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["免責事項",null,null,null,null,null,"弊社では、作業トラブルによる事後の損害については一切のご負担を致しかねます。",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,"同意して申し込む",null,null,null,null,null,null,null,null,"サイン"]
[]
["▼ ▼ ▼ ▼ ▼ ▼ ▼ ▼ ▼　　　ここから下は弊社使用欄のため、記入しないでください　　　▼ ▼ ▼ ▼ ▼ ▼ ▼ ▼ ▼"]
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["/",null,null,null,null,null,null,null,null,null,"不要",null,null,null,null,null,null,"E-mail",null,null,null,null,null,null,"電話(24h可)"]
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[":",null,null,null,null,null,null,null,null,null,"電話\n(時間指定)"]
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["作業完了後の引取方法"]
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["機械的",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"□",null,"Blu-ray複製"]
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["□",null,"販売物",null,null,null,null,null,null,null,"□",null,"DVD-R",null,null,null,null,null,null,null,null,null,null,null,"枚",null,"□",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"×",null,null,null,null,null,"本",null,"備考"]
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