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About downloading of the procedure style with a large number of uses (when he died)

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

Last Updated April 12, 2024

Overview and notes

On this page, the following forms are posted.
・Notification of Change of Residents (Resident Registration, National Health Insurance, Medical System for Elderly Senior Citizens, 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 the common contents, and print the required form.
※This format has been confirmed on Microsoft Windows 10 and Microsoft Excel 2016. Other OS. Please note that it may not be possible to use the software or smartphone.

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

Those who have not taken out National Health Insurance, Medical System for Elderly Senior Citizens, The 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 head of household. You can use it in any of the following formats.

If the deceased had taken out National Health Insurance

[Procedure Form, Submission Address, required items]

Age of the person who died

Notification of Change of Residents
(Resident Registration)

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

If the deceased had taken out National Health Insurance


Under 65 years old△※1×× ※2〇 ※3
65 years old or older△※1×〇 ※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 necessary items, etc.)

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

What is necessary for the procedure (don't forget to report in such a case)

Application related: Guidance of welfare for the elderly

No. 1 Insured (when he died)

Payment of funeral expenses

※1 ・ ・ Notification of change of resident (resident registration) is required only when the head of the household dies. However, notification is not required if the head of the household becomes one 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 transferring funds to 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 details, please refer to the payment of funeral expenses.
※4. Procedures are required at the ward office in Address where the deceased was registered as a resident.

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

If the deceased had joined the medical system for elder senior citizens

[Procedure Form, Submission Address, required items]
 

Notification of Change of Residents
(Resident Registration)

National Health Insurance
Notification of transfer

Notification of Change of Residents
(Medical System for Elderly Senior Citizens)

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

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

If the deceased had joined the medical system for elder senior citizens

△※1△※2〇 ※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 necessary items, etc.)

Notification of change of household (change of head of household, separation of household, merger, etc.)What is necessary for the procedure (don't forget to report in such a case)Notification of participation, withdrawal, renewal of insurance card, etc.Application related: Guidance of welfare for the elderlyWhen going to a medical institution, apply for benefits and submit a third-party act

※1: Notification of change of resident (resident registration) is required only when the head of the household dies. However, notification is not required if the head of the household becomes one household due to the death of the head of the household.
※2. Notification is required if the deceased is the head of the household and has taken out National Health Insurance in the same household.
※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 the notification of third-party acts when you go to a medical institution.
※4. Procedures are required at the ward office in Address where the deceased was registered as a resident.

Please note that depending on the situation of the household, supplements may be made 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 (Resident 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△※1× ※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 necessary items, etc.)Notification of change of household (change of head of household, separation of household, merger, etc.)Application related: Guidance of welfare for the elderlyNo. 1 Insured (when he died)

※1: Notification of change of resident (resident registration) is required only when the head of the household dies. However, notification is not required if the head of the household becomes one 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 transferring funds to National Pension Plan (Kokumin Nenkin) insurance premiums, a notification is required.
※3. Procedures are required at the ward office in Address where the deceased was registered as a resident.

Please note that depending on the situation of the household, etc., it may be supplemented 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 form, submission destination, notes that need to be prepared]

Notification of Change of Residents (pension)
If the deceased had joined National Pension Plan (Kokumin Nenkin)× ※1
Submission addressWard office Insurance and Pension Division
Notes
(Please refer to here for details.)
No. 1 Insured (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 transferring funds to National Pension Plan (Kokumin Nenkin) insurance premiums, a notification is required.

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Page ID: 403-723-858

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