{"text_format":"2","workbook":"xls","n_sheets":1,"sheets":["Sheet1"],"not_rendered":{"charts":0,"images":0,"macros":0,"external_links":1,"defined_names":1,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"run_cost":"one","rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900","formulas":"cached_only"}

{"sheet":"Sheet1","index":0,"n_rows":65,"n_cols":58,"rows_kept":65,"cut":false,"hidden":false,"merged":[[33,13,35,13],[33,14,35,14],[33,17,35,17],[6,46,6,48],[6,57,6,58],[7,57,7,58],[6,49,6,56],[7,49,7,56],[8,41,9,45],[33,1,35,1],[33,3,35,3],[33,4,35,4],[33,5,35,5],[33,6,35,6],[33,15,35,16],[33,7,35,7],[33,8,35,8],[33,9,35,9],[33,10,35,10],[28,11,30,11],[28,12,30,12],[28,13,30,13],[28,14,30,14],[33,18,35,18],[28,31,30,31],[28,29,30,29],[33,11,35,11],[33,12,35,12],[33,20,35,20],[33,19,35,19],[28,55,30,55],[28,34,30,34],[28,23,30,23],[28,24,30,24],[28,41,30,41],[28,32,30,32],[28,39,30,39],[33,21,35,21],[33,22,35,22],[28,21,30,21],[28,56,30,56],[28,50,30,50],[28,51,30,51],[28,52,30,52],[28,53,30,53],[21,39,23,43],[28,42,30,42],[22,29,22,30],[49,1,49,58],[38,1,38,58],[36,1,36,58],[26,39,27,42],[26,50,27,56],[26,22,27,25],[26,26,27,38],[28,38,30,38],[28,54,30,54],[8,46,9,58],[5,6,7,18],[5,20,7,31],[28,10,30,10],[22,57,22,58],[21,44,23,56],[7,38,7,45],[8,22,9,25],[28,7,30,7],[21,31,23,38],[6,33,7,37],[1,53,1,58],[28,19,30,19],[6,38,6,45],[24,1,24,58],[28,8,30,8],[28,9,30,9],[8,6,9,21],[28,20,30,20],[28,22,30,22],[28,17,30,17],[28,18,30,18],[12,30,12,33],[28,1,30,1],[28,3,30,3],[28,4,30,4],[28,5,30,5],[28,6,30,6],[10,39,12,41],[10,44,12,46],[10,6,12,25],[28,40,30,40],[28,25,30,25],[28,30,30,30],[28,26,30,26],[28,27,30,27],[28,28,30,28],[26,43,27,49],[1,47,1,52],[11,47,11,48],[11,42,11,43],[11,37,11,38],[17,13,20,14],[8,26,9,40],[10,30,10,33],[11,30,11,33],[13,34,17,58],[18,34,20,58],[31,3,32,22],[13,24,16,25],[17,19,20,20],[17,24,20,25],[21,16,23,28],[21,9,23,15],[13,13,16,14],[17,6,20,9],[32,24,33,57],[13,19,16,20],[28,43,30,49],[28,15,30,16],[28,2,30,2],[26,3,27,21],[18,26,20,33],[28,36,30,36],[28,37,30,37],[21,1,23,8],[28,35,30,35],[28,33,30,33],[8,1,9,5],[10,1,12,5],[13,1,16,5],[17,1,20,5],[10,49,12,52],[10,53,12,58],[13,26,17,33],[10,26,12,29],[10,34,12,36],[13,6,16,9]],"flags":["formulas_cached_only"]}
[]
[{"$nulls":47},"照 合",{"$nulls":5},"係"]
[]
[]
[]
[{"$nulls":6},"埋葬料\n家族埋葬料\n埋葬料附加金\n家族埋葬料附加金",{"$nulls":13},"請 求 書"]
[{"$nulls":33},"決定額",{"$nulls":4},"埋　葬　料\n家族埋葬料",{"$nulls":7},"※",{"$nulls":10},"円"]
[{"$nulls":38},"附　加　金",{"$nulls":18},"円"]
[null,"組合員\n氏　名",{"$nulls":20},"記号\n番号",null,null,null,"　　　　―",{"$nulls":14},"所　属\n機関名"]
[]
[null,"死亡者\n氏　名",{"$nulls":24},"生年\n月日",null,null,null,"昭和",{"$nulls":18},"続柄"]
[{"$nulls":30},"平成",{"$nulls":6},"年",{"$nulls":4},"月",{"$nulls":4},"日"]
[{"$nulls":30},"令和"]
[null,"死　亡　\n年月日",{"$nulls":4},"令和",{"$nulls":6},"年",{"$nulls":5},"月",{"$nulls":4},"日",null,"死亡の場所"]
[]
[]
[]
[null,"埋　葬\n年月日",{"$nulls":4},"令和",{"$nulls":6},"年",{"$nulls":5},"月",{"$nulls":4},"日"]
[{"$nulls":26},"死亡の原因"]
[]
[]
[null,"埋  葬  料\n家族埋葬料",{"$nulls":7},"請求金額",{"$nulls":21},"埋　葬　料\n家族埋葬料",{"$nulls":7},"附加金"]
[{"$nulls":29},"円",{"$nulls":27},"円"]
[]
[null,"給　　付　　金　　等　　の　　振　　込　　口　　座"]
[]
[null,null,null,"金　融　機　関　名\n(カタカナ)",{"$nulls":18},"銀行\nコード",null,null,null,"支　店　名\n(カタカナ)",{"$nulls":12},"支店\nコード",null,null,null,"預金区分",{"$nulls":6},"口座番号"]
[]
[{"$nulls":43},"１ 普通　　２ 当座"]
[]
[]
[null,null,null,"口　座　名　義",{"$nulls":19},"《埋葬料・埋葬料附加金のみ》"]
[{"$nulls":24},"□　公金受取口座を利用する"]
[]
[{"$nulls":24},"※公金受取口座を登録していない方は、マイナポータルから登録できます。"]
[]
[null,"　　※口座名義は請求者と同一人に限ります。"]
[]
[null,"　　上記の通り請求します。"]
[]
[{"$nulls":6},"愛知県市町村職員共済組合理事長 様"]
[]
[{"$nulls":8},"令和",{"$nulls":7},"年",{"$nulls":5},"月",{"$nulls":4},"日"]
[{"$nulls":32},"住　所"]
[]
[{"$nulls":24},"請 求 者",{"$nulls":7},"氏　名"]
[]
[{"$nulls":32},"組合員との続柄"]
[]
[null,"　　上記の記載事項は、事実と相違ないものと認めます。"]
[]
[{"$nulls":8},"令和",{"$nulls":7},"年",{"$nulls":5},"月",{"$nulls":4},"日"]
[]
[{"$nulls":32},"職　名"]
[{"$nulls":25},"所属所長"]
[{"$nulls":32},"氏　名"]
[]
[]
[null,"１ この請求書を提出するときは、市町村長の埋葬許可証の写し（やむを得ない場合がある場合には、死亡の事実を証明"]
[null,"　 する書類）を添えてください。"]
[null,"２ 被扶養者であった者以外の人が埋葬料を請求する場合には、１のほか埋葬に要した費用の額に関する証拠書類を添え"]
[null,"　 てください。"]
[null,"３ 組合員との続柄については、埋葬料を請求する場合に記入してください。"]
[null,"４ ※印欄は記入しないでください。"]
[null,"５ 埋葬料・埋葬料附加金の請求者が、被扶養者以外であり、公金受取口座の利用を希望する場合は、同意書が必要です。"]