脱退一時金請求書　Claim form for the Lump-sum Withdrawal Payment

Notes for submission

When you request Lump-Sum Withdrawal Payment (Employees’ Pension Insurance and Retirement Pension Benefits (Private schools version)), use this Claim form. Check the Lump-sum Withdrawal Payment Brochure and request it.

1. Please read the Lump-sum Withdrawal Payment Brochure and confirm you meet the Eligibility requirements.
2. You can claim Lump-sum Withdrawal Payment for Employees’ Pension Insurance and Lump-sum Withdrawal Payment for Retirement Pension Benefits (Private schools version) at the same time. When you request it at the same time, Please fill in the Claim form and circle “I claim the Payment” in the “6. Confirmation of your Intention to Claim the Lump-sum Withdrawal Payment for Retirement Pension Benefits (Private schools version)”
3. In the following cases, other agencies than PMAC will determine and pay the Lump-sum Withdrawal Payment. Please submit your Claim to the relevant agency.
   3-1.
   If your last pension enrollment in Japan was in the National Public Officers Mutual Aid Association or Local Public Officers Mutual Aid Association…please submit your Claim to each Mutual Aid Association.
   3-2.
   If your last pension enrollment in Japan was a private company…please submit your Claim to the Japan Pension Service.
   3-3.
   If your National Pension contribution-paid period is six months or more…please submit your Claim to the Japan Pension Service.
4. Suppose you want to claim the Lump-sum Withdrawal Payment for the Retirement Pension Benefits, and you have claimed the Lump-sum withdrawal payment for the Employees’ Pension Insurance to an agency other than PMAC. In that case, you have to separately claim the Lump-sum Withdrawal Payment for the Retirement Pension Benefits to PMAC.

Necessary Attachments

1. A copy of your passport (copy of page verifying your name, date of birth, nationality, signature, your status of residence)
2. Documents verifying the “bank name”, “branch name”, “branch location”, “bank account number” and “bank account holder’s name – showing that the bank account holder is the claimant himself” (certificate issued by the bank, copy of your passbook, invalid checks, etc. Or the bank may verify your account information by placing a certification stamp in the “Bank account certification column”.)
   
   Note:
   Please also submit a document issued by the financial institution with the IBAN code (Europe), SORT code (UK), ABA/Routing No. (USA), BSB No. (Australia, New Zealand), IFSC code (India), Transit No. (Canada), AGENCIA code (Brazil), CLABE code (Mexico), SWIFT/BIC code (worldwide), etc.
3. A copy of a document verifying your Basic Pension Number (Please attach a copy, not the original.)
4. A document confirming that you no longer have an address in Japan (Deleted Residence Record, etc.)
   
   Note:
   If you submit the Moving-out Notification to the municipality of your residence before returning to your country, based on the deleted information in your Residence Certificate, the Promotion and Mutual Aid Corporation for Private Schools of Japan can confirm that you do not have an address in Japan. Therefore, you do not need to submit the No. 4 Document to be attached “A document confirming that you no longer have an address in Japan”.

Note:
Suppose you claim the Lump-sum Withdrawal Payment for the Employees’ Pension Insurance and the Promotion and Mutual Aid Corporation for Private Schools of Japan, Retirement Pension Benefits at the same time. In that case, you do not have to attach some documents twice.

For details,Please check the Lump-sum Withdrawal Payment Brochure.