A declaration of change to the tax-exempt savings limit must state the following matters:
非課税貯蓄限度額変更申告書には、次に掲げる事項を記載しなければならない。
the submitter's name, date of birth, domicile, and individual number (meaning an individual number prescribed in Article 2, paragraph (5) (Definitions) of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures (Act No. 27 of 2013); the same applies hereinafter);
提出者の氏名、生年月日、住所及び個人番号（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（平成二十五年法律第二十七号）第二条第五項（定義）に規定する個人番号をいう。以下同じ。）
the fact that the submitter is a Person with a Disability or other eligible person;
障害者等に該当する事実
the name and location of the business office of that financial institution or other such place;
その金融機関の営業所等の名称及び所在地
The type of those deposits and similar savings that the submitter has stated in the statement of tax-exempt savings submitted via the business office of that financial institution or other such place;
預貯金等のうち提出者がその金融機関の営業所等を経由して提出した非課税貯蓄申告書に記載したものの種別
The maximum limitation listed in Article 10, paragraph (3), item (iii) (Nontaxability of Interest Income from Small Amounts of Deposits Held by Persons with Disabilities and Other Eligible Persons) of the Act that is stated in the statement of tax-exempt savings referred to in the preceding item (where a declaration of change to the tax-exempt savings limit has already been submitted in respect of that statement, the maximum limitation after the change stated in that declaration of change to the tax-exempt savings limit);
前号の非課税貯蓄申告書に記載した法第十条第三項第三号（障害者等の少額預金の利子所得等の非課税）に掲げる最高限度額（当該申告書につき既に非課税貯蓄限度額変更申告書を提出している場合には、当該非課税貯蓄限度額変更申告書に記載した変更後の最高限度額）
The maximum limitation after the change;
変更後の最高限度額
Where the person has submitted a statement of tax-exempt savings via the business office of another financial institution or other such place, the sum of the maximum limitations listed in Article 10, paragraph (3), item (iv) of the Act that are stated in that statement;
他の金融機関の営業所等を経由して非課税貯蓄申告書を提出している場合には、当該申告書に記載した法第十条第三項第四号に掲げる最高限度額の合計額
The date of submission of the statement of tax-exempt savings referred to in item (iv) and other matters that should serve as a reference.
第四号の非課税貯蓄申告書の提出年月日その他参考となるべき事項
The maximum limitation after the change referred to in item (vi) of the preceding paragraph that may be stated in a declaration of change to the tax-exempt savings limit is to be an amount that is 10,000 yen multiplied by an integer and that is 3,000,000 yen or less (where there is a sum of the maximum limitations listed in item (vii) of that paragraph that is to be stated in that declaration, the balance remaining after deducting that sum from 3,000,000 yen).
A declaration of change to the tax-exempt savings limit may not be submitted, at the time the person is about to submit it, by an individual who does not have an address in Japan or an individual who does not fall under a Person with a Disability or other eligible person.
非課税貯蓄限度額変更申告書は、その提出をしようとする際に、国内に住所を有しない個人及び障害者等に該当しない個人については、その提出をすることができない。
Read this with the articles around it
deposits and similar savingsmachine translation
「預貯金等」
The deposits and savings, jointly managed trusts (合同運用信託), specified publicly offered bond investment trusts (特定公募公社債等運用投資信託) and securities that Article 10, paragraph (1) of the Income Tax Act describes.
Defined inArticle 31, paragraph (1), item (ii)· applies only in this section
individual numbermachine translation
「個人番号」
The individual number (the personal 'My Number') as defined in Article 2, paragraph (5) of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures (Act No. 27 of 2013).
Defined inArticle 41, paragraph (1), item (i)