Identity Verification Documents The following documents will be

　Identity Verification Documents The following documents will be required to verify your identity. You can submit a combination of documents as below: ① Any 1 document from section A ② Any 2 documents from section B ③ A combination of 2 documents from B and C (1 document from each) Section A (must be currently valid/within expiry date） ・Driver’s License ・Passport ・Residence card, Special Permanent Residence Certificate ・My Number card * Do not send the reverse side of the card (side with your personal number) ・Basic Resident Registration card (with picture) ・Any photo ID, license, permit, qualification certificate, etc. issued by a national or local public institution) （船員手帳、海技免状、小型船舶操縦免許証、猟銃・空気銃所持許可証、戦傷病者手帳、宅地建 物取引主任者証、電気 事士免状、無線従事者免許証、認定電気 事従事者認定証、特種電気 事資格者認定証、耐空検査員の証、航空従事者技能証明書、運航管理者技能検定合格証明 書、動力車操縦者運転免許証、教習資格認定証、警備業法第 23条第 4項に規定する合格証明書、 身体障害者手帳、療育手帳）、運転経歴証明書 Section B ・Provisional certificate issued if documents in “A” are currently being updated ・Health Insurance Card ・Pension Handbook, Pension Certificate ・Welfare Recipient Certificate ・Any other document recognized as appropriate by your municipality Section C. Documents issued in the name of the person other than the documents above Cash card, credit card, deposit (savings) bankbook, tax notice, employee ID (with face photo), patient ID card To people applying for Special Cash Payment by post 　N. B This form is not required when submitting your application This form is for your reference when applying for Special Cash Payment by post. When filling out the application form, please refer to the entry examples on page 2 onward. ○ Regarding application If you have already applied online, you do not need to apply by post. If you have already applied using your My Number Card, you do not need to apply by mail. Please be aware that double application will NOT result in double payment. Please confirm the following before sending your application: When applying, please note that any errors in the bank transfer account number or with the attached documents will most likely result in a delay of payment. Please ensure to provide details correctly. Please be vigilant of Special Cash Payment fraud: If you receive instructions from somebody pretending to be from a Municipality or Ministry of Internal Affairs and Communications to do the following: ・Pay money using an ATM machine; ・Pay a transfer fee upon receiving benefit; ・Send an email and access a URL for the application procedure; Please IGNORE them. Do NOT follow any such fraudulent directions. If your current household situation has changed as of April 27 th, 2020 please correct the corresponding information in red ink. If you have further questions, please contact the number below ○ Tsukuba City: Special Cash Payment Application Office 　　Phone Number　　 ： 029 -883 -1111 　　Hours ： 8： 30～ 17： 15 （excluding Saturday, Sunday, holidays）

Example If you applied online, you are NOT required to apply by post. Please make sure to fill in the bold frames. If your current household situation has changed as of April 27 th, 2020 please correct the corresponding information in red ink. If you do NOT wish to receive the payment, please put an“X” mark in the box below. Otherwise, leave them blank. Please fill in the form below if you are NOT the head of household. You can apply for the payment, instead of the head of household, if you; meet one of the following conditions: • You live in the same household. • You are a legal representative of the head of household. ※ Please send a copy of both your identity verification document and a copy of bankbook / cash card for the transfer, and do NOT send the original. ※ If you are not the head of household, you are required to submit copies of both the head of household and your documents. • If you wish the payment to be transferred to one of the bank accounts that is used for withdrawal of water/sewerage bill, residence tax, etc. , or payment for child allowances, etc. , please tick the box of the account. . • In case of using one of these accounts, you do NOT need to submit a copy of a bankbook or cash card. . ・ Please fill in the details of either one of financial institutions. Above is for a financial institution other than Japan Post Bank and below if for Japan Post Bank. ・Please fill in the bank account of the head of household or his/her proxy. ・Please do not use an account that have been inactive for a long time. Eligible only for people who do not have a bank account or those who live far away from financial institutions. Please send the application by post and refrain from coming to the office in order to prevent the spread of COVID-19.