○When acquiring the status of a qualified foreign intermediary
■ Who submits
Foreign indirect account management institutions and foreign further indirect account management institutions that acquire the status of qualified foreign intermediaries, and which have their head office or main office in a signatory country to a tax convention or similar that includes provisions for the exchange of information.
■ Document to submit
Application Form for Qualified Foreign Intermediary
■ When to submit
At any time
■ Where to submit
Specified book-entry transfer institutions, etc.
■ Form Completion Guide
・ Sections to be completed by the person acquiring the status of qualified foreign intermediary
① Date of submission
② Name of foreign corporation
②' Name of foreign corporation in Japanese kana
③ Representative of foreign corporation
④ Name of contact person
⑤ Section of contact person
⑥ Telephone number of contact person
⑦ Address of foreign corporation (Place of head or main office, Place where established or organized, Place where the business is managed or controlled)
⑧ Name of the contracting country to an income tax convention or other international agreement to which Japan is a partner
⑨ If the corporation has a permanent establishment in Japan, check the box
→ Enter the name, address and other details of the permanent establishment in ⑨'
⑩ If the corporation has no permanent establishment in Japan, check the box
→ If there is no office, etc. in Japan, entering in ⑩' is unnecessary
⑪ Name and address of specified foreign branches
→ If the applicant attaches separate sheets, check box ⑪'
⑫ Name and address of branch or office located in Japan of specified book-entry transfer institution, etc.
⑬ Check the relevant box under Capacity of agent in Japan, enter name, domicile, telephone number of agent
If the agent is a tax agent, the name of the tax office where the agent is registered
→ If there is no tax agent, entering information here is unnecessary
⑭ Date signed
⑮ Signature of applicant
⑯ If the applicant does not desire an announcement after approval as a qualified foreign intermediary, check the box.
・Section to be completed by the Japan Securities Depository Center, Inc.
A Certification that the applicant is a foreign indirect account management institution or foreign further indirect account management institution
(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.
(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.
* 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.
