11SPCSW No. 0000
0 00, 2023

330-8529
2F Sainokuni Sukoyaka Plaza
4-2-65 Harigaya, Urawa-ku, Saitama-shi, Saitama
Taro Saitama

Hiroki Yamaguchi, Chairman
Saitama Prefectural Council of Social Welfare(Official seal omitted)

Information Regarding Repayment Deferment for Special Loans such as Emergency
Small Amount Funds
This is to inform you of the repayment deferment of emergency small amount funds and other special loans
provided by the Council.
If you are having trouble with future repayments, repayment deferment may be available to you. If you wish toapply for repayment deferment, please read the enclosed "How to apply for repayment deferment" carefully.
* This notice is also sent to those who have already applied for exemption, regardless of the outcome of
the review.

1If you are having trouble with repayment (regarding repayment deferment)
Even if you are not eligible for repayment forgiveness, you may be able to defer repayment if you have difficulty inrepaying the loan due to illness, unemployment, decreased income, or other circumstances. If you wish to apply forrepayment deferment, please read the enclosed "How to apply for repayment deferment" carefully and apply for it.
* If you wish to defer repayment from January 2024, please submit your application by Thursday,
November 30 (postmarked).
* You may also apply if you are in the process of applying for exemption.

2

Requirements to be eligible to applying for repayment exemption, other than exemption frominhabitants tax
Exemption can be applied for if any of the following conditions are met after the start of repayment.
••

3

If you have received public assistanceIf you have been issued the Mental Health and Welfare Handbook (Level 1) or the Physical Disability Certificate (Level 1 or 2)
For information on how to apply and the documents required, please contact us via the information below.

If you are currently applying for exemption due to inhabitants tax exemption
We are currently reviewing your application documents. Please note that the results of the review will be sent to you
by December 2023, although may vary depending on the time of application.
* If you have omitted any application documents, we have sent you a notice of omission, so please checkthem again.
If you have any questions, please contact us via the information below.
[For Inquiries]

Saitama Prefectural Council of Social Welfare,Repayment and Exemption of COVID-19 Special Loan Section[Phone number] 050-2018-1839 [Office hours] Weekdays 9:00-17:00

https://www.fukushi-saitama.or.jp/site/problem_33.html

Application for repayment deferment of special loans such as emergency small amount funds
under the Livelihood Welfare Fund Loan SystemI have read and agree to all of the following items and hereby apply for repayment deferment as follows.
ABCIf repayment deferment is approved, I agree to my personal information being provided to a self-reliancesupport consultation agency for the purpose of utilizing it in the performance of the organization's duties.
I agree to my personal information being provided to third parties to the extent necessary for this program.
I agree that the Saitama Prefectural Council of Social Welfare may query municipal councils of socialwelfare, self-reliance support consultation agencies, local governments, and other related organizations toreceive my personal information to the extent necessary for this program.

//* Please be sure to sign yourname (the name written on thenotification) in the box on theleft.

Borrower's Name
Telephone Number
To the Chair of the Saitama Prefectural Council of Social Welfare
Reason forapplication(Tick the box ) (1) If you are affected by an earthquake or fire, etc.
 (2) If you are receiving treatment for an illness (3) If you are involuntarily unemployed or separated from employment
 (4) If you are receiving repayment deferment on other loans, such as scholarships or business loans(excluding mortgages)

 (5) If, as a result of consultation with a self-reliance support consultation agency, the opinion of the agency isthat repayment deferment is appropriate.
* If you checked any of (1) through (5), please enclose documents with which the circumstances of
the checked items can be confirmed.

 (6) Reasons other than (1) through (5) above* If you checked item (6), please describe the circumstances that make repayment difficult below.
Regarding living and income, etc. *Please provide as much detail as possible.

Type of fundDetails of loan

<Special loan name>Amountborrowed<Loan amount>yen

Loan Code<Fund code><Loan code>

Deferment
period* The repayment deferment period after the deferment listed below will vary depending on the timing of the application.

Repayment
period before
deferment

1 year<Repayment Start Date> from
<Final repayment date> toRepayment
period afterdeferment<Repayment start dateafter deferment> from
<Repayment deadline
after deferment> toHow to apply for repayment deferment
1

Reasons why repayment deferment may be applied for and documents required
Reasons why repayment deferment may be applied forRequired documents(1) If you are affected by an earthquake or fire, etc.

Disaster Victim Certificate, or other documentation that
confirms that you have been affected by the disaster(2) If you are receiving treatment for an illness

Medical certificate, medical condition certificate, or otherdocumentation that confirms that you are receiving
treatment for an illness(3) If you are involuntarily unemployed or separated fromemployment

Certificate of retirement, release form, or other documentthat confirms that you are involuntarily unemployed or
separated from employment(4) If you are receiving repayment deferment on other loans,such as scholarships or business loans (excludingmortgages)

Documentation confirming that the applicant has been
granted deferment of repayment of other loans(5) If, as a result of consultation with a self-reliance support
consultation agency, the opinion of the agency is that
repayment deferment is appropriate

Opinion letter from the self-reliance support consultation
agency(6) If redemption is difficult for reasons other than (1) through(5)

No documents need to be submitted* Please be sure to indicate the circumstances thatmake repayment difficult in the "Reason forApplication" section of the application form.

*You may also apply if you are in the process of applying for exemption.

2

How to apply[If you fall under (1) to (5) above]
Please send in the application form and the required documents mentioned above.
[If you fall under (6) above]
Please send in only the application form.
* Please be sure to fill in the column on the application form that describes the situation whichmakes repayment difficult.

3

Repayment deferment start date• For applications that are postmarked by Thursday, November 30 and have no documentomissions, etc., payment deferment will begin from January 2024.
• For applications postmarked after Friday, December 1, the start date of deferment will be decided
sequentially from February 2024, depending on the date of arrival at the Council.

4

Deadline for applications
The deadline for repayment deferment is by the 15th of the month prior to the month of final repayment.

5

Results of review
You will be notified of the results in writing.
* It takes about one to one and a half months from the application to the sending out of the results.
* Notifications may also be sent to those who are in the process of applying for an exemption.
[For Inquiries]

Saitama Prefectural Council of Social Welfare,
Repayment and Exemption of COVID-19 Special Loan Section[Phone number] 050-2018-1839 [Office hours] Weekdays 9:00-17:00

https://www.fukushi-saitama.or.jp/site/problem_33.html