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[{"$nulls":4},"不在者投票宣誓書・請求書"]
[]
[]
["  私は、　　　　　年　　　月　　　日執行の",{"$nulls":8},"選挙","の当日、下記のいずれかの事由に"]
[]
["該当する見込みです。ここに真実に相違ないことを誓い、投票用紙等の交付を請求します。"]
[]
[]
[null,"○ 仕事、学業、地域行事、冠婚葬祭その他の用務に従事"]
[null,"○ 用事又は事故のため、投票所のある区域の外に外出・旅行・滞在"]
[null,"○ 疾病、負傷、出産、老衰、身体障害等のため歩行が困難又は刑事施設等に収容"]
[null,"○ 交通至難の島等に居住・滞在"]
[null,"○ 住所移転のため、当町以外に居住"]
[null,"○ 天災又は悪天候により投票所に行くことが困難"]
[]
[]
[null,"　　　　　年　　　　月　　　　日"]
[]
[]
[null,"現住所",null,null,null,"（〒　　-　　　）"]
[]
[]
[null,"選挙人名簿に記載"]
[null,"されている住所"]
[null,"(現住所と異なる場合のみ記載すること。)"]
[]
[]
[null,"連絡先電話番号",null,null,null,"（　　　　　－　　　　　　　－　　　　　　）"]
[{"$nulls":5},"＊郵送物の不達等、連絡を取る必要がある場合以外使用いたしません。"]
[]
[{"$nulls":5},"大正\n昭和\n平成"]
[]
[null,"生年月日",{"$nulls":5},"年",null,"月",null,"日生"]
[]
[]
[null,"氏名"]
[]
[null,null,null,"玉城町選挙管理委員会委員長　　あて"]
[]
["投　 票 　区",null,null,null,"名 簿 番 号",null,"区　　　　分",null,"交 付 方 法",null,"交　付　月　日",null,"整　理　番　号"]
[{"$nulls":8},"直 ・ 郵",null,"　　　月　　日"]
[{"$nulls":8},"直 ・ 郵",null,"　　　月　　日"]