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About downloading the procedure style of condolence (when you die) with a large number of uses

On this page, we publish procedure styles that are often used when family members die for the purpose of reducing the burden on citizens who list the same contents many times.

Last update date April 12, 2024

Summary and Precautions

On this page, the following formats are posted.
・The Long-term Care Insurance,pension)
・National Health Insurance Funeral Expenses Payment Application
・Application for payment of funeral expenses for late-elderly medical care

You can download this form to your personal computer, enter common content, and print the required form.
※The operation of this form has been confirmed on Microsoft Windows 10 and Microsoft Excel 2016. Please note that it may not be available on OS. Software or smartphones.

For other procedures, please refer to the list of procedures when a family member died.
Please note that depending on the content of the application and the situation of the household, you may be required to submit additional documents, seal, and additional documents at the counter.

Those who do not haveThe Long-term Care Insurance or National Pension Plan (Kokumin Nenkin)

You can use the style on this page only when there is a change in the head of household. You can use any of the following formats.

When the deceased had taken out National Health Insurance

[Procedure Form, Submission Address, required items]

Age of a deceased person

Notification of Change of Residents
(Registration of residents)

National Health Insurance Transfer Notification

Notification of Change of Residents
(The Long-term Care Insurance)

Notification of Change of Residents
(pension)

National Health Insurance Funeral Expenses Payment Application

When the deceased had taken out National Health Insurance


Under 65 years old△※1Oh×× ※2Oh ※3
65 years old or older△※1OhOh×Oh ※3

Submission address ※4

Ward Office Family Registry Division

Ward Office
Insurance and Pension Division

Ward Office
Insurance and Pension Division

Ward Office
Insurance and Pension Division

Ward Office
Insurance and Pension Division

Precautions (Please be sure to check the necessary belongings.)

Notification of household change (change of head of household, separation of household, merger, etc.)

Necessary items for the procedure (don't forget to submit a report)

Various applications related: Information on welfare for the elderly

No. 1 insured person (when he died)

Payment of funeral expenses

※1 ・ ・ ・ Notification of change of resident (resident registration) is required only when the head of household dies. However, notification is not required if you become a single household due to the death of the head of the household.
※2. In principle, notification is not required. However, if the Japan pension Organization does not stop sending mails related to National Pension Plan (Kokumin Nenkin) or fund transfer of National Pension Plan (Kokumin Nenkin) insurance premiums, a notification is required.
※3. Funeral expenses are paid to the mourner who performed the funeral of the deceased. For more information, please refer to the following link.
※4 ... The deceased will need to apply at the ward office in Address, where the deceased was registered.

Please note that depending on the household situation, etc., we may make supplements at the counter.
In the case of notification by proxy/agent, a power of attorney is required.

When the deceased has joined the medical system for elder senior citizens

[Procedure Form, Submission Address, required items]
 

Notification of Change of Residents
(Registration of residents)

National Health Insurance
Transfer notice

Notification of Change of Residents
(Medical System for Elderly Seniors)

Notification of Change of Residents
(The Long-term Care Insurance)

Application for payment of funeral expenses for late-elderly medical care

When the deceased has joined the medical system for elder senior citizens

△※1△※2OhOhOh ※3
Submission address ※4Ward Office Family Registry Division

Ward Office
Insurance and Pension Division

Ward Office
Insurance and Pension Division

Ward Office
Insurance and Pension Division

Ward Office
Insurance and Pension Division

Precautions (Please be sure to check the necessary belongings.)

Notification of household change (change of head of household, separation of household, merger, etc.)Necessary items for the procedure (don't forget to submit a report)Notification of participation, withdrawal, reissuing insurance card, etc.Various applications related: Information on welfare for the elderlyWhen you go to a medical institution, apply for a benefit, report a third-party act

※1 ・ ・ ・ Notification of change of resident (resident registration) is required only when the head of household dies. However, notification is not required if you become a single household due to the death of the head of the household.
※2. If the deceased person is the head of the household and has a “National Health Insurance” in the same household, a notification is required.
※3. Funeral expenses are paid to the mourner who performed the funeral of the deceased. For details, please refer to the application for benefits and notification of third-party acts when you go to a medical institution.
※4 ... The deceased will need to apply at the ward office in Address, where the deceased was registered.

Please note that depending on the household situation, etc., we may make supplements at the counter.
In the case of notification by proxy/agent, a power of attorney is required.

If the deceased had only joined The Long-term Care Insurance

[Procedure Form, Submission Address, required items]
 Notification of Change of Residents (Registration)Notification of Change of Residents (The Long-term Care Insurance)Notification of Change of Residents (pension)
If the deceased had only joined The Long-term Care Insurance△※1Oh× ※2

Submission address ※3

Ward Office Family Registry DivisionWard Office Insurance and Pension Division

Ward Office Insurance and Pension Division

Precautions (Please be sure to check the necessary belongings.)Notification of household change (change of head of household, separation of household, merger, etc.)Various applications related: Information on welfare for the elderlyNo. 1 insured person (when he died)

※1 ・ ・ ・ Notification of change of resident (resident registration) is required only when the head of household dies. However, notification is not required if you become a single household due to the death of the head of the household.
※2. In principle, notification is not required. However, if the Japan pension Organization does not stop sending mails related to National Pension Plan (Kokumin Nenkin) or fund transfer of National Pension Plan (Kokumin Nenkin) insurance premiums, a notification is required.
※3. Procedures are required at the ward office in Address where the deceased had registered as a resident.

Please note that depending on the situation of your household, you may be able to add additional information at the counter.
In the case of notification by proxy/agent, a power of attorney is required.

If the deceased had only joined National Pension Plan (Kokumin Nenkin)

[Procedure Forms, Submissions, and Precautions]

Notification of Change of Residents (pension)
If the deceased had joined the National Pension Plan (Kokumin Nenkin)× ※1
Submission addressWard Office Insurance and Pension Division
Precautions
(Please refer to here for details.)
No. 1 insured person (when he died)

※1. In principle, notification is not required. However, if the Japan pension Organization does not stop sending mails related to National Pension Plan (Kokumin Nenkin) or fund transfer of National Pension Plan (Kokumin Nenkin) insurance premiums, a notification is required.

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Page ID: 403-723-858

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