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[{"$nulls":26},"（太線枠内をご記入下さい）"]
[]
[{"$nulls":28},"年",null,null,"月",null,null,"日"]
[null,"一般財団法人 食品環境検査協会　殿"]
[{"$nulls":16},"申請者の名称"]
[]
[{"$nulls":16},"住所"]
[null,"申　請　書"]
[{"$nulls":16},"（法人にあっては、名称及びその主たる事業所の所在地）"]
[{"$nulls":16},"代理人の名称"]
[]
[{"$nulls":16},"住所"]
[]
[]
[]
[]
[null,"下記の製品について、食品衛生法第26条第3項に基づく検査を検査命令書を添えて申請します。"]
[{"$nulls":19},"記"]
["検査命令書の発行年月日及び番号"]
["製品の名称"]
["製造者又は加工者の氏名及び\n住所（法人にあっては、名称及び\nその主たる事業所の所在地）"]
["製造所又は加工所の名称及び\n所在地（加工食品以外の食品\nにあっては、生産地）"]
["製品の着港年月日"]
["製品の保管場所"]
["申請数量"]
["届出受付番号及び年月日"]
["その他"]
[]
["製品検査項目",{"$nulls":22},"手数料コード",{"$nulls":5},"検査手数料"]
[]
[]
[]
[]
[]
["抜取り手数料"]
["合計金額"]
["会計担当者",{"$nulls":4},"請求書番号",{"$nulls":7},"料金請求先（コード）",{"$nulls":7},"決裁",null,null,null,"試験品番号"]