「払戻申込書」記⼊例（英語版）
※Please fill-up in Japanese or
Romaji
Please write the date today
Please write your address
starting from prefecture to
house number. Avoid
erasures in writing your
address
Please write the form
number if you are filling-up
more than 2 forms (6
card numbers per form)
Please write the card
numbers clearly
Please choose the refund
method: Bank Transfer or
Cash Refund through JP
Bank
For those who chose Bank
Transfer, please make sure
to write your bank details
The account holder MUST
be the same with the
applicant
Check here if you read the
terms and conditions
written at the back page
Cut this part and insert the
application form inside the
envelope

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