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

法務大臣殿

To the Minister of Justice

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.

写真

Photo

40mm × 30mm