(Attached List of Formats II-1)(Japanese Industrial Standards A4 format)
Warning to Persons Using Similar Trade Name (Draft)___Type ___ Financial Instruments Business Operator
To: (Representative Director)

Director-General of (Branch) Finance Bureau

No person other than a financial instruments business operator may use “financial instruments business
operator,” as a trade name or name, or use a trade name or name leading to misunderstandings regarding identity,
pursuant to the provision of Article 31-3 of the Financial Instruments and Exchange Act.
The Finance Bureau has conducted an investigation into the trade name of your company and found the nameto be in violation of the said provision. This notification is for the purpose of warning you to immediately change
your company’s trade name. Therefore, I request you to submit a correction plan for your company in writing by(MM/DD/YY).
Appropriate measures will be taken if no response is made or if you fail to heed the warning of the Finance
Bureau by the deadline.
In addition, the Finance Bureau will make sure that your financial instruments business is a registered business,
and I would like to inform you that any non-registered person conducting the said business is violating the
Financial Instruments and Exchange Act.
(Note) A correction plan shall normally be submitted no later than two weeks after the date of the issuance of
this warning statement (hereinafter the same shall apply to the drafts below).

(Attached List of Formats II-2)(Japanese Industrial Standards A4 format)
Warning to Persons Using Similar Trade Name (Draft)___ Securities Trust Company
To: (Representative Director)
Director-General of (Branch) Finance Bureau

No person other than a financial instruments business operator may use “financial instruments business
operator” as a trade name or name, or use a trade name or name leading to misunderstandings regarding identity,
pursuant to the provision of Article 31-3 of the Financial Instruments and Exchange Act.
This notification is for the purpose of warning you to immediately change your company’s trade name since
the trade name of your company may be in violation of the said provision.
Therefore, I request you to submit a correction plan for your company in writing by (MM/DD/YY).
Appropriate measures will be taken if no response is made or if you fail to heed the warning of the Finance
Bureau by the deadline.
In addition, the Finance Bureau will make sure that your financial instruments business is a registered business,
and I would like to inform you that any non-registered person conducting the said business is violating the“Financial Instruments and Exchange Act.”

(Attached List of Formats II-3)(Japanese Industrial Standards A4 format)
Warning to Persons Using Similar Trade Name (Draft)___ Securities Trust Company
To: (Representative Director)
Director-General of (Branch) Finance Bureau

You were recently warned to change the trade name of your company since it may be in violation of theprovision of Article 31-3 of the Financial Instruments and Exchange Act. A subsequent investigation conductedby the Finance Bureau has found that the trade name of your company is in violation of the said provision. (Itwas also identified that the operations of your company fall under the category of financial instruments business.)
Use of the words “financial instruments business operator” in a trade name or name, or use of a trade name orname leading to misunderstandings regarding identity (and conduct of a financial instruments business) by any
person other than a financial instruments business operator is strictly prohibited under the provision of Article31-3 of the Financial Instruments and Exchange Act. I thereby re-issue this warning notification and warn you to
immediately change your company’s trade name (and to cease the said conduct).
Therefore, I request you to submit a correction plan for your company in writing by (MM/DD/YY).
I would like to remind you that appropriate measures will be taken if no response is made or if you fail to heed
the warning of the Finance Bureau by the deadline.
(Note) The terms in the bracket refers to the statement of warning applied to the cases where the said business
entity is conducting financial instruments business without registration.

(Attached List of Formats II-4)(Japanese Industrial Standards A4 format)
Warning to Persons Conducting Financial Instruments Business Without Registration (Draft)___ General Trading Company
To: (Representative Director)
Director-General of (Branch) Finance Bureau

Financial instruments business shall not be conducted by any person who has not been registered by thePrime Minister pursuant to the provision of Article 29 of the Financial Instruments and Exchange Act.
The Finance Bureau has conducted an investigation into the business of your company and found yourcompany to be in violation of the said provision, and this is a notification warning you to immediately cease thesaid conduct.
Therefore, I request you to submit a correction plan for your company in writing by (MM/DD/YY).
I would like to inform you that appropriate measures will be taken if no response is made or if you fail to heed
the warning of the Finance Bureau by the deadline.

(Attached List of Formats II-5)(Japanese Industrial Standards A4 format)
Statement of Referral to Persons That May Be Conducting Financial Instrument Business Without Registration(Draft)___ Company Limited
To: (Representative Director)
Director-General of (Branch) Finance Bureau

Financial instruments business shall not be conducted by any person who has not been registered by the Prime
Minister pursuant to the provision of Article 29 of the Financial Instruments and Exchange Act.
The Finance Bureau has conducted an investigation into the business of your company and found it may be in
violation of the said provision.
Therefore, I request you to submit the conditions of your business in writing by (MM/DD/YY).
I would like to inform you that appropriate measures, such as provision of information to the investigation,
will be taken if no response is made by the deadline.

(Attached List of Formats II-6)(Japanese Industrial Standards A4 format)
Registry of Non-Registered Entities and Users of Similar Trade Name
Company Name
Address
Number ofRepresentative

Capital(¥million) Officers &(persons)

Employees
Office Name
(Address)
Type of business
Date

Details of complaints/referrals, etc., and details of instructions from the Finance
Bureau, response of the concerned party, etc.

(Attached List of Formats II-7)(Japanese Industrial Standards A4 format)
Status of Financial Instruments Business Operators’ Major Shareholders or Financial Instruments Exchange
Holding Companies’ Major Shareholders(Branch) Finance Bureau
As of the end of MM/YY
Items related tofinancial
instruments
business operators
or holding
companies offinancial
instruments
exchanges

Trade
Name

Addressof Head
OfficeItems related to submitters

Category(Individual orCompany/Firm)

Name(also enter thename of arepresentativein the case of ajuridical
person)Address

Telephone
NumberNumberof votingrightsheld

Number of
votingrights heldby thesubmitter

Ownership
ratio ofvoting rights

Date ofcommencementof submission
obligation(Notes for filling the form)
・“Financial Instruments Business Operators” in this form are limited to those who conduct Type I Financial Instruments Businessor Investment Management Business, and exclude foreign corporations.
・Information on all the persons who have submitted the notification as of the standard date of formulation shall be entered inthis form.
・Details of notification submitted to each finance bureau from holders of voting rights shall be entered in this form (Notifications
referred by other finance bureaus need not to be entered).
・Number of voting rights held by the submitters and by specially related persons shall be entered in the “Number of Voting
Rights Held” column. (Enter the number listed in (A) of the Notification.)(Attached List of Formats II-8)(Japanese Industrial Standards A4 format)
Report on Status of Confirmation Procedures
Financial Instruments
Business Operator(Department)

Details of Application for Confirmation
Date of
ReceiptName ofconcerned
party

Title

Name ofclientOutline ofincident

Status of Procedures
Amountof profits
provided

Date ofprocedures

Details ofprocedures(Instructions for Filling the Form)
1. Take the relevant information from the application for confirmation and enter it in the “Outline of incident” and “Amount of profits provided”
columns
2. Enter either “confirmation received” or “confirmation denied” in the column “Details of procedures,” by separating the matters as follows:(1) In the case of “Confirmation received,” enter the corresponding provision of Article 118 of the Cabinet Ordinance Concerning Financial
Instruments Business, etc.
(2) In the case of “Confirmation denied,” enter the reason(s) for denial.
3. There is no need to compile a report in the case applicable to the provision of Article 119-(3) of the Cabinet Ordinance Concerning Financial
Instruments Business, etc.

(Attached List of Formats II-9)(Japanese Industrial Standards A4 format)
Complaints about Financial Instruments Business Operators, etc.
Affiliation
Date

MM/DD/YY (Day of the Week) Start Time – End Time
(Telephone, Visit, Document)

Company Name
Grievant
Details ofComplaint

OutlineReceived by(Attached List of Formats II-10)(Japanese Industrial Standards A4 format)
Correspondence Slip
Affiliation
Date/Place
Referred by
Details of Referral

Suggested Response

Procedures

MM/DD/YY (Day of the Week) [Telephone/Visit/Other]
Received by(Attached List of Formats II-11)(Japanese Industrial Standards A4 format)
Reception Slip
Affiliation
Date/Place
Referred by
Details of Referral

Response

Remarks

MM/DD/YY (Day of the Week) [Telephone/Visit/Other]
Received by(Attached List of Formats II-12)(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY(Trade Name)
To: (Name of Representative)

Director-General of (Branch) Finance Bureau

Report on the Progress of Improvement in Response to Notified Items of Inspection Results
I hereby order you to submit a report with respect to problems in relation to the inspection results notified toyour company by Notification No.____, dated on MM/DD/YY, pursuant to Article 56-2(1) (Law No. 25, 1948)of the Financial Instruments and Exchange Law.
The report shall contain recognition of the facts, an analysis of causes, and measures for improvement/responses concerning problems indicated in the Notification and shall be submitted by (MM/DD/YY).
If you are dissatisfied with this order, you may request the Commissioner of the Financial Instruments Service
Agency to conduct an inspection under the Administrative Appeal Act (Law No. 68, 2014) within three months
after the day on which you receive this notice.
If you demand the rescission of this order in a legal proceeding, you may file an action against the national
government for rescission under the Administrative Appeal Act (Law No. 139, 1962) within six months after the
day on which you receive this notice.

(Attached List of Formats II-13)(Japanese Industrial Standards A4 format)
Warning to Persons Who Indicate That They Conduct Financial Instruments Business, Despite Not Being a Person
Able to Conduct Financial Instruments Business Pursuant to the Provisions of Laws and Regulations (Draft)____ General Trading Company
To: (Representative Director)

Director-General of (Branch) Finance Bureau

A person, who is not a financial instruments business operators, etc., a financial instrumentsintermediary service provider or another person able to conduct financial instruments business pursuant
to the provisions of laws and regulations, is prohibited, pursuant to the provisions of Article 31-3-2 of the
Financial Instruments and Exchange Act, from making an indication that he/she conducts financial
instruments business, and from soliciting customers to sign contracts for financial instruments
transactions for the purpose of conducting financial instruments business.
The Finance Bureau has conducted an investigation into the actions of your company, and has foundthem to be in violation of the said provisions. This is a notification warning you to immediately cease thesaid actions.
Therefore, I request that you submit a correction plan for your company in writing by (MM/DD/YY).
I would like to add that appropriate measures will be taken if no response is made or if you fail to heed
the warning of the Finance Bureau by the deadline.

(Attached List of FormatsIII-1)(Japanese Industrial Standards A4 format)
Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau
To: ___, Director of the Okinawa General Bureau
Name of Financial Institution
Representative
Person in Charge
Affiliation
Name
Phone
E-mailI hereby report the following system failures pursuant to No. ___ dated on MM/DD/YY.

Report on System Failures(Report No. )(Report Date: MM/DD/YY Time:
Items

Time and Place ofFailureOccurrence

Date/time of occurrence

Outline of services

Failures Occurred

Impacts on services

System Failure

Affected System

Time, MM/DD/YY

Place of occurrence

Services in Which

Cause(s) of

Details

Type of failure
Details of cause(s), etc.

□Not identified□ Identified

Details (Name of system
System outline□ Recovered (time, day)State of Damage,etc.

Prospect of recovery, etc.

□ Unknown
State of damage
Impact before recovery

Impact on Other Business Operators, etc.
Response for recovery
State of Response□ Expected to be recovered (time, day)External explanation
Other persons contacted, etc.

Measures for Ex-post Improvement))

(Instructions for Filling the Form)
1. A first report containing only fragmentary information is acceptable until the full spectrum of the failures, etc., isidentified.
The second report and thereafter shall be compiled to provide notification of changes in the circumstances following
the first report, on a timely manner whenever necessary.
In the “Report Date, Time” row, enter the date and time the report is made.
2. In the cases where impacts on services and causes, etc., of a failure are extensive or where there are supplementary
explanatory materials, you may list them in an attachment (discretionary format) and provide a note to that effect inthis form.
3. Place of installation of the failed system (down to the municipality) and the name of the office shall be entered under“Place of occurrence” in the “Time and Place of Failure Occurrence” row.
4. Classifiable causes indicated in the Table of Classification of Failures at the time of report shall be entered under“Type of failure” in the “Cause(s) of System Failure” row.
Meanwhile, in the cases where causes of failure are extensive, several corresponding causes may be entered.
With respect to system failures caused by a disaster, only those which occurred in areas other than disaster stricken
areas shall be entered in this form, such as a reduction in communication throughput in a remote area due tocommunication disruption. (It is not necessary to enter system failures that happened in the disaster afflicted areas.)
5. Name of the failed system or name of operations assumed by the relevant system (such as accounting, or external
connection, etc.) shall be entered under “Name of system” in the “Affected System” row.
6. Enter the state of damage, as necessary, under “State of damage” in the “State of Damage, etc.” row, when thedamage (impact on clients, etc.) has been confirmed.
7. If confirmed, enter the details of the possibility and the current status of the spread of attack/failure, etc., to otherbusiness operators, etc., in the “Impacts on Other Business Operators, etc.” row.
8. Enter emergency measures or full-fledged responses (status/policy of alternative measures, etc.) and time, etc.,
needed for the preparation of drastic measures under “Response for recovery” in the “State of Response” row.
9. In the cases where the relevant failure has been reported to the police, security-related organizations, or otherauthorities, etc., enter the details under “Other persons contacted, etc” in the “State of Response” row.

(Table of Classification of Failures)
The classification codes (Main classes－Divisions－Sections－Threats) listed in the following table shallbe entered in “Type of failure” of the “Cause(s) of System Failure” column of the form.
In the cases where cause(s) of failure is (are) unknown at the time of reporting, the space may be left blank.

Types ofthreats
Intentional
factors,
including cyberattacks
Non-intentional
factors

Cod
e
No.
1－1
1－2
1－3
2－1
2－2
2－3
2－4

Disaster anddisease
Ripple effects offailures that
occurred inother fields

3
4－1
4－2
4－3
4－4

Others5Classification of causes

Explanation

Unauthorized access by
Failures caused by cyber attacks from outside
outsiders, DoS attacks
Computer virus infection
Failures due to computer virus infection
Other intentional factors
Failures due to other intentional factors
Software failure
Failures attributed to software defects, etc.
Failures attributed to defects in physical
Hardware failurecomponents, including hardware
Management/man-madeFailures due to set-up errors, operational errors, or
factors
problems in outsourcing management
Other non-intentional factors Failures due to other non-intentional factors
Disaster and disease

Failures caused by disaster and disease

Rippleeffectsfromtelecommunications services
Ripple effects from power
supplyRipple effects from watersupplyRipple effects from others

Failuresdue
torippletelecommunications services

Otherseffects

from

Failures due to ripple effects from power supply
Failures due to ripple effects from water supply
Failures due to ripple effects from others
Failures due to causes other than the above types of
threats

(Attached List of Formats III-2)(Japanese Industrial Standards A4 format)
Registration Number File of Financial Instruments Business Operators
Finance Bureau
Registration Number(Financial instruments)

Date of Registration

Name of Financial Business Operator

day, month, year

No.

(Note) When registration has been rescinded, cross it out with double lines ()

(Attached List of Formats III-3)(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY(Trade Name)
To: (Name of Representative)

Director-General of (Branch) Finance Bureau

Registration of Financial Instruments BusinessI hereby notify that registration regarding the application filed on (MM/DD/YY) has been completed asfollows, pursuant to Article 57(3) of the Financial Instruments and Exchange Act:
Registration Date: MM/DD/YY
Registration Number:, Director-General of (Branch) Finance Bureau, (Financial
Business) No.

(Attached List of Formats III-4)(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY(Trade Name)
To: (Name of Representative)

Director-General of (Branch) Finance Bureau

Refusal of Registration of Financial Instruments BusinessI hereby notify that the application for registration of financial instruments business filed on (MM/DD/YY)
has been refused on the following grounds, pursuant to Article 57(3) of the Financial Instruments and ExchangeAct.
If you are dissatisfied with the refusal, you may request the Commissioner of the Financial Instruments
Service Agency to conduct an inspection under the Administrative Appeal Act (Law No. 68, 2014) within threemonths after the day on which you receive this notice of refusal.
If you demand the rescission of this action in a legal proceeding, you may file an action against the national
government for rescission under the Administrative Appeal Act (Law No. 139, 1962) within six months after
the day on which you receive this notice of refusal.
Grounds for refusal

(Attached List of Formats III-5)(Japanese Industrial Standards A4 format)
Public Inspection of the Registry of Financial Instruments Business Operators
Inspection

Name of

Date

Inspector

Address andPhone Numberof Inspector

Name ofRegistration

Financial

Time

Number

Instruments

Lent

Business Operator

Time
Returned

Check(Attached List of Formats V-1)
(Japanese Industrial Standards A4 format)(From Money to Securities)
Date: MM/DD/YY
To: Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau
Address of Major Office of Applicant
Trade Name or Name
Name
(Name of representative in the case of juridical person)
Application for Issuance of Certification of the Original Deposit Statement
Original Deposit Statement x 1
Description of Deposit
Place of Deposit: _________ Legal Affairs Bureau
Date of Deposit: MM/DD/YY
Number of Deposit Year: Fiscal Year _____, Finance No. _____
Money on Deposit: ¥..........................
Legal Basis: Article 31-2(1) of the Financial Instruments and Exchange Act
Name of Depositor: Address of Major Office
Trade Name or Name
Registration Number: Director-General of (Branch) Finance Bureau(Financial Business) No. _____
This is a request for you to certify that the original copy of the Deposit Statement above was issued to redeem
money on deposit, because the depositor (name) made a deposit in order to replace the money on deposit that theoriginal copy of the Deposit Statement concerns, which the said depositor submitted to your bureau, with anequivalent amount of securities (__________ Legal Bureau, Fiscal Year _____, Finance No. _____).
Date: MM/DD/YY
I hereby certify that the above statement is true and correct.
Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau(Seal)

(Japanese Industrial Standards A4 format)(From Securities to Securities)
Date: MM/DD/YY
To: Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau
Address of Major Office of Applicant
Trade Name or Name
Name
(Name of representative in the case of juridical person)
Application for Issuance of Certification of the Original Deposit Statement
Original Deposit Statement x 1
Description of Deposit
Place of Deposit: _________ Legal Affairs Bureau
Date of Deposit: MM/DD/YY
Number of Deposit Year: Fiscal Year _____, Finance No. _____
Articles on Deposit: Number of Securities ________/Total face value ¥................
Legal Basis: Article 31-2(1) of the Financial Instruments and Exchange Act
Name of Depositor: Address of Major Office
Trade Name or Name
Registration Number: Director-General of (Branch) Finance Bureau(Financial Business) No. ___This is a request for you to certify that the original copy of the Deposit Statement above was issued to redeem
money on deposit, because the depositor (name) made a deposit in order to replace the articles on deposit that theoriginal copy of the Deposit Statement concerns, which the said depositor submitted to your bureau, with anequivalent amount of securities (__________ Legal Bureau, Fiscal Year _____, Finance No. _____).
Date: MM/DD/YY
I hereby certify that the above statement is true and correct.
Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau(Seal)

(Japanese Industrial Standards A4 format)(From Securities to Money)
Date: MM/DD/YY
To: Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau
Address of Major Office of Applicant
Trade Name or Name
Name
(Name of representative in the case of juridical person)
Application for Issuance of Certification of the Original Deposit Statement

Original Deposit Statement x 1
Description of Deposit
Place of Deposit: __________ Legal Affairs Bureau
Date of Deposit: MM/DD/YY
Number of Deposit Year: Fiscal Year _____, Finance No. _____
Articles on Deposit: Number of Securities ________/Total face value ¥...............
Legal Basis: Article 31-2(1) of the Financial Instruments and Exchange Act
Name of Depositor: Address of Major Office
Trade Name or Name
Registration Number: Director-General of (Branch) Finance Bureau(Financial Business) No. ___This is a request for you to certify that the original copy of the Deposit Statement above was issued to redeem
money on deposit, because the depositor (name) made a deposit in order to replace the articles on deposit thatthe original copy of the Deposit Statement concerns, which the said depositor submitted to your bureau, withan equivalent amount of money (__________ Legal Bureau, Fiscal Year _____, Finance No. _____).
Date: MM/DD/YY
I hereby certify that the above statement is true and correct.
Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau(Seal)

(Attached List of Formats V-2)
(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY(Trade Name or Name)
Name
To: (Name of Representative in the case of a juridical person)
Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau

Approval of Change in Contract in Lieu of Business Security Deposit
This is notification that the matters regarding the application filed on (MM/DD/YY) have been approved
pursuant to Article 15-13(iii) of the Ordinance for Enforcement of the Financial Instruments and Exchange Act.

(Attached List of Formats V-3)
(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY(Trade Name or Name)
Name
To: (Name of Representative in the case of a juridical person)
Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau

Approval of Dissolution of a Contract in Lieu of Business Security Deposit
This is notification that the matters regarding the application filed on (MM/DD/YY) have been approved
pursuant to Article 15-13(iii) of the Ordinance for Enforcement of the Financial Instruments and Exchange Act.

(Attached List of Formats V-4)
(Japanese Industrial Standards A4 format)
Public Notice of Redemption of Business Security Deposit of Financial
Instruments Business Operator
The following public notice is given pursuant to Article 14(2) of theOrdinance for Business Security Deposit of Financial Instruments Business
Operator (Ordinance of Cabinet Office/Ministry of Justice No. 3, 2007):
1. Trade name or name of depositor ◎2. Address ◎3. Name of representative
4. Amount of Business Security Deposit to be redeemed:¥.................
5. Any person who holds a Business Security Deposit right concerning
the person above (Registration No. XXX, Director-General of(Branch) Finance Bureau, No. ___), as specified in Article 31-2(6) of
the Financial Instruments and Exchange Act, is requested to submit anapplication, using the Attached List of Formats V of the Ordinance for
Business Security Deposit of Financial Instruments Business Operator,
to the __________ Section, of the ___________ Department of(Branch) Finance Bureau, together with a document proving thathe/she holds the said right by (MM/DD/YY).
6. Depositors who fail to file such a request within the period set forth in
the provision of the preceding item shall be excluded from thedividend computations.
Date: MM/DD/YY
Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau[Instructions for Filling the Form](1) In the case where the current facts listed in items 1 to 3 are different from those publicly inspected, due to nonsubmission of notification, etc., all the facts that emerged after the public inspection shall be entered.
(2) Enter the address of the head office, etc., listed on page 7 of the Registry.
(3) Use a 14-point font for words and one-byte characters (English input) for numerals.
(4) ◎ indicates one space. Delete the underlined word if it is unnecessary.
(5) Type 22 characters per line.

(Attached List of Formats V-5)
(Japanese Industrial Standards A4 format)
Document Number
Certificate of Custody
Original Copy of Deposit Statement: x ( )1. Name of Depositor
2. Name of Deposit Site/Deposit NumberThis certifies the above-mentioned deposit is in custody.
Date: MM/DD/YY
Commissioner of the Financial Services Agency
Director-General of (Branch) Finance Bureau

(Attached List of Formats VI-1)（Japanese Industrial Standards A4 format）

Register Book of the Notification of Establishment of Investment Corporations, etc.
Matters concerning
application for
Matters concerning

Date

Date

Expected

application

notification

date offorof failure ofestablishment

registration

establishment

received

received

investment units toproject planner
Receipt

Date

Notified

be issued at the timeNo.

receivedbyof establishment
PersonAddress

Offer

Name

providingor location

periodsolicitation
～
～
～
～
～
～
～
～
～
～

Remarks(Attached List of Formats VI-2)（Japanese Industrial Standards A4 format）
Registration Number File of Registered Investment Corporation(Local) Finance Bureau

Registration No.

Registration Date

Trade Name of Registered Investment
Corporation(Notes for filling the form)
When registration has been rescinded, cross it out with double lines ().

(Attached List of Formats VI-3)（Japanese Industrial Standards A4 format）
Document Number
Date: MM/DD/YY

To the FSA Commissioner

Director-General of (Local) Finance Bureau
Registrations of Investment Corporations
This is to report that registrations of investment corporations have been made (dated MM/YY) as stated in theattached sheet.

(Attached sheet)___________ (Local) Finance Bureau
Investment
Trade

Financial Situation at the Time of Establishment

Asset
Trust

Registration

Registration

Name ofCustody

Date ofCompany

Establishment

Management
Date

No.

Investment
Company
Corporation

Name
Name

Total Amount

Total Number of

Number ofof Contribution

Investment Units

Investors

(Attached List of Formats VI-4)（Japanese Industrial Standards A4 format）
Application for Inspection of the Registry of Registered Investment Corporations
Date: MM/DD/YY

To the Director-General of (Local) Finance Bureau
Purpose of
Inspection
RegistrationNo.

Trade Name of Registered Investment Corporation

Lending

Returnconfirmed confirmed

I wish to borrow the registry in order to inspect the registrations of the investment corporations stated above.
Applicant:Name
Address
Phone

Time Lent

Occupation

Time Returned

(Attached List of Formats VI-5)（Japanese Industrial Standards A4 format）
Document Number
Date: MM/DD/YY
To the FSA Commissioner

Director-General of (Local) Finance Bureau
Changes Related to Registered Investment Corporations
This is to report that changes related to registered investment corporations have been made (dated MM/YY) as
stated in the attached sheet.

(Attached sheet)(Local) Finance Bureau
Registration

Date

Registration

Trade Name ofApplicable

Date

Changed

No.

Investment Corporation

Provisions

Details of Changes(Notes for filling the form)“Applicable provisions” means any applicable items of Article 188(1) of the Act on Investment Trusts andInvestment Corporations or any applicable items of Article 214 of the Enforcement Act for the Act on
Investment Trusts and Investment Corporations.

(Attached List of Formats VI-6)(Japanese Industrial Standards A4 format)
OpinionOverview of the Investment Corporation(Original Registration Date)(Status of Executive Officers)(Status of Supervisory Executives)(Status of Investment Trust Management Company)(Others)(Issues)Results of the Most Recent Inspection

Complaints

Administrative Actions, etc.

(Attached List of Formats VI-7)(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY

To the FSA Commissioner
Director-General of (Local) Finance Bureau

Cross-Jurisdictional Relocation of Head OfficeThis is to report that cross-jurisdictional relocations of head offices have been made (dated MM/YY) as statedin the attached sheet.

(Attached sheet)(Local) Finance Bureau
Date

Relocation

Authorized Local

Registration

Finance Bureau

No. Before

Before Relocation

Relocation

Date
Relocation

Registration

Trade Name of Investment Corporation

Relocated
RegisteredNo.

(Attached List of Formats VI-8)(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY

To the FSA Commissioner
Director-General of (Local) Finance Bureau

Dissolution of Investment Corporations
This is to report that notifications of dissolution of investment corporations have been submitted (dated MM/YY)
as stated in the attached sheet.

(Attached sheet)(Local) Finance Bureau
Date ofPrior Registration

Trade Name of Investment

Applicable

Dissolution

No.

Corporation

provisions

Reason for Dissolution(Notes for filling the form)“Applicable provisions” means any applicable items of Article 192(1) of the Act on Investment Trusts andInvestment Corporations.

(Attached List of Formats VI-9)(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY(Trade Name)
To: (Name of Representative)
Director-General of (Local) Finance Bureau

Notice Granting

Permission
Approval

Regarding ________

I hereby notify that the application filed on (MM/DD/YY) regarding the above-mentioned matter has
been

Permitted.
Approved

(Attached List of Formats VI-10)(Japanese Industrial Standards A4 format)
Document Number
Date: MM/DD/YY(Trade Name)
To: (Name of Representative)
Director-General of (Local) Finance Bureau

Notice of Refusal of

I hereby notify that the application for

Permission
Approval

Regarding ________

Permission
Approval filed on (MM/DD/YY) regarding the above-

mentioned matter has been refused on the following grounds.
If you are dissatisfied with the refusal, you may request the Commissioner of the Financial Instruments
Service Agency to conduct an inspection under the Administrative Appeal Act (Law No. 68, 2014) within threemonths after the day on which you receive this notice of refusal.
If you demand the rescission of this action in a legal proceeding, you may file an action against the national
government for rescission under the Administrative Appeal Act (Law No. 139, 1962) within six months after
the day on which you receive this notice of refusal.
Grounds for refusal

(Attached List of Formats VI-11)(Investment Trust) (Registration and License Tax)
(Japanese Industrial Standards A4 format)
Application for Certificate(Date)To the FSA Commissioner
ApplicantAddress:
Trade name:
Director:
Seeking to become eligible for the provision of Article 83-2-2(2) of the Act on Special Measures
Concerning Taxation, in regard to the registration of ownership transfer of the real estate stated in theattached document, for which a transaction contract was concluded between the applicant and__________________ on (MM/DD/YY), I hereby apply for the issuance of a certificate certifying theitems specified under Article 31-5(2) of the enforcement rules for the Act on Special Measures
Concerning Taxation.
Attached documents:- Investment trust contract provisions (copy)- Real estate transaction contract (copy), etc. (One that allows confirmation of the date of the realestate ownership acquisition)- Certificate of registered matters for real estate. (Present original if attaching copy. However, in cases
where the reference number obtained through the use of the Registration Information Provision
Services is attached, attachment of a certificate of registered matters may be omitted.)- If the section for type of building of the real estate on the separate sheet is specified as warehouseand the date of acquisition of the ownership of the said building precedes April 1, 2015, which is thedate specified in the main clause of Article 1 of the Supplementary Provisions Law No. 9 to Partially
Revise the Income Tax and Other Laws (2015), a document that verifies the total floor area not used
for warehousing purposes (limited to documents certified by the Land, Infrastructure, Transport andTourism Minister).

- In cases where funds are borrowed, a certificate showing the lender’s balance- Asset investment report (for the latest term)- In cases falling under Article 83-2-2(2)(ii)(b) of the Act on Special Measures Concerning Taxation,
an asset investment report for the latest term (or latest certificate) and materials showing the status ofother assets (to be attached to the submitted application in the format specified in the Attached List ofFormats VI-12)
Certificate
1. The applicant’s acquisition of the real estate stated in the attached document was made byundertaking investment trust meeting the criteria under Article 83-2-2(2)(i)(a) and (c) of the Act on
Special Measures Concerning Taxation (hereinafter referred to as “the Act”).
The said investment trust is investment based on settlor’s instruction as defined in Article 2(1) of
the Act on Investment Trusts and Investment Corporations, as specified under Article 83-2-2(2)(i)(b)of the Act. (In cases where the said investment trust is an investment trust managed without
instructions from the settler, it shall be stated that, “The said investment trust is an investment trust
managed without instructions from the settlor as defined in Article 2(2) of the Act on Investment Trusts
and Investment Corporations.”)
2. The applicant acquired the said real estate in accordance with its investment trust contract
provisions, prescribed in Article 83-2-2(2) of the act. The specified real estate asset ratio prescribedunder Article 83-2-2(2)(ii) of the act is as follows:In cases falling under Article 83-2-2(2)(ii)(a): __ percent
In cases falling under Article 83-2-2(2)(ii)(b): __ percent
Percentage before the acquisition of the said real estate: __ percent
3. The applicant acquired the specified real estate asset stated in 2 above on (MM/DD/YY), and isaccordingly eligible for the provision of Article 83-2-2(2) of the act until (MM/DD/YY).

4. The ratio of the floor area of non-warehouse part of the building in the attached document is ___percent. (This shall only be stated in cases where “warehouse” is stated in the section for recording
building type for the real estate stated in the attached document, and the date on which the ownershipof the said building was acquired is before April 1, 2015, which is the date specified in the main clauseof Article 1 of the Supplementary Provisions Law No. 9 to Partially Revise the Income Tax and Other
Laws (2015) )I hereby certify the above.
(Date)FSA Commissioner (Seal)

(Attached sheet)[Real Estate]
Location of Land

Land Lot Number

Type of Land

Area㎡

Location of Building

Building Number

Type

Structure

Floor Area㎡

Note: The details of the real estate must be filled out in conformity with the items recorded in the registration
record.

(Attached List of Formats VI-12)(Japanese Industrial Standards A4 format)
Status of Specified Assets (As of the end of ____________)
Submitted on (date)
Applicant’s location or address:
Trade name:
1. Status of Specified Assets (Overview)(Unit: ¥million, %)Latest fiscal term
Category

AmountComposition

At the time of application
Amountratio

Composition
ratio

Specified assets
Specified real estate assets
Other specified assets
Note:(1) “Other specified assets” means specified assets excluding specified real estate assets.
(2) “Specified real estate assets” at the time of application shall include the acquisition cost of the real estate, etc.,
applied for.
(3) Among “other specified assets” at the time of application, those measurable in market value, such as securities,
must be stated in value as of the end of the previous month of the month to which the application date belongs.
2. Status of Other Specified Assets
Status of Securities(Number Unit: thousand, Amount Unit: ¥million)
Category
Share certificates
Share option certificates
National government bonds
Municipal bonds
Special bonds
Bonds(Of which, bonds with share options)
Others
Total

NumberAmountStatus of Future Trading, etc.
(Unit: ¥million)
Category

AmountTrading of shares
Future trading

Trading of bonds
OthersTrading of shares

Option trading

Trading of bonds
OthersStatus of Other Specified Assets(Unit: ¥million)
Category

Note: This table is for other specified assets excluding those stated above.

Amount(Attached List of Formats VI-13)(Investment Trust) (Real Estate Acquisition Tax)
(Japanese Industrial Standards A4 format)
Application for Certificate(Date)To the FSA Commissioner
ApplicantAddress:
Trade name:
Director:
Seeking to become eligible for the provision of Article 11(4) of the supplementary provisions of
the local tax act in regard to the real estate acquisition tax imposed on the real estate stated in theattached document, for which a transaction contract was concluded between the applicant and__________________ on (MM/DD/YY), I hereby apply for the issuance of a certificate certifying theitems specified under Article 7(5) of the supplementary provisions of the enforcement ordinance forthe local tax act.
Attached documents:- Investment trust contract provisions (copy)- Real estate transaction contract (copy), etc. (One that allows confirmation of the date of the realestate ownership acquisition)- Certificate of registered matters for real estate. (Present original if attaching copy. However, in cases
where the reference number obtained through the use of the Registration Information Provision
Services is attached, attachment of a certificate of registered matters may be omitted.)- In cases where funds are borrowed, a certificate showing the lender’s balance- Asset investment report (for the latest term)- In cases falling under Article 7(9)(iv)(b) of the supplementary provisions of the enforcement
ordinance for the local tax act, an asset investment report for the latest term (or latest certificate) andmaterials showing the status of other assets (to be attached to the submitted application in the format
specified in the Attached List of Formats VI-13)
Certificate
1. The applicant’s acquisition of the real estate stated in the attached document was made byundertaking investment trust meeting the criteria under Article 7(5)(i) and (iii) of the supplementaryprovisions of the enforcement ordinance for the local tax act (hereinafter referred to as “thesupplementary provisions of the enforcement ordinance”).
The said investment trust is investment based on settlor’s instruction as defined in Article 2(1) of
the Act on Investment Trusts and Investment Corporations, as specified under Article 7(12)(ii) of the
supplementary provisions of the enforcement ordinance. (In cases where the said investment trust is
an investment trust managed without instructions from the settler, it shall be stated that, “The said
investment trust is an investment trust managed without instructions from the settlor as defined in
Article 2(2) of the Act on Investment Trusts and Investment Corporations.”)
2. The specified real estate asset ratio for the said real estate, prescribed under Article 7(5)(iv) of the
supplementary provisions of the enforcement ordinance, is as follows, and accordingly meets thecriteria under the said article.
In cases falling under Article 7(12)(iv) (a): __ percent
In cases falling under Article 7(12)(iv) (b): __ percent
Percentage before the acquisition of the said real estate: __ percent
I hereby certify the above.
(Date)FSA Commissioner (Seal)

(Attached sheet)[Real Estate]
Location of Land

Land Lot Number

Type of Land

Area㎡

Location of Building

Building Number

Type

Structure

Floor Area㎡

Note: The details of the real estate must be filled out in conformity with the items recorded in the registration
record.

(Attached List of Formats VI-14)(Investment Corporation) (Registration and License Tax)
(Japanese Industrial Standards A4 format)
Application for Certificate(Date)To the FSA Commissioner
ApplicantAddress:
Trade name:
Director:
Seeking to become eligible for the provision of Article 83-2-2(3) of the Act on Special Measures
Concerning Taxation in regard to the registration of ownership transfer of the real estate stated in theattached document, for which a transaction contract was concluded between the applicant and__________________ on (MM/DD/YY), I hereby apply for the issuance of a certificate certifying theitems specified under Article 31-5(3) of the enforcement rules for the Act on Special Measures
Concerning Taxation.
Attached documents:- Investment corporation contract provisions (copy)- Real estate transaction contract (copy), etc. (One that allows confirmation of the date of the realestate ownership acquisition)- Certificate of registered matters for real estate. (Present original if attaching copy. However, in cases
where the reference number obtained through the use of the Registration Information Provision
Services is attached, attachment of a certificate of registered matters may be omitted.)- If the section for type of building of the real estate on the separate sheet is specified as warehouseand the date of acquisition of the ownership of the said building precedes April 1, 2015, which is thedate specified in the main clause of Article 1 of the Supplementary Provisions Law No. 9 to Partially
Revise the Income Tax and Other Laws (2015), a document that verifies the total floor area not used
for warehousing purposes (limited to documents certified by the Land, Infrastructure, Transport andTourism Minister).

- In cases where funds are borrowed, a certificate showing the lender’s balance- Asset investment report (for the latest term)- In cases falling under Article 83-2-3(3)(ii)(b) of the Act on Special Measures Concerning Taxation,
an asset investment report for the latest term (or latest certificate) and materials showing the status ofother assets (to be attached to the submitted application in the format specified in the Attached List ofFormats VI-12)
Certificate
1. The applicant is a investment corporation meeting the criteria under Article 83-2-3(3)(i)(a), (b) and(d) of the Act on Special Measures Concerning Taxation (hereinafter referred to as “the Act”).
2. The applicant acquired the said real estate in accordance with its investment corporation contract
provisions, prescribed in Article 83-2-3(3) of the act. The specified real estate asset ratio prescribedunder Article 83-2-3(3)(ii) of the Act is as follows:In cases falling under Article 83-2-3(3)(ii)(a): __ percent
In cases falling under Article 83-2-3(3)(ii)(b): __ percent
Percentage before the acquisition of the said real estate: __ percent
3. The applicant acquired the specified real estate asset stated in 2 above on (MM/DD/YY), and isaccordingly eligible for the provision of Article 83-2-3(3) of the act until (MM/DD/YY).
4. The ratio of the floor area of the non-warehouse part of the building in the attached document is___ percent. (This shall only be stated in cases where "warehouse" is stated in the section for recording
building type for the real estate stated in the attached document, and the date on which the ownershipof the said building was acquired is before April 1, 2015, which is the date specified in the main clause

of Article 1 of the Supplementary Provisions Law No. 9 to Partially Revise the Income Tax and Other
Laws (2015).)

I hereby certify the above.
(Date)FSA Commissioner (Seal)

(Attached sheet)[Real Estate]
Location of Land

Land Lot Number

Type of Land

Area㎡

Location of Building

Building Number

Type

Structure

Floor Area㎡

Note: The details of the real estate must be filled out in conformity with the items recorded in the registration
record.

(Attached List of Formats VI-15)(Investment Corporation) (Real Estate Acquisition Tax)
(Japanese Industrial Standards A4 format)
Application for Certificate(Date)To the FSA Commissioner
ApplicantAddress:
Trade name:
Director:
Seeking to become eligible for the provision of Article 11(5) of the supplementary provisions of
the local tax act in regard to the real estate acquisition tax imposed on the real estate stated in theattached document, for which a transaction contract was concluded between the applicant and__________________ on (MM/DD/YY), I hereby apply for the issuance of a certificate certifying theitems specified under Article 7(7) of the supplementary provisions of the enforcement ordinance forthe local tax act.
Attached documents:- Investment corporation contract provisions (copy)- Real estate transaction contract (copy), etc. (One that allows confirmation of the date of the realestate ownership acquisition)- Certificate of registered matters for real estate. (Present original if attaching copy. However, in cases
where the reference number obtained through the use of the Registration Information Provision
Services is attached, attachment of a certificate of registered matters may be omitted.)- In cases where funds are borrowed, a certificate showing the lender’s balance- Asset investment report (for the latest term)- In cases falling under Article 7(7)(iv)(b) of the supplementary provisions of the enforcement
ordinance for the local tax act, an asset investment report for the latest term (or latest certificate) andmaterials showing the status of other assets (to be attached to the submitted application in the format
specified in the Attached List of Formats VI-12)
Certificate
1. The applicant acquired real estate meeting the criteria under Article 7(7)(i) and (iii) of the
supplementary provisions of the enforcement ordinance for the local tax act (hereinafter referred to as“the supplementary provisions of the enforcement ordinance”).
2. The specified real estate asset ratio for the said real estate, prescribed under Article 7(7)(iv) of the
supplementary provisions of the enforcement ordinance, is as follows, and accordingly meets thecriteria under the said article.
In cases falling under Article 7(11)(iv) (a): __ percent
In cases falling under Article 7(11)(iv) (b): __ percent
Percentage before the acquisition of the said real estate: __ percent
I hereby certify the above.
(Date)FSA Commissioner (Seal)

(Attached sheet)[Real Estate]
Location of Land

Land Lot Number

Type of Land

Area㎡

Location of Building

Building Number

Type

Structure

Floor Area㎡

Note: The details of the real estate must be filled out in conformity with the items recorded in the registration
record.

(Attached List of Formats IX-1)(Japanese Industrial Standards A4 format)
Warning to Persons Making False Statements to Investors Regarding Solicitation, etc. (Draft)____ Company Limited
To: (Representative Director)

Director-General of (Branch) Finance Bureau

In cases where a person, who has made notification for business specially permitted for qualified
institutional investors, etc., engages in business specially permitted for qualified institutional investors,
etc. pursuant to Article 63(4) of the Financial Instruments and Exchange Act before the revision pursuant
to the Act for Partial Revision of the Financial Instruments and Exchange Act (Law No. 32, 2015), the actof making false statements to customers concerning solicitation for such business is prohibited.
The Finance Bureau has conducted an investigation into the actions of your company, and has foundthat they fall under acts act of making false statements to customers concerning solicitation. This is a
notification warning you to immediately cease the said actions.
Therefore, I request that you submit a correction plan for your company in writing by (MM/DD/YY).
I would like to add that appropriate measures will be taken if no response is made or if you fail to heed
the warning of the Finance Bureau by the deadline.

Note: Warnings issued to persons committing acts specified in the items of Article 39(1) or (2) of the
Financial Instruments and Exchange Act shall be prepared in accordance with this format.

(Attached List of Formats IX-2)(Japanese Industrial Standards A4 format)
Warning to Persons Conducting Acts which are Questionable in Terms of Investor Protection (Draft)____ Company Limited
To: (Representative Director)

Director-General of (Branch) Finance Bureau

In cases where a person, who has made notification for business specially permitted for qualified
institutional investors, etc., engages in business specially permitted for qualified institutional investors,
etc., attention needs to be paid to investor protection.
The Finance Bureau has conducted an investigation into your company, and has found that it is engaged
in the act of ____.* This is a notification warning you to immediately cease the said actions.
Therefore, I request that you submit a correction plan for your company in writing by (MM/DD/YY).
I would like to add that appropriate measures will be taken if no response is made or if you fail to heed
the warning of the Finance Bureau by the deadline.

* Acts that are questionable in terms of investor protection need to be stated in detail, such as“misappropriating the investments of investors.”