一登記事項証明書

(i)certificate of registered information;

二役員の履歴書（役員が法人であるときは、当該役員の沿革を記載した書面）及び住民票の抄本（本籍の記載のあるものに限り、役員が法人であるときは、当該役員の登記事項証明書）又はこれに代わる書面並びに役員が法第八十二条第二項第三号イ、ロ又はホのいずれにも該当しない者であることを当該役員が誓約する書面

(ii)officers' resume (when the officer is a juridical person, a document stating the history of the officer) and extracts of residence certificate (limited to those stating the registered domicile; when the officer is a juridical person, a certificate of registered information of the officer) or other documents in lieu thereof and a document with which officers pledge that the officers do not fall under any of Article 82, paragraph (2), item (iii) (a), (b) or (e) of the Act;

三株主の氏名又は商号及びその有する株式の数を記載した書面

(iii)a document stating the name or trade name of shareholders and the number of shares held by the shareholders;

四免許申請者が金融商品取引所（法第二条第十六項に規定する金融商品取引所をいう。以下同じ。）が開設する取引所金融商品市場（同条第十七項に規定する取引所金融商品市場をいう。以下同じ。）又は認可金融商品取引業協会（同条第十三項に規定する認可金融商品取引業協会をいう。以下同じ。）が開設する店頭売買有価証券市場（法第六十七条第二項に規定する店頭売買有価証券市場をいう。以下同じ。）の決済機構を利用することについて当該金融商品取引所又は当該認可金融商品取引業協会と締結した契約に関する書面の写し

(iv)a copy of a document on a contract concerning the utilization of clearing systems of a Financial Instruments Exchange Market (meaning Financial Instruments Exchange Market prescribed in Article 2, paragraph (17) of the Act; the same applies hereinafter) established by a Financial Instruments Exchange (meaning Financial Instruments Exchange prescribed in paragraph (16) of that Article; the same applies hereinafter) or an Over-the-Counter Securities Market (meaning Over-the-Counter Securities Market prescribed in Article 67, paragraph (2) of the Act; the same applies hereinafter) established by an Authorized Financial Instruments Firms Association (meaning Authorized Financial Instruments Firms Association prescribed in Article 2, paragraph (13) of the Act; the same applies hereinafter) concluded by the applicant for license with the Financial Instruments Exchange or the Authorized Financial Instruments Firms Association;

五金銭又は有価証券の貸付けの条件に関する書面

(v)a document related to the conditions for lending money or Securities;

六資金調達の方法に関する書面

(vi)a document related to fund procurement method;

七業務開始後三事業年度（事業年度の期間が一年以上の場合においては、二事業年度。以下同じ。）における取引及び収支の予想を記載した書面

(vii)a document stating the projections for transactions and income and expenditure for the three business years after the commencement of business (if the duration of the business year is one year or more, two business years; the same applies hereinafter);

八免許申請の際現に金融商品取引所の会員等（法第八十一条第一項第三号に規定する会員等をいう。）又は認可金融商品取引業協会の協会員に対して金銭又は有価証券を貸し付けている場合においては、その貸付けの状況を記載した書面

(viii)if money or Securities are loaned to a Member, etc. of a Financial Instruments Exchange (meaning Member, etc. prescribed in Article 81, paragraph (1), item (iii) of the Act) or an Association Member of an Authorized Financial Instruments Firms Association upon filing an application for a license, a document stating the loan status thereof;

九最近三事業年度末の貸借対照表（関連する注記を含む。第三条の三第一項第二号を除き、以下同じ。）及び最近三事業年度の損益計算書（関連する注記を含む。以下同じ。）

(ix)the balance sheet as of the end of the last three business years (including related notes; the same applies hereinafter, excluding Article 3-3, paragraph (1), item (ii)) and profit and loss statement for the last three business years (including related notes; the same applies hereinafter);

十最近三事業年度の株主資本等変動計算書（関連する注記を含む。以下同じ。）

(x)the statements of changes in net assets for the last three business years (including related notes; the same applies hereinafter);

十一最近の日計表

(xi)recent daily trial balance sheet; and

十二その他参考となるべき書類

(xii)other documents that will be helpful.

一定款（認可及び承認に係る事項を除く。）を変更したとき。

(i)if the articles of incorporation (excluding matters pertaining to authorization and approval) are amended;

二業務の内容及び方法（法第百五十六条の二十八第一項に定める認可に係る事項を除く。）を変更したとき。

(ii)if the contents and methods of business (excluding matters pertaining to authorization prescribed in Article 156-28, paragraph (1)) of the Act are amended; or

三金融商品取引所が開設する取引所金融商品市場又は認可金融商品取引業協会が開設する店頭売買有価証券市場の決済機構を利用することについて当該金融商品取引所又は当該認可金融商品取引業協会と締結した契約を変更したとき。

(iii)if a contract concerning the utilization of clearing systems of a Financial Instruments Exchange Market established by a Financial Instruments Exchange or an Over-the-Counter Securities Market established by an Authorized Financial Instruments Firms Association concluded with the Financial Instruments Exchange or the Authorized Financial Instruments Firms Association are amended.

一トラックフォーマットについては、日本工業規格Ｘ六二二五に規定する方式

(i)track format: Method prescribed in JIS X6225;

二ボリューム及びファイル構成については、日本工業規格Ｘ〇六〇五に規定する方式

(ii)volume and file composition: Method prescribed in JIS X0605.

一申請者の商号

(i)trade name of applicant; and

二申請年月日

(ii)application date.

一有価証券の担保を徴して行う金銭の貸付け（法第百五十六条の二十四第一項並びに法第百五十六条の二十七第一項第二号及び第三号に掲げる業務を除く。）

(i)lending of money secured by securities (excluding business specified in Article 156-24, paragraph (1) of the Act and Article 156-27, paragraph (1), items (ii) and (iii) of the Act);

二有価証券の受渡しに関する代理業務

(ii)agency business related to delivery of securities;

三国債証券の元利金支払の代理業務

(iii)agency business for payment of principal and interest of national government bond securities;

四有価証券及び金融庁長官に届け出た証書等の保管業務

(iv)custody business for securities and certificates, etc. notified to the Commissioner of the Financial Services Agency;

五法第百五十六条の二十四第一項、法第百五十六条の二十七第一項第一号から第三号まで又は前各号に掲げる業務に際し、取引の相手方となる顧客に金銭又は有価証券等を収納するための施設を賃貸する業務

(v)business of leasing facilities to accommodate money or securities, etc. to a customer who will be the counterparty to a transaction when conducting business specified in Article 156-24, paragraph (1) of the Act, Article 156-27, paragraph (1), items (i) to (iii) inclusive of the Act or the preceding items;

六社債、株式等の振替に関する法律（平成十三年法律第七十五号）第二条第四項の口座管理機関として行う振替業

(vi)transfer business conducted as an account management institution referred to in Article 2, paragraph (4) of the Act on Book-Entry of Company Bonds, Shares, etc. (Act No. 75 of 2001); and

七金融商品取引清算機関（法第二条第二十九項に規定する金融商品取引清算機関をいう。）の清算参加者（法第百五十六条の七第二項第三号に規定する清算参加者をいう。）による有価証券等清算取次ぎ（法第二条第二十七項に規定する有価証券等清算取次ぎをいう。）の決済に必要な金銭又は有価証券を取引所金融商品市場又は店頭売買有価証券市場の決済機構を利用して貸し付ける業務（金融商品取引法施行令（昭和四十年政令第三百二十一号）第十九条の六第二号及び第三号に掲げる取引に係る業務を除く。）

(vii)business of lending money or securities as necessary for settlement of Brokerage for Clearing of Securities, etc. (meaning Brokerage for Clearing of Securities, etc. prescribed in Article 2, paragraph (27) of the Act) by a Clearing Participant (meaning Clearing Participant prescribed in Article 156-7, paragraph (2), item (iii) of the Act) of a Financial Instruments Clearing Organization (meaning Financial Instruments Clearing Organization prescribed in Article 2, paragraph (29) of the Act) by utilizing clearing systems of a Financial Instruments Exchange Market or Over-the-Counter Securities Market (excluding business pertaining to transactions specified in Article 19-6, items (ii) and (iii) of the Order for Enforcement of the Financial Instruments and Exchange Act (Cabinet Order No. 321 of 1965).

一法第百五十六条の二十七第一項各号に掲げる業務を行う理由を記載した書面

(i)a document stating the reason for conducting the businesses listed in the items of Article 156-27, paragraph (1) of the Act;

二業務の方法を記載した書面

(ii)a document stating the methods of business; and

三その他参考となる書類

(iii)other documents that will be helpful.

一承認を受けようとする業務の内容及びその収支の予想を記載した書面

(i)a document stating the contents of business to be approved and the projections of income and expenditure thereof;

二定款の変更を必要とする場合には、これに関する株主総会の議事録（会社法（平成十七年法律第八十六号）第三百十九条第一項の規定により株主総会の決議があったものとみなされる場合にあっては、当該場合に該当することを証する書面。以下同じ。）

(ii)if it is necessary to amend the articles of incorporation, the minutes of the shareholders meeting related thereto (if a resolution of the shareholders meeting is deemed to have been made pursuant to the provisions of Article 319, paragraph (1) of the Companies Act (Act No. 86 of 2005), a document proving that such case applies; the same applies hereinafter); and

三最近の日計表

(iii)a recent daily trial balance sheet.

一変更の理由を記載した書面

(i)a document stating the reason for the change;

二当該認可申請が、資本金の額の減少に係るものであるときは、これに関する株主総会の議事録又は取締役会の議事録その他必要な手続があったことを証する書面

(ii)if the application for authorization pertains to the reduction of the amount of the stated capital, the minutes of the shareholders meeting or the minutes of the meeting of the board of directors related thereto, or other document proving that necessary procedures had been taken; and

三最近の日計表

(iii)a recent daily trial balance sheet.

一金銭又は有価証券の貸付けの条件を決定又は変更しようとするとき貸付けの条件を記載した書面の新旧対照表

(i)when determining or changing the conditions for lending money or securities:a table comparing the new and old documents stating the conditions for lending;

二資本金の額を増加しようとするとき株主総会の議事録又は取締役会の議事録その他必要な手続があったことを証する書面及び増資の方法を記載した書面並びに増資後に想定される貸借対照表

(ii)when increasing the amount of the stated capital:the minutes of the shareholders meeting or the minutes of the meeting of the board of directors or other document proving that necessary procedures had been taken, and a document stating the method of capital raising as well as the estimated balance sheet after the capital raising;

三商号を変更しようとするとき株主総会の議事録

(iii)when changing the trade name:the minutes of the shareholders meeting.

一取引の制限措置を実施又は解除した場合

(i)if restrictive measures for transactions have been implemented or withdrawn;

二貸付金利及び貸借取引貸株料の率を設定又は変更した場合

(ii)if the lending interest rate or the rate of stock lending fees in lending transactions has been established or changed; or

三融資限度額を設定又は変更した場合

(iii)if the loan limit amount has been established or changed.

一法第百五十六条の三十六各号に掲げる事項の決定をした理由を記載した書面

(i)a document stating the reason for determining the matters listed in the items of Article 156-36 of the Act;

二株主総会の議事録その他必要な手続があったことを証する書面

(ii)the minutes of the shareholders meeting or other document proving that necessary procedures had been taken; and

三決議時における日計表並びに資産及び負債の内容を明らかにした書面

(iii)a daily trial balance sheet and a document clarifying what assets and liabilities consisted of as at the time of the resolution.

一当該申請を補正するために要する期間

(i)period required to make corrections to the application;

二当該申請をした者が当該申請の内容を変更するために要する期間

(ii)period required by the person who filed the application to change the content of the application; or

三当該申請をした者が当該申請に係る審査に必要と認められる資料を追加するために要する期間

(iii)period required by the person who filed the application to add materials deemed necessary for examination of the application.