日本-资格外活动许可申请书(留学生用).pdf

別記第⼆⼗九の四号様式 （第⼗九条の⼆関係） ⽇本国政府法務省 Ministry of Justice,Government of Japan 資格外活動許可申請書 APPLICATION FOR PERMISSION TO ENGAGE IN ACTIVITY OTHER THAN THAT PERMITTED UNDER THE STATUS OF RESIDENCE PREVIOUSLY GRANTED ⼊国管理局⾧　　殿 To the Director General of Regional Immigration Bureau 出⼊国管理及び難民認定法第１９条第２項の規定に基づき，次のとおり資格外活動の許可を申請します。 Pursuant to the provisions of Paragraph 2 of Article 19 of the Immigration Control and Refugee Recognition Act, I hereby apply for permission to engage in activities other than those permitted under the status of residence previously granted. ※ 上陸許可に引き続き資格外活動許可申請を⾏うことができるのは，上陸の許可により「留学」 の在留資格を決定された場合（３⽉の在留期間を決定された場合を除く。）に限られます。 Persons, who are able to file for this application following acquisition of landing permission, are limited to those who have been granted the status of residence of “Student” based on the landing permission (excluding those who have been granted a period of stay of three (3) months). 1 国　籍地　域 Nationality / Region 2 ⽣年⽉⽇ 年 ⽉ ⽇ Date of Birth Year Month Day 3 ⽒　名　 Name (in English) 4 性　別 男 ⼥ Sex Male / Female 申請⼈の署名／申請書作成年⽉⽇ Signature of the applicant / Date of filling in this form