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{"sheet":"E5048","index":0,"n_rows":118,"n_cols":24,"rows_kept":118,"cut":false,"hidden":false,"merged":[[110,1,110,20],[111,1,111,20],[101,17,105,19],[107,1,107,16],[117,1,117,20],[109,1,109,15],[116,1,116,5],[116,6,116,7],[116,11,116,19],[108,8,108,9],[108,10,108,15],[90,17,99,20],[98,9,98,14],[99,8,99,14],[99,2,99,7],[94,3,94,14],[97,3,97,14],[98,2,98,5],[98,6,98,8],[26,7,26,14],[39,6,39,7],[81,4,81,9],[81,17,89,20],[84,4,84,7],[85,4,85,6],[85,7,85,14],[87,4,87,8],[88,4,88,8],[86,4,86,9],[86,10,86,14],[49,10,49,15],[52,1,52,20],[5,12,6,18],[9,17,21,20],[48,1,48,16],[22,17,30,20],[28,4,28,8],[20,4,20,7],[38,3,38,14],[39,2,39,5],[40,8,40,14],[40,2,40,7],[39,8,39,14],[31,17,40,20],[27,10,27,14],[16,5,16,9],[2,2,2,17],[10,3,10,14],[57,6,57,7],[8,6,8,14],[16,10,16,14],[19,4,19,8],[19,9,19,14],[49,8,49,9],[35,3,35,14],[22,4,22,9],[14,10,14,14],[25,4,25,7],[26,4,26,6],[21,4,21,9],[57,1,57,5],[50,1,50,15],[78,4,78,8],[78,9,78,14],[72,4,72,7],[42,17,46,19],[1,2,1,11],[60,2,60,11],[7,2,7,6],[8,2,8,5],[14,4,14,9],[13,4,13,7],[13,8,13,14],[11,4,11,14],[29,4,29,8],[58,1,58,20],[51,1,51,20],[27,4,27,9],[61,2,61,17],[68,17,80,20],[57,11,57,19],[79,4,79,7],[80,4,80,9],[67,2,67,5],[72,8,72,14],[70,4,70,14],[69,3,69,14],[67,6,67,14],[64,12,65,18],[66,2,66,6],[73,4,73,9],[73,10,73,14],[75,5,75,9],[75,10,75,14]]}
[null,null,"日商瑞穗銀行  Mizuho Bank, Ltd."]
[null,null,"外 匯 收 支 或 交 易 申 報 書",null,null,null,null,null,null,null,null,null,"（結 售 外 匯 專 用）",null,null,null,null,null,null,null,null,null,null,"□"]
[null,null,"Declaration Statement of Foreign Exchange Receipts and Disbursements or Transactions  (For settlement of sale only)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"☑"]
[null,"□","由國外匯入直接結售",null,null,null,null,"□","由國內他行匯入結售",null,null,null,null,"□","由外匯存款提出結售"]
[null,null,"Direct inward remittance from abroad",null,null,null,null,null,"Remittance from another domestic bank",null,null,null,null,null,"Withdrawal from foreign currency deposit account"]
[null,"□","以外幣現鈔或旅行支票結售",null,null,null,null,null,"□","其他（請說明）:"]
[null,null,"Sale of foreign currency cash or traveler's check",null,null,null,null,null,null,"Others (please indicate):"]
[null,"一.","申報日期 (Date of Declaration):",null,null,null,null,null,"年(Yr)",null,"月(Mo)",null,"日(Dy)"]
[null,"二.","申報義務人 (Declarant):",null,null,null,null,null,null,null,null,null,null,null,null,null,"注意 (Notices) :"]
[null,"三.","申報義務人登記證號 (Declarant's ID No.):",null,null,null,null,null,null,null,null,null,null,null,null,null,"一.","申報義務人務請審慎據實申報，申報後除有「外匯收支或交易申報辦法」第13條之情形外，不得要求更改申報書內容。\nThe Declarant shall exercise Deliberation in making a truthful declaration. Except for the situations under Article 13 of the Regulations Governing the Declaration of Foreign Exchange Receipts and Disbursements or Transactions, the declarant may not request to make changes to the contents of the Declaration Statement after the declaration is made."]
[null,null,"□","1. 公司、有限合夥、行號：統一編號 (Company, Limited Partnership, or firm：Uniform No.):"]
[]
[null,null,"□","2. 團體、辦事處及事務所 (Association, representative's office):"]
[null,null,null,null,"統一編號 (Uniform No.):"]
[null,null,null,null,"其他無統一編號者: 設立登記主管機關:"]
[null,null,null,null,"Others without Uniform No. : Competent authority for establishment and registration:"]
[null,null,null,null,null,"登記證號 (Registration No.):"]
[null,null,"□","3. 個人 (國民身分證、居留證效期一年以上)"]
[null,null,null,"Individual (Citizen's ID Card or Resident Certificate with a validity for at least one year)"]
[null,null,null,null,"身分證號或統一證號 (ID No.):"]
[null,null,null,null,"出生日期 (Date of birth):",null,null,null,null,"年(Yr)",null,"月(Mo)",null,"日(Dy)"]
[null,null,null,null,"居留證發給日期 (Date of issuance):",null,null,null,null,null,null,"年(Yr)",null,"月(Mo)",null,"日(Dy)"]
[null,null,null,null,"居留證到期日期 (Date of expiry):",null,null,null,null,null,null,"年(Yr)",null,"月(Mo)",null,"日(Dy)","二.","申報義務人申報不實，依管理外匯條例第20條第1項規定，處新臺幣3萬元以上，60萬元以下罰鍰。\nUntruthful declarations are subject to a fine of at  least New Taiwan dollars 30,000 and no more than New Taiwan dollars 600,000 pursuant to Paragraph 1, Article 20 of Foreign Exchange Control Act."]
[null,null,"□","4. 非居住民 (護照、入出境許可相關證明文件、居留證效期未滿一年)"]
[null,null,null,"Non-resident (Passport, Entry and Exit Permit or related document, or Resident Certificate with a validity of less than one year)"]
[null,null,null,null,"出生日期 (Date of birth):",null,null,null,null,"年(Yr)",null,"月(Mo)",null,"日(Dy)"]
[null,null,null,null,"國別 (Nationality):"]
[null,null,null,null,"護照或證照號碼 (Passport or Certificate No.):"]
[null,null,null,null,"居留證發給日期 (Date of issuance):",null,null,null,null,null,"年(Yr)",null,"月(Mo)",null,"日(Dy)"]
[null,null,null,null,"居留證到期日期 (Date of expiry):",null,null,null,null,null,"年(Yr)",null,"月(Mo)",null,"日(Dy)"]
[null,"四.","外匯收入或交易性質 (性質超過一種者，應加填每種性質之金額):"]
[null,null,"Nature of foreign exchange receipts or transactions (if more than one category, indicate amount for each category)",null,null,null,null,null,null,null,null,null,null,null,null,null,"三.","本申報書匯款金額不得塗改，其餘部分如經塗改，應由申報義務人在塗改處簽章，否則本申報書不生效力。\nThe remittance amount stated in this Declaration Statement shall not be altered. If any other section stated in this Declaration Statement is altered, the  declarant shall affix his/her seal or signature next to the alteration; failure to do so shall render this Declaration Statement invalid."]
[null,null,"□","出口貨品收入或對非居住民提供服務收入 (應具體詳填性質)"]
[null,null,null,"Receipts from the export of goods or the provision of services to non-residents"]
[null,null,null,"(indicate in detail the nature of the transaction )"]
[]
[null,null,"□","其他匯入款項(應具體詳填性質)"]
[null,null,null,"Other inward remittance (indicate in detail the nature of the transaction)"]
[]
[null,"五.","匯款金額 Amount remitted:"]
[null,"六.","匯款地區國別 Remittance from (country):"]
[null,"茲具結以上所報均屬真實"]
[null,"The undersigned hereby declares that all information provided above is true and correct.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"銀行業或外匯證券商\n負責輔導申報義務人員\n簽章\nSignature of Banking\nEnterprise or DSF Personnel\nAdvising the Declarant"]
[null,null,null,null,null,"此     致",null,"To"]
[null,"中央銀行 Central Bank of the Republic of China (Taiwan)"]
[]
[]
[]
[null,"申報義務人及其負責人簽章 Signature of the Declarant and its responsible person"]
[null,"地址 Address:",null,null,null,null,null,null,"電話 Tel:"]
[]
[null,"以下各欄由銀行業或外匯證券商填寫"]
[null,"The banking enterprise or DSF (Domestic Security Firm Approved To Conduct Foreign Exchange Business) shall fill out the section below"]
[null,"送件編號 Case No.:",null,null,null,null,null,"銀行業或外匯證券商簽章及日期 Banking Enterprise or DSF seal and date:"]
[null,"外匯水單編號 Foreign Exchange Memo No.:"]
[null,"第一聯 (承辦銀行業或外匯證券商留存)"]
[null,"First Copy (to be kept by the banking enterprise or DSF)"]
[null,"(E5048) Electronic Application ",null,null,null,null,20211201,null,null,null,null,"保存期限至少五年  (Retained for at least five years)  (21公分 × 29.7公分)"]
[null," "]
[null,null,"日商瑞穗銀行  Mizuho Bank, Ltd."]
[null,null,"外 匯 收 支 或 交 易 申 報 書",null,null,null,null,null,null,null,null,null,"（結 售 外 匯 專 用）"]
[null,null,"Declaration Statement of Foreign Exchange Receipts and Disbursements or Transactions  (For settlement of sale only)"]
[null,{"$f":"IF($B$4=\"\",\"\",$B$4)","v":"□"},"由國外匯入直接結售",null,null,null,null,{"$f":"IF($H$4=\"\",\"\",$H$4)","v":"□"},"由國內他行匯入結售",null,null,null,null,{"$f":"IF($N$4=\"\",\"\",$N$4)","v":"□"},"由外匯存款提出結售"]
[null,null,"Direct inward remittance from abroad",null,null,null,null,null,"Remittance from another domestic bank",null,null,null,null,null,"Withdrawal from foreign currency deposit account"]
[null,{"$f":"IF($B$6=\"\",\"\",$B$6)","v":"□"},"以外幣現鈔或旅行支票結售",null,null,null,null,null,{"$f":"IF($I$6=\"\",\"\",$I$6)","v":"□"},"其他（請說明）:",null,null,{"$f":"IF($M$6=\"\",\"\",$M$6)","v":""}]
[null,null,"Sale of foreign currency cash or traveler's check",null,null,null,null,null,null,"Others (please indicate):"]
[null,"一.","申報日期 (Date of Declaration):",null,null,null,null,{"$f":"IF($H$8=\"\",\"\",$H$8)","v":""},"年(Yr)",{"$f":"IF($J$8=\"\",\"\",$J$8)","v":""},"月(Mo)",{"$f":"IF($L$8=\"\",\"\",$L$8)","v":""},"日(Dy)"]
[null,"二.","申報義務人 (Declarant):",null,null,null,{"$f":"IF($G$9=\"\",\"\",$G$9)","v":""},null,null,null,null,null,null,null,null,null,"注意 (Notices) :"]
[null,"三.","申報義務人登記證號 (Declarant's ID No.):",null,null,null,null,null,null,null,null,null,null,null,null,null,"一.","申報義務人務請審慎據實申報，申報後除有「外匯收支或交易申報辦法」第13條之情形外，不得要求更改申報書內容。\nThe Declarant shall exercise Deliberation in making a truthful declaration. Except for the situations under Article 13 of the Regulations Governing the Declaration of Foreign Exchange Receipts and Disbursements or Transactions, the declarant may not request to make changes to the contents of the Declaration Statement after the declaration is made."]
[null,null,{"$f":"IF($C$11=\"\",\"\",$C$11)","v":"□"},"1. 公司、有限合夥、行號：統一編號 (Company, Limited Partnership, or firm：Uniform No.):"]
[null,null,null,null,{"$f":"IF($E$12=\"\",\"\",$E$12)","v":""}]
[null,null,{"$f":"IF($C$13=\"\",\"\",$C$13)","v":"□"},"2. 團體、辦事處及事務所 (Association, representative's office):"]
[null,null,null,null,"統一編號 (Uniform No.):",null,null,null,{"$f":"IF($I$14=\"\",\"\",$I$14)","v":""}]
[null,null,null,null,"其他無統一編號者: 設立登記主管機關:",null,null,null,null,null,{"$f":"IF($K$15=\"\",\"\",$K$15)","v":""}]
[null,null,null,null,"Others without Uniform No. : Competent authority for establishment and registration:"]
[null,null,null,null,null,"登記證號 (Registration No.):",null,null,null,null,{"$f":"IF($K$17=\"\",\"\",$K$17)","v":""}]
[null,null,{"$f":"IF($C$18=\"\",\"\",$C$18)","v":"□"},"3. 個人 (國民身分證、居留證效期一年以上)"]
[null,null,null,"Individual (Citizen's ID Card or Resident Certificate with a validity for at least one year)"]
[null,null,null,null,"身分證號或統一證號 (ID No.):",null,null,null,null,{"$f":"IF($J$20=\"\",\"\",$J$20)","v":""}]
[null,null,null,null,"出生日期 (Date of birth):",null,null,null,{"$f":"IF($I$21=\"\",\"\",$I$21)","v":""},"年(Yr)",{"$f":"IF($K$21=\"\",\"\",$K$21)","v":""},"月(Mo)",{"$f":"IF($M$21=\"\",\"\",$M$21)","v":""},"日(Dy)"]
[null,null,null,null,"居留證發給日期 (Date of issuance):",null,null,null,null,null,{"$f":"IF($K$22=\"\",\"\",$K$22)","v":""},"年(Yr)",{"$f":"IF($M$22=\"\",\"\",$M$22)","v":""},"月(Mo)",{"$f":"IF($O$22=\"\",\"\",$O$22)","v":""},"日(Dy)"]
[null,null,null,null,"居留證到期日期 (Date of expiry):",null,null,null,null,null,{"$f":"IF($K$23=\"\",\"\",$K$23)","v":""},"年(Yr)",{"$f":"IF($M$23=\"\",\"\",$M$23)","v":""},"月(Mo)",{"$f":"IF($O$23=\"\",\"\",$O$23)","v":""},"日(Dy)","二.","申報義務人申報不實，依管理外匯條例第20條第1項規定，處新臺幣3萬元以上，60萬元以下罰鍰。\nUntruthful declarations are subject to a fine of at  least New Taiwan dollars 30,000 and no more than New Taiwan dollars 600,000 pursuant to Paragraph 1, Article 20 of Foreign Exchange Control Act."]
[null,null,{"$f":"IF($C$24=\"\",\"\",$C$24)","v":"□"},"4. 非居住民 (護照、入出境許可相關證明文件、居留證效期未滿一年)"]
[null,null,null,"Non-resident (Passport, Entry and Exit Permit or related document, or Resident Certificate with a validity of less than one year)"]
[null,null,null,null,"出生日期 (Date of birth):",null,null,null,{"$f":"IF($I$26=\"\",\"\",$I$26)","v":""},"年(Yr)",{"$f":"IF($K$26=\"\",\"\",$K$26)","v":""},"月(Mo)",{"$f":"IF($M$26=\"\",\"\",$M$26)","v":""},"日(Dy)"]
[null,null,null,null,"國別 (Nationality):",null,null,{"$f":"IF($H$27=\"\",\"\",$H$27)","v":""}]
[null,null,null,null,"護照或證照號碼 (Passport or Certificate No.):",null,null,null,null,null,{"$f":"IF($K$28=\"\",\"\",$K$28)","v":""}]
[null,null,null,null,"居留證發給日期 (Date of issuance):",null,null,null,null,{"$f":"IF($J$29=\"\",\"\",$J$29)","v":""},"年(Yr)",{"$f":"IF($L$29=\"\",\"\",$L$29)","v":""},"月(Mo)",{"$f":"IF($N$29=\"\",\"\",$N$29)","v":""},"日(Dy)"]
[null,null,null,null,"居留證到期日期 (Date of expiry):",null,null,null,null,{"$f":"IF($J$30=\"\",\"\",$J$30)","v":""},"年(Yr)",{"$f":"IF($L$30=\"\",\"\",$L$30)","v":""},"月(Mo)",{"$f":"IF($N$30=\"\",\"\",$N$30)","v":""},"日(Dy)"]
[null,"四.","外匯收入或交易性質 (性質超過一種者，應加填每種性質之金額):"]
[null,null,"Nature of foreign exchange receipts or transactions (if more than one category, indicate amount for each category)",null,null,null,null,null,null,null,null,null,null,null,null,null,"三.","本申報書匯款金額不得塗改，其餘部分如經塗改，應由申報義務人在塗改處簽章，否則本申報書不生效力。\nThe remittance amount stated in this Declaration Statement shall not be altered. If any other section stated in this Declaration Statement is altered, the  declarant shall affix his/her seal or signature next to the alteration; failure to do so shall render this Declaration Statement invalid."]
[null,null,{"$f":"IF($C$33=\"\",\"\",$C$33)","v":"□"},"出口貨品收入或對非居住民提供服務收入 (應具體詳填性質)"]
[null,null,null,"Receipts from the export of goods or the provision of services to non-residents"]
[null,null,null,"(indicate in detail the nature of the transaction )"]
[null,null,null,{"$f":"IF($D$36=\"\",\"\",$D$36)","v":""}]
[null,null,{"$f":"IF($C$37=\"\",\"\",$C$37)","v":"□"},"其他匯入款項(應具體詳填性質)"]
[null,null,null,"Other inward remittance (indicate in detail the nature of the transaction)"]
[null,null,null,{"$f":"IF($D$39=\"\",\"\",$D$39)","v":""}]
[null,"五.","匯款金額 Amount remitted:",null,null,null,{"$f":"IF($G$40=\"\",\"\",$G$40)","v":""},null,null,{"$f":"IF($I$40=\"\",\"\",$I$40)","v":""}]
[null,"六.","匯款地區國別 Remittance from (country):",null,null,null,null,null,{"$f":"IF($I$41=\"\",\"\",$I$41)","v":""}]
[null,"茲具結以上所報均屬真實"]
[null,"The undersigned hereby declares that all information provided above is true and correct.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"銀行業或外匯證券商\n負責輔導申報義務人員\n簽章\nSignature of Banking\nEnterprise or DSF Personnel\nAdvising the Declarant"]
[null,null,null,null,null,"此     致",null,"To"]
[null,"中央銀行 Central Bank of the Republic of China (Taiwan)"]
[]
[]
[]
[null,"申報義務人及其負責人簽章 Signature of the Declarant and its responsible person"]
[null,"地址 Address:",null,null,null,null,null,null,"電話 Tel:",null,{"$f":"IF($K$50=\"\",\"\",$K$50)","v":""}]
[null,{"$f":"IF($B$51=\"\",\"\",$B$51)","v":""}]
[null,"以下各欄由銀行業或外匯證券商填寫"]
[null,"The banking enterprise or DSF (Domestic Security Firm Approved To Conduct Foreign Exchange Business) shall fill out the section below"]
[null,"送件編號 Case No.:",null,null,null,null,null,"銀行業或外匯證券商簽章及日期 Banking Enterprise or DSF seal and date:"]
[null,"外匯水單編號 Foreign Exchange Memo No.:"]
[null,"第二聯 (申報義務人留存備查)"]
[null,"Second Copy (to be kept by the declarant)"]
[null,{"$f":"IF($B$58=\"\",\"\",$B$58)","v":"(E5048) Electronic Application "},null,null,null,null,{"$f":"IF($G$58=\"\",\"\",$G$58)","v":20211201},null,null,null,null,"保存期限至少五年  (Retained for at least five years)  (21公分 × 29.7公分)"]
[null,"Note: 使用此申請書時，本人/本公司同意不更動除填記欄位以外之申請書內容及文字，若更動該申請書內容或文字而造成 貴行損失時願負一切責任。"]