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[null,"就労証明書"]
[]
["岡山市長",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,"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,"事業所名"]
[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,"所在地"]
[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,"担当者名"]
[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,"―"]
[]
["　下記の内容について、事実であることを証明いたします。"]
["　※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。"]
["No.","項目",null,null,null,null,"記載欄"]
[1,"業種",null,null,null,null,"□ 農業・林業",null,null,"□ 漁業",null,null,null,"□ 鉱業・採石業・砂利採取業",null,null,null,null,"□ 建設業",null,null,null,"□ 製造業",null,null,"□ 電気・ガス・熱供給・水道業"]
[null,null,null,null,null,null,"□ 情報通信業",null,null,"□ 運輸業・郵便業",null,null,null,"□ 卸売業・小売業",null,null,null,null,"□ 金融業・保険業",null,null,null,"□ 不動産業・物品賃貸業"]
[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,null,"□ 医療・福祉"]
[null,null,null,null,null,null,"□ 教育・学習支援業",null,null,null,null,null,null,"□ 複合サービス事業",null,null,null,null,"□ 公務",null,null,null,"□ その他（　　　　　　　　　　　　　　　　　　）"]
[2,"フリガナ"]
[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,"生年\n月日",null,"　　　　　年　　　　　月　　　　　日　"]
[3,"雇用（予定）期間等",null,null,null,null,"□ 無期　□ 有期",null,null,"期間\n（無期の場合は雇用開始日のみ）",null,null,null,null,null,"　　　　　　年　　　　　　月　　　　　　日　～　　　　　　　年　　　　　　月　　　　　　日"]
[4,"本人就労先事業所",null,null,null,null,"名称"]
[null,null,null,null,null,null,"住所"]
[5,"雇用の形態",null,null,null,null,"□ 正社員",null,null,"□ パート・アルバイト",null,null,null,"□ 派遣社員",null,null,null,"□ 契約社員",null,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,"□ 自営業主",null,null,"□ 自営業専従者",null,null,null,"□ 家族従業者",null,null,null,"□ 内職",null,null,"□ 業務委託",null,null,null,"□ その他（　　　 　　　　　　　）　　"]
[6,"就労時間\n（固定就労の場合）",null,null,null,null,"月","火","水","木","金","土","日","祝日",null,"合計\n時間",null,"　月間　　　　　　　　時間　　　　　　　　分　（うち休憩時間　　　　　　　分）"]
[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　　　　　　　　　日",null,null,null,null,"一週当たりの就労日数",null,null,null,null,null,"週間　　　　　　　　　日"]
[null,null,null,null,null,null,"平日　　　　　　　　　　時　　　　　　　　　　分　　　　～　　　　　　　　時　　　　　　　　　　分　（うち休憩時間　　　　　　　　　　分）"]
[null,null,null,null,null,null,"土曜　　　　　　　　　　時　　　　　　　　　　分　　　　～　　　　　　　　時　　　　　　　　　　分　（うち休憩時間　　　　　　　　　　分）"]
[null,null,null,null,null,null,"日祝　　　　　　　　　　時　　　　　　　　　　分　　　　～　　　　　　　　時　　　　　　　　　　分　（うち休憩時間　　　　　　　　　　分）"]
[null,"就労時間\n（変則就労の場合）",null,null,null,null,"合計時間",null,null,"□ 月間　　　　□ 週間　　　　　　　　　 　　　　　時間　　　　　　　　　　　　分　（うち休憩時間　　　　　　　　　　　分）"]
[null,null,null,null,null,null,"就労日数",null,null,"□ 月間　　　　□ 週間　　　　　　　　　　　　　　日"]
[null,null,null,null,null,null,"主な就労時間等\n・シフト時間等",null,null,"　　　　　　　時　　　　　　　　　分　　　～　　　　　　　時　　　　　　　　分　（うち休憩時間　　　　　　　分）　　"]
[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,"年月",null,"　　　　　年　　　　　　　月",null,null,null,null,null,"年月",null,"　　　　　年　　　　　　　月",null,null,null,null,null,"年月",null,"　　　　　年　　　　　　　月"]
[null,null,null,null,null,null,"日／月",null,null,null,"時間／月",null,null,null,"日／月",null,null,null,"時間／月",null,null,null,"日／月",null,null,null,"　　　　　　　　時間／月"]
[8,"産前・産後休業の取得\n※取得予定を含む",null,null,null,null,"　□ 取得予定　　□ 取得中"]
[null,null,null,null,null,null,"期間",null,"　　　　　　　年　　　　　　　月　　　　　　　日　　～　　　　　　　　年　　　　　　　月　　　　　　　日"]
[9,"育児休業の取得\n※取得予定を含む",null,null,null,null,"　□ 取得予定　　□ 取得中　　　□ 取得済み"]
[null,null,null,null,null,null,"期間",null,"　　　　　　　年　　　　　　　月　　　　　　　日　　～　　　　　　　　年　　　　　　　月　　　　　　　日"]
[10,"産休・育休以外の休業の取得",null,null,null,null,"　□ 取得予定　　□ 取得中　　　□ 取得済み",null,null,null,null,null,null,null,null,null,null,"理由",null,"□介護休業　□病休　□その他（　　　　　　　　）"]
[null,null,null,null,null,null,"期間",null,"　　　　　　　年　　　　　　　月　　　　　　　日　　～　　　　　　　　年　　　　　　　月　　　　　　　日"]
[11,"復職（予定）年月日",null,null,null,null,"　□ 復職予定　　□ 復職済み　　　　　　　　　　年　　　　　　　　　　月　　　　　　　　　　日"]
[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,"　□ 取得予定　　□ 取得中",null,null,null,null,null,null,null,null,null,null,"期間",null,"　　　年　　　月　　　日　～　　　年　　　月　　　日"]
[null,null,null,null,null,null,"主な就労時間等\n・シフト時間等",null,null,"　　　　　　　時　　　　　　　　　分　　　～　　　　　　　時　　　　　　　　分　（うち休憩時間　　　　　　　分）　　"]
[13,"保育士等としての\n勤務実態の有無",null,null,null,null,"　□ 有　　　□ 有（予定）　　　□無"]
[14,"備考欄"]
[15,"入所が内定した場合の\n育児休業の短縮可否",null,null,null,null,"　□ 可　　　□ 否"]
["（※事業者証明欄はここまで）"]
["※以下は保護者が記載してください。"]
["保護者\n記載欄","クラブ名",null,null,null,null,null,null,"小学校（学園）\n児童クラブ",null,null,"児童名",null,null,null,null,null,null,null,null,null,"生年月日",null,"（平成　　　　年　　　　月　　　　日生）　"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（平成　　　　年　　　　月　　　　日生）　"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（平成　　　　年　　　　月　　　　日生）　"]
["※自営業又は農業の方は、帳簿、領収書、納品書、請求書、作付面積のわかる資料（農業）など自営業が確認できる書類の写しをＡ４コピーで２点以上（概ね６か月以内）添付してください。"]

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