Petition

To: Embassy of Japan in the Philippines

I, , used to reside in Japan as a

status of residence of "Permanent Resident" holder.

However, after leaving Japan with valid re-entry permission (including "special re-entry
permission"), I was unable to re-enter Japan by the re-entry permission deadline due to the
influence of spread of the Novel Coronavirus, consequently, my status of residence expired.
Therefore, I would like to lodge a visa application as attached.

I hereby certify that the above statements are true and correct to the best of my knowledge.

Date:

Signature:

(Notes)
Please attach a photocopy of the Residence Card at the time of application.