Receiving Residence Certificate Copies (By Mail)

Request Form for Resident Certificate Copy by Mail(JPN only)

Please fill out the form with the following contents. You can either print out the form above to fill out, or simply list out the necessary information on any sort of writing/letter paper.

Note: Please sign your name either by hand or by your inkan seal.

Please indicate how many copies of the residence certificate are needed, and if they are required for multiple people in the household or only one.

Note: Please indicate whether it is necessary to provide information such as the resident's permanent address, the registered head of family, the applicant's relation to the head of the family, or any additional information used to identify an address. If not specified, an abbreviated version of the certificate will be issued.

　Note: For foreign residents, please indicate whether it is necessary to provide information such as the applicant's relation to the head of the family/any additional information used to identify an address, the residents country/region of origin as indicated on your passport, residence card number, status of residence/period of stay/expiration of period of stay, resident classification as specified by article 30-45, or the residents name in katakana. If not specified, an abbreviated version of the certificate will be issued.

Note: If you require a certificate for someone other than yourself or someone within your same household, there are instances in which we will inevitably be unable to fulfill your request, so please contact us in advance.

Note: For those who would like to request a certificate of removal of residence (for proof of past residence in Tokushima City) for automobile scrapping procedures, filing taxes/tax reductions, etc, please indicate in the Details of Intended Use section which address should be displayed on the certificate of residence.

（1） Copy of Identity Verification Document of the applicant --- Please confirm which documents apply here (About Identity Verification Documents JPN only)
（2） In the case that a proxy is applying, a letter of power of attorney (by the one authorized to make the application) is required. See here for more details: About Power of Attorney (JPN only)

Copy of Certificate of Residence is 350 yen for each household or each individual member of the household.

Please enclose a fixed-sum money order (which you can purchase at the Japan Postal Bank) for the handling fee. Stamps and revenue stamps will not be accepted.

Please include a self-addressed stamped envelope with your name and address (registered place of residence) along with your application documents for return postage.

2-5, Saiwaicho, Tokushima-shi, Tokushima-ken 770－8571 (If you fill in this zip code you can omit the preceding address)

Tokushima City Hall, Resident Registration Division

Resident Registration Division TEL: 088-621-5140