別記第三十号様式（第二十条関係）
申請人等作成用 1
For applicant, part 1
日本国政府法務省
Ministry of Justice, Government of Japan
在留資格変更許可申請書
APPLICATION FOR CHANGE OF STATUS OF RESIDENCE
出入国管理及び難民認定法第20条第2項の規定に基づき、次のとおり在留資格の変更を申請します。
Pursuant to the provisions of Paragraph 2 of Article 20 of the Immigration Control and Refugee Recognition Act,
I hereby apply for a change of status of residence.
1 国籍・地域
Nationality/Region
2 生年月日
Date of birth
年
Year
月
Month
日
Day
3 氏名
Name
Family name
Given name
6 配偶者の有無
Marital status
Married / Single
4 性別
Sex
Male/Female
5 出生地
Place of birth
7 職業
Occupation
8 本国における居住地
Home town/city
9 住居地
Address in Japan
電話番号
Telephone No.
携帯電話番号
Cellular phone No.
10 旅券 (1)番号
Passport Number
(2)有効期限
Date of expiration
年
Year
月
Month
日
Day
11 現に有する在留資格
Status of residence
在留期間
Period of stay
在留期間の満了日
Date of expiration
年
Year
月
Month
日
Day
12 在留カード番号
Residence card number
13 希望する在留資格
Desired status of residence
在留期間
Period of stay
（審査の結果によって希望の期間とならない場合があります。）
( It may not be as desired after examination. )
14 変更の理由
Reason for change of status of residence
15 犯罪を理由とする処分を受けたことの有無（日本国外におけるものを含む。）※交通違反等による処分を含む。
Criminal record (in Japan / overseas)※Including dispositions due to traffic violations, etc.
Yes ( Detail: ） / No
16 在日親族（父・母・配偶者・子・兄弟姉妹・祖父母・叔（伯）父・叔（伯）母など）及び同居者
Family in Japan (father, mother, spouse, children, siblings, grandparents, uncle, aunt and others) and anyone you currently reside with
Yes (If yes, please fill in your family members in Japan and anyone you currently reside with in the following columns.) / No
@for ($i = 1; $i <= 6; $i++) @endfor
続柄
Relationship 		氏名
Name 		生年月日
Date of birth 		国籍・地域
Nationality/Region 		同居の有無
Residing with applicant or not
有・無
Yes / No 		勤務先名称・通学先名称
Place of employment/ school 		在留カード番号
特別永住者証明書番号
Residence card number
Special Permanent Resident Certificate number
※ 3について、有効な旅券を所持する場合は、旅券の身分事項ページのとおりに記載してください。
Regarding item 3, if you possess a valid passport, please write as shown in the passport.
16について、記載欄が足りない場合は別紙に記入して添付すること。なお、「研修」、「技能実習」に係る申請の場合は、「在日親族」のみ記載してください。
Regarding item 16, if there is not enough space in the given columns to write in all of your family in Japan, fill in and attach a separate sheet.
（注）裏面参照の上、申請に必要な書類を作成して下さい。
Note : Please fill in forms for application. (See notes on reverse side.)
（注）申請書に事実に反する記載をしたことが判明した場合には、不利益な扱いを受けることがあります。
Note : In case of to be found that you have misrepresented the facts in an application, you will be unfavorably treated in the process.
17
活動内容 Type of activity
① 【
activity_diplomat ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_official ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_lawyer ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_judicial_scrivener ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_land_building_investigator ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_foreign_qualified_lawyer ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_public_accountant ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_foreign_certified_public_accountant ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_tax_accountant ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_social_labor_consultant ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_patent_attorney ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_maritime_procedure_agent ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_administrative_procedures_specialist ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
】
② 【
activity_doctor ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_dentist ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_pharmacist ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_public_health_nurse ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_midwife ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_nurse_except_epa ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_assistant_nurse ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_dental_hygienist ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_radiology_technician ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_physical_therapist ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_occupational_therapist ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_orthoptist ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_clinical_engineer ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_prosthetist ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
】
③ 【
activity_housekeeper ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_family_together ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
】
④
activity_working_holiday ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_foreign_lawyer ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
⑤
activity_amateur_sports ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
⑥
activity_internship ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
⑦ 【
activity_epa_nurse ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_epa_certified_careworker ?? '') == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_epa_nurse_candidate ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_epa_careworker_candidate ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_epa_careworker_student_candidate ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
】
⑧
activity_foreign_construction ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_foreign_manufacturing ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_crop_farming ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_foreign_shipbuilding ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_domestic_workers ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_livestock_farming ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
⑨
activity_fourth_generation ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
⑩
activity_entrepreneurial ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
⑪
activity_others ?? '') == '1' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
（ ）
（17で選択した区分に応じ以下の項目について記入）
(Fill in the following items in accordance with your answer to the question 17)
instruction_option) && $record->instruction_option == 1 ? 'checked' : '' }} disabled>
18,27及び「署名欄」を記入
Fill in the questions 18,27 and signature.
instruction_option) && $record->instruction_option == 2 ? 'checked' : '' }} disabled>
18,19,27及び「署名欄」を記入
Fill in the questions 18,19,27 and signature.
instruction_option) && $record->instruction_option == 3 ? 'checked' : '' }} disabled>
27及び「署名欄」を記入
Fill in the questions 27 and signature.
instruction_option) && $record->instruction_option == 4 ? 'checked' : '' }} disabled>
22,27及び「署名欄」を記入
Fill in the questions 22,27 and signature.
instruction_option) && $record->instruction_option == 5 ? 'checked' : '' }} disabled>
18,20,27及び「署名欄」を記入
Fill in the questions 18,20,27 and signature.
instruction_option) && $record->instruction_option == 6 ? 'checked' : '' }} disabled>
21,27及び「署名欄」を記入
Fill in the questions 21,27 and signature.
instruction_option) && $record->instruction_option == 7 ? 'checked' : '' }} disabled>
18,19,22,27及び「署名欄」を記入
Fill in the questions 18,19,22,27 and signature.
instruction_option) && $record->instruction_option == 8 ? 'checked' : '' }} disabled>
18,27及び「署名欄」を記入
Fill in the questions 18,27 and signature.
instruction_option) && $record->instruction_option == 9 ? 'checked' : '' }} disabled>
22,27及び「署名欄」を記入
Fill in the questions 22,27 and signature.
instruction_option) && $record->instruction_option == 10 ? 'checked' : '' }} disabled>
19,23～27及び「署名欄」を記入
Fill in the questions 19,23～27 and signature.
instruction_option) && $record->instruction_option == 11 ? 'checked' : '' }} disabled>
22,27及び「署名欄」を記入
Fill in the questions 22,27 and signature.
18 勤務先又は通学先
Place of employment or school
(1)
(2)
(3)
-
-
19 最終学歴
Education (last school or institution)
(1)
education_country) && in_array('japan', $record->education_country) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
education_country) && in_array('foreign', $record->education_country) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
(2)
education_level) && in_array('doctor', $record->education_level) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
education_level) && in_array('master', $record->education_level) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
education_level) && in_array('bachelor', $record->education_level) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
education_level) && in_array('junior_college', $record->education_level) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
education_level) && in_array('college_technology', $record->education_level) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
education_level) && in_array('senior_high', $record->education_level) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
education_level) && in_array('junior_high', $record->education_level) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
education_level) && in_array('others', $record->education_level) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
（ ）
(3)
(4)
(5)
年 Year
月 Month
20 経歴
Record
olympic_participation) && $record->olympic_participation == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
年
Year
world_championship_participation) && $record->world_championship_participation == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
年
Year
other_international_participation) && $record->other_international_participation == 1 ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
年
Year
)
21 在学中の大学名
University name and faculty
22 具体的な在留目的（滞在費支弁方法を含む。）
Purpose of staying in detail (including method of support)
23 専攻・専門分野
Major field of study
(19で大学院(博士)～短期大学の場合)
(Check one of the followings when the answer to the question 19 is from doctor to junior college)
major_field) && is_string($record->major_field) && in_array('law', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('economics', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('politics', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('commercial_science', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('business_administration', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('linguistics', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('sociology', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('history', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('psychology', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('education', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('cultural_social_science_other', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
)
major_field) && is_string($record->major_field) && in_array('science', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('chemistry', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('literature', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('art_science', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('agriculture', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('fisheries', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('pharmacy', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('medicine', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('dentistry', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('engineering', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('natural_science_other', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
)
major_field) && is_string($record->major_field) && in_array('sports_science', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
major_field) && is_string($record->major_field) && in_array('others_university', explode(',', $record->major_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
)
(23で専門学校の場合)
(Check one of the followings when the answer to the question 23 is College of technology)
technical_field) && is_string($record->technical_field) && in_array('engineering_tech', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
technical_field) && is_string($record->technical_field) && in_array('agriculture_tech', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
technical_field) && is_string($record->technical_field) && in_array('medical_hygienics', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
technical_field) && is_string($record->technical_field) && in_array('education_social_welfare', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
technical_field) && is_string($record->technical_field) && in_array('law_tech', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
technical_field) && is_string($record->technical_field) && in_array('commercial_business', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
technical_field) && is_string($record->technical_field) && in_array('dress_design', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
technical_field) && is_string($record->technical_field) && in_array('culture_education', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
technical_field) && is_string($record->technical_field) && in_array('others_technical', explode(',', $record->technical_field)) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
)
24 起業を目指す分野に関連する事業の経営又は管理についての外国における実務経験年数
No. of years of practical experience in a foreign country of managing or supervising business related to the field in which the applicant intends to start a business
年 Year
25 起業を目指す分野に関連する業務についての実務経験年数
No. of years of practical experience of work related to the field in which the applicant intends to start a business
年 Year
26 職歴（外国におけるものを含む）
Work experience (including those in a foreign country)
@for ($i = 1; $i < 4; $i++) > @endfor
入社
Date of joining the company		 退社
Date of leaving the company		 勤務先名称
Place of employment		 入社
Date of joining the company		 退社
Date of leaving the company		 勤務先名称
Place of employment
年
Year		 月
Month		 年
Year		 月
Month		 年
Year		 月
Month		 年
Year		 月
Month
27 代理人（法定代理人による申請の場合に記入）
Legal representative (in case of legal representative)

以上の記載内容は事実と相違ありません。

I hereby declare that the statement given above is true and correct.

申請人（法定代理人）の署名／申請書作成年月日

Signature of the applicant (representative) / Date of filling in this form

注意 Attention

申請書作成後申請までに記載内容に変更が生じた場合、申請人（法定代理人）が変更箇所を訂正し、署名すること。

申請書作成年月日は申請人（法定代理人）が自署すること。

In cases where descriptions have changed after filling in this application form up until submission of this application, the applicant (legal representative) must correct the part concerned and sign their name.

The date of preparation of the application form must be written by the applicant (legal representative).

※ 取次者
Agent or other authorized person
所属機関等作成用 1 U (その他)
在留期間更新・在留資格変更用
For organization, part 1 U (Others) For extension or change of status
1 契約、招へい又は同居している外国人の氏名及び在留カード番号

Name and residence card number of the foreigner contracting, inviting or living together with

Name

Residence card number

(In the case of a contract, select one of the following forms.)

contract_type) && ( is_string($record->contract_type) ? in_array('employment', explode(',', $record->contract_type)) : in_array('employment', $record->contract_type) ) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
contract_type) && ( is_string($record->contract_type) ? in_array('delegation', explode(',', $record->contract_type)) : in_array('delegation', $record->contract_type) ) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
contract_type) && ( is_string($record->contract_type) ? in_array('contract_agreement', explode(',', $record->contract_type)) : in_array('contract_agreement', $record->contract_type) ) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
contract_type) && ( is_string($record->contract_type) ? in_array('others', explode(',', $record->contract_type)) : in_array('others', $record->contract_type) ) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}> )
2 申請人の活動内容

the applicant's activities

activity_type) && is_string($record->activity_type) && str_contains($record->activity_type, 'diplomat_official') ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
・・・・・・・・・・・・・ 3,4,5(1)～(5)及び「記名（署名）欄」を記入
Fill in the questions 3,4,5(1)～(5) and name(signature).
activity_type) && is_string($record->activity_type) && str_contains($record->activity_type, 'epa_candidate') ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
activity_type) && is_string($record->activity_type) && str_contains($record->activity_type, 'epa_candidate_1') ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
・・・・・・・・・・・・・ 3,4,5(1)～(5),7及び「記名（署名）欄」を記入
Fill in the questions 3,4,5(1)～(5),7and name(signature).
activity_type) && is_string($record->activity_type) && str_contains($record->activity_type, 'housekeeper') ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
・・・・・・・・・・・・・ 3,4,6,7,8,9及び「記名（署名）欄」を記入
Fill in the questions 3,4,6,7,8,9and name(signature).
activity_type) && is_string($record->activity_type) && str_contains($record->activity_type, 'dependent_support') ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
・・・・・・・・・・・・・ 10及び「記名（署名）欄」を記入
Fill in the questions 10 and name(signature).
activity_type) && is_string($record->activity_type) && str_contains($record->activity_type, 'fourth_generation') ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
・・・・・・・・・・・・・ 11又は12及び「記名（署名）欄」を記入
Fill in the questions 11 or 12 and name(signature).
3 職種 (Occupation)
Select the main type of work from the attached sheet "a list of occupation", and fill in the number (select only one)
If there is any other kind of work, select from "a list of occupation", and fill in the number (more than one answer may be selected)
（注意）Attention
・「法律・会計」での在留を希望する場合は、別紙「職種一覧」の29,65～75,999から選択してください。
Those who wish to reside in Japan with "legal / accounting services" should select from 29,65 to 75, and 999 on the attached "a list of occupation".
・「医療」での在留を希望する場合は、別紙「職種一覧」の47～50,55～64,999から選択してください。
Those who wish to reside in Japan with "medical services" should select from 47 to 50, from 55 to 64 and 999 on the attached "a list of occupation".
・「公用」での在留を希望する場合は、本欄中に、別紙「職種一覧」の「112 公用」を選択してください。
Those who wish to reside in Japan with "official" should select "112 official" on the attached "a list of occupation".
・「特定活動」での在留を希望する場合は、別紙「職種一覧」の80,82～99,111～112,999から選択してください。
Those who wish to reside in Japan with "designated activities" should select from 80,82 to 99,111 to 112 and 999 on the attached "a list of occupation".
4 活動内容詳細 (Details of activities)
5 勤務先、所属機関又は通学先 (Place of employment, organization or school to which the applicant is to belong)
※ (1), (3), (5)及び(6)については、主たる勤務先について記載すること。
For sub-items (1), (3), (5) and (6), fill in the information of principal place of employment where foreign national is to work.
@for ($i = 1; $i <= 13; $i++) @endfor
@php $empInsFields = 11; // Total number of emp_ins fields @endphp @for ($i = 1; $i <= $empInsFields; $i++) @if ($i == 5 || $i == 11) - @endif @endfor
business_type) && $record->business_type == 'main_business' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
business_type) && $record->business_type == 'other_business' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
円 (Yen)
円 (Yen)
名
名
8 月額報酬(税引き前の支払額) (Monthly salary (amount of payment before taxes))
※ 各種手当(通勤・住宅・扶養等)・実費弁償の性格を有するものを除く。
Excludes various types of allowances (commuting,housing,dependents,etc.) and personal expenses.
円 (Yen)
9 雇用主(家事使用人の場合に記入) (Employer (Fill in the followings in case of housekeeper.))
employer_sex) && $record->employer_sex == 'male' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
employer_sex) && $record->employer_sex == 'female' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
年 (Year)
月 (Month)
日 (Day)
年 (Year)
月 (Month)
日 (Day)
所属機関等作成用 2 U (その他) (For organization, part 2 U (Others))
在留期間更新・在留資格変更用 (For extension or change of status)
(11)雇用主の同居家族(父・母・配偶者・子など) (Employer's family (Father, Mother, Spouse, Son and Daughter, etc.))
@for ($i = 1; $i <= 5; $i++) @endfor
続柄
Relationship 		氏名
Name 		生年月日
Date of birth 		国籍・地域
Nationality 		同居の有無
Residing with applicant or not 		勤務先名称・通学先名称
Place of employment / school 		在留資格
Status of residence
{'family_residing_'.$i}) && $record->{'family_residing_'.$i} == 'yes' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
{'family_residing_'.$i}) && $record->{'family_residing_'.$i} == 'no' ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
10 扶養者 (申請人が扶養を受ける場合に記入) (Supporter (Fill in the followings when the applicant is to be supported))
年 (Year)
月 (Month)
日 (Day)
年 (Year)
月 (Month)
日 (Day)
supporter_relationship) && in_array('husband', (array)$record->supporter_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_relationship) && in_array('wife', (array)$record->supporter_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_relationship) && in_array('father', (array)$record->supporter_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_relationship) && in_array('mother', (array)$record->supporter_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_relationship) && in_array('foster_father', (array)$record->supporter_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_relationship) && in_array('foster_mother', (array)$record->supporter_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_relationship) && in_array('others', (array)$record->supporter_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
@for ($i = 1; $i <= 13; $i++) @endfor
@for ($i = 1; $i <= 11; $i++) @if ($i == 5 || $i == 11) - @endif @endfor
円 (Yen)
11 日系四世受入れサポーター（同サポーターが個人の場合に記入）
Supporter accepting the fourth-generation foreign national of Japanese descent
(Fill in the following items if the supporter accepting the fourth-generation foreign national of Japanese descent is an individual)
supporter_individual_relationship) && in_array('family', (array)$record->supporter_individual_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_individual_relationship) && in_array('friend', (array)$record->supporter_individual_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_individual_relationship) && in_array('employer', (array)$record->supporter_individual_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
supporter_individual_relationship) && in_array('other', (array)$record->supporter_individual_relationship) ? 'checked' : '' }} {{ $type == 'detail' ? 'disabled' : '' }}>
12 日系四世受入れサポーター（日系四世で受入れサポーターが団体の場合に記入）
Supporter accepting fourth-generation foreign national of Japanese descent
(Fill in the following items if the supporter accepting the fourth-generation foreign national of Japanese descent is an organization)

以上の記載内容は事実と相違ありません。
The above statement is true and correct.

所属機関等契約先の名称又は日系四世受入れサポーター（法人名）、代表者氏名の記名／申請書作成年月日
Name of the organization the contracting organization such as the organization of affiliation or supporter accepting the fourth-generation foreign national of Japanese descent (organization), and its representative of the organization／Date of filling in this form

扶養者、身元保証人又は日系四世受入れサポーター（個人）の署名／申請書作成年月日
Signature of the supporter, guarantor, or supporter accepting the fourth-generation foreign national of Japanese descent (individual) form

／Date of filling in this form

注意 (Attention)

申請書作成後申請までに記載内容に変更が生じた場合、所属機関等又は扶養者等が変更箇所を訂正すること。
In cases where descriptions have changed after filling in this application form up until submission of this application, the organization of affiliation or the supporter etc. must correct the changed part.