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[]
[null,"　　建退共事務受託様式第５号"]
[null,"被共済者就労状況報告書（日別報告様式）"]
[]
[null,"提出先共済契約者番号",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,"整理番号"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"殿",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"","報告日"]
[]
[null,"報告事業所名"]
[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,"掛金納付についての\n事務を委託します。"]
[null,"電話番号"]
[null,"共済契約者番号",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,"就労実績の集計に建設\nキャリアアップシステムを\n活用しています。"]
[null,"建設キャリアアップシステム"]
[null,"事業者ⅠD"]
[null,"工事番号および\n工事名"]
[null,"工事コード",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"現場責任者確認"]
[null,"建設キャリアアップシステム"]
[null,"現場ⅠD"]
[null,"備考"]
[]
[null,"（契約者番号）",null,null,null,null,null,null,null,null,null,null,null,null,null,"（契約者番号）"]
[null,"元請事業所名",null,null,null,null,null,null,null,null,null,null,null,null,null,"一次事業所名"]
[null,"次の表のとおり、就労実績を報告します。"]
[null,null,"CCUS情報"]
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[null,"　※　建設キャリアアップシステム登録技能者は、ＣＣＵＳ欄に「○」印を記載"]