一第十七条第一項の規定による資格確認書の再交付の申請書の提出の受付及び同条第三項の規定により再交付される資格確認書の引渡し

(i)acceptance of the submission of a written application for reissuance of a written confirmation of qualification pursuant to the provisions of Article 17, paragraph (1) and delivery of the written confirmation of qualification to be reissued pursuant to the provisions of paragraph (3) of the same Article;

二第十七条第四項の規定による資格確認書の返還の受付

(ii)acceptance of the return of a written confirmation of qualification pursuant to the provisions of Article 17, paragraph (4);

三第十八条第二項の規定による資格確認書の提出の受付及び同条第一項の規定による検認又は更新を受けた資格確認書の引渡し

(iii)acceptance of the submission of a written confirmation of qualification pursuant to the provisions of Article 18, paragraph (2) and delivery of a written confirmation of qualification that has been validated or renewed pursuant to the provisions of paragraph (1) of the same Article;

四第二十条第一項（同条第三項において準用する場合を含む。）の規定による通知書の引渡し

(iv)delivery of a written notice under the provisions of Article 20, paragraph (1) (including as applied mutatis mutandis pursuant to paragraph (3) of that Article);

五第二十一条第一項の規定による再通知の申請書の提出の受付及び同条第二項の規定による再通知書の引渡し

(v)acceptance of the submission of a written application for re-notification under the provisions of Article 21, paragraph (1) and delivery of a written re-notification under the provisions of paragraph (2) of the same Article;

六第二十二条から第二十四条までの規定による届書の提出の受付

(vi)acceptance of the submission of notifications under the provisions of Articles 22 through 24;

七第五十四条の二第一項の規定による資格確認書の返還の受付及び同条第四項の規定による資格確認書の引渡し

(vii)acceptance of the return of a written confirmation of qualification pursuant to the provisions of Article 54-2, paragraph (1) and delivery of the written confirmation of qualification pursuant to the provisions of paragraph (4) of the same Article;

八第五十四条の四の規定による届書の提出の受付

(viii)acceptance of submission of notifications under the provisions of Article 54-4;

九第五十四条の五の規定による届書の提出の受付

(ix)acceptance of submission of notifications under the provisions of Article 54-5.

一第三十二条の規定による申請書の提出の受付

(i)acceptance of the submission of written applications under the provisions of Article 32;

二第三十三条第二項の規定による申請書の提出の受付及び当該申請に係る同条第三項に規定する一部負担金減免等証明書の引渡し

(ii)acceptance of the submission of written applications under the provisions of Article 33, paragraph (2) and delivery of certificates of reduction of or release from co-payment, etc. prescribed in paragraph (3) of the same Article pertaining to the relevant application;

三第三十七条第二項の規定による申請書の提出の受付

(iii)acceptance of the submission of a written application under the provisions of Article 37, paragraph (2);

四第四十二条第二項の規定による申請書の提出の受付

(iv)acceptance of the submission of written applications pursuant to the provisions of Article 42, paragraph (2);

五第四十六条（第五十三条及び第七十一条において準用する場合を含む。）の規定による届書の提出の受付

(v)acceptance of the submission of notifications under Article 46 (including as applied mutatis mutandis pursuant to Article 53 and Article 71);

六第四十七条第一項の規定による申請書の提出の受付

(vi)acceptance of the submission of written applications under the provisions of Article 47, paragraph (1);

七第五十四条第一項の規定による申請書の提出の受付及び第五十四条の三に規定する通知書の引渡し

(vii)acceptance of the submission of written applications under the provisions of Article 54, paragraph (1) and delivery of written notices under the provisions of Article 54-3;

八第六十条第一項の規定による申請書の提出の受付

(viii)acceptance of the submission of a written application under the provisions of Article 60, paragraph (1);

九第六十二条第一項の規定による申請書の提出の受付及び当該申請に係る特定疾病療養受療証等（同条第四項に規定する特定疾病療養受療証等をいう。次号において同じ。）の引渡し

(ix)acceptance of the submission of written applications under the provisions of Article 62, paragraph (1) and delivery of certificate for receipt of medical care for specific diseases, etc. (meaning the certificate for receipt of medical care for specific diseases, etc. prescribed in paragraph (4) of that Article; the same applies in the following item) pertaining to the relevant application;

十第六十二条第五項の規定による特定疾病療養受療証等の返還の受付

(x)acceptance of the return of certificate for receipt of medical care for specific diseases, etc. under the provisions of Article 62, paragraph (5);

十一第六十二条第八項において準用する第十七条第一項の規定による特定疾病療養受療証（第六十二条第四項に規定する特定疾病療養受療証をいう。以下この号から第十三号までにおいて同じ。）の再交付の申請書の提出及び第十七条第一項の規定による資格確認書（第六十二条第四項に規定する資格確認書をいう。以下この号から第十三号までにおいて同じ。）の再交付の申請書の提出の受付並びに第六十二条第八項において準用する第十七条第三項の規定により再交付される特定疾病療養受療証及び同項の規定により再交付される資格確認書の引渡し

(xi)submission of a written application for reissuance of a certificate for receipt of medical care for specific diseases (meaning the certificate for receipt of medical care for specific diseases prescribed in Article 62, paragraph (4); hereinafter the same applies in this item through item (xiii)) pursuant to the provisions of Article 17, paragraph (1) as applied mutatis mutandis pursuant to Article 62, paragraph (8), acceptance of the submission of a written application for reissuance of a written confirmation of eligibility (meaning the written confirmation of eligibility prescribed in Article 62, paragraph (4); hereinafter the same applies in this item through item (xiii)) pursuant to the provisions of Article 17, paragraph (1), and delivery of a certificate for receipt of medical care for specific diseases to be reissued pursuant to the provisions of Article 17, paragraph (3) as applied mutatis mutandis pursuant to Article 62, paragraph (8) and a written confirmation of eligibility to be reissued pursuant to the provisions of the same paragraph;

十二第六十二条第八項において準用する第十七条第四項の規定による特定疾病療養受療証の返還及び同項の規定による資格確認書の返還の受付

(xii)acceptance of the return of the certificate for receipt of medical care for specific diseases under the provisions of Article 17, paragraph (4) as applied mutatis mutandis pursuant to Article 62, paragraph (8) and the return of the written confirmation of eligibility under the provisions of that paragraph;

十三第六十二条第八項において準用する第十八条第二項の規定による特定疾病療養受療証の提出及び同項の規定による資格確認書の提出の受付並びに第六十二条第八項において準用する第十八条第一項の規定による検認又は更新を受けた特定疾病療養受療証及び同項の規定による検認又は更新を受けた資格確認書の引渡し

(xiii)the submission of a certificate for receipt of medical care for specific diseases under the provisions of Article 18, paragraph (2) as applied mutatis mutandis pursuant to Article 62, paragraph (8), the acceptance of the submission of a Written Confirmation of Eligibility under the provisions of that paragraph, and the delivery of a certificate for receipt of medical care for specific diseases that has been validated or renewed under the provisions of Article 18, paragraph (1) as applied mutatis mutandis pursuant to Article 62, paragraph (8) and a Written Confirmation of Eligibility that has been validated or renewed under the provisions of that paragraph;

十三の二第六十六条の二第二項の規定による申請書の提出の受付及び当該申請に係る資格確認書（同項に規定する資格確認書をいう。次号から第十三号の六までにおいて同じ。）の引渡し

(xiii)-2acceptance of the submission of written applications under the provisions of Article 66-2, paragraph (2) and delivery of the written confirmation of qualification (meaning the written confirmation of qualification prescribed in the same paragraph; the same applies in the following item through item (xiii) - 6) pertaining to the relevant application;

十三の三第六十六条の二第三項の規定による資格確認書の返還の受付

(xiii)-3acceptance of the return of a written confirmation of eligibility under the provisions of Article 66-2, paragraph (3);

十三の四第十七条第一項の規定による資格確認書の再交付の申請書の提出の受付及び同条第三項の規定により再交付される資格確認書の引渡し

(xiii)-4acceptance of the submission of a written application for reissuance of a written confirmation of qualification pursuant to the provisions of Article 17, paragraph (1) and delivery of the written confirmation of qualification to be reissued pursuant to the provisions of paragraph (3) of the same Article;

十三の五第十七条第四項の規定による資格確認書の返還の受付

(xiii)-5acceptance of the return of a written confirmation of qualification pursuant to the provisions of Article 17, paragraph (4);

十三の六第十八条第二項の規定による資格確認書の提出の受付及び同条第一項の規定による検認又は更新を受けた資格確認書の引渡し

(xiii)-6acceptance of the submission of a written confirmation of qualification under the provisions of Article 18, paragraph (2) and delivery of a written confirmation of qualification that has been validated or renewed under the provisions of paragraph (1) of the same Article;

十四第六十七条第二項の規定による申請書の提出の受付及び当該申請に係る資格確認書（同項に規定する資格確認書をいう。次号から第十八号までにおいて同じ。）の引渡し

(xiv)acceptance of the submission of written applications under the provisions of Article 67, paragraph (2) and delivery of the written confirmation of qualification (meaning the written confirmation of qualification prescribed in the same paragraph; the same applies in the following item through item (xviii)) pertaining to the relevant application;

十五第六十七条第三項の規定による資格確認書の返還の受付

(xv)acceptance of the return of a written confirmation of qualification pursuant to the provisions of Article 67, paragraph (3);

十六第十七条第一項の規定による資格確認書の再交付の申請書の提出の受付及び同条第三項の規定により再交付される資格確認書の引渡し

(xvi)acceptance of the submission of a written application for reissuance of a written confirmation of qualification pursuant to the provisions of Article 17, paragraph (1) and delivery of a written confirmation of qualification to be reissued pursuant to the provisions of paragraph (3) of the same Article;

十七第十七条第四項の規定による資格確認書の返還の受付

(xvii)acceptance of the return of a written confirmation of qualification pursuant to the provisions of Article 17, paragraph (4);

十八第十八条第二項の規定による資格確認書の提出の受付及び同条第一項の規定による検認又は更新を受けた資格確認書の引渡し

(xviii)acceptance of submission of a written confirmation of qualification pursuant to the provisions of Article 18, paragraph (2) and delivery of a written confirmation of qualification that has been validated or renewed pursuant to the provisions of paragraph (1) of the same Article;

十九第七十条第一項の規定による申請書の提出の受付

(xix)acceptance of the submission of written applications under the provisions of Article 70, paragraph (1);

十九の二第七十一条の九第一項の規定による申請書の提出の受付

(xix)-2acceptance of the submission of written applications under the provisions of Article 71-9, paragraph (1);

十九の三第七十一条の十第一項の規定による申請書の提出の受付

(xix)-3acceptance of the submission of written applications under the provisions of Article 71-10, paragraph (1);

十九の四第七十一条の十第二項の規定による証明書の引渡し

(xix)-4delivery of a certificate under the provisions of Article 71-10, paragraph (2);

二十第七十三条の規定による届書の提出の受付

(xx)acceptance of the submission of notifications under Article 73;

二十一第七十五条の規定による通知書の引渡し

(xxi)delivery of written notices under the provisions of Article 75;

二十二第八十二条の規定による通知書の引渡し

(xxii)delivery of a written notice under the provisions of Article 82.

一日本の国籍を有しない者であって、住民基本台帳法（昭和四十二年法律第八十一号）第三十条の四十五に規定する外国人住民以外のもの（入管法に定める在留資格を有する者であって既に被保険者（法第五十条に規定する被保険者をいう。以下同じ。）の資格を取得しているもの及び国民健康保険法施行規則（昭和三十三年厚生省令第五十三号）第一条第一号の規定に基づき厚生労働大臣が別に定める者を除く。）

(i)a person who does not have Japanese nationality and is not a foreign resident prescribed in Article 30-45 of the Act for Basic Register of Residents (Act No. 81 of 1967) (excluding a person who has a status of residence prescribed in the Immigration Control Act and has already acquired a status of residence in the insured (meaning the insured prescribed in Article 50 of the Act; the same applies hereinafter) and a person specified separately by the Minister of Health, Labour and Welfare pursuant to the provisions of Article 1, item (i) of the Regulation for Enforcement of the National Health Insurance Act (Order of the Ministry of Health and Welfare No. 53 of 1958));

二日本の国籍を有しない者であって、入管法第七条第一項第二号の規定に基づく入管法別表第一の五の表の下欄に掲げる活動として法務大臣が定める活動のうち、病院若しくは診療所に入院し疾病若しくは傷害について医療を受ける活動又は当該入院の前後に当該疾病若しくは傷害について継続して医療を受ける活動を行うもの及びこれらの活動を行う者の日常生活上の世話をする活動を行うもの（前号に該当する者を除く。）

(ii)a person who does not have Japanese nationality and who, among the activities specified by the Minister of Justice as those listed in the right-hand column of Appended Table I (5) of the Immigration Control Act pursuant to the provisions of Article 7, paragraph (1), item (ii) of the Immigration Control Act, is engaged in activities of being hospitalized in a hospital or a clinic and receiving medical treatment for an illness or injury, or activities of continuously receiving medical treatment for the illness or injury before and after the hospitalization, and activities of taking care of a person who engages in these activities in their daily life (excluding a person who falls under the preceding item);

三日本の国籍を有しない者であって、入管法第七条第一項第二号の規定に基づく入管法別表第一の五の表の下欄に掲げる活動として法務大臣が定める活動のうち、本邦において一年を超えない期間滞在し、観光、保養その他これらに類似する活動を行うもの（第一号に該当する者を除く。）

(iii)a person who does not have Japanese nationality, who stays in Japan for a period not exceeding one year and engages in sightseeing, recreation, or other similar activities among the activities specified by the Minister of Justice as those listed in the right-hand column of the Appended Form No. 1-5 of the Immigration Control Act pursuant to the provisions of Article 7, paragraph (1), item (ii) of the Immigration Control Act (excluding a person who falls under item (i));

四日本の国籍を有しない者であり、かつ、前号に規定する者に同行する配偶者であって、入管法第七条第一項第二号の規定に基づく入管法別表第一の五の表の下欄に掲げる活動として法務大臣が定める活動のうち、本邦において一年を超えない期間滞在し、観光、保養その他これらに類似する活動を行うもの（第一号及び前号に該当する者を除く。）

(iv)spouses who do not have Japanese nationality and who accompany the persons prescribed in the preceding item, who stay in Japan for a period not exceeding one year and engage in sightseeing, recreation, or other similar activities, among the activities specified by the Minister of Justice as those listed in the right-hand column of the Appended Form No. 1-5 of the Immigration Control Act pursuant to the provisions of Article 7, paragraph (1), item (ii) of the Immigration Control Act (excluding those who fall under item (i) and the preceding item);

五健康保険法施行規則等の一部を改正する等の省令（平成十四年厚生労働省令第百十七号）第三条の規定による改正前の国民健康保険法施行規則第一条第一号に該当する者

(v)a person who falls under Article 1, item (i) of the Regulation for Enforcement of the National Health Insurance Act prior to the revision by Article 3 of the Ministerial Order for Partial Revision, etc. of the Regulation for Enforcement of the Health Insurance Act (Order of the Ministry of Health, Labour and Welfare No. 117 of 2002);

六その他特別の事由がある者で条例で定めるもの

(vi)any other person for whom a special reason exists and who is specified by Prefectural or Municipal Ordinance.

一氏名、性別、生年月日、住所及び行政手続における特定の個人を識別するための番号の利用等に関する法律第二条第五項に規定する個人番号（以下「個人番号」という。）

(i)the name, sex, date of birth, address, and Individual Number as prescribed in Article 2, paragraph (5) of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures (hereinafter referred to as the "Individual Number");

二資格取得の年月日

(ii)the date of acquisition of qualification;

三世帯主である者についてはその旨、世帯主でない者については世帯主の氏名、性別、生年月日及び個人番号並びに世帯主との続柄

(iii)if the person is the Householder, a statement to that effect; and if the person is not the Householder, the name, sex, date of birth, and Individual Number of the Householder and the person's relationship with the Householder;

四その世帯に既に被保険者の資格を取得している者がある場合にあっては、その旨及び当該者の被保険者番号（法第百六十一条の二第一項に規定する被保険者番号をいう。以下同じ。）、その世帯に被保険者の資格を取得している者がない場合にあっては、その旨

(iv)if there is a person in the household who has already acquired the status of a insured, a statement to that effect and the insured Number (meaning the Article 161-2, paragraph (1) Number as prescribed in the insured of the Act; the same applies hereinafter) of the person, and if there is no person in the household who has acquired the status of a insured, a statement to that effect;

五被保険者の資格を取得した者が、日本の国籍を有しない者であって、入管法別表第一の五の表の上欄の在留資格をもって在留するものである場合にあっては、その旨及び本邦において行うことができる活動

(v)if the person who has acquired the status of residence of "insured" does not have Japanese nationality and is residing with a status of residence set forth in the left-hand column of the Appended Table I (5) of the Immigration Control Act, a statement to that effect and the activities that may be carried out in Japan.

一氏名、性別、生年月日、現住所、従前の住所及び個人番号

(i)name, sex, date of birth, current address, previous address, and Individual Number;

二資格取得の年月日及びその理由

(ii)the date of and reason for the acquisition of qualification;

三前項第三号及び第四号に規定する事項

(iii)the particulars prescribed in items (iii) and (iv) of the preceding paragraph;

四被保険者の資格を取得した者が、日本の国籍を有しない者であって、入管法別表第一の五の表の上欄の在留資格をもって在留するものである場合にあっては、その旨及び本邦において行うことができる活動

(iv)if the person who has acquired the status of "insured" does not have Japanese nationality and is residing with a status of residence set forth in the left-hand column of the Appended Table I (5) of the Immigration Control Act, a statement to that effect and the activities that may be carried out in Japan.

一被保険者番号

(i)insured number;

二氏名、現住所、従前の住所及び個人番号

(ii)name, current address, previous address, and Individual Number;

三被保険者が、法第五十五条第一項本文若しくは第二項（これらの規定を法第五十五条の二第二項において準用する場合を含む。）若しくは法第五十五条の二第一項の規定の適用を受けるに至った年月日又は継続住所変更をした年月日

(iii)the date on which insured came to be subject to the provisions of the main clause of Article 55, paragraph (1) or paragraph (2) of the Act (including the cases where these provisions are applied mutatis mutandis pursuant to Article 55-2, paragraph (2) of the Act) or the provisions of Article 55-2, paragraph (1) of the Act, or the date on which the change of the continued address was made;

四入院等をしている病院等の名称

(iv)the name of the hospital, etc. in which the hospitalization, etc. is performed;

五世帯主である者についてはその旨、世帯主でない者については世帯主の氏名、性別、生年月日及び個人番号並びに世帯主との続柄

(v)if the person is the Householder, a statement to that effect; and if the person is not the Householder, the name, sex, date of birth, and Individual Number of the Householder and the person's relationship with the Householder.

一申請の年月日

(i)the date of application;

二申請者の氏名、生年月日及び個人番号

(ii)the name, date of birth, and Individual Number of the applicant;

三申請の理由

(iii)the reason for the application;

四その他後期高齢者医療広域連合が定める事項であって、申請者が資格確認書への記載を求めるものがある場合には、その旨

(iv)if there are any other matters specified by the Association of Medical Care Systems for the Elderly Aged 75 and older which the applicant is to request to be stated in the written confirmation of eligibility, a statement to that effect.

一被保険者の氏名、性別及び生年月日

(i)the name, sex, and date of birth of the insured;

二被保険者番号及び保険者番号並びに後期高齢者医療広域連合の名称

(ii)the insured number, insurer number, and name of the Association of Medical Care Systems for the Elderly Aged 75 and older;

三資格取得年月日及び資格確認書の交付年月日

(iii)the date of acquisition of qualification and the date of issuance of the written confirmation of qualification;

四一部負担金の割合及び発効期日

(iv)the percentage of co-payment and the effective date;

五有効期限

(v)expiration date;

六その他後期高齢者医療広域連合が定める事項であって、申請者が記載を求めたもの

(vi)any other particulars specified by the Association of Medical Care Systems for the Elderly Aged 75 and older that the applicant requests to be stated.

一次に掲げる事項

(i)the following particulars:

二氏名及び生年月日又は住所（以下この号において「個人識別事項」という。）が記載された書類であって、次のいずれかに該当するもの

(ii)a document that contains the name and date of birth or address (hereinafter referred to as the "particulars for individual identification" in this item), which falls under any of the following:

一被保険者の氏名及び生年月日

(i)name and date of birth of insured;

二被保険者の個人番号又は被保険者番号

(ii)insured Individual Number or insured Number.

一氏名

(i)name;

二被保険者番号及び保険者番号並びに後期高齢者医療広域連合の名称

(ii)the insured number, insurer number, and name of the Association of Medical Care Systems for the Elderly Aged 75 and older;

三資格情報通知書の通知年月日

(iii)the notification date of the written notice of qualification information;

四一部負担金の割合及び発効期日（法第八十二条第一項又は第二項本文の規定により特別療養費を支給することとされている場合を除く。）

(iv)the rate of co-payment and the effective date (excluding the case where special medical expenses are to be paid pursuant to the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) of the same Article of the Act);

五有効期限

(v)expiration date;

六法第八十二条第一項又は第二項本文の規定により特別療養費を支給することとされている場合には、その旨

(vi)in cases where special medical expenses are to be paid pursuant to the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) of the same Article of the Act, a statement to that effect.

一前項各号に掲げる事項は、被保険者が自らの資格に係る情報を確認するために通知するものであり、これらの事項の提示のみでは保険医療機関等（保険医療機関（健康保険法第六十三条第三項第一号に規定する保険医療機関をいう。以下同じ。）又は保険薬局（同号に規定する保険薬局をいう。以下同じ。）をいう。以下同じ。）又は指定訪問看護事業者から被保険者であることの確認を受けることができないこと。

(i)the particulars set forth in the items of the preceding paragraph are to be notified by the insured in order to confirm their qualifications, and it is impossible to obtain confirmation from a medical institution providing services covered by health insurance, etc. (meaning a medical institution providing services covered by health insurance (meaning a medical institution providing services covered by health insurance as prescribed in Article 63, paragraph (3), item (i) of the Health Insurance Act; the same applies hereinafter) or pharmacies providing services covered by health insurance (meaning pharmacies providing services covered by health insurance as prescribed in the same item; the same applies hereinafter); the same applies hereinafter) or a designated home-nursing provider that the relevant person is a insured only by presenting those particulars;

二前号の規定にかかわらず、災害その他の特別な事情により電子資格確認（法第六十四条第三項に規定する電子資格確認をいう。第三十条の三第三号において同じ。）を受けることができない状況にある場合において、前項の通知を受けた被保険者は、個人番号カードとともに、資格情報通知書又は行政手続における特定の個人を識別するための番号の利用等に関する法律附則第六条第三項に規定する情報提供等記録開示システムを通じて取得した当該被保険者の資格に係る情報を提示する方法により、保険医療機関等又は指定訪問看護事業者から被保険者であることの確認を受けることができること。

(ii)notwithstanding the provisions of the preceding item, if an electronic certification of eligibility (meaning the electronic certification of eligibility prescribed in Article 64, paragraph (3) of the Act; the same applies in Article 30-3, item (iii)) cannot be obtained due to a natural disaster or other special circumstances, the insured that has received the notification referred to in the preceding paragraph is able to obtain confirmation that it is an insured from a medical institution providing services covered by health insurance or a designated home-nursing provider by presenting the individual number card as well as the information on the status of the insured obtained through the written notice of certification information or the information disclosure system prescribed in Article 6, paragraph (3) of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures.

一氏名、生年月日及び住所

(i)name, date of birth, and address;

二個人番号又は被保険者番号

(ii)individual Number or insured Number;

三再通知申請の理由

(iii)the reason for the application for re-notification.

一被保険者番号

(i)insured number;

二個人番号

(ii)individual Number;

三変更前及び変更後の氏名

(iii)the name before and after the change.

一被保険者番号

(i)insured number;

二氏名

(ii)name;

三個人番号

(iii)individual Number;

四変更前及び変更後の住所並びに変更の年月日

(iv)the address before and after the change and the date of the change;

五世帯主となる場合はその旨、世帯主とならない場合は世帯主の氏名、性別、生年月日及び個人番号並びに世帯主との続柄

(v)if the person becomes the Householder, a statement to that effect, and if the person does not become the Householder, the name, sex, date of birth, and Individual Number of the Householder and the relationship with the Householder.

一被保険者番号

(i)insured number;

二氏名

(ii)name;

三変更前及び変更後の個人番号並びに変更の年月日

(iii)the Individual Numbers before and after the change and the date of the change.

一被保険者番号

(i)insured number;

二氏名

(ii)name;

三個人番号

(iii)individual Number;

四変更の年月日

(iv)the date of the change;

五変更後の世帯において世帯主となる場合はその旨、世帯主とならない場合は変更後の世帯主の氏名、性別、生年月日及び個人番号並びに世帯主との続柄

(v)if the person will become the Householder of the household after the change, a statement to that effect; and if the person will not become the Householder of the household after the change, the name, sex, date of birth, and Individual Number of the Householder after the change and the relationship with the Householder.

一被保険者番号

(i)insured number;

二氏名及び個人番号

(ii)name and Individual Number;

三令別表に掲げる障害の状態に該当しなくなった旨及びその年月日

(iii)the fact that the relevant person has ceased to fall under the state of disability listed in the Appended Table of the Order and the date of the cessation.

一被保険者番号

(i)insured number;

二氏名及び個人番号

(ii)name and Individual Number;

三資格喪失の年月日及びその理由

(iii)the date of loss of qualification and the reason therefor;

四住所の変更により資格を喪失したときは、変更後の住所

(iv)in the case of loss of eligibility due to a change in address, the address after the change.

一準用介護保険法第百三十四条第二項に規定する年金額の見込額　当該年の八月一日から翌年の五月三十一日までの間に支払を受けるべき老齢等年金給付（法第百七条第二項に規定する老齢等年金給付をいう。以下同じ。）の総額を十で除した額に十二を乗じて得た額

(i)long-Term Care Insurance Act applied mutatis mutandis: the estimated amount of pension prescribed in Article 134, paragraph (2): the amount obtained by dividing the total amount of old age, etc. pension benefit (meaning the old age, etc. Article 107, paragraph (2) prescribed in the pension benefit of the Act; the same applies hereinafter) to be received during the period from August 1 of the relevant year to May 31 of the following year by 10 and then multiplying the result by 12;

二準用介護保険法第百三十四条第三項に規定する年金額の見込額　当該年の十月一日から翌年の五月三十一日までの間に支払を受けるべき老齢等年金給付の総額を八で除した額に十二を乗じて得た額

(ii)long-Term Care Insurance Act Applied Mutatis Mutandis: the estimated amount of pension prescribed in Article 134, paragraph (3): the amount obtained by dividing the total amount of the Old Age pension benefit to be received during the period from October 1 of the relevant year to May 31 of the following year by 8 and then multiplying the result by 12;

三準用介護保険法第百三十四条第四項に規定する年金額の見込額　当該年の十二月一日から翌年の五月三十一日までの間に支払を受けるべき老齢等年金給付の総額を六で除した額に十二を乗じて得た額

(iii)the estimated amount of pension prescribed in Article 134, paragraph (4), Long-Term Care Insurance Act as applied mutatis mutandis: the amount obtained by dividing by six the total amount of the old age, etc. pension benefit to be received during the period from December 1 of the relevant year to May 31 of the following year, and then multiplying the result by twelve;

四準用介護保険法第百三十四条第五項に規定する年金額の見込額　当該年の翌年の二月一日から五月三十一日までの間に支払を受けるべき老齢等年金給付の総額を四で除した額に十二を乗じて得た額

(iv)long-Term Care Insurance Act to be Applied Mutatis Mutandis: the estimated amount of pension prescribed in Article 134, paragraph (5): the amount obtained by dividing by four the total amount of the old age, etc. pension benefit to be received during the period from February 1 to May 31 of the year following the relevant year, and then multiplying the result by twelve;

五準用介護保険法第百三十四条第六項に規定する年金額の見込額　当該年の翌年の四月一日から五月三十一日までの間に支払を受けるべき老齢等年金給付の総額を二で除した額に十二を乗じて得た額

(v)long-Term Care Insurance Act to be Applied Mutatis Mutandis: the estimated amount of pension prescribed in Article 134, paragraph (6): the amount obtained by dividing by two the total amount of the old age, etc. pension benefit to be received during the period from April 1 to May 31 of the year following the relevant year, and then multiplying the result by twelve.

一準用介護保険法第百三十四条第一項から第六項までの規定による通知に係る者（以下「通知対象者」という。）の性別及び生年月日

(i)the sex and date of birth of the person to whom the notice under the provisions of Article 134, paragraphs (1) through (6), Long-Term Care Insurance Act as applied mutatis mutandis (hereinafter referred to as the "person subject to notice") pertains;

二通知対象者が支払を受けている老齢等年金給付の種類、額及びその支払を行う年金保険者（法第百七条第一項に規定する年金保険者をいう。）の名称

(ii)the type and amount of the Old Age, etc., pension benefit which the Person Subject to a Notice is paid, and the name of the Pension Insurer (meaning the Pension Insurer prescribed in the Article 107, paragraph (1) of the Act) which makes the payment.

一国民年金法（昭和三十四年法律第百四十一号）第二十条、国民年金法等の一部を改正する法律（昭和六十年法律第三十四号。以下「昭和六十年国民年金等改正法」という。）附則第十一条若しくは第三十二条の規定により適用される昭和六十年国民年金等改正法第一条による改正前の国民年金法第二十条、厚生年金保険法（昭和二十九年法律第百十五号）第三十八条、昭和六十年国民年金等改正法附則第五十六条若しくは第七十八条の規定により適用される昭和六十年国民年金等改正法第三条による改正前の厚生年金保険法第三十八条、国家公務員共済組合法第七十四条、国家公務員等共済組合法等の一部を改正する法律（昭和六十年法律第百五号。以下「昭和六十年国共済法等改正法」という。）附則第十一条（私学共済法第四十八条の二の規定によりその例によることとされる場合を含む。）、地方公務員等共済組合法第七十六条、地方公務員等共済組合法等の一部を改正する法律（昭和六十年法律第百八号。以下「昭和六十年地共済法等改正法」という。）附則第十条、昭和六十年国民年金等改正法第五条の規定による改正前の船員保険法第二十三条の七、厚生年金保険制度及び農林漁業団体職員共済組合制度の統合を図るための農林漁業団体職員共済組合法等を廃止する等の法律（平成十三年法律第百一号。以下「平成十三年厚生農林統合法」という。）附則第十六条第一項の規定によりなおその効力を有するものとされた平成十三年厚生農林統合法附則第二条第一項第一号に規定する平成十二年農林共済改正法第二十三条の二又は平成十三年厚生農林統合法附則第十六条第一項の規定によりなおその効力を有するものとされた平成十三年厚生農林統合法附則第二条第一項第四号に規定する昭和六十年農林共済改正法附則第十条の規定に基づき当該老齢等年金給付の支給が停止されていること。

(i)payment of the relevant old age, etc., mutual aid association has been suspended pursuant to the provisions of Article 20 of the National Pension Act (Act No. 141 of 1959), Article 20 of the National Pension Act prior to the amendment by Article 1 of the National Pension Amendment Act of 1985 which is applied pursuant to the provisions of Article 11 or Article 32 of the Supplementary Provisions of the National Pension Amendment Act of 1985 (Act No. 34 of 1985; hereinafter referred to as the "National Pension Amendment Act of 1985"), Article 38 of the Employees' Pension Insurance Act (Act No. 115 of 1954), Article 38 of the Employees' Pension Insurance Act prior to the amendment by Article 3 of the National Pension Amendment Act of 1985 which is applied pursuant to the provisions of Article 56 or Article 78 of the Supplementary Provisions of the National Pension Amendment Act of 1985, Article 74 of the National Public Officers' mutual aid association Act, Article 11 of the Supplementary Provisions of the Act Partially Amending the National Public Officers' mutual aid association Act, etc. (Act No. 105 of 1985; hereinafter referred to as the "National Mutual Aid Act Amendment Act of 1985") (including the cases that are to be governed by that Article pursuant to the provisions of Article 48-2 of the Private School Mutual Aid Act), Article 76 of the local public employee, etc., mutual aid association Act, Article 10 of the Supplementary Provisions of the Act Partially Amending the local public employee, etc., pension benefit Act, etc. (Act No. 108 of 1985; hereinafter referred to as the "Land Mutual Aid Act Amendment Act of 1985"), Article 23-7 of the Mariners Insurance Act prior to the amendment by the provisions of Article 5 of the National Pension Amendment Act of 2001, Article 23-2 of the Agriculture Forestry Mutual Aid Amendment Act of 2000 which is prescribed in Article 2, paragraph (1), item (i) of the Supplementary Provisions of the Act for Abolishing the mutual aid association Act of Officials of Agriculture, Forestry and Fishery Organizations for Integration of the Welfare Pension Insurance System and the Welfare Pension Insurance System (Act No. 101 of 2001; hereinafter referred to as the 2001 2001 2001 1985 mutual aid association

二国民年金法第七十二条若しくは第七十三条、昭和六十年国民年金等改正法附則第三十二条の規定により適用される昭和六十年国民年金等改正法第一条による改正前の国民年金法第七十二条若しくは第七十三条、厚生年金保険法第七十七条若しくは第七十八条、昭和六十年国民年金等改正法附則第七十八条の規定により適用される昭和六十年国民年金等改正法第三条による改正前の厚生年金保険法第七十七条若しくは第七十八条、国家公務員共済組合法第七十五条若しくは第九十五条から第九十七条まで、昭和六十年国共済法等改正法附則第三条の規定により適用される昭和六十年国共済法等改正法第一条による改正前の国家公務員等共済組合法第七十五条若しくは第九十五条から第九十七条まで（私学共済法第四十八条の二の規定によりその例によることとされる場合を含む。）、地方公務員等共済組合法第七十七条若しくは第百九条から第百十一条まで、昭和六十年地共済法等改正法附則第三条の規定により適用される昭和六十年地共済法等改正法第一条による改正前の地方公務員等共済組合法第七十七条若しくは第百九条から第百十一条まで又は昭和六十年国民年金等改正法第五条の規定による改正前の船員保険法第五十六条若しくは第五十七条の規定に基づき当該老齢等年金給付の支給が停止され、一時差し止められ、又は行わないこととされていること。

(ii)based on the provisions of Article 72 or 73 of the National Pension Act, Article 72 or 73 of the National Pension Act prior to the amendment by Article 1 of the National Pension Amendment Act of 1985 as applied pursuant to Article 32 of the Supplementary Provisions of the National Pension Amendment Act of 1985, Article 77 or 78 of the Employee's Pension Insurance Act, Article 77 or 78 of the Employee's Pension Insurance Act prior to the amendment by Article 3 of the National Pension Amendment Act of 1985 as applied pursuant to Article 78 of the Supplementary Provisions of the National Pension Amendment Act of 1985, Article 75 or 95 through 97 of the National Public Officers' mutual aid association Act, Article 75 or 95 through 97 of the National Public Officers' mutual aid association Act prior to the amendment by Article 1 of the National Mutual Aid Act Amendment Act of 1985 as applied pursuant to Article 3 of the Supplementary Provisions of the National Mutual Aid Act Amendment Act of 1985 (including the cases that are to be governed by the same rules pursuant to the provisions of Article 48-2 of the Private School Mutual Aid Act), Article 77, or Articles 109 through 111 of the local public employee, etc. mutual aid association Act, Article 77, or Articles 109 through 111 of the local public employee, etc. mutual aid association Act prior to the amendment by Article 1 of the Mutual Aid Act of 1985 as applied pursuant to Article 3 of the Supplementary Provisions of the Mutual Aid Act of 1985, or Article 56 or 57 of the Mariners' Insurance Act prior to the amendment by Article 5 of the National Pension Amendment Act of 1985, payment of the relevant old age, etc. pension benefit is suspended, temporarily suspended, or;

三国民年金法第二十一条、昭和六十年国民年金等改正法附則第三十二条の規定により適用される昭和六十年国民年金等改正法第一条による改正前の国民年金法第二十一条、厚生年金保険法第三十九条、昭和六十年国民年金等改正法附則第七十八条の規定により適用される昭和六十年国民年金等改正法第三条による改正前の厚生年金保険法第三十九条、昭和六十年国共済法等改正法附則第十条第二項において準用する国家公務員共済組合法第七十四条の三（私学共済法第四十八条の二の規定によりその例によることとされる場合を含む。）、昭和六十年地共済法等改正法附則第九条第二項において準用する地方公務員等共済組合法第七十六条の三、昭和六十年国民年金等改正法第五条の規定による改正前の船員保険法第二十四条の三又は平成十三年厚生農林統合法附則第十六条第一項の規定によりなおその効力を有するものとされた平成十三年厚生農林統合法附則第二条第一項第一号に規定する平成十二年農林共済改正法第二十三条の四の規定により内払とみなされた年金があること。

(iii)there is a pension that is deemed to be a partial payment pursuant to the provisions of Article 21 of the National Pension Act; Article 21 of the National Pension Act prior to its amendment by Article 1 of the National Pension, etc. Amendment Act of 1985 as applied pursuant to Article 32 of the Supplementary Provisions of the National Pension, etc. Amendment Act of 1985; Article 39 of the Employee's Pension Insurance Act; Article 39 of the Employee's Pension Insurance Act prior to its amendment by Article 3 of the National Pension, etc. Amendment Act of 1985 as applied pursuant to Article 78 of the Supplementary Provisions of the National Pension, etc. Amendment Act of 1985; Article 74-3 of the National Public Officers' mutual aid association Act as applied mutatis mutandis pursuant to Article 10, paragraph (2) of the Supplementary Provisions of the National Public Officers' Mutual Aid Act of 1985 (including as governed by the same rules pursuant to the provisions of Article 48-2 of the Private School Mutual Aid Act); Article 76-3 of the local public employee, etc. mutual aid association Act as applied mutatis mutandis pursuant to Article 9, paragraph (2) of the Supplementary Provisions of the Land Mutual Aid Act of 1985; Article 24-3 of the Mariners Insurance Act prior to its amendment by Article 5 of the National Pension, etc. Amendment Act of 1985; 2000 2001 2001;

四その他前各号に掲げる事由に類する事由があること。

(iv)that any other grounds similar to those set forth in the preceding items exist.

一当該年度に当該特別徴収対象被保険者（準用介護保険法第百三十五条第五項に規定する特別徴収対象被保険者をいう。以下同じ。）について仮徴収（準用介護保険法第百四十条第一項又は第二項の規定に基づく特別徴収をいう。以下同じ。）が行われていないとき。

(i)when provisional collection (meaning special collection based on the provisions of the insured of Long-Term Care Insurance Act as applied mutatis mutandis; the same applies hereinafter) has not been carried out for the relevant Article 135, paragraph (5) subject to special collection (meaning the insured subject to special collection prescribed in the Long-Term Care Insurance Act Article 140, paragraph (1) or paragraph (2) as applied mutatis mutandis; the same applies hereinafter) in the relevant fiscal year;

二当該年度における当該特別徴収対象被保険者に係る仮徴収の方法により徴収する保険料額の総額の見込額が当該年度において当該者に対して課する見込みの保険料額の二分の一に相当する額に満たないと認められる場合であって、市町村が、その満たない額を普通徴収の方法によって徴収することが適当と認めたとき。

(ii)when the prospective amount of the total amount of insurance premiums to be collected by the method of provisional collection pertaining to the insured subject to special collection in the fiscal year is found to be less than the amount equivalent to one half of the prospective amount of insurance premiums to be imposed on the person in the fiscal year, and the municipality finds it appropriate to collect the shortfall amount by the method of general collection;

三当該特別徴収対象被保険者に係る当該年度分の保険料額について準用介護保険法第百三十六条第一項（令第二十八条から第三十二条までにおいて準用する場合を含む。）の規定による通知が行われた後の当該年度中に増額された場合であって、当該特別徴収対象被保険者について引き続き特別徴収の方法により保険料の一部を徴収することについて市町村が適当と認めたとき。

(iii)if the amount of insurance premiums for the relevant fiscal year pertaining to the insured subject to special collection has been increased during the relevant fiscal year after the notification under the provisions of the Long-Term Care Insurance Act Article 136, paragraph (1) as applied mutatis mutandis (including as applied mutatis mutandis pursuant to Articles 28 through 32 of the Order) was made, and the municipality finds it appropriate to continue to collect a part of the insurance premiums by the method of special collection with regard to the insured subject to special collection;

四当該特別徴収対象被保険者に対して課する保険料額が当該年度前の年度において賦課すべき保険料額が含まれるとき。

(iv)when the amount of insurance premiums to be imposed on the insured subject to special collection includes the amount of insurance premiums to be imposed in a fiscal year preceding the relevant fiscal year.

一準用介護保険法第百三十四条第一項の規定による通知が行われた場合において、準用介護保険法第百三十五条第一項の規定により特別徴収の方法によって保険料を徴収されると見込まれる被保険者　当該年度の初日の属する年の十月一日以降最初に支払われる老齢等年金給付に係る準用介護保険法第百三十六条第二項の規定により算出される支払回数割保険料額

(i)a Long-Term Care Insurance Act for which insurance premiums are expected to be collected by the method of special collection pursuant to the provisions of Article 134, paragraph (1), Long-Term Care Insurance Act as applied mutatis mutandis, if a notice is given pursuant to the provisions of Article 135, paragraph (1), insured as applied mutatis mutandis: the amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of Article 136, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis, pertaining to an Old Age, etc. pension benefit, which is to be paid for the first time on or after October 1 of the year that includes the first day of the relevant fiscal year;

二準用介護保険法第百三十四条第二項の規定による通知が行われた場合において、準用介護保険法第百三十五条第二項の規定により特別徴収の方法によって保険料を徴収されると見込まれる被保険者　当該年度の初日の属する年の十二月一日以降最初に支払われる老齢等年金給付に係る令第二十八条第一項において準用する介護保険法第百三十六条第二項の規定により算出される支払回数割保険料額

(ii)a Long-Term Care Insurance Act for which insurance premiums are expected to be collected by the method of special collection pursuant to the provisions of Article 134, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis, in the case where a notice is given pursuant to the provisions of Article 135, paragraph (2), insured as applied mutatis mutandis: the amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of Article 136, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to Article 28, paragraph (1) of the Order pertaining to an Old Age, etc. pension benefit, which is to be paid for the first time on or after December 1 of the year that includes the first day of the relevant fiscal year;

三準用介護保険法第百三十四条第三項の規定による通知が行われた場合において、準用介護保険法第百三十五条第二項の規定により特別徴収の方法によって保険料を徴収されると見込まれる被保険者　当該年度の初日の属する年の翌年の二月一日以降最初に支払われる老齢等年金給付に係る令第二十九条第一項において準用する介護保険法第百三十六条第二項の規定により算出される支払回数割保険料額

(iii)a Long-Term Care Insurance Act for which insurance premiums are expected to be collected by the method of special collection pursuant to the provisions of Article 134, paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis, in the case where a notice is given pursuant to the provisions of Article 135, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis: the amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of Article 136, paragraph (2), Hokkaido as applied mutatis mutandis pursuant to Article 29, paragraph (1) of the Order pertaining to an Old Age, etc. pension benefit, which is to be paid for the first time on or after February 1 of the year following the year that includes the first day of the relevant fiscal year. insured

四準用介護保険法第百三十四条第二項若しくは第三項の規定による通知が行われた場合（準用介護保険法第百三十五条第二項の規定により当該通知に係る被保険者に対して課する当該年度の保険料の一部を特別徴収の方法によって徴収する場合を除く。）又は準用介護保険法第百三十四条第四項の規定による通知が行われた場合において、準用介護保険法第百三十五条第三項の規定により特別徴収の方法によって保険料を徴収されると見込まれる被保険者　当該年度の初日の属する年の翌年の四月一日以降最初に支払われる老齢等年金給付に係る準用介護保険法第百三十五条第四項の規定により算出される支払回数割保険料額の見込額（当該額によることが適当でないと認められる特別な事情がある場合においては、所得の状況その他の事情を勘案して市町村が定める額）

(iv)in the case where a notice is given pursuant to the provisions of Article 134, paragraph (2), or paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis (excluding the case where, pursuant to the provisions of Article 135, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis, part of the insurance premiums for the fiscal year to be imposed on the insured pertaining to the notice are collected by the method of special collection) or in the case where a notice is given pursuant to the provisions of Article 134, paragraph (4), Long-Term Care Insurance Act as applied mutatis mutandis, a insured from which the insurance premiums are expected to be collected by the method of special collection pursuant to the provisions of Article 135, paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis: the estimated amount of insurance premiums divided by the number of payments, calculated pursuant to the provisions of Article 135, paragraph (4), Long-Term Care Insurance Act as applied mutatis mutandis, pertaining to an Old Age, etc. pension benefit, which is to be paid for the first time on or after April 1 of the year following the year that includes the first day of the relevant fiscal year (in the case where there are special circumstances where it is deemed inappropriate to pay the amount, the amount specified by a Municipality by taking into consideration the;

五準用介護保険法第百三十四条第五項の規定による通知が行われた場合において、準用介護保険法第百三十五条第三項の規定により特別徴収の方法によって保険料を徴収されると見込まれる被保険者　当該年度の初日の属する年の翌年の六月一日以降最初に支払われる老齢等年金給付に係る準用介護保険法第百三十五条第四項の規定により算出される支払回数割保険料額の見込額（当該額によることが適当でないと認められる特別な事情がある場合においては、所得の状況その他の事情を勘案して市町村が定める額）

(v)a Long-Term Care Insurance Act for which insurance premiums are expected to be collected by the method of special collection pursuant to the provisions of Article 134, paragraph (5), Long-Term Care Insurance Act as Applied Mutatis Mutandis, if a notice under the provisions of Article 135, paragraph (3), Long-Term Care Insurance Act as Applied Mutatis Mutandis has been given: the estimated amount of insurance premiums divided by the number of payments that is calculated pursuant to the provisions of Article 135, paragraph (4), Fukuoka Prefecture as Applied Mutatis Mutandis, for an Old Age, etc. pension benefit, which is to be paid for the first time on or after June 1 of the year following the year that includes the first day of the relevant fiscal year (or the amount specified by the Municipality in consideration of income status and other circumstances, if there are special circumstances that are found to be inappropriate for the amount to be so calculated). insured;

六準用介護保険法第百三十四条第六項の規定による通知が行われた場合において、準用介護保険法第百三十五条第三項の規定により特別徴収の方法によって保険料を徴収されると見込まれる被保険者　当該年度の初日の属する年の翌年の八月一日以降最初に支払われる老齢等年金給付に係る準用介護保険法第百三十五条第四項の規定により算出される支払回数割保険料額の見込額（当該額によることが適当でないと認められる特別な事情がある場合においては、所得の状況その他の事情を勘案して市町村が定める額）

(vi)a Long-Term Care Insurance Act for which insurance premiums are expected to be collected by the method of special collection pursuant to the provisions of Article 134, paragraph (6), Long-Term Care Insurance Act as Applied Mutatis Mutandis, in the case where a notice under the provisions of Article 135, paragraph (3), Long-Term Care Insurance Act as Applied Mutatis Mutandis has been given: the estimated amount of insurance premiums divided by the number of payments, calculated pursuant to the provisions of Article 135, paragraph (4), Fukuoka Prefecture as Applied Mutatis Mutandis, pertaining to an Old Age, etc., pension benefit to be paid for the first time on or after August 1 of the year following the year that includes the first day of the relevant fiscal year (or the amount specified by a Municipality by taking into consideration the status of income and other circumstances, in the case where there are special circumstances where it is found to be inappropriate to pay the amount). insured.

一前条第一号に掲げる被保険者　当該年度の初日の属する年の十月一日以降最初に支払われる老齢等年金給付に係る介護保険法第百三十六条第二項の規定により算出される支払回数割保険料額

(i)insured listed in item (i) of the preceding Article: the amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of Article 136, paragraph (2), Long-Term Care Insurance Act pertaining to an Old Age pension benefit, which is to be paid for the first time on or after October 1 of the year which includes the first day of the relevant fiscal year;

二前条第二号に掲げる被保険者　当該年度の初日の属する年の十二月一日以降最初に支払われる老齢等年金給付に係る介護保険法第百三十六条第一項に規定する支払回数割保険料額又は介護保険法施行令（平成十年政令第四百十二号）第四十五条の二第一項において準用する同法第百三十六条第二項の規定により算出される支払回数割保険料額

(ii)insured listed in item (ii) of the preceding Article: the amount of insurance premiums divided by the number of payments prescribed in Article 136, paragraph (1), Long-Term Care Insurance Act pertaining to an Old Age pension benefit, which is to be paid for the first time on or after December 1 of the year containing the first day of the relevant fiscal year, or the amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of Article 136, paragraph (2) of the Order for Enforcement of Long-Term Care Insurance Act (Cabinet Order No. 412 of 1998) as applied mutatis mutandis pursuant to Article 45-2, paragraph (1) of the same Act;

三前条第三号に掲げる被保険者　当該年度の初日の属する年の翌年の二月一日以降最初に支払われる老齢等年金給付に係る介護保険法第百三十六条第一項（介護保険法施行令第四十五条の二第一項において準用する場合を含む。）に規定する支払回数割保険料額又は同令第四十五条の三第一項において準用する同法第百三十六条第二項の規定により算出される支払回数割保険料額

(iii)insured listed in item (iii) of the preceding Article: the amount of insurance premiums divided by the number of payments prescribed in Article 136, paragraph (1), Long-Term Care Insurance Act (including the case where it is applied mutatis mutandis pursuant to Article 45-2, paragraph (1) of the Order for Enforcement of Long-Term Care Insurance Act) pertaining to an Old Age pension benefit, which is to be paid for the first time on or after February 1 of the year following the year containing the first day of the relevant fiscal year, or the amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of Article 136, paragraph (2) of the same Act as applied mutatis mutandis pursuant to Article 45-3, paragraph (1) of the same Order;

四前条第四号に掲げる被保険者　当該年度の初日の属する年の翌年の四月一日以降最初に支払われる老齢等年金給付に係る介護保険法第百四十条第一項（介護保険法施行令第四十五条の二第一項及び第四十五条の三第一項において準用する場合を含む。）に規定する支払回数割保険料額に相当する額又は同法第百三十五条第四項の規定により算出される支払回数割保険料額の見込額（当該額によることが適当でないと認められる特別な事情がある場合においては、所得の状況その他の事情を勘案して市町村が定める額）

(iv)the insured listed in item (iv) of the preceding Article: the amount equivalent to the amount of insurance premiums divided by the number of payments prescribed in the Long-Term Care Insurance Act pension benefit (including the cases where it is applied mutatis mutandis pursuant to Article 45-2, paragraph (1) and Article 45-3, paragraph (1) of the Order for Enforcement of Long-Term Care Insurance Act) pertaining to the old age, etc. Article 140, paragraph (1) to be paid for the first time on or after April 1 of the year following the year containing the first day of the relevant fiscal year, or the estimated amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of the Article 135, paragraph (4) of the same Act (in the case where there are special circumstances where it is deemed inappropriate to use the amount, the amount specified by the municipality in consideration of the income status and other circumstances);

五前条第五号に掲げる被保険者　当該年度の初日の属する年の翌年の六月一日以降最初に支払われる老齢等年金給付に係る介護保険法第百四十条第二項（介護保険法施行令第四十五条の二第一項及び第四十五条の三第一項において準用する場合を含む。）に規定する支払回数割保険料額に相当する額、同法第百三十五条第三項に規定する支払回数割保険料額の見込額（第百十一条第一項の規定を適用する場合においては所得の状況その他の事情を勘案して市町村が定める額）又は同法第百三十五条第四項の規定により算出される支払回数割保険料額の見込額（当該額によることが適当でないと認められる特別な事情がある場合においては、所得の状況その他の事情を勘案して市町村が定める額）

(v)the insured listed in item (v) of the preceding Article: the amount equivalent to the amount of insurance premiums divided by the number of payments prescribed in the Article 140, paragraph (2) of Long-Term Care Insurance Act (including the cases where it is applied mutatis mutandis pursuant to Article 45-2, paragraph (1) and Article 45-3, paragraph (1) of the Order for Enforcement of Long-Term Care Insurance Act) pertaining to the Old Age pension benefit to be paid for the first time on or after June 1 of the year following the year containing the first day of the relevant fiscal year, the estimated amount of insurance premiums divided by the number of payments prescribed in the Article 135, paragraph (3) of the same Act (in the case where the provisions of the Article 111, paragraph (1) are applied, the amount specified by the Municipality by taking into consideration the income status and other circumstances), or the estimated amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of the Article 135, paragraph (4) of the same Act (in the case where there are special circumstances where it is deemed inappropriate to use the amount, the amount specified by the Municipality by taking into consideration the income status and other circumstances;

六前条第六号に掲げる被保険者　当該年度の初日の属する年の翌年の八月一日以降最初に支払われる老齢等年金給付に係る介護保険法第百四十条第二項（介護保険法施行令第四十五条の二第一項及び第四十五条の三第一項において準用する場合を含む。）に規定する支払回数割保険料額に相当する額（第百十条第二項の規定を適用する場合においては、所得の状況その他の事情を勘案して市町村が定める額）、同法第百三十五条第三項に規定する支払回数割保険料額の見込額（第百十一条第一項又は第百十二条第一項の規定を適用する場合においては、所得の状況その他の事情を勘案して市町村が定める額）又は同法第百三十五条第四項の規定により算出される支払回数割保険料額の見込額（当該額によることが適当でないと認められる特別な事情がある場合においては、所得の状況その他の事情を勘案して市町村が定める額）

(vi)the insured set forth in item (vi) of the preceding Article: the amount equivalent to the amount of insurance premiums divided by the number of payments prescribed in the Long-Term Care Insurance Act pension benefit (including the cases where it is applied mutatis mutandis pursuant to Article 45-2, paragraph (1) and Article 45-3, paragraph (1) of the Order for Enforcement of the Article 140, paragraph (2)) (in the case where the provisions of the Article 110, paragraph (2) are applied, the amount specified by the Municipality in consideration of the income status and other circumstances), the estimated amount of insurance premiums divided by the number of payments prescribed in the Article 135, paragraph (3) of the same Act (in the case where the provisions of the Article 111, paragraph (1) or Article 112, paragraph (1) are applied, the amount specified by the Municipality in consideration of the income status and other circumstances), or the estimated amount of insurance premiums divided by the number of payments calculated pursuant to the provisions of the Article 135, paragraph (4) of the same Act (in the case where there are special circumstances where it is deemed inappropriate to use that amount, the amount specified by the Municipality in consideration of the income status and other circumstances), pertaining to the Old Age Long-Term Care Insurance Act to be paid for the first time on or after August 1 of the year following the year containing the first day of the.

一特別徴収対象被保険者の氏名、性別、生年月日及び住所

(i)the name, sex, date of birth, and address of the insured subject to special collection;

二特別徴収対象年金給付（準用介護保険法第百三十五条第六項に規定する特別徴収対象年金給付をいう。以下同じ。）の種類、額及び特別徴収義務者（同条第五項に規定する特別徴収義務者をいう。以下同じ。）の名称

(ii)the type and amount of the pension benefit subject to special collection (meaning the Article 135, paragraph (6) subject to special collection prescribed in the Long-Term Care Insurance Act pension benefit Applied Mutatis Mutandis; the same applies hereinafter) and the name of the person under obligation of special collection (meaning the person under obligation of special collection prescribed in paragraph (5) of the same Article; the same applies hereinafter).

一準用介護保険法第百三十四条第二項若しくは第三項の規定による通知（準用介護保険法第百三十五条第二項の規定により当該通知に係る被保険者に対して課する当該年度の保険料の一部を特別徴収の方法によって徴収する場合を除く。）又は準用介護保険法第百三十四条第四項の規定による通知が行われた場合において、準用介護保険法第百三十五条第三項の規定により特別徴収を行うとき　当該年度の保険料額を十二（ただし、十二とすることが適当でないと認められる市町村においては、一以上十二以下の範囲内において市町村が定める数とする。）で除して得た額に六を乗じて得た額

(i)if a notice under the provisions of Article 134, paragraph (2), or paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis (excluding the case where a part of the insurance premiums for the relevant fiscal year imposed on the Long-Term Care Insurance Act pertaining to the notice pursuant to the provisions of Article 135, paragraph (2), insured as applied mutatis mutandis is collected by the method of special collection) or a notice under the provisions of Article 134, paragraph (4), Long-Term Care Insurance Act as applied mutatis mutandis is given, and special collection is to be made pursuant to the provisions of Article 135, paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis: the amount obtained by multiplying by six the amount obtained by dividing the amount of insurance premiums for the relevant fiscal year by twelve (provided, however, that in the case of a municipality where twelve is found to be inappropriate, it is the number specified by the municipality within the range of one or more and 12 or less);

二準用介護保険法第百三十四条第五項の規定による通知が行われた場合において、準用介護保険法第百三十五条第三項の規定により特別徴収を行うとき　当該年度の保険料額を十二（ただし、十二とすることが適当でないと認められる市町村においては、一以上十二以下の範囲内において市町村が定める数とする。）で除して得た額に四を乗じて得た額

(ii)if a notice is given pursuant to the provisions of Article 134, paragraph (5), Long-Term Care Insurance Act as applied mutatis mutandis, and special collection is to be carried out pursuant to the provisions of Article 135, paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis: the amount obtained by multiplying by four the amount obtained by dividing the amount of insurance premiums for the relevant fiscal year by twelve (provided, however, that in the case of a municipality where twelve is found to be inappropriate, the relevant amount is the number specified by the municipality within the range of one or more and 12 or less);

三準用介護保険法第百三十四条第六項の規定による通知が行われた場合において、準用介護保険法第百三十五条第三項の規定により特別徴収を行うとき　当該年度の保険料額を十二（ただし、十二とすることが適当でないと認められる市町村においては、一以上十二以下の範囲内において市町村が定める数とする。）で除して得た額に二を乗じて得た額

(iii)if a notification has been made pursuant to the provisions of Article 134, paragraph (6), Long-Term Care Insurance Act as applied mutatis mutandis, and special collection is to be implemented pursuant to the provisions of Article 135, paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis: the amount obtained by multiplying by two the amount obtained by dividing the amount of insurance premiums for the relevant fiscal year by twelve (provided, however, that in the case of a municipality where it is found to be inappropriate to use twelve, it is the number specified by the municipality within the range of one or more and 12 or less).

一当該特別徴収対象被保険者が、当該市町村の区域内に住所を有しなくなったとき。

(i)when the insured subject to special collection is no longer domiciled within the area of the municipality;

二当該特別徴収対象被保険者に係る当該年度分の保険料額が、準用介護保険法第百三十六条第一項（令第二十八条第一項及び第二十九条第一項において準用する場合を含む。）の規定による通知が行われた後の当該年度中に減額されたとき。

(ii)if the amount of insurance premiums for the relevant fiscal year pertaining to the insured subject to special collection has been reduced in the relevant fiscal year after the notification under the provisions of the Long-Term Care Insurance Act Article 136, paragraph (1) Applied mutatis mutandis (including as applied mutatis mutandis pursuant to Article 28, paragraph (1) and Article 29, paragraph (1) of the Order) was made;

三当該特別徴収対象被保険者に係る当該年度分の保険料額が、準用介護保険法第百三十六条第一項（令第二十八条第一項及び第二十九条第一項において準用する場合を含む。）の規定による通知が行われた後の当該年度中に増額された場合であって、市町村が当該特別徴収対象被保険者について準用介護保険法第百三十六条第二項に規定する特別徴収対象保険料額から既に特別徴収の方法により徴収された額を控除した額の全部について普通徴収の方法により徴収することが適当と認めたとき。

(iii)cases where the amount of insurance premiums for the relevant fiscal year pertaining to the insured subject to special collection has been increased during the relevant fiscal year after the notification under the provisions of the Long-Term Care Insurance Act Article 136, paragraph (1) as applied mutatis mutandis (including cases where it is applied mutatis mutandis pursuant to Article 28, paragraph (1) and Article 29, paragraph (1) of the Order) was made, and when a municipality finds it appropriate to collect all of the amount obtained by deducting the amount already collected by the method of special collection from the amount of insurance premiums subject to special collection as prescribed in the insured Article 136, paragraph (2) of Long-Term Care Insurance Act as applied mutatis mutandis with regard to the relevant region subject to special collection by the method of general collection;

四前二号の規定は、令第三十条から第三十二条までにおいて準用介護保険法第百三十六条第一項を準用する場合について準用する。この場合において、前二号中「当該年度分」とあるのは「当該年度の翌年度分」と、「当該年度中」とあるのは「当該年度の翌年度中」と読み替えるものとする。

(iv)the provisions of the preceding two items apply mutatis mutandis to the case where Article 136, paragraph (1), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to Articles 30 through 32 of the Order is applied mutatis mutandis. In this case, the terms "for the relevant fiscal year" and "during the relevant fiscal year" in the preceding two items are deemed to be replaced with "for the fiscal year following the relevant fiscal year" and "during the fiscal year following the relevant fiscal year" respectively;

五当該特別徴収対象被保険者が、法第五十五条第一項若しくは第二項（これらの規定を法第五十五条の二第二項において準用する場合を含む。）又は法第五十五条の二第一項の規定の適用を受ける場合であって、介護保険法第十三条第一項及び第二項（介護保険法施行法（平成九年法律第百二十四号）第十一条第三項の規定により読み替えて適用される場合を含む。）の規定の適用を受けないとき。

(v)if the insured subject to special collection is subject to the provisions of Article 55, paragraph (1) or (2) of the Act (including cases where these provisions are applied mutatis mutandis pursuant to Article 55-2, paragraph (2) of the Act) or Article 55-2, paragraph (1) of the Act, and is not subject to the provisions of Article 13, paragraphs (1) and (2) of the Long-Term Care Insurance Act (including cases where applied by replacing terms pursuant to the provisions of Article 11, paragraph (3) of the Act for Enforcement of the Long-Term Care Insurance Act (Act No. 124 of 1997));

六災害その他の特別の事情が生じたことにより、当該特別徴収対象被保険者について特別徴収の方法により保険料を徴収することが適当でないと市町村が認めたとき。

(vi)when a Municipality finds it inappropriate to collect insurance premiums by the method of special collection for the insured subject to special collection due to the occurrence of disasters or other special circumstances.

一当該通知に係る特別徴収対象被保険者の氏名、性別、生年月日及び住所

(i)the name, sex, date of birth, and address of the insured subject to special collection related to the notification;

二当該特別徴収対象被保険者について特別徴収を行わないこととする旨及びその理由

(ii)the fact that special collection will not be carried out for the insured subject to special collection and the reason therefor;

三特別徴収対象年金給付の種類及び特別徴収義務者の名称

(iii)the type of pension benefit subject to special collection and the name of the person under obligation of special collection.

一準用介護保険法第百三十九条第三項の規定により当該充当を行う旨

(i)long-Term Care Insurance Act applied mutatis mutandis: a statement to the effect that the appropriation is to be made pursuant to the provisions of Article 139, paragraph (3);

二当該充当を行う未納保険料等の額及び当該充当を行った後の過誤納額

(ii)the amount of unpaid insurance premiums, etc. to be appropriated and the amount of payment in excess or in error after the appropriation;

三その他必要と認める事項

(iii)other particulars found to be necessary.

一特別徴収対象被保険者の氏名、性別、生年月日及び住所

(i)the name, sex, date of birth, and address of the insured subject to special collection;

二仮徴収に係る額を変更する旨及び八月の変更仮徴収額

(ii)a statement to the effect that the amount pertaining to provisional collection will be changed and the changed provisional amount to be collected in August.

三特別徴収対象年金給付の種類及び特別徴収義務者の名称

(iii)the type of pension benefit subject to special collection and the name of the person under obligation of special collection.

一特別徴収対象被保険者の氏名、性別、生年月日及び住所

(i)the name, sex, date of birth, and address of the insured subject to special collection;

二仮徴収に係る額を変更する旨及び六月に変更する支払回数割保険料額の見込額

(ii)a statement to the effect that the amount pertaining to provisional collection will be changed and the estimated amount of insurance premiums divided by the number of payments that will be changed to six months.

三特別徴収対象年金給付の種類及び特別徴収義務者の名称

(iii)the type of pension benefit subject to special collection and the name of the person under obligation of special collection.

一特別徴収対象被保険者の氏名、性別、生年月日及び住所

(i)the name, sex, date of birth, and address of the insured subject to special collection;

二仮徴収に係る額を変更する旨及び八月に変更する支払回数割保険料額の見込額

(ii)a statement to the effect that the amount pertaining to provisional collection will be changed and the estimated amount of insurance premiums divided by the number of payments to be changed in August.

三特別徴収対象年金給付の種類及び特別徴収義務者の名称

(iii)the type of pension benefit subject to special collection and the name of the person under obligation of special collection.

一被保険者に係る医療及び介護に関する情報等（当該被保険者に係る療養に関する情報、健康診査及び保健指導に関する記録並びに法第十八条第一項に規定する特定健康診査及び特定保健指導に関する記録、国民健康保険法の規定による療養に関する情報並びに介護保険法の規定による保健医療サービス及び福祉サービスに関する情報をいう。）に係るデータベース（情報の集合物であって、それらの情報を電子計算機を用いて検索することができるように体系的に構成したものをいう。）であって、国保連合会が構成するものを用いて提供する方法

(i)a method of providing information, etc. concerning medical care and nursing care pertaining to the insured (meaning information concerning medical treatment pertaining to the insured, records concerning health checkups and health guidance, records concerning Special health examinations and specified health guidance prescribed in Article 18, paragraph (1) of the Act, information concerning medical treatment pursuant to the provisions of the National Health Insurance Act, and information concerning health and medical services and welfare services pursuant to the provisions of the Long-Term Care Insurance Act) by using a database (meaning a collection of information that is systematically organized so as to be searchable by using a computer) composed by the NHI National Health Insurance Federation;

二電子情報処理組織（電子資格確認（法又は医療保険各法に規定する電子資格確認をいう。以下この号において同じ。）において保険者及び後期高齢者医療広域連合が回答を行う際に使用する電子情報処理組織をいう。）を使用する方法その他の情報通信の技術（電子資格確認において保険者及び後期高齢者医療広域連合が回答を行う際に利用する情報通信の技術をいう。）を利用して提供する方法

(ii)a method of providing information by using an electronic data processing system (meaning an electronic data processing system used by insurers and Association of Medical Care Systems for the Elderly Aged 75 and older to respond to an electronic certification confirmation (meaning an electronic certification confirmation as prescribed in the Act or the Medical Insurance Acts; hereinafter the same applies in this item)) or any other information and communications technology (meaning information and communications technology used by insurers and Association of Medical Care Systems for the Elderly Aged 75 and older to respond to an electronic certification confirmation);

三前二号に掲げるもののほか、適切な方法

(iii)beyond what is set forth in the preceding two items, an appropriate method.