How to complete “application form for issuance of the Individual Number Card“
”Application form for issuance of the Individual Number Card/the electronic certificate” / Front side
(1) ”Application form for issuance of the Individual Number Card/the electronic certificate”
“The Individual Number Card” and “electronic certificate” contained in the card can be applied by this single application form.
See here for “the Individual Number Card”
See here for “electronic certificate”
(2) Application form ID
(3) Name, (4) Address, (5) Date of birth, (6) Sex
If there is any error in the name, address, etc. printed on the form or there is any change due to moving, etc., please contact your local municipality as you will not be able to use this application form.
*Contact phone number is printed on the enclosed address label.
(7) Phone number
Please enter a phone number where you can be contacted during the day.
* This phone number is used only for inquiries regarding this matter.
(8) Classification of foreign residents (For foreign residents only)
When the entered information is different from the one appearing on the residence card, you cannot use this application form. Please contact your local municipality.
(9) Whether or not there is the date of expiration of the period of stay, etc. / Date of expiration of the period of stay
(10) Braille writing in the right box is desired.
When you need Braille writing for the “Individual Number Card,” please fill the box completely using a black pen.
Your name in the right box will be shown in Braille.
If braille Kana is not printed, display in braille is not available. In such a case, contact your municipality.
(11) By scanning the QR code on the left, you can make an application for issuance of the Individual Number Card with a smartphone, etc.
(12) Uni-Voice for the visually impaired
(13) Application form ID
”Application form for issuance of the Individual Number Card/the electronic certificate” / Back side
(1) Having confirmed there is no error in the descriptions on the front side, I make an application for issuance of the Individual Number Card and electronic certificates.
(2) Application date
Please enter application date.
(3) Applicant name
The applicant’s signature or affixing applicant’s name and seal is required.
(4) ID photograph attachment box
Please attach your ID photograph.
“Check points of your photograph” are here
(5) Whether or not issuance of “Electronic certificate for the bearer’s signature” or “Electronic certificate for user identification” is required
The electronic certificate is necessary to receive a variety of services including filing electronic applications such as e-Tax, logging in to Disclosure System of Personal Information Cooperation Record and Convenience Store Issuance service.
Note that if you blacken the square mark, the electronic certificate is not issued.
See here for “electronic certificate”
(6) Columns to be filled in by agent
As a rule, the certificate is not issued for a person under 15 years of age and for an adult ward.
(7) Japanese syllabaries, (8) Name of the representative (written by the applicant), (9) Relationship with the applicant, (10) Address, (11) Phone number
- ●When a minor under the age of 15 or an adult ward makes an application, his/her statutory agent must enter name and other information in the “Columns to be filled by agent”.
- ●When making an application, fill in the form by referring to the enclosed "Guidance" (written in Japanese only).
- ●If there is any error or alteration in the items marked with an asterisk (*) described on the front side, the application cannot be accepted. In such a case, do not send this application form and contact a service counter of your municipality.
- ●Keep this separated part safe along with the notification card because it is necessary to make an inquiry.