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Notification/Application Form for the Extension ofSubmission Deadline to File Tax Statement

TelLocation of the head office
Corporate number

Corporate name

Representative's nameName of person in charge of accounting
Amount of stated capital or capital contribution
With respect to the extension of the submission deadline for 〔Taxreturns/Consolidated final returns〕for corporation tax form the〔Amount for the business year/Amount for the consolidated business year〕〔from Date(YY/MM/DD)/to Date(YY/MM/DD)〕,

Please check the box that applies□ Approval has been undertaken on the extension as follows.
□ DesignaƟon has been made as follows.
□ The numberof months related to the designaƟon has been changed as follows.
□ The designaƟon has been cancelled.
□ CorporaƟon tax shall be paid as follows in connecƟon with the corporaiton subjected to approval on the extension.

Extension period for due date of final return ( )month(s)Designated number of months( )month(s)Number of months with regard to the desination after changing( )month(s)I apply for extension of due date from final return with regard to business tax and special corporate enterprise tax for business year from DD/MM/YY to DD/MM/YY,or designation thereof, rescission of designation thereof or change in the number of months with regard to designation thereof.

1 Period of extension of submission deadline for declaration(1) Corporation with no extension of submission deadline for declaration□ If you wish to extend submission deadline for declaraƟon(excluding the following cases)□ If you wish to receive extension of submission deadline for declaraƟon and designaton(2) Corporation with a one-month extension (two months for corporations submittig
consolidateed retrens) of submission deadline fore declaration□ If you wish to be designed(3) Corporation that has been designated□ If you wish to have the designaƟon cancelled, and to receive a one-month extension(two months for corporations submitting consolidated returns) of submission deadline
for declaration※ Describe the number of months in ( )2 Desceribe the Reasons for not calling an ordinary general meeting on the settlement of accounts
within two months frrom the date of the end of each business year (within three months from thedate of the end of the business year in the case of a corporation that wishes to be designated)(in thecase of a corporation submitting consolidated returns,reasons for not calling an ordinary general
meeting on the settlement of accounts for the consolidated parent corporation within two months
from the date of the end of the business year (within four months from the date of the end of thebusiness year in the case of a corporation that wishes to be designated) or reasons why a consolidated
parent corporation is unable to complete the calculation of the aomunt of consolidated income)3 Grounds□Local Tax Act, ArƟcle 72(25), Paragraphs 3 or 5 (Including cases where theseprovisions are applied mutatis mutandis in Paragraph 2 of Article 72(28) andParagraph 2 of Article 72(29)of the same Act)
□Local Tax Act, ArƟcle 72(25), Paragraphs 3(1) or Paragraph 5(1) (Including cases
where these provisions are applied mutatismutandis in Paragraph 2 of Article 72(28) and Paragraph 2 of Article 72(29)of the same Act)
□Local Tax Act, ArƟcle 72(25), Paragraphs 3(2) or Paragraph 5(2) (Including caseswhere these provisions are applied mutatismutandis in Paragraph 2 of Article 72(28) and Paragraph 2 of Article 72(29)of the same Act)
□Order for Enforcement of the Local Tax Act, ArƟcle 24(4), Paragraphs 1 (Including
cases where these provisions are applied mutatismutandis in Paragraph 1 of Article24(4-3) of the same Act)
4 Attached documents,etc.
□Copy of ArƟcles of Incorporaiton,etc.
□Others

Location of head office and telephone number of aggregate parent corporation

Corporate name and corporate number
Signature by Tax accountExistencce/Non-existence

Name of the company's branch office

Requested length of extension (in month)

Address of the company's branch office

Date of submission

Describe whether you have submitted to a national tax office
an application for extension of time to file a corporate income tax statement.