[{"$nulls":4},"□","一般職３級～６級"]
[{"$nulls":4},"□","一般職７級以上"]
[{"$nulls":4},"□","指定職"]
["備　　考"]
["住民登録地：〒１２３－４５６７　東京都新宿区西新宿９-８-７-６５４"]
["　　　　　　　　　　　　　上記の内容で誤りがないことを確認しました。",{"$nulls":19},"担当係長：",null,null,"○　○　○　○",{"$nulls":5},"㊞"]
[]
[{"$nulls":20},"研究所名：",null,null,"××××研究所"]
[{"$nulls":20},"担当者名：",null,null,"△　△　△　△",{"$nulls":5},"㊞"]
[]
["（注1）生年月日の欄は、謝金受給対象者は必ず記載してください。"]
["（注2）非居住者及び外国籍の方は口座名義確認のため、通帳の写し（表紙と1枚目）も添付してください。"]
[]
["《個人情報の利用目的》"]
["　ご記入いただいた個人情報は、旅費、謝金等の支払業務、支払調書の作成、電子メールによる振込\n　通知の送付のために利用します。"]