Application for Revision of Retained Personal Data
Attn: Customer Relations Office, KOKUYO Co., Ltd.
Date: MM/DD/YYYY
Item
1

Entry field

ExampleName of person to be

Ichiro Suzuki

revised2

Current address

x-x-x

Otemachi,Chiyoda-ku, Tokyo
3

Telephone number

03-xxx-xxxx

4Company

KOKUYO ●● Co., Ltd.

5

Detailsof(revision,deletion,request

Revisionaddition,suspensionofuse, erasure)6

Items and details of thecompany’s

Revision of nameretained

Beforepersonal data requested

revision:

Ichiro Suzuki

for revision

After revision: IchiroSuzuki (different kanjicharacter)

7

Name of applicant(Alsoinclude

current

address if applicant isdifferent

fromSealtheindividual to be revised)8

Relationship to individualSame person

to be revised
Remarks:
1. If you would like to know whether there are any retained personal data and its contents,
please request for disclosure (required a fee) separately through the Application for
Disclosure of Retained Personal Data.
2. Please be sure to enclose identity verification documents if the applicant in Item 7. is thesame person as the individual to be revised. If the application is a different person,please be sure to fill in “Item 8. Relationship to individual to be revised” and enclose
documents that verify the relationship. In addition, please note that it is not possible forthe notification documents to be sent if the address stated in the verification documents
differs from the current address. The required documents are as listed under “Notes”.
3. Only one company and one person can be requested for revision with this application.
Even if multiple companies and names are entered, only one company and one person
will be revised with this application.

For official use only
Date and time of receipt
Receipt no.
Please read the Notes on the next page.

Notes
1. Items available for revision
Revision, addition, deletion, suspension of use and erasure (revision) of retained
personal data regarding “target company” and “individual to be revised”, (such as names,addresses, telephone numbers and email addresses) can be requested through theApplication for Revision of Retained Personal Data.
2. Request for revision (mailing address)
6-1-1 Oimazato-minami, Higashinari-ku, Osaka-shi 537-8686
Customer Relations Office, KOKUYO Co., Ltd.
3. Items to be submitted for request for revision(1) Application for Revision of Retained Personal Data
(2) Documents to verify identity or qualification of agent(i)

If the applicant is the same person
One copy of any of the following: copy of driver’s license or passport (portion
that lists name and current address), certificate of seal impression (originalcopy only), certificate of residence (original copy only), health insurance card.
Certificate of seal impression and certificate of residence will be enclosed
and returned in the reply.
(Note): Please black out your permanent domicile on copies of documentsthat list your permanent domicile.

(ii)If the applicant is a different person(a) In the case of a legal representative
The prescribed declaration form and documents certifying statutory
power of representation (for example: extract of family register,
certificate of residence (including relationships)).
Legal representative verification documents (such as a copy of thedriver’s license of the legal representative, corresponding to identity
verification documents.)(b) In the case of an agent
The prescribed power of attorney and the person’s certificate of seal
impression (within 3 months of creation).

4. Method of replies to requests for revision
We will reply in writing to the applicant’s current address written in the application form.
5. Purpose of use of personal information acquired through requests for revision
Personal information acquired through requests for revision shall only be handled within
the scope necessary for revision. Documents submitted will be stored for two years after
the answer to the request for revision is completed and will be discarded thereafter.
6. In cases of non-revision of retained personal data
We will not revise retained personal data in the following cases. We will notify applicants
regarding the reasons should we decide on non-revision.
(i)

In cases where the identity of the person cannot be confirmed, such as if theaddress stated in the application is different from the address stated in theidentity or agent qualification verification documents.

(ii)

In cases where the authority of representation of the agent applying cannot beverified.

(iii)

In cases where the prescribed application form is not completed.

(iv)

In cases where the subject of revision does not fall under retained personal data.

(v)

In cases where the details of the request for revision is contrary to fact.

(vi)

In cases where it is stipulated by other laws and regulations or in cases whererevision violates other laws and regulations.