Reference forms for the Status of Residence "Specified Skilled Worker" (new versions)

Items related to applications for residency

Reference forms Form name Forms
No. 1-2 Written Assessment of the Technical Intern Trainee Excel (in Japanese)Excel PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-3 Health Check Report
(Including the "Declaration by Medical Checkup Examinee" attachment.)
Word (in Japanese)Word PDF (in Japanese)PDF
No. 1-4 Statement of Remuneration for Foreign National Specified Skilled Workers Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-5 Employment Contract for Specified Skilled Workers Word (in Japanese)Word PDF (in Japanese)PDF
No. 1-6 Written Employment Conditions
(Includes the "Payment of Wages" attachment.)
Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-9 Statement of Expense Collection Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-10 Written Declaration on the Transfer of Skills Word (in Japanese)Word PDF (in Japanese)PDF
No. 1-11 Overview of the Affiliated Organization Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-12 Dispatch Plan Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-13 Statement of Employment Conditions Excel (in Japanese)Excel PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-14 Overview of the dispatch destination (Agriculture) Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-15 Overview of the dispatch destination (Fisheries) Word (in Japanese)Word PDF (in Japanese)PDF
No. 1-16 Explanation of Employment Background Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-17 Support Plan for Specified Skilled Worker (i) Excel (in Japanese)Excel PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-20 Curriculum Vitae of the Support Supervisor Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-22 Curriculum Vitae of the Support Manager Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-23 Written Pledge for Affiliated Organization Staff Word (in Japanese)Word PDF (in Japanese)PDF
No. 1-25 Explanation of the Contracted Consignment of Aid with the Registered Support Organization Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 1-26 Pledge to Fulfill Public Obligations Word (in Japanese)Word PDF (in Japanese)PDF 
No. 1-27 Statement of Public Obligations to be Fulfilled Word (in Japanese)Word PDF (in Japanese)PDF 
No. 1-28 Statement Concerning the Impact of COVID-19 Word (in Japanese)Word PDF (in Japanese)PDF 

Items related to registering (or renewing) a registered support organization

Reference forms Form name Forms
No. 2-1 Registered Support Organization Written Pledge Word (in Japanese)Word PDF (in Japanese)PDF
No. 2-2 Overview of the Registered Support Organization Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 2-3 Support Supervisor Consent of Assignment and Written Pledge Word (in Japanese)Word PDF (in Japanese)PDF
No. 2-4 Curriculum Vitae of the Support Supervisor Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 2-5 Support Manager Consent of Assignment and Written Pledge Word (in Japanese)Word PDF (in Japanese)PDF
No. 2-6 Curriculum Vitae of the Support Manager Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF
No. 2-7 Written Pledge for Registered Support Organization Staff Word (in Japanese)Word PDF (in Japanese)PDF
No. 2-8 Explanation of the Fees Related to the Consignment of Aid (Estimated) Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF

Items related to ad-hoc and periodic notifications

Reference forms Form name Forms
No. 3-1 Notification pertaining to the employment contract of a specified skilled worker Excel (in Japanese)Excel PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 3-1 (Attachment) Notification pertaining to the employment contract of a specified skilled worker (attachment) Excel (in Japanese)Excel PDF (in Japanese)PDF
No. 3-2 Notification pertaining to changes to the support plan Excel (in Japanese)Excel PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 3-2 (Attachment) Notification pertaining to changes to the support plan (attachment) Excel (in Japanese)Excel PDF (in Japanese)PDF
No. 3-3 Notification pertaining to the support contract of the affiliated organization Excel (in Japanese)Excel PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 3-3 (Attachment) Notification pertaining to the support contract of the affiliated organization (attachment) Excel (in Japanese)Excel PDF (in Japanese)PDF
No. 3-4 Notification pertaining to employment difficulties (attachment) Excel (in Japanese)Excel PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 3-4 (Attachment) Notification pertaining to employment difficulties Excel (in Japanese)Excel PDF (in Japanese)PDF
No. 3-5 Notification pertaining to unfair acts (misconduct)
under immigration/labor laws and regulations
Excel (in Japanese)Excel PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 3-5 (Attachment) Regarding laws related to immigration and labor
Notification pertaining to unfair acts (misconduct) (attachment)
Excel (in Japanese)Excel PDF (in Japanese)PDF
No. 3-6 Notification pertaining to status of employment Word (in Japanese)Word PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 3-7 Notification pertaining to the status of implementation of a support system Word (in Japanese)Word PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 3-7 (Attachment) List of Specified Skilled Workers (i) to be supported Word (in Japanese)Word PDF (in Japanese)PDF
No. 3-8 Notification pertaining to an organization's status of activities Word (in Japanese)Word PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 3-8 (Attachment) Status of payment of remuneration for foreign national specified skilled workers Word (in Japanese)Word PDF (in Japanese)PDF
No. 4-1 Notification pertaining to the suspension or dissolution of support services Excel (in Japanese)Excel PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 4-2 Notification of the resumption of support services Excel (in Japanese)Excel PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 4-3 Notification pertaining to the status of implementation of a support system Word (in Japanese)Word PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 4-3 (Attachment) List of Specified Skilled Workers (i) to be supported Word (in Japanese)Word PDF (in Japanese)PDF
No. 4-4 Notification pertaining to changes in registration matters
(Attachment No. 29-16 in the appendix)
Excel (in Japanese)Excel PDF (in Japanese)PDF
No. 5-1 Improvement Report (pursuant to Article 19-19) Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-2 Improvement Report (pursuant to Article 19-21) Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-3 Improvement Report (pursuant to Article 19-31) Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-4 Consultation Records Word (in Japanese)Word PDF (in Japanese)PDF
Example (in Japanese)PDF
No. 5-5 Periodic Questionnaire (for Specified Skilled Workers (i)) Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-6 Periodic Questionnaire (for Supervisors) Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-7 Proof of Payment of Remuneration Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-8 Confirmation of Orientation for Life in Japan Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-9 Confirmation of Advance Guidance Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-10 Consignment of Aid Contract Word (in Japanese)Word PDF (in Japanese)PDF 
Example (in Japanese)PDF

Forms available in English (and nine other languages)

Forms which require the applicant's signature and a clear understanding of their contents (*1) have been translated into English and nine other languages.
Please note that with certain system settings, some languages may not display correctly.

Language Forms
English WordWord ExcelExcel PDFPDF (*2)
Vietnamese WordWord ExcelExcel PDFPDF (*3)
Tagalog WordWord ExcelExcel PDFPDF (*3)
Indonesian WordWord ExcelExcel PDFPDF (*3)
Thai WordWord ExcelExcel PDFPDF (*3)
Myanmar Language WordWord ExcelExcel PDFPDF (*3)
Khmer WordWord ExcelExcel PDFPDF (*3)
Mongolian WordWord ExcelExcel PDFPDF (*3)
Nepali WordWord ExcelExcel PDFPDF (*3)
Chinese WordWord ExcelExcel PDFPDF (*3)

(*1)
Form No. 1-3 Health Check Report
Form No. 1-5 Employment Contract for Specified Skilled Workers
Form No. 1-6 Written Employment Conditions
Form No. 1-7 Confirmation of Advance Guidance
Form No. 1-10 Written Declaration on the Transfer of Skills
Form No. 1-13 Statement of Employment Conditions
Form No. 1-16 Explanation of Employment Background
Form No. 1-17 Support Plan for Specified Skilled Worker (i)
Form No. 5-7 Proof of Payment of Remuneration
Form No. 5-8 Confirmation of Orientation for Life in Japan

(*2)
Form No. 1-13 and 1-17 are only available as Excel documents, due to their use of variable data. All other reference forms are available as Word documents.
(*3)
Form No. 1-13 is only available as an Excel document, due to its use of variable data. All other reference forms are available as Word documents.

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