Itochu Urban Community Ltd.

DATE:

Application Form//(mm/dd/yyyy)

I agree to the terms and conditions of use of my personal information.
Signature:
Co-ed

WASEDA , MUSASHIKOSUGI , MOTOSUMIYOSHI

Boy's

Southern MOTOSUMIYOSHI , KOMABA-TODAIMAE

Term of contract

Room request

Chronic / allergy

1year

/

TSUTSUJIGAOKA

Girl'sTSUNASHIMAMIZONOKUCHIJEUNESSE JIYUGAOKA , MIOPORTO IIDABASHI

MUSASHIKOSUGI , KOMABA-TODAIMAE

2yearsYES

Meal plan contract

orNO

e.g. higher ﬂoor. maximum \ ￥60,000.

No or Yes ( e.g. Peanuts)

Move-in date

DATE:(request)//(mm/dd/yyyy)

Contractor Employment/Financial information
SEX

First nameLast nameDate of Birth

M or F(Middle name）//(mm/dd/yyyy)

Present Home Address

氏名Home phone number
Email address(Contractor）

＠Employer namePresent occupation

Employer phone number

Current Gross Income￥

per month

Personal Information (Tenant)
Last name

氏名

SEXFirst nameM or F(Middle name）

Date of Birth//(mm/dd/yyyy)/(mm/dd/yyyy)

Relationship with the tenant

Name of your school
Guarantor
Last nameFirst name(Middle name）

SEXM or F

Date of Birth/Present Home Address※Home phone number
Cell phone number
Email address(Guarantor）

＠Relationship withthe tenant

Employer namePresent occupation

Employer phone number

Current Gross Income￥per monthUse of Personal Information

Itochu Urban Community Ltd,. will handle the personal information we received from our customers in accordance with"Act on the Protection of Personal Information". Below, we will explain the purposes of use and management of
the personal information we received.
（1）NAME OF THE COMPANY

Itochu Urban Community Ltd,（2）NAME OF THE DIVISION

Student House Division（3）PURPOSES OF USE（1）For services regarding lease, management, introduction of realestates.
（2）To provide information to the third party to achieve the goal
described in（1）.
（3）To execute and provide information regarding the insurance onreal estates we deal with.
（4）To introduce to our customers about products and services,regarding real estate, home interior, and reform, we and ourpartner companies provide.
（5）To send questionaires regarding our services.
We do not disclose personal information we received from ourcustomers to third parties without agreement from the customer.
However, exceptions apply to the cases described below.

（4）DISCLOSURE OF INFORMATION
TO THIRD PARTIES（1）When we are legally required to disclose.
（2）In case we need to disclose the personal information to third parties
who are included in business contracts.
（3）In the case we need to disclose the information for property dealing
purposes.
（4）In the case we need to disclose the information for property
management purposes.
（5）Educational institutions:
The following types of personal information pertaining to a customer
may be provided to their aﬃliated educational institution upon request.
Moreover, in case of an emergency or extraordinary circumstances,other information may also be provided as appropriate to the aﬃliatededucational institution if there is a special need for this.
●Name ●Faculty/department ●Address●Contact information (including. emergency contact information)（5）Supervision of Trustees

We will supervise appropriately, in case our consignee is required todeal with the personal information.

（6）Contact〒１０３−００１１
1-4 Nihonbashi Oodenma, Chuo-ku, Tokyo, Japan.
In charge of Use of Personal Information aﬀairs

https://www.itc-uc.co.jp/contact/inquiry/◆Please refer to our company web site for our guide to the use of personal information.

http://www.itc-uc.co.jp◆About the disclosure, modiﬁcation, and elimination of the personal information we hold, please refer to our company
website.