Shizuoka-ken Jutaku Kyokyu Kousha
Dear Residents,Submission of the Income Declaration
Residents of prefectural housing are required to declare their income according to the Public Housing
Act. Therefore, please be aware that you need to declare the incomes of all your household members
who live in with you this year as usual years.

Please submit the Income Declaration Form and anothernecessary documents by Monday (holiday), July 15.
(If you fail to submit, your rent will become as high as the rent of private rental housing.)

Due Date NLT:

Monday (holiday), July 15, 2024

Place of Submission:

Shizuoka-ken Jutaku Kyokyu Kousha Jutaku Service-ka*Please mail the documents in an enclosed envelope.

Submitted Documents for All:
1. Income Declaration Form for Residents of Prefectural Housing
Please refer to an attached example entry when filling in the form.
2. Municipal and Prefectural Tax Certification* Gensen- choushu-hyou (withholding certificate) is not available.
・ Please be the Municipal and Prefectural Tax Certificates of all your household members whowere born before April 1, 2008 submitted.
・ Please ask the civil tax division of the city where you live to issue the certificate that clarifies
revenue incomes, and deductions for 2023. (Be subject to fee)
・ The certificate can also be obtained for those who depend on only pensions and those who have noincome.
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・It is available for some of the household members who are school students and have no incomes tosubmit a copy of a Student ID Card with the details of their name, birthdate, and the date ofissue, or a school certificate instead of the Municipal and Prefectural Tax Certification.
・ It is available for welfare recipients to submit a certificate of the welfare recipient. (Free ofcharge)

・ It is unacceptable to use Civil/prefectural Tax with Earning Income and/or Notice ofDetermination of Special Tax withheld as a substitute for the Taxation Certificate.

Please submit documents below if needed.
3. A copy of the Physical Disability Certificate or/and Rehabilitation Certificate
If household member(s) has these certificates. In case of non-submitted, a deduction will not beapplied.
・Please attach documents subscribed in name, grade, and expire date.
4. Certificate of Residence with the details of the relationship, and the head of the household,and the place of the family registry. (With no description of My Number)
In cases that there were household members’ birth, decease, and move-out, and that information is
not described on the Income Declaration Form.
・Please have the Certificate of Residence issued at a city hall that lists all of the household members
including a person of birth, a move-out, a deceased person.
・Please fill in the necessary information on the Income Declaration Form. (Refer to an attached entryexample.)
5. Application Form for the Approval of Succession to Residence in Prefectural Housing
In cases that there were residence contractor’s decease and move-out, and that information is notdescribed on the Income Declaration Form.
・ Only those who are spouses, disabled people, aged people, intractable diseases patient, and who
are recognized to need to have housing, Or those who meet the Governor's requirements, taking
into account the condition of the housing (excluding homes and leased public housing within ten
years of reconstruction and five years of rehabilitation) and other situations will have a successionof the right of residence.
・ Other documents to fill in are needed as well as the document above. Please ask us the details.

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6. Application Form for the Approval of Household in Prefectural Housing*In the case that there was a household member’s move-in, and that information is not describedon the Income Declaration Form.
・There would be a case that sharing an apartment room is not permitted if a condition regarding an
income is not satisfied.
・Other documents to fill in are needed as well as the document above. Please ask us the details.
7. Written Opinion against the Certified Incomes*
In the case that the composition of household member(s) was changed, and you hope the rent
desirably become low.
・The document above (No.7) should be submitted because an income decrease by a change of thecomposition of family members, such as a birth of a baby(s) or someone’s move-out, would bepossible to make the rent lower.

* The documents above (No.6 and No.7) are attached with “Residence Guide, aka Sumaino
Shiori” that were handed out at the time of move-in. You can also obtain them from theShizuoka-ken Jutaku Kyokyu Kousha website, the Shizuoka-ken Jutaku Kyokyu Kousha
office, and any Doboku Jimusho (civil engineering office).

Determination of the Rent
1. The rent of each tenant for 2025 (From April 2025 to March 2026) will be determined by theincome declaration this time.
2. The amount of the rent for 2025 and the certified incomes will be informed around the end ofFebruary 2025. For those who have an opinion regarding the certified incomes, please submit aWritten Opinion against the Certified Incomes to each Doboku Jimusho (civil engineeringoffice).
3. Shizuoka Prefecture will implement a survey on the incomes of all the tenants in prefectural
housing to check the contents of their income declaration.
4. Be sure to submit all documents related to the income declaration. If failed to submit, your rent
will be as high as the rent of private rental housing.
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Shizuoka-ken Jutaku Kyokyu Kousha （Phone: 054－255－4148）
Direct Number (July 1 - July 31, 2024): 054－255－4825

Multiple language versions of “Submission of the Income Declaration” and “How to Fillout the Income Declaration Form” can be found by scanning the QR codes below.

Portuguese

Informações em português, acesse este QR

EnglishTo see an English version, scan the QR code.

SpanishInformación en espaňol, escanea este QR

Chinese中文介绍请看这边。

Tagalog

Paki-klik dito para sa impormasyon.

VietnameseHãy xem Bản hướng dẫn bằng tiếng việt ở đây

Protection of Information:
To manage the personal information safely and properly, Shizuoka Prefecture has taken measures the following steps
based on the “personal information protection ordinance” of Shizuoka Prefecture.
･ Limits on obtaining the information:

We use the information within the limited necessary.

･ Restrictions on using and providing the information:

The personal information will not be used for purposes
other than the purpose of use.

･ Appropriate management of the information:

We prevent information leaks.

Shizuoka Prefecture has introduced a computer system to manage prefectural housing properly and promptly and has
entrusted a part of its operations to Shizuoka-ken Jutaku Kyokyu Kousha.
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(英語）

How to Fill out the Income Declaration Form
1. Please fill in the submission date, name of Danchi, your name, andtelephone number. No need to stamp your seal if you sign your name.

2. If there is a name(s) of a person(s) printed on the form who passed away or
moved-out, please cross off the name(s). If a birth took place, fill in the baby's
name, gender, relationship, and the date of birth. Also, fill in the date the events
above occurred.

Sample 1

Sample 2

3. ・Please fill in the amount of total income in the column of ④.
・Please fill in the numbers "subtracting the salary income and miscellaneous income(pertaining to the public pension) from the total income" in the columns ⑤.
Write "0" yen if no income.
・Please fill in the names and phone numbers of the work places in the column ⑥.

4. ・ Please fill in the number of a dependant(s) not living inDanchi in the column ⓼ if someone has them.
・ Please circle the applicable persons in the column ⑭, ⑮, ⑯, ⑰.

A chief of police would be requested to check whether the persons printed on the income declaration are members of a gang of criminals.

* The circled numbers on this paper correspond with those on the Income Declaration Form.
How to Fill out the Income Declaration Form
A. Please confirm names, genders, relationship to the head of household, and the date of births in the column ①-③.

Move-out or decease of a family member(s) :Cross off the name(s) of the family member(s) and circle the appropriate numbers in the column ⑲. Refer to the other side of the Income Declaration Form.
Submit "residence certificates" of all of the household members living with you and a "delated residence record (Johyou)" of ones who moved out or passed away.

A baby was born but not yet being registered: Fill in a baby name, gender, relationship, the date of birth and circle "1. 出生 (birth)" in the column ⑲. Refer to the other side of the Income Declaration Form.
Submit "residence certificates" of all of the household members including a baby living with you.
B. Please fill in the amount of "After-Income Deduction" or "After-Necessary Expense Deduction"in the column ④.
Fill in the "amount of total income" printed on the “Municipal and Prefectural Tax Certification” of 2024.

J. Please circle the appropriate numbers in the column ⑲ if needed.
Circle the numbers if there were a birth, a move-out, and decease in you family.
The "residence certificates" are needed to be checked by us.

K. Please fill in the appropriate dates in the column ⑳ if you circled the numbers in the column ⑲.

C. Please fill in the "total amount of incomes other than the salary income and/or
the miscellaneous income pertaining to the public pension" in the column ⑤.

(The appropriate dates: Dates of a "birth date of baby", "Household members' moving out", and "decease of a family member(s).)

If you only have the salary income and/or the miscellaneous income pertaining to the public pension, fill in just 0 yen.

D. Please fill in "places of works" and "phone numbers" in the column ⑥.

⑨
In the case of no job, write "Unemployed" in the box of the applicable person(s). ⑩⑪E. Please fill in the number of persons who live together with other than⑫
the head of household in the column ⓻.

老 配
老 人
特 定
障 害

A spouse sharing the same livelihood, under the Income Tax Act, of 70 years or more as of Oct 1, 2024.

A dependant of 70 years or more as of Oct 1, 2024.
A dependant of between 16 - 23 as of Oct 1, 2024.

A person who has a physical disability certificate. A person who has a mental
disability certificate. A person who has a rehabilitation certificate.
A person who has a war injury and illness certificate.

F. Please fill in the number of persons who are your dependant, under the Income Tax Act,

⑬ 特 障

not living with you in the column ⑧.

A person who has a physical disability certificate of Level 1 or 2. A person who has a mental disability
certificate of Level 1. A person who has a rehabilitation certificate of A grade. A person who has a war
injury and illness certificate from the special symptom to the third symptom. A person who has beencertified as the atomic bomb survivor by the Ministry of Health, Labour, and Welfare.

G. Please fill in the numbers of the applicable dependant(s) in the columns ⑨-⑬.
* Refer to the next box (⑨-⑬) that lists the kinds of Income Deduction.

H. Please circle the applicable person(s) in the column ⑭-⑰.

⑭ 一 般
⑮ 特 別
⑯ 寡 婦

* Refer to the next box. (⑭-⑰) that lists the kinds of Income Deduction.

A person falls under "⑫: 障害 Disability"
A person falls under "⑬: 特障 Particular Disability"
A woman who lost her spouse and have not married after then. The following must be met.

1. Yearly taxable income under 5,000,000 yen.
2. Not having a partner who is in a de facto marital relationship or having divorced

I. Please circle in the box of the applicable person(s) in the column ⑱.

and is not engaged to remarry. The following condition must be met, too.

* The following categories fall into the applicable person(s).

A person falls under "⑫: 障害 Disability". (See the next box)

1. Having a dependant who shares living expenses. (whose yearly earning is 480,000 yen or less)⑰ ひとり親A person currently unmarried or whose spouse’s life or death is not clear. The following must be met.

A person falls under "⑬: 特障 Particular Disability". (Ditto)

1. Having a son or daughter who shares living expenses. (whose yearly earning is 480,000 yen or less)

A person who used to be in the leprosarium.

2. Yearly taxable income is under 5,000,000 yen.

A child who is before a school age as of April 2024.

3. Not having a partner who is in a de facto marital relationship.