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["様式第10号（R4.12.2改正）"]
["労働移動支援助成金（早期雇入れ支援コース）支給申請書"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申請日",null,null,null,null,null,"年",null,"月",null,"日"]
[]
[null,null,null,null,null,"労　働　局　長　　殿",null,null,null,null,null,null,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　主",null,null,"所在地"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"名称"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　","代表者氏名"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（","〒",null,null,null,null,null,"）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"代　理　人",null,null,"所在地"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"名称"]
[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,null,null,null,null,null,null,null,null,null,null,null,"（提出代行者・",null,null,"所在地"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"　事務代理者）",null,null,"名称"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"社会保険労務士",null,null,"氏名"]
[]
["　労働移動支援助成金（早期雇入れ支援コース）の支給を受けたいので別紙を添付のうえ、次のとおり申請します。"]
[]
[1,"事業所の名称"]
[]
[2,"事業所の所在地",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,"電話番号",null,null,null,null,null,"－",null,null,"－"]
[3,"雇用保険適用事業所番号",null,null,null,null,null,null,null,null,null,null,null,"－",null,null,null,null,null,null,"－"]
[4,"労働保険番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"－"]
[5,"事業内容"]
[]
[null,null,null,null,null,null,null,null,null,"産業分類",null,null,"大分類",null,null,null,null,null,null,null,null,null,null,"中分類"]
[6,"支給申請額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円","（対象者数　　　　　人）"]
[null,"うち人材育成支援分申請額",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円","（対象者数　　　　　人）"]
[7,"国・地方公共団体の補助金等の申請の有無",null,null,null,null,null,null,null,null,null,null,null,null,"有",null,"（名称",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"）",null,"無"]
[8,"事業主都合による\n解雇等の有無",null,null,null,null,null,null,null,"対象者の雇入れ日の前日から起算して６か月前の日から１年を経過した日までの間に事業主都合による解雇等（退職勧奨を含む。）を行ったことの有無",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有",null,"無"]
[]
["※賃金上昇加算及び優遇助成による申請を希望される場合のみ、太枠内（9（賃金上昇加算がある場合のみ）、10及び11）を記載してください。"]
[9,"賃金上昇加算該当",null,null,null,null,null,null,null,null,"該当あり"]
[10,"区分",null,null,null,null,null,null,null,null,"優遇助成",null,null,null,null,null,null,null,null,null,"優遇助成（新型コロナウイルス感染症対応）"]
[11,null,"(1)","直近の会計年度と3年度前を比較した売上高が５％以上伸びていること。",null,null,null,null,null,null,null,"売上高を\n記載",null,null,"Ａ","（　　）年度\n※Bの３年度前",null,null,null,"Ｂ","（　　）年度\n※直近の会計年度　",null,null,null,"Ｃ",null,null,"（Ｂ－Ａ）/Ａ","添付書類",null,null,null,"※確認欄"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"千円",null,null,null,null,"千円",null,null,null,"％　"]
[null,null,"(2)"," ローカルベンチマークの財務分析結果（総合評価点）がＢ以上であること。",null,null,null,null,null,null,null,"該当する\n財務分析\n結果に○",null,null,null,"Ａ",null,"Ｂ",null,"Ｃ",null,"Ｄ"]
[null,null,"(3)","直近の会計年度と3年度前を比較した生産性の伸び率が6％以上であること。(※1）",null,null,null,null,null,null,null,"生産性の伸び率を記載",null,null,null,null,null,null,"％　"]
[null,null,"(4)","(1)～(3)に該当しないが、優遇助成を希望する場合\n(※1、2）",null,null,null,null,null,null,null,"生産性の伸び率を記載",null,null,null,null,null,null,"％　","申請事業主の与信取引状況等について\n金融機関へ照会することについて",null,null,null,null,null,null,null,null,null,"同意する"]
[null,"(※1）生産性の算定対象となった期間中に、雇用している労働者を事業主都合によって解雇等（退職勧奨を含む）をしていないことが必要です。"]
[null,"(※2)(1)～(3)に該当しない場合であっても、(3)の生産性の伸び率が１％以上６％未満であり、申請事業主の承諾の上で金融機関が行う与信取引状況や企業の事業に関する見立てを参考に、当該企業の成長性・将来性が見込まれるものと労働局長が判断した場合には、優遇助成の対象と見なします。"]
[]
[12,"申請に関する担当者",null,null,null,null,null,null,null,"所属",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,"氏名",null,null,null,null,null,null,null,null,null,null,null,"E-MAIL",null,null,null,null,null,null,"＠"]
[]
[]
[]
["※","処　理　欄"]
["局長",null,null,"部長",null,null,"課長",null,"課長補佐",null,null,null,"職業指導官",null,null,null,null,"係長",null,"担当",null,null,"受理年月日",null,null,null,null,null,null,null,"年",null,"月",null,"日"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"起案年月日",null,null,null,null,null,null,null,"年",null,"月",null,"日"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支給（不支給）決定年月日",null,null,null,null,null,null,null,"年",null,"月",null,"日"]
["所長",null,"部長・次長",null,null,null,null,"課長・統括",null,null,null,"上席・係長",null,null,null,null,"職業指導官",null,null,"担当",null,null,"支給決定番号",null,null,null,null,"第",null,null,null,null,null,null,"号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支給決定額",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,"通知書発送年月日",null,null,null,null,null,null,null,"年",null,"月",null,"日"]
[null,"記載にあたっては、裏面の記入上の注意を必ずご覧ください。"]
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