Instruction manual for Tax Exemption

When acquiring the status of a qualified account management institution

Who submits
Specified account management institutions or specified indirect account management institutions that acquire the status of a qualified account management institution
Document to submit
Application Form for Qualified Account Management Institution
When to submit
At any time
Where to submit
Japan Securities Depository Center, Inc.
Form Completion Guide
E Sections to be completed by the person acquiring the status of qualified account management institution
@ Date of submission
A Name of corporation
A' Name of corporation in Japanese kana
B Name of president of the corporation
C Name of contact person
D Section of contact person
E Telephone number of contact person
F Place of corporation's head or main office
G Names and addresses of branches or offices
If the applicant attaches separate sheets, check box G'
H Date signed
When using seal, it is required that the seal is legally registered.
When writing name of representative, it is required that the name written is legally registered as representative.
I Signature of applicant
J If the applicant does not desire an announcement after approval as a qualified account management institution, check the box.

E Section to be completed by the Japan Securities Depository Center, Inc.
A Certification that the applicant is a specified account management institution or specified indirect account management institution

(Attachment 5)

Attachment 5

Attachment 4

* This form was created by the Japan Securities Dealers Association.
* These examples of completed forms are merely meant as illustrations. Please consult your financial institution for full details on how to complete the form.