A Resident paid severance pay or other such compensation in Japan must, by the time of being paid, submit a declaration stating the following particulars to the competent district director for the locality for paying over taxes under Article 17 (Locality for Paying Over Withholding Tax) (or, if a designation has been made under Article 18, paragraph (2) (Designation of Locality for Paying Over Taxes), the locality so designated) for the income taxes on that severance pay or other such compensation, via the person paying that severance pay or other such compensation. In such a case, when submitting a declaration stating that there is other severance pay or other such compensation already paid as prescribed in item (ii), the Resident must attach to that declaration the withholding receipt issued pursuant to Article 226, paragraph (2) (Withholding Receipts) for that other severance pay or other such compensation already paid.
the name of that person paying the severance pay or other such compensation;
その退職手当等の支払者の氏名又は名称
whether there is other severance pay or other such compensation already paid as prescribed in Article 201, paragraph (1), item (i) (Amount of Taxes Withheld), and, if there is, whether that other severance pay or other such compensation already paid falls under ordinary severance pay or other such compensation, short-term severance pay or other such compensation, or specified officer severance pay or other such compensation, and its amount;
第二百一条第一項第一号(徴収税額)に規定する支払済みの他の退職手当等があるかどうか並びに当該支払済みの他の退職手当等があるときは当該支払済みの他の退職手当等が一般退職手当等、短期退職手当等又は特定役員退職手当等のいずれに該当するかの別及びその金額
the years of service that form the basis for calculating the amount of the retirement income deduction prescribed in Article 201, paragraph (2);
whether the Resident falls under the case set forth in Article 30, paragraph (6), item (iii) (Retirement Income), and, if so, the facts on which that is based;
その居住者が第三十条第六項第三号(退職所得)に掲げる場合に該当するかどうか及びこれに該当するときはその該当する事実
any other particulars specified by Ministry of Finance Order.
その他財務省令で定める事項
Severance pay or other such compensation from which income taxes are not required to be withheld and paid over pursuant to Article 200 (Person Paying Severance Pay or Other Such Compensation Exempt from Withholding at the Source) is not included in the severance pay or other such compensation prescribed in the preceding paragraph.
In the case referred to in paragraph (1), if a declaration under that paragraph is accepted by the person paying the severance pay or other such compensation via whom it is to be submitted, the declaration is deemed to have been submitted to the district director prescribed in that paragraph at the time it was accepted.
If the person paying the severance pay or other such compensation via whom a declaration under paragraph (1) is to be submitted meets the requirements specified by Cabinet Order, including having taken measures that enable it to properly receive, by electronic or magnetic means (meaning the electronic or magnetic means prescribed in Article 198, paragraph (2) (Special Provisions on the Time of Submission of Declarations by Salary Income Earners Concerning Withholding and Related Matters); the same applies in this paragraph), the particulars to be stated in that declaration (referred to as the "required particulars" in this paragraph), a Resident paid severance pay or other such compensation referred to in that paragraph may, in lieu of submitting that declaration, provide the required particulars to that person paying the severance pay or other such compensation by electronic or magnetic means. In such a case, the second sentence of paragraph (2) of that Article applies mutatis mutandis.
For the purpose of applying paragraph (3) in a case where the preceding paragraph applies, the phrase "a declaration" in that paragraph is deemed to be replaced with "the particulars to be stated in a declaration"; the phrase "is accepted by the person paying the severance pay or other such compensation" is deemed to be replaced with "are provided to the person paying the severance pay or other such compensation"; and the phrase "at the time it was accepted" is deemed to be replaced with "at the time they were provided".
A declaration under paragraph (1) is referred to as a declaration on receipt of retirement income.
第一項の規定による申告書は、退職所得の受給に関する申告書という。