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["様式第12号（R4.12.2改正）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（",null,"枚中",null,null,"枚目",null,"）"]
["労働移動支援助成金（早期雇入れ支援コース）Off-JT実施状況報告書"]
[]
["１","訓練計画番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"３","訓練の実施機関\n（実施場所）"]
[]
["２","受講者氏名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"４","訓練の名称",null,null,null,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","Off-JTの総訓練受講時間数",null,null,null,null,null,null,null,null,null,null,null,"時間",null,null,null,null,null,null,"分"]
[]
[]
["６","実施日",null,null,null,null,"７","実施内容等"]
[null,null,null,null,null,null,"訓練実施時間帯\n（うち除外時間数）",null,null,null,null,null,null,null,null,null,null,null,null,null,"実訓練時間数",null,null,null,null,null,null,null,"受講時間数",null,null,null,null,null,null,null,"実施内容"]
[]
[null,null,"月",null,null,"日",null,null,"時",null,null,"分","～",null,null,"時","時",null,null,"分",null,null,null,"時間",null,null,null,"分",null,null,null,"時間",null,null,null,"分"]
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["（",null,null,"曜日",null,"）"]
[null,null,null,null,null,null,"（",null,null,null,"時間",null,null,null,null,"分","分",null,null,"）"]
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[null,null,"月",null,null,"日",null,null,"時",null,null,"分","～",null,null,"時","時",null,null,"分",null,null,null,"時間",null,null,null,"分",null,null,null,"時間",null,null,null,"分"]
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["（",null,null,"曜日",null,"）"]
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[null,null,"月",null,null,"日",null,null,"時",null,null,"分","～",null,null,"時","時",null,null,"分",null,null,null,"時間",null,null,null,"分",null,null,null,"時間",null,null,null,"分"]
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["（",null,null,"曜日",null,"）"]
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[null,null,"月",null,null,"日",null,null,"時",null,null,"分","～",null,null,"時","時",null,null,"分",null,null,null,"時間",null,null,null,"分",null,null,null,"時間",null,null,null,"分"]
[]
["（",null,null,"曜日",null,"）"]
[null,null,null,null,null,null,"（",null,null,null,"時間",null,null,null,null,"分","分",null,null,"）"]
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[null,null,"月",null,null,"日",null,null,"時",null,null,"分","～",null,null,"時","時",null,null,"分",null,null,null,"時間",null,null,null,"分",null,null,null,"時間",null,null,null,"分"]
[]
["（",null,null,"曜日",null,"）"]
[null,null,null,null,null,null,"（",null,null,null,"時間",null,null,null,null,"分","分",null,null,"）"]
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[null,null,"月",null,null,"日",null,null,"時",null,null,"分","～",null,null,"時","時",null,null,"分",null,null,null,"時間",null,null,null,"分",null,null,null,"時間",null,null,null,"分"]
[]
["（",null,null,"曜日",null,"）"]
[null,null,null,null,null,null,"（",null,null,null,"時間",null,null,null,null,"分","分",null,null,"）"]
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[null,null,"月",null,null,"日",null,null,"時",null,null,"分","～",null,null,"時","時",null,null,"分",null,null,null,"時間",null,null,null,"分",null,null,null,"時間",null,null,null,"分"]
[]
["（",null,null,"曜日",null,"）"]
[null,null,null,null,null,null,"（",null,null,null,"時間",null,null,null,null,"分","分",null,null,"）"]
[]
[]
["６欄及び７欄のとおり訓練を実施したことを証明します。"]
["８","訓練実施者の証明",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日",null,null,"９","申請事業主の証明\n（事業主又は訓練実施責任者）",null,null,null,null,null,null,null,null,null,null,null,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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"６欄及び７欄のとおり訓練を受講したことを証明します。"]
[null,"訓練実施機関名",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,"役職名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,10,"訓練受講者の証明\n（本人直筆の署名）",null,null,null,null,null,null,null,null,null,null,null,null,null,"年",null,null,"月",null,null,"日"]
[]
[null,"又は講師名",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,"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,"氏名"]
[]
[]
[]
["様式第12号〔ＯＦＦ－ＪＴ実施状況報告書〕（裏面）"]
[]
["記入上の注意"]
[]
["１",null,"この様式は、OFF-JTによる訓練の実施状況について、訓練の受講者及び訓練の実施機関ごとに作成してください。"]
["２",null,"１欄は、労働局長の認定を受けた職業訓練計画（様式第２号）で記入した番号を記入してください。"]
["３",null,"３欄には、事業外訓練を実施する場合は教育訓練施設等の名称を記載し、事業内訓練で外部講師を招聘して実施する場合は「事業内訓練（外部講師）」と記載の上、外部講師の所属と氏名を記載し、事業内訓練を自ら雇用する従業員を講師として実施する場合は「事業内訓練」と記載してください。"]
["４",null,"４欄は、労働局長の認定を受けた職業訓練計画（様式第２号）に記入した訓練の名称を記入してください。"]
["５",null,"５欄には、全ての実施日の受講時間数を合計した時間数を記載してください。"]
["６",null,"７欄「訓練実施時間帯」には、訓練実施日における訓練等の開始時間と終了時間を記載してください。"]
["７",null,"７欄「うち除外時間数」には、昼食等の食事を伴う休憩時間・移動時間・助成対象とならないカリキュラム等の時間等の合計を記載してください。"]
["８",null,"７欄「実訓練時間数」には、当該日の訓練時間数から除外時間数を差し引いた時間数を記載してください。"]
["９",null,"７欄「受講時間数」には、実訓練時間数のうち受講者が受講した時間数を記載してください。"]
["10",null,"７欄「実施内容」には、訓練の実施内容を記載してください。なお、訓練等を受講していない時間がある場合は、その時間帯及び内容を当欄に記載してください。"]
[11,null,"８欄には、訓練を実施した教育訓練施設等の名称又は訓練を実施した外部講師の所属と名称を記載してください。"]
[12,null,"10欄には、訓練の受講者が直筆で署名してください。"]
[13,null,"欄が不足する場合は、様式第12号（継紙）に記載し、本紙に添付してください。"]
[14,null,"６欄及び７欄について、他の書類により証明できる場合は、それらの書類の提出により、本様式への記載に代えることができます。"]
[15,null,"訓練受講者が支給対象と認められた訓練計画における計画時間数の８割以上受講していない場合には助成の対象となりません。"]
["　※",null,"「OFF-JT」とは、生産ライン又は就労の場における通常の生産活動と区別して業務の遂行の過程外で行われる職業訓練のことをいいます。"]
[]
[]
[]
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