Check List for Leaving Preparation Student NO.

Check List for Leaving Preparation
Student NO. :
Home University:
Housing:
Name :
Moving-out date:
/
Departure date:
Student Dormitory ・ Overseas Student House ・ Private apartment
/
(Circle either)
Please make sure to follow the requests 1) and 2) below, and submit this check sheet to the UF International Affairs Division a few days before you leave.
1) TICK or SIGN in each blank box in “①Self-assessed Check List”. TICK means that you HAVE COMPLETED the item next to the ticked box. SIGN means
that you promise that you will complete the item next to the signed box by no later than your departure. After completing all the boxes, make your signature at
the end of Self-assessed Check List if you pledge that there is no false in your self-assessment.
2) Receive signature(s) or stamp(s), including date(s), from administrator(s) in charge of each section in “②UF Administrators’ Check List”.
① Self-assessed Check List
Tick / Sign
Items
1. Housing:
Those who live in one of the UF dormitories have to inform the Student Affairs Division of your moving-out day as soon as it is decided. Those who
live in a private apartment have to notify your landlord or real estate agent of your moving-out day very early, by no later than 1 month or more before that day. Read
your contract carefully to find out when you must contact your landlord or real estate agent to cancel your contract. Of course, you must complete your payment
including rent fee and other expenses for repair before leaving.
2. Gas, Electricity, Water and Internet:
Once moving-out day is decided, you should contact each service center for gas, electricity, water and internet to
inform when you move out. Some of them ask for your presence to finish contracts, so you should contact them earlier to make reservation on the days you like.
Residents in the UF dormitories can contact the office on the first floor and complete cancellation procedures for utility. You must make all payments before you leave.
3. Garbage:
You will dispose of a lot of garbage when moving out. To dispose of home appliances and large sized furniture, it may take a few days and you also
may be charged. Make sure to find out how to dispose of all garbage in advance, and make your plan for garbage disposal as early as you can. Residents in the UF
dormitories should contact the office of the Overseas Student House or the Student Affairs Division. The following URL is helpful for you:
http://www.city.fukui.lg.jp/foreign/english/garbage.html
Be sure not to act an illegal disposal (disposing garbage at improper place), that is one of the crimes in Japan!! Of course, disposing your garbage on the premises of
the UF dormitories is one of the illegal disposals and it will be reported to the police.
4. Procedures at the City Hall:
1 to 2 weeks before you leave, you should visit the City Hall to make procedures about your resident registration, National
Health Insurance and National Pension System. Bring your National Health Insurance card, National Pension book (colored blue) and INKAN (name stamp). If you do
not complete these procedures before you leave, troubles may be happened in case you will live in Japan again.
5. Cellular Phone:
You have to visit a cell-phone shop to cancel your contract. At the same time, you have to pay all bills there. You may be charged penalty fee
about ¥10,000 for early cancelation if you cancel less than 2 years.
6. Bank account:
You should close your bank account prior to your leaving. Before closing your bank account, make sure to complete all payments if you pay
cell-phone and public utility bills by automatic withdrawal. Also, if you are a JASSO Scholarship recipient, you should close your account after the scholarship for
February / August will be paid at the middle of February / August.
Check each blank
below
7. Documents to submit to the International Affairs Division:
Before your departure, you must submit the following documents to the UF
International Affairs Division (UFIAD):
1) Departure Sheet
2) Check List for Leaving Preparation
3) Application Form for Issuance of Certificate
4) Questionnaire Survey at End of Study at UF
5) 2 documents for JASSO Scholarship
*ONLY applicable to JASSO scholarship recipients
A) Completion Report of Student Exchange Support Program (Original copy with your signature) and B) JASSO Questionnaire (Excel data)
8. Good-byes:
It is nice to visit your academic supervisor, tutor, and friends to say goodbye. You do not need to give them anything to show your appreciation.
They will be pleased if you keep in touch with them after you are apart from them.
9. Books lent at off-campus Library:
Make sure to return books to off-campus libraries, such as public libraries, at least a few days before your
departure if you borrowed them.
10. Resident Card:
Do not miss to return your Residence Card when you go through the immigration at the airport.
I pledge that I complete all the items above mentioned about leaving preparation by no later than my departure.
Date:
Signature：
/
/
②UF Administrators’ Check List
*1: SAD = Student Affairs Division, *2: OSH = Overseas Student House
担当課署名等欄
項目
Signature / Stamp from Administrator
Items
( 学生サービス課 )
( 退去検査予定日 )
SAD *1
Date reserved for check
/
１．大学寮退去時の部屋検査の予約
Appointment for Room Inspection before leaving
【大学寮（国際交流学生宿舎、留学生会館）入居者のみ】
Only applicable to Residents in the UF dormitories
大学寮（国際交流学生宿舎、留学生会館）入居者は、自分の退去日を学生サービス課（または留学生会館１階事務室）に知らせ
たあと、退去検査日時の予約をしてください。予約が完了したら、左側の欄に担当者の印またはサイン、日付をもらってください。
Residents in the UF dormitories have to make an appointment for your room inspection after informing of the SAD*1 (or the office of OSH*2)
of your moving-out day. When you completed that, you can receive a signature or stamp from the administrator in the left box.
( 財務課出納係 )
( 支払い完了日 )
“SUITO-KAKARI”
Date
２．大学寮の寄宿料の支払い
Payment for Rent fee
【大学寮（国際交流学生宿舎、留学生会館）入居者のみ】
Only applicable to Residents in the UF dormitories
退去する月の寄宿料を、財務課出納係窓口で支払う必要があります（現金のみ）。支払いが終わったら、左側の欄に印またはサ
in Finance Division
/
( 学生サービス課 /
( 支払い完了日 )
留学生会館事務室)
Date
イン、日付をもらってください。 Residents in the UF dormitories are required to pay each rent fee for last month at “SUITO-KAKARI” in
Finance Division (UF Cashier) by cash. At the same time, you can receive a signature or stamp from the administrator in the left box.
３．大学寮の共益費および水道代の支払い
Payment for UF dormitories Common Service Fee and Water charges
【大学寮（国際交流学生宿舎、留学生会館）入居者のみ】
退去する月の大学寮の共益費と水道代を、現金で支払う必要があります。国際交流学生宿舎入居者は学生サービス課窓口で、留
SAD / Office of OSH
/
学生会館居住者は留学生会館１階事務室で、それぞれ支払ってください。支払いをしたら、左側の欄に印またはサイン、日付をも
らってください。 Residents in the UF dormitories are required to pay each common service fee and water charges for last month by cash.
Residents in the UF Student Dormitory pay them at the Student Affairs Division, and residents in the OSH do at the office of OSH. At the same
time, you can receive a signature or stamp from the administrator in the left box.
( 附属図書館 )
( 確認日 )
UF Library
Date
/
４．大学附属図書館で借りている本の返却
Book lent at the UF library
大学附属図書館で借りている本があれば、必ず返却してください。返却後、左側の欄に担当者の印またはサイン、日付をもらっ
てください。本を借りていない人は、図書館に行って借りていないという確認をしてもらい、同様に左側の欄に印またはサイン、
日付をもらってください。Make sure to return books to the UF library, and you can receive a signature or stamp from the administrator in the
left box. In case that you do not lend any books from the UF library, please visit there to receive a signature or stamp.

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