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

1 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 .

2 (See notes on reverse side.) Note : In case of to be found that you have misrepresented the facts in an APPLICATION , you will be unfavorably treated in the process. APPLICATION FOR EXTENSION OF PERIOD OF STAY To the Minister of Justice Pursuant to the provisions of Paragraph 2 of Article 21 of the Immigration Control and Refugee Recognition Act,I hereby apply for extension of period of stay. Married / Single YearMonth YearMonth YearMonth(If yes, please fill in your family members in Japan and co-residents in the following columns) RelationshipNameDate of birthNationality/RegionResiding withapplicant or notPlace of employment/ schoolResidence card numberSpecial Permanent Resident Certificate number Yes / NoYes / No Yes / No Yes / No Yes / No Yes / No3 Regarding item 3, if you possess your valid passport, please fill in your name as shown in the , Regarding item 16, if there is not enough space in the given columns to write in all of your family in Japan, fill in and attach a separate addition, take note that you are only required to fill in your family members in Japan for applications pertaining to Trainee or Technical Intern Training.

3 Photo40mm 30mm Select type of form which corresponds to the purpose of residence in Temporary Visitor Visiting relatives, Temporary business ProfessorActivities of highly skilled professionals who engage in research,research guidance or educationat colleges Activities for research, research guidance or education at colleges Activities to engage in language instruction at junior high schools and high schools, high school language teacher Activities for the arts that provide an income Composer, Photographer Academic or artistic activities that provide no income, or activities for the purpose of pursuing learningStudy tea ceremony, judoand acquiring Japanese culture or arts Religious activities conducted by foreign religious workers dispatched by foreign religious organizationsBishop, Missionary , Journalistic activities conducted on the basis of a contract with a foreign press organizationJournalist.

4 News photographer Activities of research who have been transferred to a business office in Japan for a limited period of timeResearcher assigned to a foreign firm Employee assigned to a foreign firm Activities of highly skilled professionals who have been transferred toa business office in Japan for a limited period of time and who are to engage in services which require knowledge pertinent to the field of natural science or human science Activities of specialists who have been transferred to a business officein Japan for a limited period of time ( Activities of highly skilled professionals who operate or manage business Operation or Management of business Activities of highly skilled professionals who engage in research.)

5 Research guidance or educationat colleges Except in cases falling under 2 Researcher of a government body or company Activities to engage in research that provide income Activities of highly skilled professionals who engage in services which require knowledge pertinent to naturalscience fields or human science fields Except in cases falling under 5 Engineer of mechanical engineering Marketing specialist Activities to engage in services which require knowledge pertinent to natural science fields or human science fieldsor to engage in services which require specific ways of thinking or sensitivity acquired through experience withforeign culture Activities to engage in nursing care or teaching nursing careCertified care worker Activities to engage in services which require skills belonging to special fields Foreign cuisine chef, Sport's instructor Designated activities to engage in research, business related to research or information-processing-relatedservicesRe searcher or Information-technology engineer of a designated organization Activities to engage in services using knowledge acquired at a university or a master's program in Japan andadvanced Japanese language skillsGradutate from a university or master's program in Japan who has advancedJapanese language skill.

6 Engaging in work requiring skills which need considerable knowledge or experience based on an employmentcontract for specified skilled workersSpecified skilled worker Engaging in work requiring proficient skills based on an employment contract for specified skilled workers9 Entertainment Singer, Model 10 Technical intern training Technical intern trainee Y--Y 11 Study Student Training Trainees not including in the on-the-job training, traineeswho participate in public training Dependent who lives together with their supporter EPA Dependent who intends to live together with their supporter whose status is Designated Activities(Nurse and Certified Careworker under EPA) Dependent who lives together with his/her supporter whose status is Designated Activities(Gradutate from a university or master's program in Japan) Spouse or child of Japanese national, Permanent resident, of Japanese national 1 Other purposes (1) 2 Other purposes (2)Medical activities, entrepreneurial activities J K O U For it is also possible to use forms J,K,O and U in accordance with the activities in which the applicant is to engage while residing in Japan.

7 Notes When the space provided is not sufficient for your answer, write on a separate piece of paper and attach it to the APPLICATION . All parts of this APPLICATION must be on JIS size A 4 Paper (210 297 ). In cases of the following applications, there is no need to submit the APPLICATION form for the organization. APPLICATION for changing the status of residence to "Designated Activities" or for extension of the period of stay for a college student to continue job hunting after graduation APPLICATION for extension of the period of stay of "Designated Activities" for a working holiday APPLICATION for changing the status of residence to "Designated Activities" or extension of the period of stay for a person who is applying for refugee recognition The legal representative of the applicant may make an APPLICATION in lieu of the applicant.

8 The following persons may complete the APPLICATION procedure (submit the passport, residence card and APPLICATION form, etc.) in lieu of the applicant. 15 EPA EPA EPA A relative of the applicant, a person living together with the applicant or an equivalent person, whom the director of the regional services bureau deems respectively to be appropriate (in cases where the applicant is under the age of 16 years,suffers from an illness or owing to other grounds) There is no need to submit this sheet. When engaging in the activities "Artist" not based on a contract with a public or private organization in Japan or engaging in the activities of "Journalist" as a freelancer, applicant him/herself must fill out the APPLICATION form for member of the staff of the accepting institution, etc.

9 Or of a public interest corporation whom the director of the regional immigration services bureau deems to be appropriate. (in cases pursuant to a request from the applicant or the legalrepresentative of the applicant)An attorney or administrative scrivener who has given notification, via the bar association or administrative scriveners' association to which he or she belongs, to the director of the regional immigration services bureau which has jurisdictionover the area where such bar association or administrative scriveners' association is located. (in cases pursuant to a request from the applicant or the legal representative of the applicant) Diplomat, Official, Lawyer, Public accountant, Doctor, Housekeeper, Workingholiday, Amateur athlete, Internship, Nurse and Certified Careworker under EPA,Nurse and Certified Careworker candidates under EPA, Certified CareworkerCandidates (student) under EPA, Fourth-generation foreign national of Japanesedescent 14 13 12 Dependent living together with their supporter under the status of residence of "Designated Activities" inorder to engage in research, business related to research or information-processing-related services8 - 7 - - 6 President, director ,division head of a company - - 5 4 23 I I I There is no need to submit this sheet.

10 Purpose of residence Example Type of form For applicantsFor organization V For applicant, part 2 V ("Specified Skilled Worker ( i ) " "Specified Skilled Worker ( ii ) ")For extension of status17 Organization of affiliation of the specified skilled worker(1) Name of person or organization(2) AddressTelephone Skill level Proof based on the passing of an exam Name of passed exam Exam location Japan Foreign countryCountry name Japan Foreign countryCountry name Proof based on some other evaluation method 2 Successfully completed Technical Intern Training (ii)19 1 (Fill in this section if you wish to reside in Japan with the status of residence of "Specified Skilled Worker (i)") Proof based on a Japanese language test Name of passed exam Exam location Japan Foreign countryCountry name Japan Foreign countryCountry name Proof based on some other evaluation method 2 Successfully completed Technical Intern Training (ii)20 2 18 19 2 (1) 2 OccupationOperations Proof of successful completion 3 Proof based on a document relating to the status of the technical intern training (2) (Fill in (2) if you have several forms of proof)(2)