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Documents Necessary for Each Circumstance

Members/dependents

Situation

Form to use

When changing or correcting a member’s birthdate, sex, name, address, etc.

Change of Member Information Notification.

Note:
Describe the reasons for the changes in detail.

When a “Membership Card” or “Membership Card for a Dependent” is lost or damaged

Reissue request form for Membership Card/Membership Card for a Dependent/Elderly Recipient Card

Note:
Describe the reasons in detail. Make a report to the police when the card is lost.

When a member already has a dependent who satisfies the requirements for dependency approval or has a new dependent.

Application form for Dependency Approval

Note:
Attachment (refer to documents needed to apply for a dependent)

When a dependent no longer satisfies any of the requirements for dependent approval

Application form for Dependent Cancellation

When changing or correcting a dependent’s birthdate, relationship, name, etc.

Change of Dependent Information Notification

Note:
Describe the reasons for the changes in detail. Attachment(s) may be necessary depending on the reason.

Voluntarily Continued Insurance Members

Circumstances

Form to use

When joining the Voluntarily Continued Insurance Plan

Application form for Voluntarily Continued Insurance Plan

When the name, address or bank account, etc. has changed

Notification form for Voluntarily Continued Insurance Member information change

When discontinuing Voluntarily Continued Insurance Plan

Application form for withdrawal Voluntarily Continued Insurance Plan

When changing the payment method of Voluntarily Continued Insurance Plan

Payment method change request form

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