一the name, date of birth, domicile and individual number of the person who submits the statement prescribed in Article 43, paragraph (1) of the Order (hereinafter referred to as the "submitter" in this item and the following item) (in the case where the submitter has changed their name or domicile, the name, date of birth and domicile of the submitter);

二the name, domicile or individual number of the submitter before the change and the name, domicile or individual number after the change;

三the type of deposits and similar savings stated in the statement of tax-exempt savings submitted via the business office, etc. of that financial institution;

四the date of submission of the statement of tax-exempt savings referred to in the preceding item; and

五any other matters for reference.

一the name, date of birth, domicile and individual number of the person who submits the statement prescribed in Article 43, paragraph (2) of the Order;

二the name and location of the business office, etc. before transfer prescribed in Article 43, paragraph (2) of the Order, and the name and location of the business office, etc. to which the transfer is made as prescribed in that paragraph;

三the type of deposits and similar savings stated in the statement of tax-exempt savings submitted via the business office, etc. before transfer prescribed in the preceding item;

四the date of submission of the statement of tax-exempt savings referred to in the preceding item; and

五any other matters for reference.

一the name, date of birth, domicile and individual number of the person who submits the statement prescribed in Article 43, paragraph (3) of the Order;

二the category of the grounds set out in the items of Article 43, paragraph (3) of the Order that have arisen with respect to the specified business prescribed in that paragraph, and the date on which those grounds arose;

三the name and location of the specified business office, etc. prescribed in Article 43, paragraph (3) of the Order of the specified financial institution prescribed in that paragraph with respect to whose specified business referred to in the preceding item the grounds referred to in that item arose, and the name and location of the business office, etc. to which the transfer is made as prescribed in that paragraph;

四the type of deposits and similar savings stated in the statement of tax-exempt savings submitted via the specified business office, etc. prescribed in the preceding item;

五the date of submission of the statement of tax-exempt savings referred to in the preceding item; and

六any other matters for reference.

一the name and location of the business office, etc. to which the transfer is made as prescribed in Article 44, paragraph (1) of the Order, and the corporate number of the financial institution, etc. prescribed in that paragraph pertaining to that business office, etc. to which the transfer is made.

二the name and location of the business office, etc. of the financial institution that made the transfer prescribed in Article 44, paragraph (1) of the Order;

三the name, date of birth and domicile of the individual concerned in that transfer, the fact that the individual is a Person with a Disability or other eligible person, the type of deposits and similar savings stated or recorded in the statement of tax-exempt savings that the individual submitted via the business office, etc. of the financial institution referred to in the preceding item (including an electronic or magnetic record recording the matters to be stated in the statement of tax-exempt savings that were provided by electronic or magnetic means; the same applies in the following item), and the maximum limitation set out 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 (or, if a statement of change of the tax-exempt savings limit has been submitted, the maximum limitation after the change);

四the total amount of the maximum limitations set out in Article 10, paragraph (3), item (iv) of the Act that are stated or recorded in the statement of tax-exempt savings referred to in the preceding item; and

五any other matters for reference.

一the name, date of birth, domicile and individual number of the person who submits the statement of discontinuance of tax-exempt savings;

二the type of the deposits and similar savings placed with the business office, etc. of that financial institution, or otherwise deposited there, for which the person intends to cease to be subject to the application of the provisions of Article 10, paragraph (1) of the Act (Nontaxability of Interest Income from Small Amounts of Deposits Held by Persons with Disabilities and Other Eligible Persons);

三the maximum limitation set out in Article 10, paragraph (3), item (iii) of the Act pertaining to the deposits and similar savings referred to in the preceding item (or, if a statement of change of the tax-exempt savings limit has been submitted, the maximum limitation after the change; the same applies in item (iii) of the following paragraph); and

四any other matters for reference.

一the name, date of birth, domicile and individual number of the person who is deemed, pursuant to the provisions of Article 45, paragraph (4) of the Order, to have submitted a statement of discontinuance of tax-exempt savings;

二the type of deposits and similar savings stated or recorded in the statement of tax-exempt savings pertaining to the statement of discontinuance of tax-exempt savings that is deemed to have been submitted pursuant to the provisions of Article 45, paragraph (4) of the Order (including an electronic or magnetic record recording the matters to be stated in that statement of tax-exempt savings that were provided by electronic or magnetic means; the same applies in the following item);

三the maximum limitation set out in Article 10, paragraph (3), item (iii) of the Act pertaining to the statement of tax-exempt savings referred to in the preceding item;

四the date on which the statement of discontinuance of tax-exempt savings is deemed to have been submitted pursuant to the provisions of Article 45, paragraph (4) of the Order; and

五any other matters for reference.

一the name and domicile of the heir who submits the notification of the death of a tax-exempt saver;

二the name, date of birth and domicile at the time of death of the decedent, and the date of death;

三the type of the deposits and similar savings of the decedent placed with the business office, etc. of that financial institution, or otherwise deposited there, that are subject to the application of the provisions of Article 10, paragraph (1) of the Act (Nontaxability of Interest Income from Small Amounts of Deposits Held by Persons with Disabilities and Other Eligible Persons); and

四any other matters for reference.

一the name, date of birth and domicile at the time of death of the decedent of the person who submitted the notification of the death of a tax-exempt saver, or of the individual who submitted a statement of tax-exempt savings and whose death has come to be known (hereinafter referred to as the "decedent, etc." in this paragraph), and the date of death;

二the type of the deposits and similar savings of the decedent, etc. placed with the business office, etc. of that financial institution, or otherwise deposited there, that are subject to the application of the provisions of Article 10, paragraph (1) of the Act;

三the maximum limitation set out in Article 10, paragraph (3), item (iii) of the Act pertaining to the deposits and similar savings referred to in the preceding item (or, if a statement of change of the tax-exempt savings limit has been submitted, the maximum limitation after the change);

四the date on which the notification of the death of a tax-exempt saver was received, or the date on which the death became known; and

五any other matters for reference.

一the name, date of birth and address of the heir who submits the application for succession to tax-exempt savings, and the fact that the heir falls under the category of a Person with a Disability or other eligible person;

二the name of the decedent and the decedent's address at the time of death;

三the type of the Deposits and Savings, etc. of the decedent that were placed, etc. at the business office of the relevant financial institution or other such place and to which the provisions of Article 10, paragraph (1) (Nontaxability of Interest Income from Small Amounts of Deposits Held by Persons with Disabilities and Other Eligible Persons) of the Act apply;

四any other matters for reference.