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[null,"一般社団法人　環境共生住宅推進協議会"]
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[null,"　以下の内容により、既存建築物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）の提案を申請します。"]
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[null,"１．補助事業\n　　の名称",{"$nulls":4},"既存建築物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）"]
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[null,"２．事業名"]
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[null,"代表提案者\n（注２）",{"$nulls":4},"法人の場合","法人名",null,null,null,"ﾌﾘｶﾞﾅ"]
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[null,"事務代行者\n（注１）（注２）",{"$nulls":4},"法人名\nまたは\n氏名",{"$nulls":4},"ﾌﾘｶﾞﾅ"]
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[null,null,"(注１)","事務代行者がいる場合は、法人名又は氏名を記載してください。"]
[null,null,"(注２)","事務代行者は代表提案者になることはできません。"]

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[null,"一般社団法人　環境共生住宅推進協議会"]
[null,"会長　竹中　宣雄　殿"]
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["令和５年度住宅・建築物環境対策事業費補助金提案申請書"]
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[null,"　以下の内容により、既存建築物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）の提案を申請します。"]
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[null,"１．補助事業\n　　の名称",{"$nulls":4},"既存建築物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）"]
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[null,"２．事業名"]
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[null,"３．種別",{"$nulls":5},"□","住宅",null,null,null,"□","非住宅",{"$nulls":4},"４．提案建物数",{"$nulls":12},"棟"]
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[null,"代表提案者\n（注２）",{"$nulls":4},"法人の場合","法人名",null,null,null,"ﾌﾘｶﾞﾅ"]
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[null,"その他の提案者",{"$nulls":4},"名称（又は氏名）"]
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["（注１）",null,null,"補助対象事業費、補助申請額は合計額とし、別紙１と金額が一致するように記載してください。"]

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["補助事業の実施場所の概要"]
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["※応募する建物が１棟のみの場合は提出の必要はありません。"]
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[{"$nulls":4},"建物所有者",{"$nulls":23},"□","登記簿謄本"]
[]
["注）記入欄が不足する場合は、適宜、コピーして使用してください。"]

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["複数戸用（複数住戸の延べ面積合算 300㎡以上）",{"$nulls":32},"（様式３－２）"]
[]
["補助事業の実施場所の概要"]
[]
["※応募する建物が１棟のみの場合は提出の必要はありません。"]
["※各建物の建築確認検査済証を添付してください。"]
["事業名",{"$nulls":7},0]
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[]
["注）記入欄が不足する場合は、適宜、コピーして使用してください。"]

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["別記様式第１"]
[{"$nulls":11},"令和　年　月　日"]
[null,"一般社団法人　環境共生住宅推進協議会"]
[null,"会長　竹中　宣雄　殿"]
[{"$nulls":9},"代表提案者　"]
[]
["令和５年度住宅・建築物環境対策事業費補助金交付申請書"]
[]
[null,"　令和５年度住宅・建築物環境対策事業費に要する費用について、補助金の交付を受けたいので、令和５年度既存建築物省エネ化推進事業補助金交付規程第５の規定により、関係書類を添えて下記の通り申請します。なお、当該手続にあたっては、令和５年度既存建築物省エネ化推進事業補助金交付規程を遵守します。"]
[]
["記"]
[]
[null,"　１．補助事業の名称　　既存建築物省エネ化推進事業"]
[{"$nulls":6},"　　　（省エネルギー性能の診断・表示に対する支援）"]
[null,null,null,"事業名（",{"$nulls":9},"）"]
[null,"　２．交付申請額",{"$nulls":8},"千円（端数切捨て）"]
[null,"　３．交付申請額の算出方法及び事業経費の配分（別紙１，２のとおり）"]
[null,"　４．補助事業の概要（様式３－１のとおり）"]
[null,"　５．事業完了の期日",{"$nulls":5},"令和　年　月　日"]
[]
[null,null,"　（申請資料）"]
[null,null,null,"１．","交付申請額の算出方法及び事業経費の配分",{"$nulls":6},"（別紙１）"]
[null,null,null,"２．","交付申請額の算出方法の明細",{"$nulls":6},"（別紙２）"]
[]
[null,null,"　（添付資料）"]
[null,null,null,"１．","事業計画及び補助申請額",{"$nulls":6},"（別添１）"]
[null,null,null,"２．","補助事業者等に関する確認書",{"$nulls":6},"（別添２）"]
[null,null,null,"３．","振込口座登録票",{"$nulls":6},"（別添３）"]
[null,null,null,"４．","補助対象事業費の見積書",{"$nulls":6},"（原本写し）"]
[null,null,null,"５．","代表提案者の登記簿等事業実態のわかる書類",{"$nulls":6},"（原本写し）"]
[null,null,null,"６．","委任状　＊該当事業者のみ",{"$nulls":6},"（任意様式）"]
[null,null,null,"７．","共同事業実施規約　＊該当事業者のみ",{"$nulls":6},"（参考様式）"]
[null,null,null,"８．","その他確認に必要と思われるもの"]
[]
[null,null,"　（記載上の注意）"]
[null,null,null,"１．","用紙の大きさは、日本工業規格で定めるＡ列４とし、縦位置とすること。（設計図書はＡ３折込で可）"]

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["交付申請額の算出方法及び事業経費の配分"]
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["(単位：千円)"]
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[]
[null,"第三者認証・認定の\n取得に要する費用\n（Ｂ）","(",null,")","1/3","(",{"$nulls":4},"）"]
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[null,"表示に要する費用（Ｃ）","(",null,")","1/3","(",{"$nulls":4},"）"]
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[null,"交付申請額\n（Ｄ）＝（Ａ＋Ｂ＋Ｃ）",null,0,null,null,null,0]
[null,"前回交付決定額\n(Ｅ)"]
[null,"変動増減\n（Ｄ-Ｅ)"]
[]
["　　補助対象建築物等における他の補助金の申請有無（予定含む）",{"$nulls":6},"□","あり","□","なし"]
["　　「あり」の場合は他の補助を受ける内容を具体的に記載した資料を添付して下さい。"]
[]
["（記載上の注意）"]
["１. 交付申請時には、下段のみ記載して下さい。※上段（　　）内は空欄のままとしてください。"]
["　　交付変更承認申請の場合は、前回申請で記載した内容を上段（　）内に記載してください。"]
["２. 補助対象事業費には他の補助金を受けるものを含めることはできません。"]
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[{"$nulls":9},"別紙２"]
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["交付申請額の算出方法の明細"]
[]
[]
["１．省エネルギー性能の診断に要する費用"]
["(単位：千円)"]
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["(",null,")","(",null,")","1/3","(",null,")"]
["　　　　　　　　　"]
[]
["２．省エネルギー性能の第三者認証・認定の取得に要する費用"]
[{"$nulls":9},"(単位：千円)"]
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["(",null,")","(",null,")","1/3","(",null,")"]
["　　　　　　　　　"]
[]
["３．省エネルギー性能表示に要する費用"]
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["　　　　　　　　　"]
[]
[]
["（記載上の注意）"]
["１. 交付申請時には、下段のみ記載して下さい。※上段（　　）内は空欄のままとしてください。"]
["　　交付変更承認申請の場合は、前回申請で記載した内容を上段（　）内に記載してください。"]
["２. 補助対象事業費には他の補助金を受けるものを含めることはできません。"]
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[{"$nulls":5},"別添１"]
["事業計画及び補助申請額"]
[]
["１．事業計画"]
["項目",null,"補助対象事業費\n（単位：千円）","補助率","補助申請額\n（単位：千円）","備考"]
[]
["１．","省エネ診断に要する費用",0,"1/3",0]
["２．","第三者認証等に要する費用",0,"1/3",0]
["３．","省エネ性能表示に要する費用",0,"1/3",0]
["合計",null,0,null,0]
[]
["２．補助対象事業費の内訳"]
["項目",null,"単価\n（単位：千円）","棟数","補助対象事業費\n（単位：千円）","備考"]
[]
["１．","省エネ診断に要する費用"]
{"$rows_empty":7}
["小計　ａ",null,null,null,0]
["２．","第三者認証等に要する費用"]
{"$rows_empty":7}
["小計　ｂ",null,null,null,0]
["３．","省エネ性能表示に要する費用"]
{"$rows_empty":7}
["小計　ｃ",null,null,null,0]
[]
["注１）消費税等は除いた額を記載してください。"]
["注２）それぞれの項目にて、千円未満は切り捨てとして、金額を記載してください。"]
["注３）複数建築物を対象とする事業で、単価が異なる場合など、適宜、項目を区分して記載してください。"]
["注４）備考欄には、建築物の種別、表示の内容などを記載してください。"]
[]
[]
[]
[]
[null,null,"事業名：",0]

{"sheet":"別添2","index":10,"n_rows":49,"n_cols":34,"rows_kept":49,"cut":false,"hidden":false,"merged":[[3,0,3,31],[45,18,45,28],[47,15,47,18],[47,19,47,28],[48,15,48,18],[48,19,48,28]],"flags":["formulas_cached_only"]}
[{"$nulls":31},"別添２"]
[]
[]
["補助事業者等に関する確認書"]
[]
[]
[null,null,"下記１.～４.の各項目について、該当する項目にチェックを入れてください。"]
[]
[null,null,"１．本補助事業において、以下の（１）～（３）の関係にある会社から行う調達の有無。"]
[]
[null,null,"（１）１００％同一の資本に属するグループ会社"]
[null,null,"（２）補助金申請者の関係会社（財務諸表等規則第８条第８項で定めるもの。上記（１）"]
[{"$nulls":4}," を除く。）"]
[null,null,"（３）補助金申請者の役員である者（親族を含む）又はこれらの者が役員に就任している法人"]
[]
[{"$nulls":4},"（１）～（３）の関係にある会社からの調達は一切ない。",{"$nulls":20},"□",{"$nulls":7},"□"]
[{"$nulls":4},"（１）～（３）の関係にある会社からの調達がある。",{"$nulls":20},"□",{"$nulls":7},"■"]
[]
[null,null,null,"（１）～（３）の関係にある会社からの調達がある場合には、価格の妥当性を確認する"]
[null,null,null,"ため、３者以上からの見積り結果の添付を求めます。"]
[]
[]
[null,null,"２．過去３カ年度内に国土交通省住宅局が所轄する他の補助事業において補助金返還命令"]
[null,null,null," を受けたこと。"]
[]
[{"$nulls":7},"該当無し",null,null,null,"□",null,null,"該当有り",null,null,null,"□"]
[]
[null,null,"３．暴力団又は暴力団員であること、及び暴力団又は暴力団員と不適切な関係にあること。"]
[]
[{"$nulls":7},"該当無し",null,null,null,"□",null,null,"該当有り",null,null,null,"□"]
[]
[null,null,"４．補助金等に係る予算の執行の適正化に関する法律（昭和30年法律第179号）第17条"]
[null,null,null,"（決定の取消）に該当した場合は、他府省庁・独立行政法人を含む他の補助金担当課"]
[null,null,null," に当該返還事案の概要（法人又は申請者名・補助金名・交付決定額・補助事業の"]
[null,null,null," 実施期間・返還を生じた理由・講じられた措置の内容等）を提供することがあります。"]
[]
[{"$nulls":7},"上記４の内容について　同意する",{"$nulls":11},"□"]
[]
[null,null,"・２．３．において該当のある事業者は、原則として補助金の申請をすることが"]
[null,null,"　できません。"]
[null,null,"・４．において個人情報の使用について同意して頂けない場合は、交付申請を受け付け"]
[null,null,"　られません。"]
[null,null,"・本確認書に虚偽の記載をし、記載内容が事実と相違していることが発覚した場合は、"]
[null,null,"　補助金の全額返還を求めることがあります。"]
[]
[{"$nulls":18},"令和　　年　　月　　日"]
[]
[{"$nulls":15},"事業名："]
[{"$nulls":15},"代表提案者："]

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[{"$nulls":22},"別添３"]
[]
[{"$nulls":15},"令和　　年　　月　　日"]
[]
[]
["振込口座登録票"]
[]
[]
["１．銀行名",{"$nulls":14},"銀行"]
[]
[null,"銀行コード"]
[]
["２．支店名",{"$nulls":14},"支店"]
[]
[null,"支店コード"]
[]
["３．預金種別（該当する種別を○で囲んでください）"]
[]
[{"$nulls":5},"普　通",null,"・","当　座",null,"・","貯　蓄",null,"・","その他"]
[]
["４．口座番号"]
[]
[]
["５．郵便番号及び住所"]
[null,"１）郵便番号",null,null,null,"〒"]
[null,"２）住　　所："]
[]
[]
[{"$nulls":4},"注）住所は、都道府県名から記載してください。"]
[]
["６．","カ　ナ："]
[]
[]
[null,"口座名："]
[]
[]
[{"$nulls":5},"事業名："]
[{"$nulls":5},"代表提案者："]

{"sheet":"委任状（任意様式）","index":12,"n_rows":29,"n_cols":11,"rows_kept":29,"cut":false,"hidden":false,"merged":[[8,3,8,9],[11,0,11,10],[12,0,12,10],[13,0,13,10],[15,7,15,10],[18,3,18,9],[28,6,28,10],[1,0,1,10],[4,3,4,9],[5,3,5,8],[6,3,6,9],[7,3,7,9],[19,3,19,8],[20,3,20,9],[21,3,21,9],[22,3,22,9]],"flags":["formulas_cached_only"]}
[{"$nulls":10},"任意様式"]
["委 任 状"]
[]
["事務代行者"]
[null,"会社名"]
[null,"役職・代表者名",{"$nulls":7},"印"]
[null,"住所",null,"〒"]
[]
[]
[]
[]
["　私は上記の者を交付申請書等の問い合わせ先となることを定め、令和５年度既存建築"]
["物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）補助金の交付申請"]
["書申請書等に関する問い合わせ先となることの権限を委任します。"]
[]
[{"$nulls":7},"令和　年　月　日　"]
[]
["委任者（代表提案者）"]
[null,"会社名"]
[null,"役職・代表者名",{"$nulls":7},"印"]
[null,"住所",null,"〒"]
{"$rows_empty":7}
[{"$nulls":5},"事業名：",0]

{"sheet":"共同事業実施規約","index":13,"n_rows":65,"n_cols":9,"rows_kept":65,"cut":false,"hidden":false,"merged":[[26,1,28,8],[44,1,47,8],[29,1,31,8],[50,1,53,8],[2,0,2,8],[12,1,14,8],[37,1,37,8],[17,1,19,8],[20,1,21,8],[40,1,41,8],[32,1,34,8],[22,1,23,8],[24,1,25,8]],"flags":["formulas_cached_only"]}
[{"$nulls":8},"参考様式"]
[]
["令和５年度既存建築物省エネ化推進事業(省エネルギー性能の診断・表示に対する支援)における共同事業実施規約\n"]
[]
["事業名："]
["建物名："]
[]
["甲（代表提案者）："]
["乙（建物所有者）："]
[]
[]
["（補助金交付への協力）"]
["　第１条","　甲と乙は、令和５年度既存建築物省エネ化推進事業費補助金（省エネルギー性能の診断・表示に対する支援）（以下「本補助金」という。）の交付を受けるための所要の手続きを、両者協力して共同で行うことを確認する。"]
[]
[]
[]
["（交付申請等）"]
["　第２条","　本補助金の申請から受領に要する諸手続については、甲及び乙を代表して甲が行う\nものとする。なお、本補助金の受領に必要な書類（支払い実績を証明する書類を含\nむ）は甲及び乙が協力して整理し、補助金受領後は甲が代表して管理する。"]
[]
[]
["２.","甲と乙は、過去３カ年度内に国土交通省住宅局所管補助金において、交付決定の取り消しに相当する理由で補助金の返還に該当する事案がないことを確認する。"]
[]
["３.","甲と乙は、関係会社等からの調達の有無について確認し、関係会社等からの調達を行う場合は、３者以上からの見積り結果を提出することを確認する。"]
[]
["４.","甲と乙は、暴力団及び暴力団員でないこと、及び暴力団または暴力団員との不適切な関係がないことを確認する。"]
[]
["５.","甲と乙は、前項の内容に虚偽等が存することが判明した場合には、本補助金交付申請に係る補助金交付決定が取り消され、また、交付された補助金を返還することについて、甲乙とも一切の意義を申し立てないことを確認する。"]
[]
[]
["６.","甲と乙は、前項の内容に虚偽等が存することが判明した場合には、本補助金交付申請に係る補助金交付決定が取り消され、また、交付された補助金を返還することについて、甲乙とも一切の意義を申し立てないことを確認する。"]
[]
[]
["７.","甲と乙は、前項の交付決定の取り消しに該当した場合には、本申請に係る個人情報について他府省庁・独立行政法人を含む他の補助金担当課に当該返還事案の概要（法人または申請者名・補助金名・交付決定額・補助事業の実施期間・返還を生じた理由・講じられた措置の内容等）を提供されることがあることを確認する。"]
[]
[]
[]
["（補助金の受領）"]
["　第３条","　本補助金の受領については甲が受領するものとし、乙はこれを異議なく承諾する。"]
[]
["（不承認の場合）"]
["　第４条","　本申請にもかかわらず本補助金の不交付が確定した場合には、甲、乙によって誠実に協議するものとする。"]
[]
[]
["（アンケート・ヒアリングへの協力）"]
["　第５条","　甲と乙は、本補助事業に伴い、一般社団法人環境共生住宅推進協議会（以下「協議会」という）より本補助事業に関する事項及び本建物についてのアンケート・ヒアリングなどをする場合、これらに協力するものとし、その資料について公開することを了承する。"]
[]
[]
[]
[]
["（取得財産の管理等について）"]
["　第６条","　甲と乙は、本補助事業の完了後においても善良な管理者の注意をもって管理し（善管注意義務）、本補助金の交付の目的に従ってその効率的運用を行うことを確認する。また、５年以内に大臣の承認を受けないで補助金の交付の目的に反して使用し、譲渡し、交換し、貸付し、担保に供し、又は取壊しすることができないことを確認する。"]
[]
[]
[]
[]
[]
[{"$nulls":8},"令和　　年　　月　　日"]
[]
[null,null,"甲（代表提案者）："]
[]
[{"$nulls":8},"印"]
[]
[null,null,"乙（建物所有者）："]
[]
[{"$nulls":8},"印"]

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["別記様式第４"]
[{"$nulls":8},"令和　　年　　月　　日"]
["一般社団法人　環境共生住宅推進協議会"]
["会長　竹中　宣雄　殿"]
[{"$nulls":6},"代表提案者　"]
[]
[]
["令和５年度住宅・建築物環境対策事業費補助金交付変更承認申請書"]
[]
["　令和　　年　　月　　日付けＫＫＪ０５発第　　　　号をもって交付決定の通知を受けた標記事業については、当該決定の額及びその内容を変更したいので、下記のとおり申請します。"]
[]
[]
["記"]
[]
["　１．補助事業の名称　　既存建築物省エネ化推進事業"]
[null,null,null,"（省エネルギー性能の診断・表示に対する支援）"]
[null,"事業名（",null,0,{"$nulls":5},"）"]
["　２．交付申請額",{"$nulls":6},"千円"]
["　　　　前回交付決定額",{"$nulls":6},"千円"]
["　　　　変更増減額",{"$nulls":6},"千円"]
["　３．変更理由　　別紙のとおり"]
["　４．交付申請額の算出・変更（別紙１，別紙２のとおり）"]
["　５．事業完了の期日",null,null,null,"令和　年　月　日"]
[]
["　　（申請資料）"]
["　　　　１．交付申請額の算出方法及び事業経費の配分",{"$nulls":6},"（別紙１)"]
["　　　　２．交付申請額の算出方法の明細",{"$nulls":6},"（別紙２)"]
[]
["　　（添付資料）"]
["　　　　１．交付決定通知書",{"$nulls":6},"（原本写し)"]
["　　　　２．事業計画及び補助申請額の変更",{"$nulls":6},"（別添１)"]
["　　　　３．その他確認に必要と思われるもの"]
[]
["　　（記載上の注意）"]
["　　　・用紙の大きさは、日本工業規格で定めるＡ列４とし、縦位置とすること。"]

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[{"$nulls":11},"別紙１"]
[]
["交付申請額の算出方法及び事業経費の配分"]
[]
["(単位：千円)"]
["事　業　区　分",null,"補助対象事業費",null,null,"補助率","補助金申請額"]
["内　訳","診断に要する費用\n(Ａ)","(",null,")","1/3","(",{"$nulls":4},")"]
[]
[null,"第三者認証・認定の\n取得に要する費用\n（Ｂ）","(",null,")","1/3","(",{"$nulls":4},"）"]
[]
[null,"表示に要する費用（Ｃ）","(",null,")","1/3","(",{"$nulls":4},"）"]
[]
[null,"交付申請額\n（Ｄ）＝（Ａ＋Ｂ＋Ｃ）",null,0,null,null,null,0]
[null,"前回交付決定額\n(Ｅ)"]
[null,"変動増減\n（Ｄ-Ｅ)"]
[]
["　　補助対象建築物等における他の補助金の申請有無（予定含む）",{"$nulls":6},"□","あり","□","なし"]
["　　「あり」の場合は他の補助を受ける内容を具体的に記載した資料を添付して下さい。"]
[]
["（記載上の注意）"]
["１. 交付申請時には、下段のみ記載して下さい。※上段（　　）内は空欄のままとしてください。"]
["　　交付変更承認申請の場合は、前回申請で記載した内容を上段（　）内に記載してください。"]
["２. 補助対象事業費には他の補助金を受けるものを含めることはできません。"]
{"$rows_empty":23}
[null,null,null,"事業名：",0]

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[{"$nulls":9},"別紙２"]
[]
["交付申請額の算出方法の明細"]
[]
[]
["１．省エネルギー性能の診断に要する費用"]
["(単位：千円)"]
["補助対象棟数",null,null,"補助対象事業費",null,null,"補助率","補助金申請額"]
["(",null,")","(",null,")","1/3","(",null,")"]
["　　　　　　　　　"]
[]
["２．省エネルギー性能の第三者認証・認定の取得に要する費用"]
[{"$nulls":9},"(単位：千円)"]
["補助対象棟数",null,null,"補助対象事業費",null,null,"補助率","補助金申請額"]
["(",null,")","(",null,")","1/3","(",null,")"]
["　　　　　　　　　"]
[]
["３．省エネルギー性能表示に要する費用"]
[{"$nulls":9},"(単位：千円)"]
["補助対象棟数",null,null,"補助対象事業費",null,null,"補助率","補助金申請額"]
["(",null,")","(",null,")","1/3","(",null,")"]
["　　　　　　　　　"]
[]
[]
["（記載上の注意）"]
["１. 交付申請時には、下段のみ記載して下さい。※上段（　　）内は空欄のままとしてください。"]
["　　交付変更承認申請の場合は、前回申請で記載した内容を上段（　）内に記載してください。"]
["２. 補助対象事業費には他の補助金を受けるものを含めることはできません。"]
{"$rows_empty":17}
[{"$nulls":4},"事業名：",0]

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[{"$nulls":5},"別添１"]
["事業計画及び補助申請額"]
[]
["１．事業計画"]
["項目",null,"補助対象事業費\n（単位：千円）","補助率","補助申請額\n（単位：千円）","備考"]
[]
["１．","省エネ診断に要する費用",0,"1/3",0]
["２．","第三者認証等に要する費用",0,"1/3",0]
["３．","省エネ性能表示に要する費用",0,"1/3",0]
["合計",null,0,null,0]
[]
["２．補助対象事業費の内訳"]
["項目",null,"単価\n（単位：千円）","棟数","補助対象事業費\n（単位：千円）","備考"]
[]
["１．","省エネ診断に要する費用"]
{"$rows_empty":7}
["小計　ａ",null,null,null,0]
["２．","第三者認証等に要する費用"]
{"$rows_empty":7}
["小計　ｂ",null,null,null,0]
["３．","省エネ性能表示に要する費用"]
{"$rows_empty":7}
["小計　ｃ",null,null,null,0]
[]
["注１）消費税等は除いた額を記載してください。"]
["注２）それぞれの項目にて、千円未満は切り捨てとして、金額を記載してください。"]
["注３）複数建築物を対象とする事業で、単価が異なる場合など、適宜、項目を区分して記載してください。"]
["注４）備考欄には、建築物の種別、表示の内容などを記載してください。"]
[]
[]
[]
[]
[null,null,"事業名：",0]

{"sheet":"別記様式第10","index":18,"n_rows":43,"n_cols":10,"rows_kept":43,"cut":false,"hidden":false,"merged":[[1,8,1,11],[4,7,4,11],[5,7,5,10],[7,0,7,11],[9,0,11,11],[13,0,13,11],[17,1,17,2],[18,5,18,6],[19,5,19,6],[20,5,20,6],[21,4,21,6],[21,8,21,10],[17,3,17,8]],"flags":["formulas_cached_only"]}
["別記様式第10"]
[{"$nulls":8},"令和　　年　　月　　日"]
["一般社団法人　環境共生住宅推進協議会"]
["会長　竹中　宣雄　殿"]
[{"$nulls":6},"代表提案者　"]
[]
[]
["令和５年度住宅・建築物環境対策事業費補助金完了実績報告書"]
[]
["　令和　　年　　月　　日付けＫＫＪ０５発第　　　号をもって補助金の交付決定を受けた標記事業が完了したので、令和５年度既存建築物省エネ化推進事業補助金交付規程第１０の規定により、関係書類を添え、下記のとおり報告します。"]
[]
[]
[]
["記"]
[]
["　１．補助事業の名称　　既存建築物省エネ化推進事業"]
[null,null,null,"（省エネルギー性能の診断・表示に対する支援）"]
[null,"事業名（",null,0,{"$nulls":5},"）"]
["　２．補助金の交付決定額及び精算額"]
["　　　　補助金の交付決定額",{"$nulls":6},"千円"]
["　　　　補助金の精算額",{"$nulls":6},"千円"]
["　３．補助事業の実施期間",null,null,null,"令和　年　月　日",null,null,"～","令和　年　月　日"]
["　４．補助事業の成果（添付書類のとおり）"]
[]
["　　（申請書類）"]
["　　　　１．交付決定通知書",{"$nulls":7},"（原本写し）"]
["　　　　２．補助金精算調書",{"$nulls":7},"（別紙１）"]
["　　　　３．科目別決算内訳",{"$nulls":7},"（別紙２）"]
["　　　　４．科目別決算内訳の明細",{"$nulls":7},"（別紙３）"]
[]
["　　（添付書類）"]
["　　　　１．事業計画及び補助申請額の変更",{"$nulls":7},"（別添１）"]
["　　　　２．事業着手確認書類",{"$nulls":7},"（任意様式）"]
["　　　　　　・ＢＥＬＳ等第三者機関の引受承諾書"]
["　　　　　　・業務委託契約書または注文書・請書"]
["　　　　３. ＢＥＬＳ等第三者機関の省エネルギー性能に関する評価結果及び領収書",{"$nulls":7},"（任意様式）"]
["　　　　４. 省エネルギー性能の診断・表示に係る費用（補助額）の支払いの事実を",{"$nulls":7},"（任意様式）"]
["　　　　　　証明できるもの（領収書及び送金伝票等）"]
["　　　　５．省エネ性能の表示が確認できるもの",{"$nulls":7},"（任意様式）"]
["　　　　６．その他確認に必要と思われるもの"]
[]
["　（記載上の注意）"]
["　　　　１．用紙の大きさは、日本工業規格で定めるＡ列４とし、縦位置とすること。"]

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[{"$nulls":6},"別紙１"]
[]
["補 助 金 精 算 調 書"]
[]
[]
["（単位：千円）"]
["区　　分",{"$nulls":4},"金　　額","備　　考"]
["交付決定の内容",1,null,"補助事業に要する経費"]
[null,2,null,"補助金額"]
["補助金換算額",3,null,"精算対象支払額"]
[null,4,null,"精算補助金額"]
[5,"補助金不用額"]
[null,"5=2-4"]
[6,"補助金受入済額"]
[7,"差引受入未済額または超過額"]
[null,"7=6-4"]
[]
["※　精算補助金額は他の補助金の受け入れ未済額とすること。"]
["※　添付する他の様式と金額が整合していること。"]
{"$rows_empty":15}
[null,null,null,"事業名：",null,0]

{"sheet":"別紙2_実績","index":20,"n_rows":46,"n_cols":12,"rows_kept":46,"cut":false,"hidden":false,"merged":[[5,6,5,11],[6,7,6,10],[7,7,7,10],[6,5,7,5],[10,5,11,5],[10,7,10,10],[11,7,11,10],[19,0,19,8],[6,0,11,0],[6,1,7,1],[10,1,11,1],[12,0,14,0],[20,0,20,11],[1,0,1,8],[2,0,2,11],[3,0,3,8],[4,0,4,11],[5,0,5,1],[9,7,9,10],[8,1,9,1],[8,5,9,5],[8,7,8,10],[5,2,5,4],[21,0,21,11],[22,0,22,11],[23,0,23,11],[44,0,44,8],[45,4,45,11],[12,7,12,10],[13,7,13,10],[14,7,14,10],[15,0,15,8],[16,0,16,6]],"flags":["formulas_cached_only"]}
[{"$nulls":11},"別紙２"]
[]
["科 目 別 決 算 内 訳"]
[]
["(単位：千円)"]
["事　業　区　分",null,"補助対象事業費",null,null,"補助率","補助金申請額"]
["内　訳","診断に要する費用\n(Ａ)","(",null,")","1/3","(",{"$nulls":4},")"]
[]
[null,"第三者認証・認定の\n取得に要する費用\n（Ｂ）","(",null,")","1/3","(",{"$nulls":4},"）"]
[]
[null,"表示に要する費用（Ｃ）","(",null,")","1/3","(",{"$nulls":4},"）"]
[]
[null,"補助金申請額合計\n（Ｄ）＝（Ａ＋Ｂ＋Ｃ）",null,0,null,null,null,0]
[null,"交付決定額\n(Ｅ)"]
[null,"変動増減\n(Ｄ-Ｅ)",{"$nulls":5},0]
[]
["　　補助対象建築物等における他の補助金の申請有無（予定含む）",{"$nulls":6},"□","あり","□","なし"]
["　　「あり」の場合は他の補助を受ける内容を具体的に記載した資料を添付して下さい。"]
[]
["（記載上の注意）"]
["１.  交付申請（または交付変更承認申請）に基づく交付決定額を上段（　）内に記載すること。"]
["２.  補助対象事業費には他の補助金を受けるものを含めることはできません。"]
{"$rows_empty":23}
[null,null,null,"事業名：",0]

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[{"$nulls":9},"別紙３"]
[]
["科目別決算内訳の明細"]
[]
[]
["１．省エネルギー性能の診断に要する費用"]
["(単位：千円)"]
["補助対象棟数",null,null,"補助対象事業費",null,null,"補助率","補助金申請額"]
["(",null,")","(",null,")","1/3","(",null,")"]
["　　　　　　　　　"]
[]
["２．省エネルギー性能の第三者認証・認定の取得に要する費用"]
[{"$nulls":9},"(単位：千円)"]
["補助対象棟数",null,null,"補助対象事業費",null,null,"補助率","補助金申請額"]
["(",null,")","(",null,")","1/3","(",null,")"]
["　　　　　　　　　"]
[]
["３．省エネルギー性能表示に要する費用"]
[{"$nulls":9},"(単位：千円)"]
["補助対象棟数",null,null,"補助対象事業費",null,null,"補助率","補助金申請額"]
["(",null,")","(",null,")","1/3","(",null,")"]
["　　　　　　　　　"]
[]
[]
[]
[null,"注１．交付申請(又は交付変更承認申請）に基づく交付決定額を上段（　）内に記載すること。"]
[null,"注２．事業量の減少による減額があった場合はその変更内容および額の積算内訳を添付すること。"]
{"$rows_empty":14}
[{"$nulls":4},"事業名：",0]

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[{"$nulls":5},"別添１"]
["事業計画及び補助申請額"]
[]
["１．事業計画"]
["項目",null,"補助対象事業費\n（単位：千円）","補助率","補助申請額\n（単位：千円）","備考"]
[]
["１．","省エネ診断に要する費用",0,"1/3",0]
["２．","第三者認証等に要する費用",0,"1/3",0]
["３．","省エネ性能表示に要する費用",0,"1/3",0]
["合計",null,0,null,0]
[]
["２．補助対象事業費の内訳"]
["項目",null,"単価\n（単位：千円）","棟数","補助対象事業費\n（単位：千円）","備考"]
[]
["１．","省エネ診断に要する費用"]
{"$rows_empty":7}
["小計　ａ",null,null,null,0]
["２．","第三者認証等に要する費用"]
{"$rows_empty":7}
["小計　ｂ",null,null,null,0]
["３．","省エネ性能表示に要する費用"]
{"$rows_empty":7}
["小計　ｃ",null,null,null,0]
[]
["注１）消費税等は除いた額を記載してください。"]
["注２）それぞれの項目にて、千円未満は切り捨てとして、金額を記載してください。"]
["注３）複数建築物を対象とする事業で、単価が異なる場合など、適宜、項目を区分して記載してください。"]
["注４）備考欄には、建築物の種別、表示の内容などを記載してください。"]
[]
[]
[]
[]
[null,null,"事業名：",0]

{"sheet":"別記様式第12","index":23,"n_rows":36,"n_cols":9,"rows_kept":36,"cut":false,"hidden":false,"merged":[[2,0,2,10],[6,4,6,7],[9,0,11,10],[14,7,14,10],[19,6,19,7],[20,6,20,10],[21,6,21,10],[22,6,22,10],[23,6,23,10],[24,6,24,9],[25,6,25,9],[28,1,31,2],[28,3,28,6],[28,7,28,9],[29,3,29,6],[29,7,29,9],[35,1,35,2],[35,3,35,9],[30,3,30,6],[30,7,30,9],[32,1,32,2],[32,3,32,9],[33,1,33,2],[34,1,34,2],[34,3,34,9]],"flags":["formulas_cached_only"]}
["別記様式第12"]
[]
["請　　求　　書"]
[]
[]
[]
[null,null,null,"請求額　　金",{"$nulls":4},"円"]
[]
[]
["　ただし、令和　　年　　月　　日付、ＫＫＪ０５発第　　　　　号で交付決定のあった令和５年度既存建築物省エネ化推進事業（省エネルギー性能の診断・表示に対する支援）に係る国庫補助金として、上記の金額を請求いたします。"]
[]
[]
[]
[]
[{"$nulls":7},"令和　　年　　月　　日"]
[]
["一般社団法人　環境共生住宅推進協議会"]
["会長　竹中　宣雄　殿"]
[]
[{"$nulls":5},"請求者　住所　","〒"]
[]
[]
[{"$nulls":5},"氏名又は名称　"]
[]
[{"$nulls":5},"代表者の職名・氏名　"]
[]
["＜ 振 込 先 ＞"]
[]
[null,"振込先",null,"銀行名",null,null,null,"支店名"]
[]
[null,null,null,"銀行コード",null,null,null,"支店コード"]
[]
[null,"預金種別",null,"普通　・　当座　・　貯蓄　・　その他"]
[null,"口座番号(右詰)"]
[null,"口座名義(カナ)"]
[null,"口座名義(漢字)"]