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["別紙様式５"]
[]
["特別な事情に係る届出書（令和",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年度）"]
[]
["基本情報"]
[]
["フリガナ"]
["法人名"]
["法人所在地",null,null,null,null,null,"〒"]
[]
[]
["フリガナ"]
["書類作成担当者"]
["連絡先",null,null,null,null,null,"電話番号",null,null,null,null,null,null,null,null,null,null,null,null,null,"E-mail"]
[]
["１．事業の継続を図るために、介護職員等の賃金を引き下げる必要がある状況について"]
["当該法人の収支（介護事業に限る。）について、サービス利用者数の大幅な減少などにより経営が悪化し、一定期間にわたり収支が赤字である、資金繰りに支障が生じるなどの状況について記載"]
[]
[]
["２．賃金水準の引き下げの内容"]
[]
[]
["３．経営及び賃金水準の改善の見込み"]
[]
["※","経営及び賃金水準の改善に係る計画等を提出し、代替することも可。"]
[]
["４．賃金水準を引き下げることについて、適切に労使の合意を得ていること等について"]
["労使の合意の時期及び方法等について記載"]
[]
[]
[]
[null,null,"令和",null,null,null,"年",null,null,"月",null,null,"日",null,null,null,null," （法人名）",null,null,null,null," "]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," （代表者名）"]