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["別記様式第６号(第８条関係)"]
[null,null,null,null,"保育停止申立書"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,"日付"]
[]
["文京区長殿"]
["保護者",null,null,"住所"]
[null,null,null,"氏名\n（自署又は\n記名押印）",null,"ﾌﾘｶﾞﾅ",null,null,null,null,null,null,"電話番号（昼間連絡先）"]
[]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ",null,null,null,null,null,null,"電話番号（昼間連絡先）"]
[]
["児童\n（生年月日）",null,null,"ﾌﾘｶﾞﾅ",null,null,null,null,"生年月日",null,null,null,null,null,null,"保育園"]
[]
[null,null,null,"ﾌﾘｶﾞﾅ",null,null,null,null,"生年月日",null,null,null,null,null,null,"保育園"]
[]
[null,null,null,"ﾌﾘｶﾞﾅ",null,null,null,null,"生年月日",null,null,null,null,null,null,"保育園"]
[]
[]
["　文京区保育所における保育に関する条例施行規則第８条第１項の規定により、下記のとおり保育停止を申し立てます。"]
[]
[]
["記"]
[]
["１　理由",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"文京区 町名 〇丁目〇番〇－〇号"]
[null,"（１） 出産　　　　　　※　母子手帳の出産予定日のページのコピーをご提出ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,{"$f":"IF(COUNTIF(R26:R28,TRUE)=1,2,1)","v":1}]
[null,"（２） 在園児の傷病　　※　診断書をご提出ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false]
[null,"（３） その他",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false]
[]
["２　期間"]
["　　　　　　　年　　　月　　　日から　　　　　年　　　月　　　日まで",null,null,null,null,"から"]
[]
["３　停止中の住所及び連絡先"]
["住所",null,null,null,null,null,null,null,null,null,null,null,"連絡先"]
[]
["　確認欄"]
["１　保育の停止は、年度で最大２か月までです。"]
["２　保育の停止は、月単位となります。停止中に登園された場合は、停止が解除され、１か月分\n　の保育料が発生します。"]
[]
["３　停止期間後、登園されない場合は、退園となります。"]
["保護者氏名"]
[null,null,null,null,null,null,null,"（自署又は記名押印）"]