Request for Retained Personal Data Correction, Etc.
Date (mm/dd/yy):

To Mitsubishi Corporation:
Home address(required)

Postal code:

Name (required)

1. Identification key*
(Check and enter in theregistered items)

Phone number(required)

Home: (Daytime: (Desired address forreceiving replynotification from us(required)(Not required if it is thesame as home address)

Postal code:))-□ Name of place of work

□ Office address

Postal code:□ Office phone number□ Office fax number□ Office email address□ Private email address□ Department

(())

-()

-□ Title□ Mobile phone number□ Date of birth(mm/dd/yy)□ MC membership No.
□ Former MC
officer/employee□ Other

Retirement date:
Last department:* Identification key is an item used to distinguish between information on people with the same
name contained in the information registered by us.

2. Request for correction or deletion of or addition to provided personal information
1) Subject organization name (required)Enter the name of our organization to which you provided your personal information:（１） Head Office (Tokyo)
Group/Section name: Select the relevant Group/Section.
□ Corporate Staff Section□ Mobility Group□ Environmental Energy Group□ Food Industry Group□ Materials Solution Group□ Smart-Life Creation Group□ Mineral Resources Group□ Power Solution Group□ Urban Development & Infrastructure Group
Department name: Enter the relevant department name.
()(2) Branch in Japan: Enter the relevant branch name and department name.
Branch name: ()Department name: ()2) Name of the product/service provided by the relevant organization (required)3) Situation, form (questionnaire answer, seminar participation, etc.) and time of personal information provision (required)Situation:Form:
Time of provision:
Note: To specify your personal information, please enclose related materials to whatever extent ispossible. e.g., seminar material, brochure or application form
4) Item of retained personal data desired to be corrected (required) (e.g., name, address or phonenumber)5) Reason for desiring correction (required)

6) Content of desired correction (required)(1) Before correction(2) After correction7) Desired method of disclosure (required)□ Mail to the desired address for receiving documents□ Email to the relevant individual’s email address (in attachment)□ Office email address □ Private email address□ Mail to the desired address to receive reply notification in electronic medium such as CD-ROM
Desired address
Postal code:

Note: If the disclosure by the desired method would incur large costs or is otherwise difficult, thedisclosure will be made by mailing documents.

8) Inquiry/Opinion
Note １: Enclose a copy of a document that identifies you as the relevant individual who owns thepersonal information you are applying for such as a driver’s license. If the document fallsunder “Other” in the confirmation field below, enter the specific document name. Send
the identification document after making the registered domicile unreadable by blacking
out or otherwise obscuring it.
Note 2: In case of a request by an agent, enclose a power of attorney by the relevant individual(containing the relationship with the agent, the reason for requiring the agent, and thename, address and phone number of the agent), a certificate of seal impression of therelevant individual (the power of attorney must have the registered seal impressionaffixed) and a copy of an identification card of the agent (public document such as adriver’s license).
Confirmation field: Document that identifies you as the relevant individual (required)□ Driver’s license□ Other ()Entry example
Request for Retained Personal Data Correction, Etc.
Date (mm/dd/yy):

To Mitsubishi Corporation:
Home address(required)

Postal code: 123-8888#303 XX Apartment, 1-2-3 Shinagawa, Shinagawa-ku, Tokyo

Name (required)
Taro Mitsubishi

1. Identification key*
(Check and enter in theregistered items)

Phone number(required)Home: (03) 1234-5678
Daytime: (090) 4321-5678

Desired address forreceiving reply
notification from us(required)(Not required if it is thesame as home address)

Postal code: 765-4321
XX Sec., XX Dept., XX Corporation, 4-5-6 Minato, Minato-ku, Tokyo□ Name of place of work
XX Corporation□ Office address

Postal code: 765-4321
4-5-6 Minato, Minato-ku, Tokyo□ Office phone number□ Office fax number□ Office email address□ Private email address□ Department(03) 1111-2222(03) 1111-3333
taro.mitsubishi@aaaa.com
taro.mitsubishi@xxx.jp
XX Sec., XX Dept.

□ TitleSection Manager□ Mobile phone number□ Date of birth (mm/dd/yy)□ MC membership No.
□ Former MC
officer/employee□ Other(090) 4444-5555
April 1, 1963
000123Retirement date:
Last department:* Identification key is an item used to distinguish between information on people with the same
name contained in the information registered by us.

2. Request for correction or deletion of or addition to provided personal information
1) Subject organization name (required)Enter the name of our organization to which you provided your personal information:（１） Head Office (Tokyo)
Group/Section name: Select the relevant Group/Section.
□ Corporate Staff Section□ Mobility Group□ Environmental Energy Group□ Food Industry Group□ Materials Solution Group□ Smart-Life Creation Group□ Mineral Resources Group□ Power Solution Group□ Urban Development & Infrastructure Group
Department name: Enter the relevant department name.
(XX Dept.)(2) Branch in Japan: Enter the relevant branch name and department name.
Branch name: ()Department name: ()2) Name of the product/service provided by the relevant organization (required)
Auto parts
3) Situation, form (questionnaire answer, seminar participation, etc.) and time of personal information provision (required)Situation: Participation in an exhibition
Form: Questionnaire answer
Time of provision: April 1, 2022
Note: To specify your personal information, please enclose related materials to whatever extent ispossible. e.g., seminar material, brochure or application form
4) Item of retained personal data desired to be corrected (required) (e.g., name, address or phonenumber)
Address5) Reason for desiring correction (required)
Residence transfer
6) Content of desired correction (required)(1) Before correction
Postal code: 123-4567#123 XX Heights, 1-2-3 Marunouchi, Chiyoda-ku, Tokyo(2) After correction
Postal code: 123-8888#303 XX Apartment, 1-2-3 Shinagawa, Shinagawa-ku, Tokyo7) Desired method of disclosure (required)□ Mail to the desired address for receiving documents□ Email to the relevant individual’s email address (in attachment)□ Office email address □ Private email address□ Mail to the desired address to receive reply notification in electronic medium such as CD-ROM

Desired address

Postal code:

Note: If the disclosure by the desired method would incur large costs or is otherwise difficult, thedisclosure will be made by mailing documents.
8) Inquiry/Opinion

Note １: Enclose a copy of a document that identifies you as the relevant individual who owns the
personal information you are applying for such as a driver’s license. If the document falls
under “Other” in the confirmation field below, enter the specific document name. Send
the identification document after making the registered domicile unreadable by blacking
out or otherwise obscuring it.
Note 2: In case of a request by an agent, enclose a power of attorney by the relevant individual(containing the relationship with the agent, the reason for requiring the agent, and thename, address and phone number of the agent), a certificate of seal impression of therelevant individual (the power of attorney must have the registered seal impression
affixed) and a copy of an identification card of the agent (public document such as adriver’s license).
Confirmation field: Document that identifies you as the relevant individual (required)□ Driver’s license□ Other ()