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{"sheet":"別記様式3","index":0,"n_rows":50,"n_cols":29,"rows_kept":50,"cut":false,"hidden":false,"merged":[[5,19,5,21],[45,11,46,25],[2,3,2,25],[26,9,27,18],[26,19,27,28],[24,9,25,21],[28,9,29,18],[28,19,29,28],[30,9,31,18],[30,19,31,28],[32,9,33,18],[32,19,33,28],[5,23,5,24],[5,26,5,27],[39,5,40,28],[12,16,12,26],[12,12,12,15],[36,19,37,28],[18,1,21,28],[36,9,37,18],[24,1,24,8],[25,1,25,8],[32,1,32,8],[31,1,31,8],[26,1,30,8],[33,1,37,8],[34,19,35,28],[34,9,35,18],[13,16,13,26],[49,1,51,28],[6,1,6,6],[9,17,9,19],[9,21,9,24],[10,16,10,28],[14,12,14,15],[8,12,8,15],[11,16,11,28],[14,16,14,18],[14,20,14,22],[14,24,14,26],[8,17,8,21],[8,23,8,27],[12,27,12,28],[9,12,9,15],[10,12,10,15]]}
[null,"別記様式３"]
[]
[null,null,null,"ＥＴＣコーポレートカード受取書"]
[]
[]
[null,"西日本高速道路株式会社",null,null,null,null,null,null,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,"殿"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"お客様番号",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,"お客様の",null,null,null,"〒",null,null,null,"‐"]
[null,null,null,null,null,null,null,null,null,null,null,null,"おところ"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"お名前※",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"ＴＥＬ",null,null,null,null,null,null,"‐",null,null,null,"‐"]
[null,null,null,null,null,null,null,null,null,null,null,null,"（※）",null,"法人（事業協同組合を含みます。）でお申込みの場合は、"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"法人名および代表者名を記入してください。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null," "]
[null,"私は、ＥＴＣコーポレートカードの引渡しを受けましたので、利用約款第６条第３項に基づき、下記のとおり受取書を提出いたします。"]
[]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"記"]
[null,"①受け取ったＥＴＣ"]
[null,"コーポレートカードの枚数",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"枚"]
[null,"\n",null,null,null,null,null,null,null,"（始）",null,null,null,null,null,null,null,null,null,"（終）"]
[]
[]
[]
[]
[null,"②受け取ったＥＴＣ"]
[null,"コーポレートカードの番号"]
[]
[]
[]
[]
[]
[]
[null,"(注)",null,"②","…","別途当社が通知した「ETCコーポレートカード発行明細書」の写しを添付していただくことも可能です。"]
[]
[]
[]
[]
[]
[null,"受取りにこられた方のお名前"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印"]
[]
[]
[null,"入力漏れチェック未了\r\n（「入力漏れチェック」を押してください。）"]