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[null,"分離課税に係る所得等のある方は、「市町村民税・道府県民税申告書（分離課税等用）」をあわせて提出してください。\nこの申告書を提出した方は事業税の申告書を提出する必要がありません。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"道 府 県 民 税"]
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[null,null,null,null,null,"３ 所得から差し引かれる金額に関する事項"]
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[null,null,null,null,null,"  ⑮",null,null,null,null,null,null,null,"新生命保険料の計",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旧生命保険料の計"]
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[null,null,null,null,null,"生命保険料"]
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[null,null,null,null,null,"控　　　　 除"]
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[null,null,null,null,null,"  ⑯　地震保",null,null,null,null,null,null,null,"地震保険料の計",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"旧長期損害保険料の計"]
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[null,null,null,null,null,"　⑰～⑲",null,null,null,null,null,null,null,"⑰　□　寡婦控除",null,null,null,null,null,null,null,null,null,null,null,null,null,"　⑱",null,null,null,null,null,null,"⑲　□　勤労学生控除　"]
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[null,null,null,null,null,"　寡婦控除、",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合譲渡",null,"短期",null,null,null,null,null,null,null,null,"コ"]
[]
[null,null,null,null,null,"　ひとり親控除、",null,null,null,null,null,null,null," □ 死別　 □ 生死不明",null,null,null,null,null,null,null,null,null,null,null,null,null,"□",null,"ひとり親",null,null,null,null,"（学校名）"]
[]
[null,null,null,null,null,"　勤労学生控除",null,null,null,null,null,null,null,"□ 離婚　 □ 未帰還　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"控　除",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"長期",null,null,null,null,null,null,null,null,"サ"]
[]
[null,null,null,null,null,"　⑳",null,null,null,null,null,null,null,1,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"障害の\n程度",null,null,null,"級\n度"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"一時",null,null,null,null,null,null,null,null,null,null,"シ"]
[null,null,null,null,null,"障　害　者",null,null,null,null,null,null,null,null,"氏名"]
[]
[]
[null,null,null,null,null,"控　　　除",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"２　所　得　金　額",null,null,"事業",null,"営業等",null,null,null,null,null,null,null,null,"①"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"農業",null,null,null,null,null,null,null,null,"②"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,2,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"障害の\n程度",null,null,null,"級\n度"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"不動産",null,null,null,null,null,null,null,null,null,null,"③"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"利子",null,null,null,null,null,null,null,null,null,null,"④"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"番号"]
[]
[null,null,null,null,null,"　㉑～㉒",null,null,null,null,null,null,null,"配偶者",null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,"生年月日",null,null,null,null,null,null,null,null,"明・大\n昭・平",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"配当",null,null,null,null,null,null,null,null,null,null,"⑤"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"．",null,null,"．"]
[]
[null,null,null,null,null,"配偶者控除・",null,null,null,null,null,null,null,null,null,"氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"配偶者の",null,null,null,null,null,null,null,"円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"給与",null,null,null,null,null,null,null,null,null,null,"⑥"]
[null,null,null,null,null,"配偶者特別控",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"合計所得金額"]
[]
[null,null,null,null,null,"除・同一生計",null,null,null,null,null,null,null,"個人番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□","同一生計配偶者(控除対象配偶者を除く。)"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業",null,"公的年金等",null,null,null,null,null,null,null,null,"⑦"]
[null,null,null,null,null,"配偶者"]
[]
[null,null,null,null,null,"㉓　扶　養　控　除",null,null,null,1,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,"生年\n月日",null,null,"明・大・昭\n平・令",null,null,null,null,"．　　．",null,null,null,"同居・\n別居の\n区分",null,null,"□　同居\n□　別居",null,null,null,"続柄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"業務",null,null,null,null,null,null,null,null,"⑧"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"氏名"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"その他",null,null,null,null,null,null,null,null,"⑨"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"控除額",null,null,null,null,"万円"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"合計",null,null,null,null,null,null,null,null,"⑩"]
[]
[null,null,null,null,null,null,null,null,null,2,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,"生年\n月日",null,null,"明・大・昭\n平・令",null,null,null,null,"．　　．",null,null,null,"同居・\n別居の\n区分",null,null,"□　同居\n□　別居",null,null,null,"続柄",null,null,null,null,null,null,null,null,null,null,null,null,"（⑦＋⑧＋⑨）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"総合譲渡・一時",null,null,null,null,null,null,null,null,null,null,"⑪"]
[null,null,null,null,null,null,null,null,null,null,null,"氏名"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"合　　　計",null,null,null,null,null,null,null,null,null,null,"⑫"]
[null,null,null,null,null,null,null,null,null,null,null,"個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"控除額",null,null,null,null,"万円"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"４　所得から差し引かれる金額",null,null,"社会保険料控除",null,null,null,null,null,null,null,null,null,null,"⑬"]
[null,null,null,null,null,null,null,null,null,3,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,"生年\n月日",null,null,"明・大・昭\n平・令",null,null,null,null,"．　　．",null,null,null,"同居・\n別居の\n区分",null,null,"□　同居\n□　別居",null,null,null,"続柄"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"小　規　模　企　業",null,null,null,null,null,null,null,null,null,null,"⑭"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"共済等掛金控除"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"控除額",null,null,null,null,"万円",null,null,null,null,null,null,null,null,null,null,"生命保険料控除",null,null,null,null,null,null,null,null,null,null,"⑮"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"番号"]
[]
[null,null,null,null,null,null,null,null,null,4,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,"生年\n月日",null,null,"明・大・昭\n平・令",null,null,null,null,"．　　．",null,null,null,"同居・\n別居の\n区分",null,null,"□　同居\n□　別居",null,null,null,"続柄",null,null,null,null,null,null,null,null,null,null,"地震保険料控除",null,null,null,null,null,null,null,null,null,null,"⑯"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"氏名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"寡婦、ひとり親控除",null,null,null,null,null,null,null,null,null,null,"⑰～"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"⑱"]
[null,null,null,null,null,null,null,null,null,null,null,"個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"控除額",null,null,null,null,"万円"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"勤　労　学　生　、",null,null,null,null,null,null,null,null,null,null,"⑲～"]
[null,null,null,null,null,null,null,null,null,null,null,"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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"障　害　者　控　除",null,null,null,null,null,null,null,null,null,null,"⑳"]
[]
[null,null,null,null,null,"１６歳未満の扶養親族\n（控除対象外）",null,null,null,1,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,"生年\n月日",null,null,"平・令",null,null,"．　　．",null,null,null,"同居・\n別居の\n区分",null,null,null,"□　同居\n□　別居",null,null,null,null,"続柄",null,null,null,null,null,null,null,null,null,null,"配偶者（特別）控除",null,null,null,null,null,null,null,null,null,null,"㉑～"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"㉒"]
[null,null,null,null,null,null,null,null,null,null,null,"氏名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"扶　養　控　除",null,null,null,null,null,null,null,null,null,null,"㉓"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"個人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"基　礎　控　除",null,null,null,null,null,null,null,null,null,null,"㉔"]
[null,null,null,null,null,null,null,null,null,null,null,"番号"]
[]
[null,null,null,null,null,null,null,null,null,2,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,"生年\n月日",null,null,"平・令",null,null,"．　　．",null,null,null,"同居・\n別居の\n区分",null,null,null,"□　同居\n□　別居",null,null,null,null,"続柄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"⑬から㉔までの計",null,null,null,null,null,null,null,null,null,null,"㉕"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"氏名"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"雑　損　控　除",null,null,null,null,null,null,null,null,null,null,"㉖"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"個人"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"医療費控除",null,null,null,null,null,null,"区分",null,null,null,"㉗"]
[]
[null,null,null,null,null,null,null,null,null,3,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,"生年\n月日",null,null,"平・令",null,null,"．　　．",null,null,null,"同居・\n別居の\n区分",null,null,null,"□　同居\n□　別居",null,null,null,null,"続柄"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"合計",null,null,null,null,null,null,null,null,null,null,"㉘"]
[null,null,null,null,null,null,null,null,null,null,null,"氏名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（㉕＋㉖＋㉗）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"地方税法附則第４条の４の規定の適用を選択する場合には、"]
[null,null,null,null,null,null,null,null,null,null,null,"個人"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「医療費控除」欄の「区分」の□に「１」と記入してください。"]
[null,null,null,null,null,null,null,null,null,null,null,"番号"]
[]
[null,null,null,null,null,"別居の扶養親族等がいる場合には、裏面「１２」に氏名、個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"扶養控除",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,5,null,"給与・公的年金等に係る所得以外（令和　　年4月1日において65歳未満の方は給与所得以外）の市町村民税・道府県民税の納税方法"]
[]
[null,null,null,null,null,"番号及び住所を記入してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"額の合計"]
[]
[]
[null,null,null,null,null,"　㉖",null,null,null,null,null,null,null,"損 害 の 原 因",null,null,null,null,null,null,null,null,null,null,"損害年月日",null,null,null,null,null,null,null,null,null,null,"損害を受けた資産の種類"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ・　　　 ・"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," □　給与から差引き  (特別徴収）"]
[null,null,null,null,null,"雑 損 控 除 "]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"損  害  金  額",null,null,null,null,null,null,null,null,null,null,"保険金などで補塡される金額",null,null,null,null,null,null,null,null,null,null,"差引損失額のうち災害関連支出の金額"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," □　自分で納付  (普通徴収）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[null,null,null,null,null,"  ㉗",null,null,null,null,null,null,null,"支 払 っ た 医 療 費 等",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"保険金などで補塡される金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"「個人番号」欄には、個人番号（行政手続きにおける特定の個人を識別するための番号の利用等に関する法律第２条第５項に規定する個人番号をいう。）を記載してください。"]
[]
[null,null,null,null,null,"医療費控除",null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[null,"裏面にも記載する欄がありますから注意してください。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（切り取らないでください。）"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和　　年度分市町村民税・道府県民税申告書受付書"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"住　所",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"受付日付印"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"氏　名"]

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[null,null,"６ 給与所得の内訳",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"裏"]
[]
[]
[null,null,"(","日給などの給与所得のある人で、源泉徴収票のない人は記入してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,")"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"７ 事業・不動産所得に関する事項"]
[]
[]
[null,null,"月",null,"日給",null,null,null,null,null,null,"勤務　日数",null,null,"月収",null,null,null,null,null,null,null,null,null,null,"所得の種類",null,null,null,null,null,"所得の生ずる場所",null,null,null,null,null,null,null,null,null,null,null,"収入金額",null,null,null,null,null,null,null,null,null,"必要経費",null,null,null,null,null,null,null,null,null,"青色申告特別控除額"]
[]
[]
[]
[null,null,1,null,"円",null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[null,null,2]
[]
[]
[]
[null,null,3]
[]
[]
[]
[null,null,4]
[]
[]
[]
[null,null,5]
[]
[]
[]
[null,null,6]
[]
[]
[]
[null,null,7]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"８ 配当所得に関する事項"]
[]
[]
[null,null,8,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"配当所得",null,null,null,null,null,"所得の生ずる場所",null,null,null,null,null,null,null,null,null,null,null,"支払確定年月",null,null,null,null,null,null,null,null,null,"収入金額",null,null,null,null,null,null,null,null,null,"必要経費"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"の種類"]
[]
[null,null,9,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[null,null,10,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・"]
[]
[]
[]
[null,null,11,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・"]
[]
[]
[]
[null,null,12,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・"]
[]
[]
[]
[null,null,"賞与等",null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"国外株式等に係\nる外国所得税額"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"９ 雑所得（公的年金等以外）に関する事項"]
[]
[null,null,"合  計"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"種　目",null,null,null,null,null,"所得の生ずる場所",null,null,null,null,null,null,null,null,null,null,null,"収入金額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"必要経費"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,0]
[]
[null,null,"勤務先所在地",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[]
[null,null,"勤務先名"]
[]
[]
[]
[]
[null,null,"電話番号"]
[]
[]
[]
[]
[]
[null,null,"10 総合譲渡・一時所得の所得金額に関する事項"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"   "]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"収入金額",null,null,null,null,null,null,null,null,null,null,null,"必要経費",null,null,null,null,null,null,null,null,null,null,null,"差引金額",null,null,null,null,null,null,null,null,null,null,null,"特別控除額",null,null,null,null,null,null,null,null,null,null,"所得金額"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(収入金額－必要経費)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(差引金額－特別控除額)"]
[]
[null,null,"総合譲渡",null,null,null,null,null,"短期",null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,"イ",null,null,null,null,null,null,"円"]
[]
[]
[]
[null,null,null,null,null,null,null,null,"長期",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ロ",null,null,null,null,null,null," "]
[]
[]
[]
[null,null,"一時",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ハ",null,null,null,null,null,null," "]
[]
[]
[]
[null,null,"　右上のイの金額を表面のコに、ロの金額を表面のサに、ハの金額を表面のシに記入してください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ニ　合計　イ＋〔(ロ+ハ)×1/2〕"]
[]
[null,null,"　右のニの金額を表面の⑪の所得金額欄へ記入してください。"]
[]
[null,null,"11 事業専従者に関する事項",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"13 事業税に関する事項"]
[]
[]
[null,null,1,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"続柄",null,null,null,null,null,"生年\n月日",null,"明・大・昭　　平・令",null,null,null,null,"．　　．",null,null,null,null,null,"専従者給与\n（控除）額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"非課税所\n得など",null,null,null,null,null,"所得金額",null,null,null,null,null,null,null,null,"円"]
[]
[]
[null,null,null,null,"氏名"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"損益通算の特\n例適用前の\n不動産所得",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[null,null,null,null,"個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"従事\n月数"]
[]
[null,null,null,null,"番号"]
[]
[null,null,2,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"続柄",null,null,null,null,null,"生年\n月日",null,"明・大・昭　　平・令",null,null,null,null,"．　　．",null,null,null,null,null,"専従者給与\n（控除）額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"事業用\n資産の\n譲渡損\n失など",null,null,null,"資産の種類"]
[]
[]
[null,null,null,null,"氏名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"損失額、被災損失額（白）",null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[null,null,null,null,"個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"従事\n月数"]
[]
[null,null,null,null,"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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"前年中の\n開廃業",null,null,null,null,null,"開始　・　廃止"]
[]
[null,null,3,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"続柄",null,null,null,null,null,"生年\n月日",null,"明・大・昭　　平・令",null,null,null,null,"．　　．",null,null,null,null,null,"専従者給与\n（控除）額"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"月　　　　　　日"]
[null,null,null,null,"氏名"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□　他都道府県の事業所等"]
[null,null,null,null,"個人",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"従事\n月数"]
[]
[null,null,null,null,"番号"]
[]
[null,null,null,null,null,null,null,"所得税における青色申告の承認の有無",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"承認あり　・　承認なし",null,null,null,null,null,null,null,null,null,"合　計　額"]
[]
[]
[]
[null,null,"12 別居の扶養親族等に関する事項"]
[]
[]
[null,null,1,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人\n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,null,"住所"]
[]
[]
[null,null,null,null,"氏名"]
[]
[]
[]
[null,null,2,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人\n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,null,"住所"]
[]
[]
[null,null,null,null,"氏名"]
[]
[]
[]
[null,null,3,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人\n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,null,"住所"]
[]
[]
[null,null,null,null,"氏名"]
[]
[]
[]
[null,null,"14 配当割額又は株式等譲渡所得割額の控除に関する事項",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"15 寄附金に関する事項"]
[]
[]
[null,null,"　 特定配当等に係る所得金額、特定株式等譲渡所得金額を総所得金額に含め、配当割額又は株式等譲渡所得割額の控除を受けようとする場合は､下の各欄に配当割額及び株式等譲渡所得割額を書き入れてください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"都道府県、市区町村分　　　　　　　　　　（特例控除対象）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"住所地の共同募金会、日赤支部分・都道府県、市区町村分（特例控除対象以外）"]
[]
[null,null,"配当割額控除額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"条例指定分",null,null,null,null,null,null,null,"都道府県"]
[]
[null,null,"株式等譲渡所得割額控除額"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"市区町村"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　支出した寄附金に応じて、各欄にそれぞれ寄附した金額を記入してください。ただし、認定特定非営利活動法人及び特例認定特定非営利活動法人に対する寄附金については、上欄に記入せず、別途「寄附金税額控除申告書（二）」を提出してください。"]
[]
[]
[]
[]
[]
[]
[]
[null,null,"16 所得金額調整控除に関する事項"]
[]
[]
[null,null,"フリ\nガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"続柄",null,null,null,null,null,"生年\n月日",null,"明・大・昭　　平・令",null,null,null,null,"．　　．",null,null,null,null,null,"特別障害者に",null,null,null,null,"級",null,null,null,null,"別居の場合"]
[]
[]
[null,null,"氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"該当する場合",null,null,null,null,"度",null,null,null,null,"の住所"]
[]
[]
[null,null,"個人"]
[]
[null,null,"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,null,null,null,null,"（切り取らないでください。）"]

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[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"市町村民税"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　　　 年度分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申告書　(分離課税等用)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"第五号の四様式別表(第二条関係)"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"道府県民税"]
[]
[null,null,"フリガナ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"生年月日",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"整理番号"]
[]
[]
[null,null,"氏　　　名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"・　　　　・"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電話番号"]
[]
[null,null,"個人番号"]
[]
[]
[]
[null,null,"　「個人番号」欄には、あなたの個人番号（行政手続における特定の個人を識別するための番号の利用等に関する法律第２条第５項に規定する個人番号をいう。）を記載してください。"]
[]
[]
[]
[]
[null,null,"２　分離課税の短期・長期譲渡所得に関する事項"]
[]
[null,null,"区分",null,null,null,"所得の生ずる場所",null,null,null,null,null,null,null,null,null,"必要経費",null,null,null,null,null,null,null,null,"差引金額",null,null,null,null,null,null,null,null,"特別控除額",null,null,null,null,null,null,null,null,null,null,"１　収　入　金　額",null,"短期譲渡",null,"一　　般　　分",null,null,null,null,null,null,null,null,"シ",null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,"この申告書(分離課税等用)は、市町村民税・道府県民税申告書と一緒に提出してください。"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(収入金額－必要経費)"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"軽　　減　　分",null,null,null,null,null,null,null,null,"ス"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"長期譲渡",null,"一 般 の 譲 渡",null,null,null,null,null,null,null,null,"セ"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"優良住宅地等",null,null,null,null,null,null,null,null,"ソ"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に 係 る 譲 渡"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"居住用財産の",null,null,null,null,null,null,null,null,"タ"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"譲　　　　　　渡"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"一般株式等の譲渡",null,null,null,null,null,null,null,null,null,null,"チ"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"上場株式等の譲渡",null,null,null,null,null,null,null,null,null,null,"ツ"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特例適用条文",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"上場株式等の配当等",null,null,null,null,null,null,null,null,null,null,"テ"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"先　 物　 取　 引",null,null,null,null,null,null,null,null,null,null,"ト"]
[]
[null,null,"３　株式等の譲渡等・先物取引に係る所得に関する事項"]
[]
[]
[null,null,"所得の種類",null,null,null,null,null,null,null,null,"種　　 目",null,null,null,null,null,null,null,null,"必　　要　　経　　費",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"５　所　得　金　額",null,"短期譲渡",null,"一　　般　　分",null,null,null,null,null,null,null,null,"㉕",null,null,"円"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"事業",null,null,"譲渡",null,null,"雑",null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"軽　　減　　分",null,null,null,null,null,null,null,null,"㉖"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"事業",null,null,"譲渡",null,null,"雑",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"長期譲渡",null,"一 般 の 譲 渡",null,null,null,null,null,null,null,null,"㉗"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,"事業",null,null,"譲渡",null,null,"雑",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"優良住宅地等",null,null,null,null,null,null,null,null,"㉘"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"に 係 る 譲 渡"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"特例適用条文",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"居住用財産の",null,null,null,null,null,null,null,null,"㉙"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"譲　　　　　　渡"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"一般株式等の譲渡",null,null,null,null,null,null,null,null,null,null,"㉚"]
[]
[null,null,"４　上場株式等の配当所得等に関する事項"]
[]
[]
[null,null,"所得の生ずる場所",null,null,null,null,null,null,null,null,null,null,"支払確定年月",null,null,null,null,null,null,null,null,null,"収入金額",null,null,null,null,null,null,null,null,null,"配当所得に係る　　負債の利子",null,null,null,null,null,null,null,null,null,null,null,null,null,"上場株式等の譲渡",null,null,null,null,null,null,null,null,null,null,"㉛"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,"上場株式等の配当等",null,null,null,null,null,null,null,null,null,null,"㉜"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"・",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"先　 物　 取　 引",null,null,null,null,null,null,null,null,null,null,"㉝"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"・"]
[]
[]
[]
[]
[]
[null,null,"６　特定支出控除の適用がある場合の給与所得に関する事項"]
[]
[]
[null,null,"Ａ　給与収入金額",null,null,null,null,null,null,null,null,null,null,null,null,"Ｂ 特定支出の金額の合計額",null,null,null,null,null,null,null,null,null,null,null,null,null,"所得金額　(Ａ－Ｂ)"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(ただし赤字の場合は０)"]
[]
[null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[]
[]
[null,null,"７　山林所得・退職所得に関する事項"]
[]
[]
[null,null,"山　　　　林",null,null,null,null,null,null,null,null,null,"Ａ　収入金額",null,null,null,null,null,null,null,null,null,null,"Ｂ　必要経費",null,null,null,null,null,null,null,null,null,null,"Ｃ　特別控除額",null,null,null,null,null,null,null,null,null,null,"Ｄ　青色申告特別控除額",null,null,null,null,null,null,null,null,null,null,null,null,null,"所得金額　(Ａ－Ｂ－Ｃ－Ｄ)"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[]
[]
[null,null,"退　　　　職",null,null,null,null,null,null,null,null,null,"Ａ　収入金額",null,null,null,null,null,null,null,null,null,"勤続年数",null,null,null,null,null,null,"普通",null,null,null,null,null,"Ｂ　退職所得控除額",null,null,null,null,null,null,null,null,null,"Ｃ　差引　(Ａ－Ｂ)",null,null,null,null,null,null,null,null,null,null,null,null,null,"所得金額　(Ｃ×１/２)"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"障害"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,"年　",null,null,null,null,null,null,"□　普通",null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,"円",null,null,null,null,null,null,null,null,null,null,null,null,null,"円"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(　 年　 月間)",null,null,null,null,null,null,"□　障害"]

{"sheet":"添付台紙","index":3,"n_rows":57,"n_cols":10,"rows_kept":57,"cut":false,"hidden":false,"merged":[[56,5,56,9],[19,4,19,10],[26,4,26,10],[33,4,33,10],[40,4,40,10],[52,5,54,9],[1,8,1,12],[3,8,5,12],[7,3,7,4],[8,3,8,4],[9,9,13,11],[10,3,10,4]]}
[]
[null,null,null,null,null,null,null,null,"　　 　　 年度分 市民税・県民税申告書"]
[]
[null,null,null,null,null,null,null,null,"添付書類台紙"]
[]
[]
[]
[null,null,null,"住　所"]
[null,null,null,"屋　号"]
[null,null,null,null,null,null,null,null,null,"　 この台紙に源泉徴収票などの書類をのりづけし、申告書と一緒に提出してください。"]
[null,null,null,"氏　名"]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,"の　り　し　ろ"]
[]
[]
[]
[]
[]
[]
[null,null,null,null,"の　り　し　ろ"]
[]
[]
[]
[]
[]
[]
[null,null,null,null,"の　り　し　ろ"]
[]
[]
[]
[]
[]
[]
[null,null,null,null,"の　り　し　ろ"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,null,null,null,null,"※ のりしろで貼りきれない大きな添付書類は、この台紙の裏面に貼ってください。"]