Reference Forms for the Status of Residence "Specified Skilled Worker" (New Versions)

Comprehensive reminders

Items related to applications for residency for specified skilled workers

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 Notes (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
* Example: multiple people (PDF, in Japanese)PDF
* Reference forms can be found here.
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: individual-owned property (PDF, in Japanese)PDF
Example: leased property (PDF, in Japanese)PDF
* (Example: multiple people) (PDF, in Japanese)PDF
* Reference forms can be found here.
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
Example: multiple people (PDF, in Japanese)PDF
* Reference forms can be found here.
No. 1-17 Support Plan for Specified Skilled Worker (i) Excel (in Japanese)Excel PDF (in Japanese)PDF Example: fully outsourced (in Japanese)PDF
Example: in-house support (PDF, in Japanese)PDF
* Example: multiple people (PDF, in Japanese)PDF
* Reference forms can be found here.
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
* (Example: multiple people) (PDF, in Japanese)PDF
* Reference forms can be found here.
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 Excel (in Japanese)Excel PDF (in Japanese)PDF Example (in Japanese)PDF
No. 3-4 (Attachment) Notification pertaining to employment difficulties (attachment) 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) Notification pertaining to unfair acts
(misconduct under immigration/labor laws and regulations) (attachment)
Excel (in Japanese)Excel PDF (in Japanese)PDF
No. 3-6 Notifications regarding acceptances and activities Word (in Japanese)Word PDF (in Japanese)PDF Example (in Japanese)PDF
No. 3-6 (Attachment) Acceptance and payment status of foreign national specified skilled workers Excel (in Japanese)Excel 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 Example (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 Example (in Japanese)PDF
No. 4-4 Notification regarding changes to registration items
(Appendix Form 29-16)
Excel (in Japanese)Excel PDF (in Japanese)PDF
No. 5-1 Improvement report (Article 19-19) Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-2 Improvement report (Article 19-21) Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-3 Improvement report (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 interview (written report, for foreign national specified skilled workers (i)) Word (in Japanese)Word PDF (in Japanese)PDF Example (in Japanese)PDF
No. 5-6 Periodic interview (written report, for supervisors) Word (in Japanese)Word PDF (in Japanese)PDF Example (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 Example (in Japanese)PDF
No. 5-9 Confirmation of advance guidance Word (in Japanese)Word PDF (in Japanese)PDF
No. 5-10 Support contract Word (in Japanese)Word PDF (in Japanese)PDF Example (in Japanese)PDF
No. 5-11 Document outlining the particular circumstances which have resulted in difficulties in accepting a specified skilled worker Word (in Japanese)Word Excel (in Japanese)Excel PDF (in Japanese)PDF

Forms in English and nine other languages

Forms that require the applicant's signature and full understanding (*1) have been published in English and nine other languages.
Please note that with certain system settings, some languages may not display correctly.

Language Forms
English (Word)Word (Excel)Excel (PDF)PDF(※2)
Vietnamese (Word)Word (Excel)Excel (PDF)PDF(※3)
Tagalog (Word)Word (Excel)Excel (PDF)PDF(※3)
Indonesian (Word)Word (Excel)Excel (PDF)PDF(※3)
Thai (Word)Word (Excel)Excel (PDF)PDF(※3)
Myanmar Language (Word)Word (Excel)Excel (PDF)PDF(※3)
Khmer (Word)Word (Excel)Excel (PDF)PDF(※3)
Mongolian (Word)Word (Excel)Excel (PDF)PDF(※3)
Nepali (Word)Word (Excel)Excel (PDF)PDF(※3)
Chinese (Word)Word (Excel)Excel (PDF)PDF(※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 Workers (i)
Form No. 5-7 Proof of Payment of Remuneration
Form No. 5-8 Confirmation of Orientation for Life in Japan

(*2)
Forms 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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