所得税法第二百三条の六第一項の規定により同項に規定する申告書を提出しなければならない者又はこの法律の施行地において同項に規定する公的年金等(所得税法第二百三条の七の規定の適用を受けるものを除く。以下この項において「公的年金等」という。)の支払を受ける第二十四条第一項第一号に掲げる者であつて、特定配偶者(所得割の納税義務者(合計所得金額が九百万円以下であるものに限る。)の自己と生計を一にする配偶者(退職手当等(第五十条の二に規定する退職手当等に限る。以下この項において同じ。)に係る所得を有する者であつて、合計所得金額が九十五万円以下であるものに限る。)をいう。第二号において同じ。)又は扶養親族(年齢十六歳未満の者又は控除対象扶養親族であつて退職手当等に係る所得を有する者に限る。)若しくは特定親族(退職手当等に係る所得を有する者であつて、合計所得金額が八十五万円以下であるものに限る。)を有する者(以下この条において「公的年金等受給者」という。)は、当該申告書の提出の際に経由すべき所得税法第二百三条の六第一項に規定する公的年金等の支払者(以下この条において「公的年金等支払者」という。)から毎年最初に公的年金等の支払を受ける日の前日までに、総務省令で定めるところにより、次に掲げる事項を記載した申告書を、第三百十七条の三の三第一項に規定する申告書と併せて、当該公的年金等支払者を経由して、当該公的年金等受給者の住所所在地の市町村長に提出しなければならない。
A person who is required to submit the return prescribed in Article 203-6, paragraph (1) of the Income Tax Act pursuant to that paragraph, or a person listed in Article 24, paragraph (1), item (i) who receives payment of the public pension, etc. prescribed in Article 203-6, paragraph (1) of the Income Tax Act (excluding that to which Article 203-7 of that Act applies; referred to as "public pension, etc." in this paragraph) in the area where this Act is enforced, and who has a specified spouse (meaning a spouse who shares a livelihood with the person liable for the income levy (limited to a person whose total income is 9,000,000 yen or less) (limited to a person who has income pertaining to severance pay or other such compensation, etc. (limited to the severance pay or other such compensation, etc. prescribed in Article 50-2; the same applies hereinafter in this paragraph) and whose total income is 950,000 yen or less); the same applies in item (ii)), or a dependent (limited to a person under 16 years of age, or a claimable dependent who has income pertaining to severance pay or other such compensation, etc.) or specified relative (limited to a person who has income pertaining to severance pay or other such compensation, etc. and whose total income is 850,000 yen or less) (referred to as a "recipient of public pensions, etc." in this Article) must, by the day before the day on which he or she first receives payment of public pension, etc. each year from the payer of public pensions, etc. prescribed in Article 203-6, paragraph (1) of the Income Tax Act through whom the return is to be submitted (referred to as a "payer of public pensions, etc." in this Article), as provided by Order of the Ministry of Internal Affairs and Communications, submit a return stating the following matters, together with the return prescribed in Article 317-3-3, paragraph (1), through that payer of public pensions, etc., to the mayor of the municipality of the place of domicile of that recipient of public pensions, etc.