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{"sheet":"還付申請書","index":0,"n_rows":64,"n_cols":30,"rows_kept":64,"cut":false,"hidden":false,"merged":[[40,2,40,3],[40,4,40,6],[40,7,40,8],[40,9,40,12],[41,2,41,3],[41,4,41,6],[27,20,27,21],[34,15,34,16],[32,22,32,25],[33,15,33,16],[35,20,35,21],[32,15,32,16],[32,17,32,19],[32,20,32,21],[27,22,27,25],[33,20,33,21],[35,22,35,25],[30,15,30,16],[30,17,30,19],[30,20,30,21],[30,22,30,25],[31,15,31,16],[31,17,31,19],[31,20,31,21],[34,17,34,19],[24,2,24,3],[25,2,25,3],[26,2,26,3],[34,4,34,6],[33,4,33,6],[32,4,32,6],[33,17,33,19],[34,20,34,21],[33,9,33,12],[34,9,34,12],[30,2,30,3],[33,2,33,3],[14,29,14,39],[23,29,23,39],[32,29,32,39],[31,4,31,6],[17,4,17,9],[23,4,23,6],[23,2,23,3],[23,20,23,21],[27,9,27,12],[25,17,25,19],[24,4,24,6],[25,7,25,8],[26,7,26,8],[24,20,24,21],[29,2,29,12],[24,7,24,8],[26,4,26,6],[23,15,23,16],[22,17,22,19],[22,15,22,16],[24,15,24,16],[32,9,32,12],[27,7,27,8],[25,4,25,6],[1,7,2,18],[26,17,26,19],[25,22,25,25],[24,22,24,25],[23,22,23,25],[23,9,23,12],[24,9,24,12],[25,9,25,12],[23,17,23,19],[24,17,24,19],[26,22,26,25],[3,19,3,27],[23,7,23,8],[26,20,26,21],[25,15,25,16],[26,15,26,16],[25,20,25,21],[17,10,17,13],[26,9,26,12],[39,2,39,3],[39,4,39,6],[39,7,39,8],[42,2,42,3],[42,4,42,6],[6,3,7,5],[8,24,9,24],[6,6,7,7],[8,6,9,7],[10,5,10,22],[22,9,22,12],[22,4,22,6],[12,1,13,24],[21,15,21,25],[21,2,21,12],[8,8,9,22],[6,8,7,22],[22,22,22,25],[22,2,22,3],[22,20,22,21],[22,7,22,8],[31,22,31,25],[34,22,34,25],[33,22,33,25],[33,7,33,8],[31,2,31,3],[31,7,31,8],[32,7,32,8],[30,4,30,6],[30,7,30,8],[30,9,30,12],[35,9,35,12],[35,7,35,8],[34,2,34,3],[34,7,34,8],[32,2,32,3],[31,9,31,12],[63,29,63,39],[54,2,56,11],[54,15,56,23],[55,12,55,14],[56,12,56,14],[55,24,55,26],[56,24,56,26],[50,2,50,9],[49,2,49,9],[51,2,51,9],[51,10,51,24],[54,12,54,14],[54,24,54,26],[58,4,58,6],[57,7,57,9],[57,4,57,6],[57,2,58,3],[58,7,58,9],[57,10,58,11],[57,19,58,26],[50,18,50,25],[49,18,49,25],[50,10,50,17],[49,10,49,17],[42,7,42,8],[42,9,42,12],[43,2,43,3],[43,4,43,6],[43,7,43,8],[43,9,43,12],[62,29,62,39],[61,29,61,39],[60,29,60,39],[59,29,59,39],[60,2,61,5],[59,2,59,5],[59,6,59,26],[60,6,61,26],[42,20,42,21],[42,22,42,25],[45,20,45,21],[45,22,45,25],[44,7,44,8],[44,9,44,12],[57,17,58,18],[57,12,58,16],[39,17,39,19],[39,20,39,21],[39,22,39,25],[39,15,39,16],[41,7,41,8],[41,9,41,12],[40,20,40,21],[40,22,40,25],[41,20,41,21],[41,22,41,25],[39,9,39,12],[40,15,40,16],[40,17,40,19],[41,15,41,16],[41,17,41,19]]}
[]
[null,null,null,null,null,null,null,"廃棄物処理手数料還付請求書"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※「ファイル」タブから印刷する場合、必ず両面印刷にしてください。"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　　　年　　　月　　　日",null,null,null,null,null,null,null,null,"←請求書記入日を入力してください。（例：9/1）"]
[null,"千代田区長　様"]
[]
[null,null,null,"（請求者） ",null,null,"住所：",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"←住所・氏名欄はそれぞれ60文字以下で入力してください。"]
[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,"60文字を超える場合は、印刷後に記入してください。"]
[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,"印",null,null,null,"←法人の場合は、社判ではなく代表者印または"]
[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,"代表者の私印（シャチハタは不可）"]
[null,null,null,null,null,"（法人にあっては、事務所の所在地、名称及び代表者の氏名）"]
[]
[null,"　千代田区一般廃棄物の処理及び再利用に関する規則第４２条の規定により、廃棄物処理手数料の還付を受けたいので、下記のとおり請求します。"]
[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,"【参考】"]
[null,null,null,null,null,null,null,null,null,null,null,null,"記",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"平成12年4月～平成20年3月に購入"]
[null,"１．還付を受けようとする金額"]
[]
[null,"　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　","合計",null,{"$f":"SUM(J28,W28,J36,W36,J45,W43)","v":0},null,null,null,null,null,"(a+b+c+d+e+f)"]
[null,"(内訳）"]
[null,"(1)事業系有料ごみ処理券　（購入日に対応した欄にご記入ください）"]
[]
[null,null,"平成12年4月～平成20年3月に購入",null,null,null,null,null,null,null,null,null,null,null,null,"平成20年4月～平成25年9月に購入"]
[null,null,"券種",null,"単価",null,null,"枚数",null,"小計",null,null,null,null,null,"券種",null,"単価",null,null,"枚数",null,"小計"]
[null,null,"70ℓ",null,378,null,null,null,null,{"$f":"E24*H24","v":0},null,null,null,null,null,"70ℓ",null,427,null,null,null,null,{"$f":"R24*U24","v":0},null,null,null,null,null,null,"平成20年4月～平成25年9月に購入"]
[null,null,"45ℓ",null,243,null,null,null,null,{"$f":"E25*H25","v":0},null,null,null,null,null,"45ℓ",null,274,null,null,null,null,{"$f":"R25*U25","v":0}]
[null,null,"20ℓ",null,108,null,null,null,null,{"$f":"E26*H26","v":0},null,null,null,null,null,"20ℓ",null,122,null,null,null,null,{"$f":"R26*U26","v":0}]
[null,null,"10ℓ",null,54,null,null,null,null,{"$f":"E27*H27","v":0},null,null,null,null,null,"10ℓ",null,61,null,null,null,null,{"$f":"R27*U27","v":0}]
[null,null,null,null,null,null,null,"小計(a)",null,{"$f":"SUM(J24:M27)","v":0},null,null,null,null,null,null,null,null,null,null,"小計(b)",null,{"$f":"SUM(W24:Z27)","v":0}]
[]
[null,null,"平成25年10月～平成29年9月に購入",null,null,null,null,null,null,null,null,null,null,null,null,"平成29年10月～令和5月9月に購入"]
[null,null,"券種",null,"単価",null,null,"枚数",null,"小計",null,null,null,null,null,"券種",null,"単価",null,null,"枚数",null,"小計"]
[null,null,"70ℓ",null,483,null,null,null,null,{"$f":"E32*H32","v":0},null,null,null,null,null,"70ℓ",null,532,null,null,null,null,{"$f":"R32*U32","v":0}]
[null,null,"45ℓ",null,310,null,null,null,null,{"$f":"E33*H33","v":0},null,null,null,null,null,"45ℓ",null,342,null,null,null,null,{"$f":"R33*U33","v":0},null,null,null,null,null,null,"平成25年10月～平成29年9月に購入"]
[null,null,"20ℓ",null,138,null,null,null,null,{"$f":"E34*H34","v":0},null,null,null,null,null,"20ℓ",null,152,null,null,null,null,{"$f":"R34*U34","v":0}]
[null,null,"10ℓ",null,69,null,null,null,null,{"$f":"E35*H35","v":0},null,null,null,null,null,"10ℓ",null,76,null,null,null,null,{"$f":"R35*U35","v":0}]
[null,null,null,null,null,null,null,"小計(c)",null,{"$f":"SUM(J32:M35)","v":0},null,null,null,null,null,null,null,null,null,null,"小計(d)",null,{"$f":"SUM(W32:Z35)","v":0}]
[]
[]
[null,null,"令和5年10月以降に購入",null,null,null,null,null,null,null,null,null,null,null,"(2)有料粗大ごみ処理券"]
[null,null,"券種",null,"単価",null,null,"枚数",null,"小計",null,null,null,null,null,"券種",null,"単価",null,null,"枚数",null,"小計"]
[null,null,"70ℓ",null,609,null,null,null,null,{"$f":"E41*H41","v":0},null,null,null,null,null,"A券",null,200,null,null,null,null,{"$f":"R41*U41","v":0}]
[null,null,"45ℓ",null,391,null,null,null,null,{"$f":"E42*H42","v":0},null,null,null,null,null,"B券",null,300,null,null,null,null,{"$f":"R42*U42","v":0}]
[null,null,"20ℓ",null,174,null,null,null,null,{"$f":"E43*H43","v":0},null,null,null,null,null,null,null,null,null,null,"小計(f)",null,{"$f":"SUM(W41:Z42)","v":0},null,null,null,null,null,null,"平成29年10月～令和5年9月に購入"]
[null,null,"10ℓ",null,87,null,null,null,null,{"$f":"E44*H44","v":0}]
[null,null,null,null,null,null,null,"小計(e)",null,{"$f":"SUM(J41:M44)","v":0}]
["裏面も必ず、ご記入ください。",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(J41:M44)","v":0}]
[]
[null,"２．還付を受けようとする理由（該当するものに○をお付け下さい）"]
[]
[null,null,"①旧券のため",null,null,null,null,null,null,null,"②券種を間違えた",null,null,null,null,null,null,null,"③千代田区外に移転した"]
[null,null,"④許可業者収集に移行した",null,null,null,null,null,null,null,"⑤他区の券と間違えた",null,null,null,null,null,null,null,"⑥捨てるのを止めた",null,null,null,null,null,null,null,null,null,null,"令和5年10月以降に購入"]
[null,null,"⑦その他（理由を記載して下さい：",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,"３．還付金の振込み先口座"]
[null,null,null,null,null,null,null,null,null,null,null,null,"銀行",null,null,null,null,null,null,null,null,null,null,null,"店"]
[null,null,null,null,null,null,null,null,null,null,null,null,"信用金庫",null,null,null,null,null,null,null,null,null,null,null,"支店"]
[null,null,null,null,null,null,null,null,null,null,null,null,"信用組合",null,null,null,null,null,null,null,null,null,null,null,"出張所"]
[null,null,"預金\n種目",null,"1.普通",null,null,"2.当座",null,null,"口座\n番号",null,null,null,null,null,null,"請求者の電話番号"]
[null,null,null,null,"3.貯蓄"]
[null,null,"フリガナ",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,"○を付ける部分にお使いください。"]
[null,null,"口座名義",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,"←２．還付を受けようとする理由の数字の部分　　　"]
[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,"←３．還付金の振込先口座の銀行種別"]
[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,"←〃店名種別"]
[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,"←〃預金種目"]

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["申出書"]
[]
[null,null,null,null,null,null,null,null,null,null,{"$f":"IF(還付申請書!T4=0,\"\",還付申請書!T4)","v":"　　　年　　　月　　　日"}]
[]
["千代田区長　　殿"]
[]
[null,null,null,"（請求者）",null,"住所",{"$f":"IF(還付申請書!I7=0,\"\",還付申請書!I7)","v":""}]
[]
[null,null,null,null,null,"氏名",{"$f":"IF(還付申請書!I9=0,\"\",還付申請書!I9)","v":""}]
[]
[null,null,null,null,"(法人にあっては、事務所の所在地、名称及び代表者の氏名)"]
[null,null,null,null,null,"担当部署名"]
[null,null,null,null,null,"担当者氏名"]
[null,null,null,null,null,"電話番号"]
[]
[]
[]
["還付請求のごみ処理券については、下記(別紙)のとおり購入したことに相違ありません。"]
[]
[]
["記"]
[]
["１　購入時期"]
[]
[null,null,null,"年",null,"月頃"]
[null,null,null,"年",null,"月頃"]
[null,null,null,"年",null,"月頃"]
[null,null,null,"年",null,"月頃"]
[]
["２　購入場所"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,"○を付ける部分にお使いください。"]
["３　領収書が添付できない理由",null,null,null,null,null,null,null,null,null,null,null,null,null,"←領収書が添付できない理由\n数字の部分"]
[null,"（該当する項目に○をしてください。その他の場合は、具体的に理由もお書きください。）"]
[]
[null,"①","紛失した"]
[null,"②","廃棄した"]
[null,"③","その他"]
[null,null,"(理由を記入してください：",null,null,null,null,null,null,null,null,null,"）"]

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[null,"第１１号様式（第４２条関係）",null,null,null,null,null,null,null,null,null,"麹・富・神・公・万・和・総・車・清",null,null,null,null,null,null,null,null,null,null,null,"№　",null,null,null,null,null,"申出書（記入例）"]
[null,null,null,null,null,null,null,"廃棄物処理手数料還付請求書"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"(記入例）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"令和",null,"○","年","○","月","○","日"]
[null,"千代田区長　様",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,"千代田区長　　殿"]
[]
[null,null,null,"（請求者） ",null,null,"住所：",null,"千代田区九段南１－６－１１",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"（請求者）",null,"住所",{"$f":"I7","v":"千代田区九段南１－６－１１"}]
[]
[null,null,null,null,null,null,"氏名：",null,"千代田商事（株）\n代表取締役社長 九段　花子　　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"印",null,null,null,null,null,null,null,null,null,"氏名",{"$f":"I9","v":"千代田商事（株）\n代表取締役社長 九段　花子　　"}]
[]
[null,null,null,null,null,"（法人にあっては、事務所の所在地、名称及び代表者の氏名）",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,"(法人にあっては、事務所の所在地、名称及び代表者の氏名)"]
[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,"担当部署名",null,"企画部　総務課"]
[null,"　千代田区一般廃棄物の処理及び再利用に関する規則第４２条の規定により、廃棄物処理手数料の還付を受けたいので、下記のとおり請求します。",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,"担当者氏名",null,"麹町　太郎"]
[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,"電話番号",null,"０３-〇〇〇〇-〇〇〇〇"]
[null,null,null,null,null,null,null,null,null,null,null,null,"記"]
[null,"１．還付を受けようとする金額"]
[null,null,"合計　\\25,948",null,null,null,null,null,"（a+b+c+ｄ+e)"]
[null,"（内訳）",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,"還付請求のごみ処理券については、下記(別紙)のとおり購入したことに相違ありません。"]
[]
[null,"(1)事業系有料ごみ処理券　（購入日に対応した欄にご記入ください）"]
[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,"記"]
[null,null,"平成12年4月～平成20年3月に購入",null,null,null,null,null,null,null,null,null,null,null,null,"平成20年4月～平成25年9月に購入"]
[null,null,"券種",null,"単価",null,null,"枚数",null,"小計",null,null,null,null,null,"券種",null,"単価",null,null,"枚数",null,"小計",null,null,null,null,null,null,"１　購入時期"]
[null,null,"70ℓ",null,"\\",378,null,10,null,"\\",3780,null,null,null,null,"70ℓ",null,"\\",427,null,32,null,"\\",13664]
[null,null,"45ℓ",null,"\\",243,null,null,null,"\\",null,null,null,null,null,"45ℓ",null,"\\",274,null,12,null,"\\",3288,null,null,null,null,null,null,"平成",14,"年",10,"月頃"]
[null,null,"20ℓ",null,"\\",108,null,null,null,"\\",null,null,null,null,null,"20ℓ",null,"\\",122,null,10,null,"\\",1220,null,null,null,null,null,null,"平成",22,"年",6,"月頃"]
[null,null,"10ℓ",null,"\\",54,null,15,null,"\\",810,null,null,null,null,"10ℓ",null,"\\",61,null,null,null,"\\",null,null,null,null,null,null,null,"平成",25,"年",12,"月頃"]
[null,null,null,null,null,null,null,"小計(a)",null,"\\",4590,null,null,null,null,null,null,null,null,null,"小計(b)",null,"\\",18172,null,null,null,null,null,null,"令和",2,"年",9,"月頃"]
[]
[null,null,"平成25年10月～平成29年9月に購入",null,null,null,null,null,null,null,null,null,null,null,null,"平成29年10月以降に購入",null,null,null,null,null,null,null,null,null,null,null,null,null,"２　購入場所"]
[null,null,"券種",null,"単価",null,null,"枚数",null,"小計",null,null,null,null,null,"券種",null,"単価",null,null,"枚数",null,"小計",null,null,null,null,null,null,null,"○○商店、○○薬局、○○町のコンビニ"]
[null,null,"70ℓ",null,"\\",483,null,null,null,"\\",null,null,null,null,null,"70ℓ",null,"\\",532,null,null,null,"\\"]
[null,null,"45ℓ",null,"\\",310,null,null,null,"\\",null,null,null,null,null,"45ℓ",null,"\\",342,null,4,null,"\\",1368]
[null,null,"20ℓ",null,"\\",138,null,null,null,"\\",null,null,null,null,null,"20ℓ",null,"\\",152,null,null,null,"\\",null,null,null,null,null,null,"３　領収書が添付できない理由"]
[null,null,"10ℓ",null,"\\",69,null,2,null,"\\",138,null,null,null,null,"10ℓ",null,"\\",76,null,5,null,"\\",380,null,null,null,null,null,null,"（該当する項目に○をしてください。その他の場合は、具体的に理由もお書きください。）"]
[null,null,null,null,null,null,null,"小計(c)",null,"\\",138,null,null,null,null,null,null,null,null,null,"小計(d)",null,"\\",1748]
[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,"①","紛失した"]
[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,"②","廃棄した"]
[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,"③","その他"]
[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,"(理由を記入してください：",null,null,null,null,null,null,null,null,null,"）"]
[null,"(2)有料粗大ごみ処理券"]
[null,null,"券種",null,"単価",null,null,"枚数",null,"計",null,null,null,"　",null,null,null,null,null,null,null,null,null,"　"]
[null,null,"A券",null,"\\",200,null,2,null,"\\",400]
[null,null,"B券",null,"\\",300,null,3,null,"\\",900]
[null,null,null,null,null,null,null,"小計(e)",null,"\\",1300]
[]
[]
[]
[]
[]
[]
[null,"裏面も必ず、ご記入ください。"]
[]
[]
[]
[null,"２．還付を受けようとする理由（該当するものに○をお付け下さい）"]
[null,null,"①","旧券のため",null,null,null,null,null,null,null,"②","券種を間違えた",null,null,null,null,null,"③","千代田区外に移転した"]
[null,null,"④","許可業者収集に移行した",null,null,null,null,null,null,null,"⑤","他区の券と間違えた",null,null,null,null,null,"⑥","捨てるのを止めた"]
[null,null,"⑦","その他（理由を記載して下さい：　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　）"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"　",null,null,null,null,null,null,null,null,null,"　"]
[null,"３．還付金の振込み先口座"]
[null,null,"千代田環境",null,null,null,null,null,null,null,null,"銀行",null,null,"九段下",null,null,null,null,null,null,null,null,null,"店"]
[null,null,null,null,null,null,null,null,null,null,null,"信用金庫",null,null,null,null,null,null,null,null,null,null,null,null,"支店"]
[null,null,null,null,null,null,null,null,null,null,null,"信用組合",null,null,null,null,null,null,null,null,null,null,null,null,"出張所"]
[null,null,"預金",null,"　１．普通　",null,null,"　２．当座",null,null,"口座",null,1234567,null,null,null,null,"電話\n番号",null,"03-1234-5678"]
[null,null,"種目",null,"　３．貯蓄　",null,null,null,null,null,"番号"]
[null,null,"フリガナ",null,null,null,"　チヨダショウジ（カ　ダイヒョウトリシマリヤクシャチョウ　クダン ハナコ"]
[null,null,"口座名義",null,null,null," 千代田商事（株）\n代表取締役社長　　九段　花子　"]