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[]
[]
[null,"住信SBIネット銀行　行"]
[]
["加盟申込書兼端末設置申込書"]
[]
[]
[]
[null,"以下の確認事項について、必ず同意の上お申込みください。"]
[null,"　・本申込書は、クレジットカード等を使用した信用販売を行うため、弊社に加盟を申し込むことを目的としたクレジットカード決済サービス加盟申込書です。"]
[]
[null,"　・お申込みになるお客さまは、別紙に定める「住信SBIネット銀行カード加盟店規約（対面店用）」、「加盟店情報の取り扱いに関する同意条項」、「反社会的勢力ではないことの表明及び確約」、「端末売買基本規約」に同意のうえ、必要事項をご記入ください。"]
[]
[]
[]
[null,"　・審査過程において、弊社よりご連絡する場合がございます。また、別途必要書類（登記事項証明書・店舗写真など）をご提出いただく場合がございます。"]
[null,"　・各決済につきましては弊社指定の端末を経由する必要があり手書き伝票等、別手段での決済は受け付けておりません。"]
[]
[]
[null,"お申込日",null,null,null,null,null,"西暦",null,null,null,null,"年",null,null,"月",null,null,"日"]
[]
[]
[]
[null,"会社情報",null,null,null,"ﾌﾘｶﾞﾅ（半角）",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,"選択可能なお支払方法・\nご精算サイクル",null,null,null,"選択可能なお支払方法",null,null,null,null,null,null,null,null,null,null,"　一括払い",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※原則、選択可能なお支払方法は「一括払い」のみとなります。\n※その他支払方法をご希望の場合は別途お問合せ下さい。\n　利用可否につきましては弊社で審査の上、判断いたします。"]
[null,null,null,null,null,"会社名（全角）"]
[]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ（半角）"]
[null,null,null,null,null,"本社所在地（全角）",null,null,null,null,null,null,"〒",null,null,"-",null,null,null,"（＊郵便番号は半角でご入力ください）",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,"ご精算サイクル",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"①月1回払い\n・末日〆：翌月末日支払\n②月2回払い\n・15日〆:末日支払　/　末日〆:翌15日支払",null,null,null,null,null,null,null,null,null,null,"＊ご精算サイクル（売上代金の入金サイクル）は左記のみと\nなります。（支払い方法にご要望がある場合は、ご相談ください）"]
[]
[]
[null,null,null,null,null,"電話番号（半角）",null,null,null,null,null,null,null,null,null,"-",null,null,null,"-",null,null,null,null,"設立年月日",null,null,null,null,null,null,"西暦",null,null,null,null,"年",null,null,"月",null,null,"日"]
[null,null,null,null,null,"URL（半角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"個人・法人区分",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ヒアリング\n項目",null,null,null,"確認事項"]
[null,null,null,null,null,"メールアドレス（半角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"法人番号（半角、13ケタ）\n＊法人の場合"]
[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,null,null,null,"■下記の項目に該当しないことを、必ず確認の上お申込みください。（＊該当がある場合、本サービスにはお申込みいただけません）"]
[null,null,null,null,null,"業種業務内容（全角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"取扱商品（全角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"✔　「訪問販売」をしている"]
[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,null,null,null,null,"✔　「電話勧誘販売」をしている"]
[null,"代表者情報",null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"姓",null,null,null,null,null,"名",null,null,null,null,null,"代表者役職名（全角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"✔　「連鎖販売取引」をしている"]
[null,null,null,null,null,"代表者氏名（全角）",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,"✔　「業務提携誘因販売」をしている"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"✔　「直近5年間の特定商取引法による行政処分」を受けている"]
[null,null,null,null,null,"代表者生年月日",null,null,null,null,null,null,"西暦",null,null,null,null,"年",null,null,"月",null,null,"日","代表者電話番号（半角）",null,null,null,null,null,null,null,null,null,"－",null,null,null,"－",null,null,null,null,null,null,null,null,null,null,"✔　「消費者契約法違反の行為を理由とした民事上の敗訴判決」を受けている"]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ（半角）"]
[null,null,null,null,null,"代表者住所（全角）",null,null,null,null,null,null,"〒",null,null,"-",null,null,null,"（＊郵便番号は半角でご入力ください）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"導入メニュー",null,null,null,"クレジットカード",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,"＊「VISA」・「Mastercard」のお申込みとなります。"]
[]
[]
[]
[null,"■弊社よりご連絡させていただく際、窓口となるご担当者さまの情報をご入力ください。"]
[null,"担当者情報①",null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"姓",null,null,null,null,null,"名",null,null,null,null,null,"電話番号（半角）",null,null,null,null,null,null,null,null,null,"－",null,null,null,"－"]
[null,null,null,null,null,"担当者氏名（全角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メールアドレス（半角）"]
[]
[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,"設置端末",null,null,null,"・端末代金は1台につき23,100円(税込)になります。"]
[null,"■経理ご担当者さまの情報をご入力ください。（＊支払明細書の送付等、精算に関するご連絡は「経理ご担当者」さま宛てにご連絡申し上げます。）"]
[null,"担当者情報②",null,null,null,"経理ご担当者さまの有無"]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"姓",null,null,null,null,null,"名",null,null,null,null,null,"電話番号（半角）",null,null,null,null,null,null,null,null,null,"－",null,null,null,"－"]
[null,null,null,null,null,"経理担当者氏名（全角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"メールアドレス（半角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申込台数",null,null,null,null,null,null,null,null,null,"台",null,null,null,null,null,null,null,null,null,null,null,"※対応レシートプリンターのご案内\n\n対応のレシートプリンターをご用意いただけますと、レシート（クレジットカード利用控え）を印刷してお渡しいただくことが可能です。\nプリンター製品をお取扱いのウェブサイト等にて、お買い求め願います。\n\n■製品情報\n　(セイコーインスツル株式会社)\n　　モバイル型レシート\n　　プリンター「MP-B20」"]
[]
[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,null,null,null,"■製品情報\n(Miura Systems株式会社)\n　M010\n■接続端末について\niPad / iPhoneもしくはAndroid端末を\nお客さまにご用意いただき、専用アプリ\n（無料）をインストールいただく必要が\nございます。"]
[null,"店舗情報",null,null,null,"ﾌﾘｶﾞﾅ（半角）"]
[null,null,null,null,null,"店舗名-漢字表記\n（全角）"]
[]
[null,null,null,null,null,"店舗名-英語表記\n（半角）"]
[]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ（半角）"]
[null,null,null,null,null,"店舗住所（全角）",null,null,null,null,null,null,"〒",null,null,"-",null,null,null,"（＊郵便番号は半角でご入力ください）"]
[]
[]
[null,null,null,null,null,"店舗電話番号（半角）",null,null,null,null,null,null,null,null,null,"-",null,null,null,"-",null,null,null,null,"事業所区分"]
[null,null,null,null,null,"店舗売上高（半角）",null,null,null,null,null,null,"年間",null,null,null,null,null,null,null,null,null,"円",null,"平均ご利用単価",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"円",null,null,"セキュリティ面",null,null,null,"カード情報保持状況",null,null,null,null,null,null,"非保持",null,null,null,null,null,null,null,"非保持化予定年月\n＊「非保持化の予定あり」の場合",null,null,null,null,null,null,"西暦",null,null,null,null,"年",null,null,"月",null,null,"日","＊左記以外の場合は、\n項目内容を変更ください。"]
[null,null,null,null,null,"業種（全角）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"許可証/免許証番号（※1）\n（無い場合は「無し」と入力）"]
[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,null,null,null,"PCIDSS準拠状況",null,null,null,null,null,null,"準拠予定なし",null,null,null,null,null,null,null,"PCIDSS準拠予定年月\n＊「準拠予定あり」の場合",null,null,null,null,null,null,"西暦",null,null,null,null,"年",null,null,"月",null,null,"日"]
[null,"（※1）許可証/免許証番号がある場合はご記入ください。なお、許可証/免許証番号とは、法令に定める営業許可証番号や資格証明書の番号を指します。"]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"決済端末ＩＣ化実施状況",null,null,null,null,null,null,"導入済み",null,null,null,null,null,null,null,"決済端末ＩＣ化予定年月\n＊「導入予定あり」の場合",null,null,null,null,null,null,"西暦",null,null,null,null,"年",null,null,"月",null,null,"日"]
[null,"■「売上代金お振込先」は口座情報を必ず確認後、ご記入ください。※誤った口座情報が入力された場合、お振込が出来ない場合がございます。"]
[null,"売上代金\nお振込先",null,null,null,"金融機関名",null,null,null,null,null,null,"住信SBIネット銀行",null,null,null,null,null,null,null,null,null,null,null,"銀行コード",null,null,null,null,null,null,"0038"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"支店名",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"■以下についてご確認のうえ、チェックボックスにチェックを入れてください。"]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"店番",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　上記の同意事項について全て同意のうえ申込みます。"]
[null,null,null,null,null,"口座名義",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"預金種目"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"口座番号",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　上記の確認事項について全て確認のうえ申込みます。"]
[]
[null,"備考",null,null,null,"＊弊社への連絡事項がございましたらご記入ください。",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,null,null,null,null,null,null,null,null,null,null,null,"　必要事項（黄色セル）が全て入力されていることを確認しました。（＊入力漏れがあるとお申込みいただけない場合がございます）"]
[]
[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,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　別シート「手数料率」の内容について全て同意のうえ申し込みます。"]
[]
[]
[]
[]
[null,"銀行使用欄",null,null,null,"手数料率",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"備考"]
[]
[null,null,null,null,null,"端末識別番号",null,null,null,null,null,null,null,null,null,null,null,"-",null,null,null,null,null,"-"]
[]
[null,null,null,null,null,"端末代金（税込）",null,null,null,null,null,null,null,null,null,null,null,"円/台",null,"×",null,null,"台","＝",{"$f":"Q90*V90","v":0},null,null,null,null,"円"]
[]
[]
[null,"<ACQ-直1-202103-001>"]

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[]
[]
[]
[]
[]
["手数料率"]
[]
[]
[]
[]
[]
[]
[]
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[]
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[null,null,"<ACQ-直1-202103-001>"]

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[]
[]
[null,"住信SBIネット銀行　行"]
[]
["加盟申込書兼端末設置申込書"]
[]
[]
[]
[null,"以下の確認事項について、必ず同意の上お申込みください。"]
[null,"　・本申込書は、クレジットカード等を使用した信用販売を行うため、弊社に加盟を申し込むことを目的としたクレジットカード決済サービス加盟申込書です。"]
[]
[null,"　・お申込みになるお客さまは、別紙に定める「住信SBIネット銀行カード加盟店規約（対面店用）」、「加盟店情報の取り扱いに関する同意条項」、「反社会的勢力ではないことの表明及び確約」、「端末売買基本規約」に同意のうえ、必要事項をご記入ください。"]
[]
[]
[]
[null,"　・審査過程において、弊社よりご連絡する場合がございます。また、別途必要書類（登記事項証明書・店舗写真など）をご提出いただく場合がございます。"]
[null,"　・各決済につきましては弊社指定の端末を経由する必要があり手書き伝票等、別手段での決済は受け付けておりません。"]
[]
[]
[null,"お申込日",null,null,null,null,null,"西暦",null,2021,null,null,"年",3,null,"月",1,null,"日"]
[]
[]
[]
[null,"会社情報",null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"ｽﾐｼﾝｴｽﾋﾞｰｱｲﾈｯﾄｷﾞﾝｺｳｶﾌﾞｼｷｶﾞｲｼｬ",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,"選択可能なお支払方法・\nご精算サイクル",null,null,null,"選択可能なお支払方法",null,null,null,null,null,null,null,null,null,null,"　一括払い",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"※原則、選択可能なお支払方法は「一括払い」のみとなります。\n※その他支払方法をご希望の場合は別途お問合せ下さい。\n　利用可否につきましては弊社で審査の上、判断いたします。"]
[null,null,null,null,null,"会社名（全角）",null,null,null,null,null,null,"住信ＳＢＩネット銀行株式会社"]
[]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"ﾄｳｷｮｳﾄﾐﾅﾄｸﾛｯﾎﾟﾝｷﾞｲｯﾁｮｳﾒ6-1ｲｽﾞﾐｶﾞｰﾃﾞﾝﾀﾜｰ18ｶｲ"]
[null,null,null,null,null,"本社所在地（全角）",null,null,null,null,null,null,"〒","106",null,"-","6018",null,null,"（＊郵便番号は半角でご入力ください）",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,"ご精算サイクル",null,null,null,null,null,null,null,null,"①月1回払い",null,null,null,null,null,"①月1回払い\n・末日〆：翌月末日支払\n②月2回払い\n・15日〆:末日支払　/　末日〆:翌15日支払",null,null,null,null,null,null,null,null,null,null,"＊ご精算サイクル（売上代金の入金サイクル）は左記のみと\nなります。（支払い方法にご要望がある場合は、ご相談ください）"]
[null,null,null,null,null,null,null,null,null,null,null,null,"東京都港区六本木一丁目６－１泉ガーデンタワー１８階"]
[]
[null,null,null,null,null,"電話番号（半角）",null,null,null,null,null,null,"03",null,null,"-","3333",null,null,"-","3333",null,null,null,"設立年月日",null,null,null,null,null,null,"西暦",null,"2007",null,null,"年","09",null,"月","12",null,"日"]
[null,null,null,null,null,"URL（半角）",null,null,null,null,null,null,"https://www.netbk.co.jp/contents/",null,null,null,null,null,null,null,null,null,null,null,"個人・法人区分",null,null,null,null,null,null,"法人",null,null,null,null,null,null,null,null,null,null,null,null,"ヒアリング\n項目",null,null,null,"確認事項",null,null,null,null,null,null,null,null,"下記の項目に該当はありません"]
[null,null,null,null,null,"メールアドレス（半角）",null,null,null,null,null,null,"xxxxx@netbk.co.jp",null,null,null,null,null,null,null,null,null,null,null,"法人番号（半角、13ケタ）\n＊法人の場合",null,null,null,null,null,null,"6010401061386"]
[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,null,null,null,"■下記の項目に該当しないことを、必ず確認の上お申込みください。（＊該当がある場合、本サービスにはお申込みいただけません）"]
[null,null,null,null,null,"業種業務内容（全角）",null,null,null,null,null,null,"銀行業",null,null,null,null,null,null,null,null,null,null,null,"取扱商品（全角）",null,null,null,null,null,null,"金融商品",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"✔　「訪問販売」をしている"]
[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,null,null,null,null,"✔　「電話勧誘販売」をしている"]
[null,"代表者情報",null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"姓","ｽﾐｼﾝ",null,null,null,null,"名","ﾀﾛｳ",null,null,null,null,"代表者役職名（全角）",null,null,null,null,null,null,"代表取締役社長",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"✔　「連鎖販売取引」をしている"]
[null,null,null,null,null,"代表者氏名（全角）",null,null,null,null,null,null,"住信",null,null,null,null,null,"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,"✔　「業務提携誘因販売」をしている"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"性別",null,null,null,null,null,null,"男性",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"✔　「直近5年間の特定商取引法による行政処分」を受けている"]
[null,null,null,null,null,"代表者生年月日",null,null,null,null,null,null,"西暦",null,"1965",null,null,"年","10",null,"月","01",null,"日","代表者電話番号（半角）",null,null,null,null,null,null,"03",null,null,"－","1111",null,null,"－","2222",null,null,null,null,null,null,null,null,null,"✔　「消費者契約法違反の行為を理由とした民事上の敗訴判決」を受けている"]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"ﾄｳｷｮｳﾄﾐﾅﾄｸﾛｯﾎﾟﾝｷﾞｻﾝﾁｮｳﾒ2-5"]
[null,null,null,null,null,"代表者住所（全角）",null,null,null,null,null,null,"〒","106",null,"-","1111",null,null,"（＊郵便番号は半角でご入力ください）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"導入メニュー",null,null,null,"クレジットカード",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,"＊「VISA」・「Mastercard」のお申込みとなります。"]
[null,null,null,null,null,null,null,null,null,null,null,null,"東京都港区六本木三丁目２－５"]
[]
[]
[null,"■弊社よりご連絡させていただく際、窓口となるご担当者さまの情報をご入力ください。"]
[null,"担当者情報①",null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"姓","ｷﾞﾝｺｳ",null,null,null,null,"名","ﾀﾛｳ",null,null,null,null,"電話番号（半角）",null,null,null,null,null,null,"03",null,null,"－","2222",null,null,"－","2222"]
[null,null,null,null,null,"担当者氏名（全角）",null,null,null,null,null,null,"銀行",null,null,null,null,null,"太郎",null,null,null,null,null,"メールアドレス（半角）",null,null,null,null,null,null,"xxxxx@netbk.co.jp"]
[]
[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,"設置端末",null,null,null,"・端末代金は1台につき23,100円(税込)になります。"]
[null,"■経理ご担当者さまの情報をご入力ください。（＊支払明細書の送付等、精算に関するご連絡は「経理ご担当者」さま宛てにご連絡申し上げます。）"]
[null,"担当者情報②",null,null,null,"経理ご担当者さまの有無",null,null,null,null,null,null,"経理担当者あり"]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"姓","ｷﾞﾝｺｳ",null,null,null,null,"名","ﾊﾅｺ",null,null,null,null,"電話番号（半角）",null,null,null,null,null,null,"03",null,null,"－","3333",null,null,"－","3333"]
[null,null,null,null,null,"経理担当者氏名（全角）",null,null,null,null,null,null,"銀行",null,null,null,null,null,"花子",null,null,null,null,null,"メールアドレス（半角）",null,null,null,null,null,null,"xxxxx@netbk.co.jp",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"申込台数",null,null,null,1,null,null,null,null,null,"台",null,null,null,null,null,null,null,null,null,null,null,"※対応レシートプリンターのご案内\n\n対応のレシートプリンターをご用意いただけますと、レシート（クレジットカード利用控え）を印刷してお渡しいただくことが可能です。\nプリンター製品をお取扱いのウェブサイト等にて、お買い求め願います。\n\n■製品情報\n　(セイコーインスツル株式会社)\n　　モバイル型レシート\n　　プリンター「MP-B20」"]
[]
[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,null,null,null,"■製品情報\n(Miura Systems株式会社)\n　M010\n■接続端末について\niPad / iPhoneもしくはAndroid端末を\nお客さまにご用意いただき、専用アプリ\n（無料）をインストールいただく必要が\nございます。"]
[null,"店舗情報",null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"ｽﾐｼﾝｴｽﾋﾞｰｱｲｼｮｳﾃﾝ"]
[null,null,null,null,null,"店舗名-漢字表記\n（全角）",null,null,null,null,null,null,"住信ＳＢＩ商店"]
[]
[null,null,null,null,null,"店舗名-英語表記\n（半角）",null,null,null,null,null,null,"SUMISHINSBISHOUTEN"]
[]
[null,null,null,null,null,"ﾌﾘｶﾞﾅ（半角）",null,null,null,null,null,null,"ﾄｳｷｮｳﾄﾐﾅﾄｸﾛｯﾎﾟﾝｷﾞｲｯﾁｮｳﾒ2-2"]
[null,null,null,null,null,"店舗住所（全角）",null,null,null,null,null,null,"〒","106",null,"-","2222",null,null,"（＊郵便番号は半角でご入力ください）"]
[null,null,null,null,null,null,null,null,null,null,null,null,"東京都港区六本木一丁目２－２"]
[]
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[null,"（※1）許可証/免許証番号がある場合はご記入ください。なお、許可証/免許証番号とは、法令に定める営業許可証番号や資格証明書の番号を指します。"]
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[null,"「売上代金お振込先」は口座情報を必ず確認後、ご記入ください。※誤った口座情報が入力された場合、お振込みが出来ない場合がございます。"]
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[null,"備考",null,null,null,"＊弊社への連絡事項がございましたらご記入ください。",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,null,null,null,null,null,null,null,null,null,null,null,"　必要事項（黄色セル）が全て入力されていることを確認しました。（＊入力漏れがあるとお申込みいただけない場合がございます）"]
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["申込・変更申請で利用する項目"]
["変更申請で利用する項目"]
["審査結果で利用する項目"]
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[null,"08",null,"無","M010","ー","移動販売",null,null,null,null,"代表者性別",null,null,null,null,null,"変更時のみ",null,"全角",null,null,"-"]
[null,"09",null,null,"FP-1",null,"その他",null,null,null,null,"代表者住所（漢字）",null,null,null,null,null,"変更時のみ",null,"全角",null,null,"-"]
[null,"10",null,null,"PAYGATEStation",null,null,null,null,null,null,"代表者\n郵便番号",null,null,null,null,null,"変更時のみ",null,"半角数字",null,null,"-"]
[null,"11",null,null,"MP-B2",null,null,null,null,null,null,"代表者住所（カナ）",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"-"]
[null,"12",null,null,null,null,null,null,null,null,null,"代表者\n電話番号",null,null,null,null,null,"変更時のみ",null,"半角数字\n（ハイフンあり）",null,null,"-"]
[null,"13"]
[null,"14",null,null,null,null,null,null,null,null,null,"店舗郵便番号",null,null,null,null,null,"変更時のみ",null,"半角数字",null,null,"-"]
[null,"15",null,null,null,null,null,null,null,null,null,"店舗住所（漢字）",null,null,null,null,null,"変更時のみ",null,"全角",null,null,"-"]
[null,"16",null,null,null,null,null,null,null,null,null,"店舗住所（カナ）",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"-"]
[null,"17",null,null,null,null,null,null,null,null,null,"店舗電話番号",null,null,null,null,null,"変更時のみ",null,"半角数字\n（ハイフンあり）",null,null,"-"]
[null,"18",null,null,null,null,null,null,null,null,null,"店舗名",null,null,null,null,null,"変更時のみ",null,"全角",null,null,"-"]
[null,"19",null,null,null,null,null,null,null,null,null,"店舗名カナ",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"-"]
[null,"20",null,null,null,null,null,null,null,null,null,"店舗名英字",null,null,null,null,null,"変更時のみ",null,"半角英字",null,null,"-"]
[null,"21",null,null,null,null,null,null,null,null,null,"営業許可証番号",null,null,null,null,null,null,null,null,null,null,"-"]
[null,"22"]
[null,"23",null,null,null,null,null,null,null,null,null,"訪問販売（有・無）",null,null,null,null,null,"変更時のみ",null,"半角数字",null,null,"0：無　、1：有"]
[null,"24",null,null,null,null,null,null,null,null,null,"電話勧誘販売\n（有・無）",null,null,null,null,null,"変更時のみ",null,"半角数字",null,null,"0：無　、1：有"]
[null,"25",null,null,null,null,null,null,null,null,null,"連鎖販売取引\n（有・無）",null,null,null,null,null,"変更時のみ",null,"半角数字",null,null,"0：無　、1：有"]
[null,"26",null,null,null,null,null,null,null,null,null,"業務提供誘引販売\n（有・無）",null,null,null,null,null,"変更時のみ",null,"半角数字",null,null,"0：無　、1：有"]
[null,"27",null,null,null,null,null,null,null,null,null,"カード情報保持状況",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"1.保存している[保持]\n2.保存していない[非保持]\n3.【非保持化】予定あり\n"]
[null,"28",null,null,null,null,null,null,null,null,null,"PCIDSS準拠状況",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"1.準拠している\n2.準拠予定あり\n3.準拠予定なし"]
[null,"29",null,null,null,null,null,null,null,null,null,"非保持化予定年月",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"ｙｙｙｙｍｍ\nＡＧ列「3.【非保持化】予定あり」を選択時のみ入力。\nその他の時はブランク。"]
[null,"30",null,null,null,null,null,null,null,null,null,"PCIDSS準拠予定年月",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"ｙｙｙｙｍｍ\nＡＨ列「2.準拠予定あり」を選択時のみ入力。\nその他の時はブランク。"]
[null,"31",null,null,null,null,null,null,null,null,null,"決済端末ＩＣ化実施状況",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"1.導入済\n2.導入予定\n3.導入予定なし\n"]
[null,null,null,null,null,null,null,null,null,null,null,"決済端末ＩＣ化実施\n予定年月",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"ｙｙｙｙｍｍ\n「2.導入予定」を選択時のみ入力。その他の時はブランク。\n"]
[null,null,null,null,null,null,null,null,null,null,null,"直近5年間の特定商取引法による行政処分有無情報",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"1.なし\n2.あり"]
[null,null,null,null,null,null,null,null,null,null,null,"消費者契約法違反の行為を理由とした民事上の敗訴判決有無",null,null,null,null,null,"変更時のみ",null,"半角",null,null,"1.なし\n2.あり"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"端末識別番号",null,null,null,null,null,"変更時のみ",null,"半角英字",null,null,"XXXXXXXXXXX-XXXXXXXXX-XXXX"]
[null,null,null,null,null,null,null,null,null,null,null,"備考",null,null,null,null,null,"変更時のみ",null,"全角",null,null,"-"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"■非対面"]
[null,null,null,null,null,null,null,null,null,null,null,"会社電話番号",null,null,null,null,null,"必須",null,"半角数字\n（ハイフンあり）",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"会社名",null,null,null,null,null,"必須",null,"全角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"会社名カナ",null,null,null,null,null,"必須",null,"半角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"本社所在地　郵便番号",null,null,null,null,null,"必須",null,"半角数字",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"本社所在地（漢字）",null,null,null,null,null,"必須",null,"全角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"本社所在地（カナ）",null,null,null,null,null,"必須",null,"半角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"設立年月日",null,null,null,null,null,"必須",null,"半角"]
[null,null,null,null,null,null,null,null,null,null,null,"業種業務内容",null,null,null,null,null,"必須",null,"全角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"取扱商品",null,null,null,null,null,"必須",null,"全角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"URL",null,null,null,null,null,"必須",null,"-",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"個人・法人区分",null,null,null,null,null,"必須",null,"半角数字",null,null,"法人：01、個人：02"]
[null,null,null,null,null,null,null,null,null,null,null,"法人番号",null,null,null,null,null,"条件付必須",null,"半角数字",null,null,"「個人・法人区分」が\n法人の場合、必須"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"代表者氏名",null,null,null,null,null,"必須",null,"全角\n（姓と名の間にスペース）",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"代表者氏名　カナ",null,null,null,null,null,"必須",null,"半角\n（姓と名の間にスペース）",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"代表者\n生年月日",null,null,null,null,null,"必須",null,"半角数字",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"代表者性別",null,null,null,null,null,"必須",null,"全角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"代表者住所（漢字）",null,null,null,null,null,"必須",null,"全角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"代表者\n郵便番号",null,null,null,null,null,"必須",null,"半角数字",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"代表者住所（カナ）",null,null,null,null,null,"必須",null,"半角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"代表者\n電話番号",null,null,null,null,null,"条件付必須",null,"半角数字\n（ハイフンあり）",null,null,"-"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"店舗名",null,null,null,null,null,"必須",null,"全角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"店舗名カナ",null,null,null,null,null,"必須",null,"半角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"店舗名英字",null,null,null,null,null,"必須",null,"半角英字",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"店舗郵便番号",null,null,null,null,null,"必須",null,"半角数字",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"店舗住所（漢字）",null,null,null,null,null,"必須",null,"全角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"店舗住所（カナ）",null,null,null,null,null,"必須",null,"半角",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"店舗電話番号",null,null,null,null,null,"必須",null,"半角数字\n（ハイフンあり）",null,null,"-"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"訪問販売（有・無）",null,null,null,null,null,"必須",null,"半角数字",null,null,"0：無　、1：有"]
[null,null,null,null,null,null,null,null,null,null,null,"電話勧誘販売\n（有・無）",null,null,null,null,null,"必須",null,"半角数字",null,null,"0：無　、1：有"]
[null,null,null,null,null,null,null,null,null,null,null,"連鎖販売取引\n（有・無）",null,null,null,null,null,"必須",null,"半角数字",null,null,"0：無　、1：有"]
[null,null,null,null,null,null,null,null,null,null,null,"業務提供誘引販売\n（有・無）",null,null,null,null,null,"必須",null,"半角数字",null,null,"0：無　、1：有"]
[null,null,null,null,null,null,null,null,null,null,null,"カード情報保持状況",null,null,null,null,null,"必須",null,"半角",null,null,"1.保存している[保持]\n2.保存していない[非保持]\n3.【非保持化】予定あり\n"]
[null,null,null,null,null,null,null,null,null,null,null,"PCIDSS準拠状況",null,null,null,null,null,"必須",null,"半角",null,null,"1.準拠している\n2.準拠予定あり\n3.準拠予定なし"]
[null,null,null,null,null,null,null,null,null,null,null,"非保持化予定年月",null,null,null,null,null,"条件付必須",null,"半角",null,null,"ｙｙｙｙｍｍ\nＡＣ列「3.【非保持化】予定あり」を選択時のみ入力。\nその他の時はブランク。"]
[null,null,null,null,null,null,null,null,null,null,null,"PCIDSS準拠予定年月",null,null,null,null,null,"条件付必須",null,"半角",null,null,"ｙｙｙｙｍｍ\nＡＤ列「2.準拠予定あり」を選択時のみ入力。\nその他の時はブランク。"]
[null,null,null,null,null,null,null,null,null,null,null,"本人認証サービス実施状況",null,null,null,null,null,"必須",null,"半角",null,null,"1.導入済\n2.導入予定\n3.導入予定なし\n"]
[null,null,null,null,null,null,null,null,null,null,null,"本人認証サービス実施\n予定年月",null,null,null,null,null,"条件付必須",null,"半角",null,null,"ｙｙｙｙｍｍ\n「2.導入予定」を選択時のみ入力。\nその他の時はブランク。\n"]
[null,null,null,null,null,null,null,null,null,null,null,"セキュリティコード実施状況",null,null,null,null,null,"必須",null,"半角",null,null,"1.導入済\n2.導入予定\n3.導入予定なし\n"]
[null,null,null,null,null,null,null,null,null,null,null,"セキュリティコード実施\n予定年月",null,null,null,null,null,"条件付必須",null,"半角",null,null,"ｙｙｙｙｍｍ\n「2.導入予定」を選択時のみ入力。\nその他の時はブランク。\n"]
[null,null,null,null,null,null,null,null,null,null,null,"不正配送先情報活用状況",null,null,null,null,null,"必須",null,"半角",null,null,"1.導入済\n2.導入予定\n3.導入予定なし\n"]
[null,null,null,null,null,null,null,null,null,null,null,"不正配送先情報活用実施 予定年月",null,null,null,null,null,"条件付必須",null,"半角",null,null,"ｙｙｙｙｍｍ\n「2.導入予定」を選択時のみ入力。\nその他の時はブランク。\n"]
[null,null,null,null,null,null,null,null,null,null,null,"属性・行動分析実施状況",null,null,null,null,null,"必須",null,"半角",null,null,"1.導入済\n2.導入予定\n3.導入予定なし\n"]
[null,null,null,null,null,null,null,null,null,null,null,"属性・行動分析実施\n予定年月",null,null,null,null,null,"条件付必須",null,"半角",null,null,"ｙｙｙｙｍｍ\n「2.導入予定」を選択時のみ入力。\nその他の時はブランク。\n"]
[null,null,null,null,null,null,null,null,null,null,null,"直近5年間の特定商取引法による\n行政処分有無情報",null,null,null,null,null,"必須",null,"半角",null,null,"1.なし\n2.あり"]
[null,null,null,null,null,null,null,null,null,null,null,"消費者契約法違反の行為を理由とした\n民事上の敗訴判決有無",null,null,null,null,null,"必須",null,"半角",null,null,"1.なし\n2.あり"]
[null,null,null,null,null,null,null,null,null,null,null,"その他独自対策",null,null,null,null,null,"必須",null,"半角",null,null,"1.導入済\n2.導入予定\n3.導入予定なし\n"]
[null,null,null,null,null,null,null,null,null,null,null,"その他独自対策実施\n予定年月",null,null,null,null,null,"条件付必須",null,"半角",null,null,"ｙｙｙｙｍｍ\n「2.導入予定」を選択時のみ入力。\nその他の時はブランク。\n"]
[null,null,null,null,null,null,null,null,null,null,null,"その他独自対策コメント",null,null,null,null,null,"条件付必須",null,"全角・半角",null,null,"具体的な対策内容を入力\n「1.導入済」「2.導入予定」を選択時のみ入力。\nその他の時はブランク。"]
[]
[null,null,null,null,null,null,null,null,null,null,null,"端末識別番号",null,null,null,null,null,"必須",null,"半角数字",null,null,"-"]
[null,null,null,null,null,null,null,null,null,null,null,"備考",null,null,null,null,null,"条件付必須",null,"全角",null,null,"-"]