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在 留 期 間 更 新 許 可 申 請 書 APPLICATION FOR …

For applicant, part1 Ministry of Justice,Government of Japan1 2 Nationality/RegionDate of birthDay3 Name Family nameGiven name4 5 SexMale/FemaleMarital status6 7 OccupationHome town/city8 Address in Japan9 Telephone phone (1) (2) Passport NumberDate of expirationDay11 Status of residencePeriod of stay Date of expirationDay12 Residence card number13 Desired length of extension ( It may not be as desired after examination.)14 Reason for extension15 Criminal record (in Japan / overseas) Including dispositions due to traffic violations, etc. Yes ( Detail:) / No16 ( ) ( ) Family in Japan (father, mother, spouse, children, siblings,grandparents, uncle, aunt or others) and cohabitants Yes/ No Note : Please fill in forms required for APPLICATION .

Activities to engage in services whic h require knowledge pertin ent to natural scie nce fields or human science fields ... Engaging in work requirin g skills whic h need considerable knowledge or experie nce based on an employment contract for specified skilled workers

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