Change of Mailing Address for Long-Term Care Insurance Related Documents
If there are unavoidable circumstances that make it difficult for the insured person to receive documents related to Long-Term Care Insurance at their registered address, and they wish to have them sent to an address other than the one listed on their Certificate of Residence, they can change the delivery address by submitting a "Long-Term Care Insurance Document Delivery Address Change Notification." A notification is also required if they wish to change or cancel an already set delivery address.
Notes
- The mail items that can be changed with this address change notification are only documents related to Long-Term Care Insurance.
- Changes to the delivery address for nursing care health facilities, hospitals, home care support offices, and nursing service offices cannot be made. Additionally, please refrain from changing to locations that are not recognized as short-term (approximately one to two months) home care.
- After changing the delivery address, if there are any changes to the notified delivery address due to relocation, a new Notification is required.
- After changing the delivery address, we will send Long-Term Care Insurance related documents to the new address unless you submit a request to cancel the change.
- If you wish to change or cancel the registered delivery address for the 'Long-Term Care Insurance Related Documents Delivery Address Setting Notification', you will need to submit a new notification, and it must be filled out with the signature of the previous applicant.
Required Attachments for Notification
Notifier (Applicant) | Required documents (If sending by mail, please attach a copy) |
---|---|
Insured Person | Identification documents of the insured person |
Other than the person (relatives) | Power of Attorney (Identification documents of the insured person in case of difficulty) + Identification documents of relatives |
Legal Representative (Adult Guardian, Assistant, Supporter) | Documents certifying that you are a legal representative + Identification materials for the legal representative |
Heir | Identification documents for heirs If the heir is not a legal heir (spouse, child, grandchild, sibling, nephew, or niece), documents proving their status as an heir (such as a will) are required. |
Identity verification documents: Currently valid certificates issued by government agencies
(My Number Card, driver's license, etc. If using a Health Insurance Card without a photo (valid within the period) or a qualification confirmation document, two documents are required for Long-Term Care Insurance, etc.)
Download Form
PDF format
- Long-Term Care Insurance Related Document Submission Destination Setting Form (PDF 97.4KB)
- Power of Attorney for Long-Term Care Insurance Related Procedures (PDF 132.6KB)
Other Formats
- Long-Term Care Insurance Related Document Submission Destination Setting Form (Excel 42.0KB)
- Power of Attorney for Long-Term Care Insurance Related Procedures (Word 14.0KB)
To view the PDF file, you need "Adobe(R) Reader(R)". If you do not have it, please download it for free from Adobe Systems' website (new window).
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Inquiries about this page
Inagi City Welfare Department Senior Welfare Division
〒206-8601 Tokyo, Inagi City, Higashi-Naganuma 2111
Phone number: 042-378-2111 Fax number: 042-377-4781
Contact Inagi City Welfare Department Senior Welfare Division