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["特別徴収税額の納期の特例に関する申請書"]
[{"$nulls":10},"令和       年       月       日"]
[null,"    恵   庭   市   長   様"]
[null,"下記のとおり地方税法３２１条の５の２の規定による令和２年度市民税・道民税特別徴収税額の"]
[null,"納期の特例についての承認方を申請します。"]
["申請者","所在地",{"$nulls":6},"特徴指定番号"]
[null,"名称",{"$nulls":6},"申請者の担当者氏名及び連絡先",null,null,"氏名"]
[null,"代表者",{"$nulls":5},"印",null,null,null,"電話"]
["特例を受けようとする特別徴収税額",null,"特別徴収税額",{"$nulls":7},"納期限"]
[null,null,"6月～11月分",{"$nulls":6},"円","令和2年12月10日"]
[null,null,"12月～5月分",{"$nulls":6},"円","令和3年 6月10日"]
["                     申請の日前6ヶ月間の各月末の給与の支払を受ける者の人員及び各月の支払金額",{"$nulls":5},"月",null,"月",null,"月",null,"月",null,"月",null,"月"]
[null,null,"常用者",null,"人数",null,"人",null,"人",null,"人",null,"人",null,"人",null,"人"]
[{"$nulls":4},"給与額",null,"円",null,"円",null,"円",null,"円",null,"円",null,"円"]
[null,null,"臨時",null,"人数",null,"人",null,"人",null,"人",null,"人",null,"人",null,"人"]
[{"$nulls":4},"給与額",null,"円",null,"円",null,"円",null,"円",null,"円",null,"円"]
["徴収金の滞納又は著しい納付遅滞の事実",null,null,"有   ・   無",{"$nulls":5},"（有りの場合はその理由の詳細）"]
[]
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["申請の日前1ヵ年以内に納期の特例について、その承認を取り消されたことがある場合には、その年月日",{"$nulls":8},"令和          年          月          日"]