26

2

1

Date : Year Month Day
If the same as applicant, you do not have to fill out.
Please circle the corresponding number to the document(s).
()(:
Company)
GAIMU HANAKO

MARRIAGE

Country of
destination

Purpose of use
If you apply on behalf of the person/company concerned, please
attach/enclose the power of attorney.

Telephone number(Mobile)
APPLICATION FORM FOR APOSTILLE
Applicant's name
Relationship with the person/company concerned
SelfRepresentative (Business / Personal)
GAIMU TARO
France

Name of person/company
concerned
GAIMU TARO
Example
Name of Country,
to be submitted
Day-time telephone
number
ex) Visa application,
Company registration
etc.

Certificate(s) of eligibility for marriage Family register(s) Head of family:

Notarial document(s) Education document(s)Graduation/Completion/
Transcript(s)/Others:
Medical and pharmaceutical document(s)

Criminal record(s) Civil status document(s) Birth / Marriage / Divorce /

Medical certificate(s)
Others
Extracts from commercial registers
Total

Official use only

Please note the document(s)

affixed apostille will be disposed if it will not be received within three years. Please pick it up as soon as possible.

You can apply for apostille only when it is required from member country of the Hague Apostille Convention.
1 31

Date of issue and the number

(if any)

Name of the person signing

the document(s)

Capacity of the person signing

the document(s)
1 12 H26
SHIBUYA-KU-CHO

D
o
c
u
m
e
n
t
(
s
)

Year

Month

Day

No.
RYOJI TARO
Death / Residence / Others:
ex)SHI-CHO,
KU-CHO etc.
ex)Name of SHI-
CHO, KU-CHO etc.
Total number of the
document(s)
Ministry of Foreign Affairs of Japan