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[null,"健康保険　被扶養者（異動減）届"]
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[null,"記号・番号\n（保険証左上に記載）",{"$nulls":10},"－",{"$nulls":6},"事業所名"]
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[null,"被保険者氏名",{"$nulls":21},"被保険者\nTEL",null,null,"　　　　　　　（　　　　　　　　　　）"]
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[null,"■届出時は健康保険証を添付してください。"]
[null,"■雇用保険受給開始により扶養から外す際は、雇用保険受給資格者証の写しを添付してください。"]
[null,"■『新保険証取得済(就職等)』で喪失証明書の発行を希望される方は新保険証の取得日(就職日)が分かる書類を必ず添付してください。"]
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[null,"被扶養者氏名",{"$nulls":14},"生年月日",{"$nulls":14},"性別",null,null,"続柄"]
[null,"ﾌﾘｶﾞﾅ",{"$nulls":19},"年",null,null,null,"月",null,null,null,"日",{"$nulls":4},"例：長男、養女"]
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[null,"異動減理由発生日",{"$nulls":14},"異動減理由"]
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[{"$nulls":16},"　　国保加入予定(収入増等)",{"$nulls":11}," （内容：　　　　　　　　　　　　　　　",{"$nulls":8},"）"]
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