In Japan, the application form for Specified Skilled Worker (特定技能) is the same form whether the field is nursing care, manufacturing, or food service. However, some fields are filled in differently depending on the field, such as the names of the skills and Japanese language tests, whether the public notice standards apply, and the numbers for occupation and industry.
In this article, we explain the application forms for Specified Skilled Worker “Nursing Care” (特定技能「介護」) (Certificate of Eligibility, change, and extension) in order, starting from the first page of the form. We have organized it so that you can prepare a nursing care application form by reading from top to bottom.
The content is based on the Immigration Services Agency (出入国在留管理庁, ISA)’s application forms, filled-in samples, and the Operational Guidelines (Nursing Care Field) (運用要領（介護分野）), checked on October 27, 2026. Forms may be revised, so obtain the latest form again before applying.
What to know before you start: the form has 7 pages, with pages for the applicant and pages for the company
The application forms are available as Excel files on the ISA’s “Status of Residence ‘Specified Skilled Worker'” page. The form differs depending on the procedure.
| Procedure | Application form to use | Main situation |
|---|---|---|
| Certificate of Eligibility | Application for Certificate of Eligibility (在留資格認定証明書交付申請書) | Bringing someone in from overseas |
| Change | Application for Change of Status of Residence (在留資格変更許可申請書) | Changing from Technical Intern Training, Student, etc. to Specified Skilled Worker (i) |
| Extension | Application for Extension of Period of Stay (在留期間更新許可申請書) | Extending the period of stay of Specified Skilled Worker (i) |
For every application form, 7 pages are submitted. The first 3 pages are “For the applicant, etc. 1–3” (申請人等作成用1〜3) (the person’s information), and the last 4 pages are “For the affiliated organization, etc. 1–4” (所属機関等作成用1〜4) (the accepting organization’s information).
- For the applicant, etc. 1–3: Prepared by the person (applicant) side, and on the 3rd page the applicant (for a Certificate of Eligibility, the agent may also do this) signs
- For the affiliated organization, etc. 1–4: Prepared by the accepting organization (Specified Skilled Worker affiliated organization, 特定技能所属機関), and on the 4th page the name of the affiliated organization and the name of the representative are entered
The Excel file also contains sheets that are not submitted. These are the explanation of how to choose the form (on the back of For the applicant, etc. 1) and the “Industry List” (業種一覧) and “Occupation List” (職種一覧) for choosing numbers. The paper size is A4, and if you cannot fit everything in a field, write it on a separate sheet and attach it (notes on the form).
The field numbers used in this article are the numbers of the same form shown in the images (for the For the applicant, etc. pages, the Certificate of Eligibility form). For the For the applicant, etc. pages, the same field has a different number in the change and extension forms, so look for it by the field name. The numbers in the For the affiliated organization, etc. pages are the same in all 3 forms, except for the support plan fields in the extension form.
As the notes on the form state, entering anything contrary to the facts may result in disadvantageous treatment. Even if a registered support organization or someone else prepared the draft, the person and the accepting organization should check the content before signing and entering their names.
(Sources: Immigration Services Agency, “Status of Residence ‘Specified Skilled Worker'”, Application for Certificate of Eligibility (Specified Skilled Worker, Excel), Application for Change of Status of Residence (Specified Skilled Worker, Excel), Application for Extension of Period of Stay (Specified Skilled Worker, Excel))
For the applicant, etc. 1: the person’s information and purpose of entry (Certificate of Eligibility)
The 1st page is for the person’s personal details, planned entry, and past history. In the Certificate of Eligibility form, fill it in in the order of the boxes in the following image.
Sources: Immigration Services Agency, “Application for Certificate of Eligibility”
Photo, and 1–10 the person’s information
Attach a photo (4 cm high × 3 cm wide) in the upper right. The List of Documents to Be Submitted (Table 1) states that it must be a clear photo taken from the front within 6 months before the application, without a hat and without a background, with the applicant’s name written on the back.
Fields 1–10 are nationality/region, date of birth, name, sex, place of birth, marital status, occupation, home town/city, address in Japan, and passport number and date of expiration. If the person has a valid passport, write the name as shown on the passport’s personal details page (note on the form). In the filled-in sample, 7 Occupation is “welder.”
11 Purpose of entry is “V Specified Skilled Worker (i)”
In 11 Purpose of entry, check “V ‘Specified Skilled Worker (i)'” (V『特定技能（1号）』).
Because there is no Specified Skilled Worker (ii) in the nursing care field, do not choose “V ‘Specified Skilled Worker (ii)'” (V『特定技能（2号）』). The Operational Guidelines explain the reason as follows: foreign nationals with highly skilled nursing care skills can stay under the status of residence “Nursing Care” (介護) as people holding the qualification of certified care worker (介護福祉士).
In other words, for people who want to continue working in nursing care after Specified Skilled Worker (i), the path is not a transition to (ii) but obtaining the certified care worker qualification and changing to the status of residence “Nursing Care.”
12–21 Planned entry and past history
- 12–16: Date of entry, port of entry, intended length of stay, accompanying persons, and intended place to apply for visa. In the filled-in sample, the intended length of stay is “1 year,” the port of entry is “Narita Airport,” and the intended place to apply for visa is a city name (“Manila”)
- 17–20: Past entries into and departures from Japan, past history of applications for a Certificate of Eligibility (including the number of times it was not issued), whether the person has received any disposition for a crime, and whether the person has departed Japan by deportation or departure order. Dispositions include those outside Japan and dispositions for traffic violations, etc.
- 21 Family in Japan and co-residents: If the person has relatives in Japan (father, mother, spouse, children, siblings, etc.) or co-residents, mark “Yes” and write the relationship, name, date of birth, etc. If there is not enough space, write it on a separate sheet
(Sources: Application for Certificate of Eligibility (Specified Skilled Worker, Excel), Application for Certificate of Eligibility (Filled-In Sample), Operational Guidelines (Nursing Care Field), List of Documents to Be Submitted, Table 1 (for Certificate of Eligibility, revised October 9, Reiwa 8))
For the applicant, etc. 1 (change and extension): current status of residence and reason for change or extension
The 1st page of the change and extension forms is for people residing in Japan. The difference from the Certificate of Eligibility form is that there are no fields for planned entry, and there are fields for the current status of residence and residence card.
Sources: Immigration Services Agency, “Application for Change of Status of Residence”
- Photo and 1–10: Same as the Certificate of Eligibility form. Field 9 is “Address in Japan” (住居地), where you write the address in Japan (place of residence)
- 11 Status of residence, period of stay, and date of expiration currently held, and 12 Residence card number: Write them as shown on the residence card
- 13 Desired status of residence: Write “Specified Skilled Worker (i)” (特定技能1号) and the desired period of stay. In the filled-in sample it is “1 year.” The form notes that “the desired period may not be granted depending on the result of the examination”
- 14 Reason for change: In the filled-in sample, “To work as a Specified Skilled Worker (i) foreign national.”
- 15 Disposition for a crime, and 16 Family in Japan and co-residents: Same as 19 and 21 in the Certificate of Eligibility form
The extension form is almost the same. The “Desired status of residence” field becomes “Desired period of stay,” and the “Reason for change” field becomes “Reason for extension,” with the same reason as for a change in the filled-in sample. The extension form has no field for place of birth, and the telephone number is a separate field, so the numbers of the person’s information fields differ from those in the change form. Check the field names as you fill it in.
Specified Skilled Worker (i) is in principle limited to a total of 5 years. The ISA advises that, depending on the period of stay so far, the desired period of stay may not be granted.
(Sources: Application for Change of Status of Residence (Filled-In Sample), Application for Extension of Period of Stay (Filled-In Sample), Immigration Services Agency, “Status of Residence ‘Specified Skilled Worker'”)
For the applicant, etc. 2: skill level and Japanese language ability fields (22–24)
The 2nd page is the one where the way of filling in changes the most for nursing care. In the first field, 22 Specified Skilled Worker affiliated organization, write the accepting organization’s name, address, and telephone number.
The skill level and Japanese language ability fields are where you choose how the person proves them. Fields 23 and 24 have the same structure, and you choose from “proof by test” (2 lines for test name and test location), “proof by other evaluation method,” and “good completion of Technical Intern Training (ii).”
Sources: Immigration Services Agency, “Application for Certificate of Eligibility”
The filled-in sample notes that the test name line should contain the name of the test specified for each work category. For the test location, check either in Japan or outside Japan (country name). The test names in the filled-in sample are those for the industrial product manufacturing field, so do not copy them as they are.
Where to check depending on the person’s background
| Person’s background | 23 Skill level | 24 Japanese language ability | 25 Technical Intern Training (ii) |
|---|---|---|---|
| Passed the tests | Proof by test. Nursing care skills test on line 1 | Proof by test. Basic Test or N4 on line 1, nursing care Japanese test on line 2 | Leave blank |
| Completed a training facility for certified care workers | Check “proof by other evaluation method” | Check “proof by other evaluation method” | Leave blank |
| Completed the 4-year period of stay as an EPA certified care worker candidate | Check “proof by other evaluation method” | Check “proof by other evaluation method” | Leave blank |
| Completed Technical Intern Training (ii) in the nursing care job category and nursing care work with good results | Good completion of Technical Intern Training (ii) | Good completion of Technical Intern Training (ii) | Write the job category and work |
| Completed Technical Intern Training (ii) other than nursing care with good results | Proof by test (nursing care skills test) | Check both “good completion of Technical Intern Training (ii)” and “proof by test” (nursing care Japanese test) | Write the completed job category and work (because “good completion of Technical Intern Training (ii)” is chosen in 24) |
Under the Operational Guidelines, completion of a training facility and completion of the 4-year EPA stay are “recognized as being at a level equal to or higher than passing the tests.” For this reason, they fall under “other evaluation method.” The documents to attach are a copy of the graduation certificate for completion of a training facility, and a copy of the result notice of the most recent national examination for certified care workers for completion of the 4-year EPA stay (Operational Guidelines).
For Japanese, write 2 test names
For Japanese in nursing care, in addition to the Japan Foundation Test for Basic Japanese or the Japanese-Language Proficiency Test (N4 or higher), passing the nursing care Japanese test is required. People who prove this by test use up to “line 2” in the image.
People who completed Technical Intern Training (ii) other than nursing care with good results are exempt from the Basic Test and N4, but not from the nursing care Japanese test and the nursing care skills test. This combination is not in the filled-in sample, so if you are unsure, check with the Regional Immigration Services Bureau.
Note that the test names have changed
On the Ministry of Health, Labour and Welfare’s page, starting with tests held in April 2026, the names became “Nursing Care Specified Skills Evaluation Test (Skills)” (介護特定技能評価試験（技能）) and “the same (Japanese)” (同（日本語）). The ISA’s Operational Guidelines and List of Documents to Be Submitted still use the old names, “Nursing Care Skills Evaluation Test” (介護技能評価試験) and “Nursing Care Japanese Language Evaluation Test” (介護日本語評価試験).
We could not find any guidance from the ISA indicating which name to write. It is safest to write the name so that it does not conflict with the test name on the pass certificate or result notice you have.
(Sources: Application for Certificate of Eligibility (Filled-In Sample), Operational Guidelines (Nursing Care Field), Ministry of Health, Labour and Welfare, “Acceptance of Specified Skilled Worker Foreign Nationals in the Nursing Care Field”)
For the applicant, etc. 2: Technical Intern Training (ii) field and total period of stay field (25 and 26)
Field 25 is filled in by people who completed Technical Intern Training (ii) in the nursing care job category and nursing care work with good results. People who prove their skills by test do not fill in this field.
- Job category and work: Job category “Nursing care” (介護), work “Nursing care” (介護)
- Proof of good completion: If the person passed the practical test of the Nursing Care Technical Intern Training Evaluation Test (Specialist Level), check “proof by passing the practical test” above. If not, check “proof by documents on the status of training” below and attach the evaluation report (Reference Form No. 1-2)
It is a precondition that the person has completed at least 2 years and 10 months of technical intern training. If the implementing organization where the training was completed is the same as the current affiliated organization, submission of the proof documents can be omitted (note in the filled-in sample; the Operational Guidelines also require that no improvement order has been received within the past year).
Field 26 is the total period of stay as Specified Skilled Worker (i) at the time of application. Write it in years and months, including past stays; for a first-time applicant it is 0 years 0 months. The total is in principle up to 5 years, but in nursing care there is a measure that allows an extension of up to 1 year depending on the result of the national examination for certified care workers. The conditions for the extension are explained in the following article.
The flow of transition from technical intern training is summarized in the following article.
(Sources: Application for Certificate of Eligibility (Filled-In Sample), Operational Guidelines (Nursing Care Field), Operational Guidelines for the Acceptance of Specified Skilled Worker Foreign Nationals (Main Text), Ministry of Health, Labour and Welfare, “Acceptance of Specified Skilled Worker Foreign Nationals in the Nursing Care Field”)
For the applicant, etc. 3: costs, public notice standards, work history, and signature (27–34)
The 3rd page contains the confirmations about costs, work history, the information on the applicant and agent, and the signature.
Sources: Immigration Services Agency, “Application for Certificate of Eligibility”
27–31 Costs and procedures
- 27: Whether there are contracts for collecting a deposit, managing property, penalties, etc. If there are, write the organization name, amount, etc.
- 28: If the person pays costs to a foreign organization in connection with the mediation of the application for the employment contract or preparation for activities abroad, whether the person fully understands and agrees to the amount and breakdown. If paying, write the organization name and amount paid (converted into Japanese yen)
- 29: If procedures to be followed regarding the activities in Japan are specified in the home country, etc., whether those procedures have been completed
- 30: If there are costs the person will regularly bear in Japan, whether the person fully understands and agrees to their content
- 31: Whether the person will strive to transfer the skills, etc. acquired in technical intern training to the home country. This field is for those applying for Specified Skilled Worker (ii), so leave it blank for nursing care
32 Public notice standards field: “Yes”
For nursing care, write “Yes.” Which field this is by its wording and what must be met to write “Yes” are explained in the heading “Public notice standards fields” below.
33 Work history
Write the years and months of joining and leaving and the name of the workplace, including work history abroad.
34 Applicant or agent, and signature
In 34 of the Certificate of Eligibility form, write the name, relationship with the person, address, and telephone number of the applicant, legal representative, or agent. An agent for a Certificate of Eligibility can be an employee of the accepting organization, etc. (notes on the form). In the filled-in sample, the relationship with the person is “employee of the Specified Skilled Worker affiliated organization.”
In the change and extension forms, this field is “Agent (fill in if applying through a legal representative).”
Below that, the applicant (agent) signs and writes the date of preparation of the application. The date of preparation is also handwritten by the applicant (agent). If the content changes after preparation and before the application, correct the changed parts and sign (notes on the form).
The “Agent” field at the very bottom (取次者) is filled in when a person holding an application agent certificate submits the application on the person’s behalf. The filled-in sample notes that employees of a registered support organization can act as application agents only when the organization has been entrusted with implementing the entire support plan.
(Sources: Application for Certificate of Eligibility (Specified Skilled Worker, Excel), Application for Certificate of Eligibility (Filled-In Sample), Application for Change of Status of Residence (Specified Skilled Worker, Excel))
Public notice standards fields: the wording on the form and the fields to mark “Yes” for nursing care
The application form has 7 fields asking whether the “standards specified by public notice in light of the circumstances specific to the specified industrial field” are met. Which fields must be filled in differs by field, as set out in the table on the last page of the filled-in sample.
Sources: Immigration Services Agency, “Application for Certificate of Eligibility (Filled-In Sample)”
In the table, “○” means a field where you write “Yes,” and “ー” means a field that does not need to be filled in. The wording of the 7 fields (as on the form) and how to fill them in for nursing care are as follows.
| Field | Wording on the form | Nursing care |
|---|---|---|
| For the applicant, etc. 3, 32 | Whether the applicant conforms to the standards specified by public notice in light of the circumstances specific to the specified industrial field (fill in if such standards are specified) | “Yes” |
| For the affiliated organization, etc. 1, 2(8) | Whether the employment relationship conforms to the standards specified by public notice in light of the circumstances specific to the specified industrial field (fill in if such standards are specified) | Not required |
| For the affiliated organization, etc. 1, 2(11) | Whether the matters necessary to contribute to the proper residence of the foreign national conform to the standards specified by public notice in light of the circumstances specific to the specified industrial field (fill in if such standards are specified) | Not required |
| For the affiliated organization, etc. 3, 3(33) | Whether the ensuring of proper performance of the specified skills employment contract conforms to the standards specified by public notice in light of the circumstances specific to the specified industrial field (fill in if such standards are specified) | “Yes” |
| For the affiliated organization, etc. 4, 3(42) | Whether the ensuring of proper implementation of the conforming support plan for Specified Skilled Worker (i) foreign nationals conforms to the standards specified by public notice in light of the circumstances specific to the specified industrial field (fill in if such standards are specified) | Not required |
| For the affiliated organization, etc. 4, 4(14) | Whether the matters specified by public notice in light of the circumstances specific to the specified industrial field are stated in the support plan for Specified Skilled Worker (i) foreign nationals (fill in if such matters are specified) | Not required |
| For the affiliated organization, etc. 4, 4(16) | Whether the content of the support plan for Specified Skilled Worker (i) foreign nationals conforms to the standards specified by public notice in light of the circumstances specific to the specified industrial field (fill in if such standards are specified) | Not required |
The condition for writing “Yes” is the 9 pledges in the written pledge
The explanation of the table in the filled-in sample says, regarding the ○ fields, that “if all the matters to be observed in the written pledge prepared by the Specified Skilled Worker affiliated organization for each field (such as the ‘Written Pledge Concerning the Acceptance of Specified Skilled Worker Foreign Nationals’) are met, mark ‘Yes.'” The written pledge for nursing care is Field Reference Form No. 1-1 (分野参考様式第1-1号). The pledges are the following 9 (as on the form).
1. The work in which Specified Skilled Worker (i) foreign nationals (meaning foreign nationals residing with the status of residence of Specified Skilled Worker in Appended Table I (2) of the Immigration Control and Refugee Recognition Act (Cabinet Order No. 319 of Showa 26) (limited to that relating to item 1 of the lower column of the Specified Skilled Worker row of that table); the same applies hereinafter) are engaged is physical care (assistance with bathing, eating, excretion, etc. according to the user’s physical and mental condition) and related support work (conducting recreation, assisting with functional training, etc.). 2. When Specified Skilled Worker (i) foreign nationals engage in nursing care, etc. work that provides services at the user’s home, the matters listed in Article 2, item 2 of the Standards Specified by the Head of the Relevant Administrative Organ with Jurisdiction over the Nursing Care Field in Light of the Circumstances Specific to that Industrial Field, Based on the Provisions of the Ministerial Ordinance Specifying the Standards under Article 7, Paragraph 1, Item 2 of the Immigration Control and Refugee Recognition Act and the Ministerial Ordinance Specifying the Standards, etc. for Specified Skills Employment Contracts and Support Plans for Specified Skilled Worker (i) Foreign Nationals (Ministry of Health, Labour and Welfare Public Notice No. 66 of Heisei 31) are observed. 3. The specified skills employment contract states that Specified Skilled Worker (i) foreign nationals will not be subject to worker dispatch as defined in Article 2, item 1 of the Act on Securing the Proper Operation of Worker Dispatching Businesses and Protecting Dispatched Workers (Act No. 88 of Showa 60). 4. The workplace that accepts Specified Skilled Worker (i) foreign nationals carries out nursing care, etc. work. 5. At the workplace that accepts Specified Skilled Worker (i) foreign nationals, the number of Specified Skilled Worker (i) foreign nationals does not exceed the total number of full-time care workers who are Japanese nationals, etc. at that workplace. 6. Being a member of the council on the acceptance of Specified Skilled Worker foreign nationals in the nursing care field established by the Minister of Health, Labour and Welfare (hereinafter the “council”). 7. Taking measures concerning the matters agreed upon through consultation in the council. 8. Providing necessary cooperation to the council. 9. Providing necessary cooperation with the necessary surveys, guidance, collection of information, hearing of opinions, and other work carried out by the Minister of Health, Labour and Welfare or a person entrusted by the Minister regarding the acceptance of Specified Skilled Worker foreign nationals in the nursing care field.
For 32 and 3(33), write “Yes” if all of these 1–9 are met. Pledge 2 is the standard for having the person work in home-visit services.
Writing “Yes” when the pledges are not met makes the application contrary to the facts. In the filled-in sample for the industrial product manufacturing field, 2(8) of For the affiliated organization, etc. 1 is also “○,” but for nursing care it is not required, so do not copy it. How to fill in the written pledge is explained in the following article.
(Sources: Application for Certificate of Eligibility (Filled-In Sample), Application for Certificate of Eligibility (Specified Skilled Worker, Excel), Application for Extension of Period of Stay (Filled-In Sample), Field Reference Form No. 1-1, Written Pledge Concerning the Acceptance of Specified Skilled Worker Foreign Nationals in the Nursing Care Field, Operational Guidelines (Nursing Care Field))
For the affiliated organization, etc. 1: content of the employment contract and occupation number
From here, the 4 pages are prepared by the accepting organization. The 1st page is for the content of the specified skills employment contract. The upper half is as shown in the following image.
Sources: Immigration Services Agency, “Application for Certificate of Eligibility”
1 Name and 2(1) Period of employment contract
In 1, write the name of the foreign national to be employed, in the same spelling as in For the applicant, etc. 1. In 2(1), write the same period of employment contract as in the employment contract and the employment conditions document.
2(2) Specified industrial field and work category: “Nursing care”
The specified industrial field is “Nursing care” (介護), and the work category is also “Nursing care” (介護) (appended table of the Operational Guidelines). The work is physical care, etc. (assistance with bathing, eating, excretion, etc.) and related support work (recreation, assisting with functional training, etc.). Having the person do only related work such as managing notices and posters is not permitted.
Occupation number
For occupation, choose one number for the main occupation from the separate sheet “Occupation List” and write it. If there are other occupations, write their numbers too (multiple choices allowed). According to the notes on the form, the numbers that can be chosen are 1–43, 45–50, 55–81, 100–112, and 999.
The numbers and occupations that can be chosen are as follows (as in the “Occupation List” on the form).
| No. | Occupation | No. | Occupation | No. | Occupation |
|---|---|---|---|---|---|
| 1 | Management | 31 | CAD operation | 64 | Prosthetist and orthotist |
| 2 | Administrative work (excluding managers) | 32 | Cooking | 65 | Attorney |
| 3 | Research and investigation | 33 | Construction techniques unique to foreign countries | 66 | Judicial scrivener |
| 4 | Technology development (agriculture, forestry and fisheries) | 34 | Manufacturing of products unique to foreign countries | 67 | Patent attorney |
| 5 | Technology development (food) | 35 | Processing of jewelry, precious metals, and furs | 68 | Land and house investigator |
| 6 | Technology development (machinery and equipment) | 36 | Animal training | 69 | Registered foreign lawyer |
| 7 | Technology development (other manufacturing) | 37 | Drilling surveys for oil, geothermal energy, etc. | 70 | Certified public accountant |
| 8 | Production management (food) | 38 | Pilot | 71 | Foreign certified public accountant |
| 9 | Production management (machinery and equipment) | 39 | Sports instruction | 72 | Certified tax accountant |
| 10 | Production management (other manufacturing) | 40 | Sommelier | 73 | Labor and social security attorney |
| 11 | Architecture, civil engineering, and surveying technology | 41 | Certified care worker | 74 | Administrative scrivener |
| 12 | Information processing and communication technology | 42 | Research | 75 | Maritime procedure agent |
| 13 | Legal work | 43 | Research guidance | 76 | Writer |
| 14 | Finance and insurance | 45 | Journalist | 77 | Artist and photographer |
| 15 | Copywriting | 46 | News photographer | 78 | Musician and performing artist |
| 16 | News reporting | 47 | Physician | 79 | Religious worker |
| 17 | Editing | 48 | Dentist | 80 | Domestic worker |
| 18 | Design | 49 | Pharmacist | 81 | Professional athlete |
| 19 | Education (education by a person with a teaching license) | 50 | Nurse | 100 | Other service workers (not elsewhere classified) |
| 20 | Education (language education at elementary, junior high, and high schools) | 55 | Public health nurse | 101 | Agriculture, forestry, and fishery workers |
| 21 | Education (specialized training colleges) | 56 | Midwife | 102 | Product manufacturing and processing workers (metal products) |
| 22 | Education (miscellaneous schools) | 57 | Assistant nurse | 103 | Product manufacturing and processing workers (excluding metal products) |
| 23 | Education (international schools) | 58 | Dental hygienist | 104 | Machine assembly workers |
| 24 | Education (outside educational institutions) | 59 | Radiological technologist | 105 | Machine maintenance and repair workers |
| 25 | Translation and interpretation | 60 | Physical therapist | 106 | Machine inspection workers |
| 26 | Overseas trade work | 61 | Occupational therapist | 107 | Construction framework workers |
| 27 | Planning work (marketing, research) | 62 | Orthoptist | 108 | Construction workers (excluding construction framework workers) |
| 28 | Planning work (public relations and advertising) | 63 | Clinical engineer | 109 | Other construction and mining workers (not elsewhere classified) |
| 29 | Accounting work | 110 | Transport, cleaning, packaging, and related workers | ||
| 30 | Corporate sales | 111 | Diplomat | ||
| 112 | Official | ||||
| 999 | Other |
The Occupation List has no item for “care worker” (介護職員). “41 Certified care worker” (介護福祉士) is an item for the name of a qualification.
In the practical experience of the supervisor (an administrative scrivener certified as an application agent), for Specified Skilled Worker (i) in nursing care, there is no problem whether the main occupation is “100 Other service workers (not elsewhere classified)” (その他のサービス職業従事者（他に分類されないもの）) or “999 Other” (その他).
2(3)–(7) Working hours, pay, and treatment
- (3) Prescribed working hours (weekly average and monthly average), and whether they are equivalent to the prescribed working hours of regular workers
- (4) Monthly pay (amount paid before tax, excluding allowances such as commuting, housing, and family allowances, and amounts in the nature of reimbursement of actual expenses), the hourly equivalent of the base pay, the monthly pay of Japanese nationals engaged in equivalent work, and whether it is equal to or higher than that of Japanese nationals. If there are no Japanese nationals in equivalent work, write “None” (filled-in sample)
- (5) Method of paying pay (payment in currency / bank transfer)
- (6) Whether there are matters in which the person is treated differently from Japanese nationals because of being a foreign national
- (7) Whether the person will be allowed to take the necessary paid leave when wishing to return home temporarily
Write the same content as in the employment conditions document and the wage payment document. How to fill them in is explained in the following article.
2(8)–(13) Public notice standards, dispatch destination, and employment placement business operator
The lower half of the 1st page is as shown in the following image.
Sources: Immigration Services Agency, “Application for Certificate of Eligibility”
- (8) and (11) Public notice standards: For nursing care, neither needs to be filled in (table under the previous heading)
- (9) Whether the accepting organization will bear the travel cost for returning home when the person cannot bear it and take measures so that departure is carried out smoothly. (10) Whether measures will be taken to understand the person’s health condition and other living conditions. Answer both with Yes or No
- (12) Dispatch destination: Leave blank. In the nursing care field, foreign nationals cannot be made subject to worker dispatch (Article 1 of the Public Notice). The Operational Guidelines state that if an organization dispatches a person or accepts a dispatched person, it will not be able to accept Specified Skilled Worker foreign nationals for 5 years thereafter. The note in the filled-in sample also states that dispatch is permitted only in agriculture and fisheries
- (13) Employment placement business operator: If an employment placement business operator mediated the conclusion of the specified skills employment contract, write its name, corporate number (13 digits), license or notification number, etc.; if not, write “None.” The corporate number is the 13-digit number designated by the National Tax Agency, including the check digit (filled-in sample)
(Sources: Application for Certificate of Eligibility (Specified Skilled Worker, Excel), Application for Certificate of Eligibility (Filled-In Sample), Operational Guidelines (Nursing Care Field))
For the affiliated organization, etc. 2: information on the accepting organization and industry number
The 2nd page is for information on the intermediary organization and the accepting organization (Specified Skilled Worker affiliated organization), and for confirming grounds for disqualification, etc.
Sources: Immigration Services Agency, “Application for Certificate of Eligibility”
(14) Intermediary organization
If there is a party that relays information when an employment placement business operator mediates, write it. The note in the filled-in sample states that this includes overseas sending organizations, and if there is none, write “None.”
3 Specified Skilled Worker affiliated organization: read the note first
The form has a note saying, “For (3) and (8), fill in information on the workplace where the person will mainly work.” (3) is the employment insurance application office number, and (8) is the number of full-time employees.
- (1) Name, and (2) Corporate number (13 digits): Write those of the head office or main office
- (3) Employment insurance application office number (11 digits): The number of the workplace where the foreign national mainly works. Omit it if the workplace is not covered
(4) Industry number
Choose one number for the main industry from the separate sheet “Industry List.” If there are other industries, write their numbers too (multiple choices allowed). The Industry List is as follows (as on the form).
| No. | Industry | No. | Industry | No. | Industry |
|---|---|---|---|---|---|
| 1 | Agriculture and forestry | 17 | Wholesale (textiles, clothing, etc.) | 33 | Accommodation |
| 2 | Fisheries | 18 | Wholesale (food and beverages) | 34 | Food and beverage services |
| 3 | Mining, quarrying, and gravel extraction | 19 | Wholesale (building materials, minerals, metal materials, etc.) | 35 | Living-related services (barber, beauty, etc.) and entertainment |
| 4 | Construction | 20 | Wholesale (machinery and equipment) | 36 | School education |
| 5 | Manufacturing (food) | 21 | Wholesale (other) | 37 | Other education and learning support |
| 6 | Manufacturing (textiles) | 22 | Retail (general merchandise) | 38 | Medical and welfare (medical services) |
| 7 | Manufacturing (plastic products) | 23 | Retail (fabrics, clothing, and personal items) | 39 | Medical and welfare (public health and hygiene) |
| 8 | Manufacturing (metal products) | 24 | Retail (food and beverages <convenience stores, etc.>) | 40 | Medical and welfare (social insurance, social welfare, and nursing care business) |
| 9 | Manufacturing (production machinery and equipment) | 25 | Retail (machinery and equipment) | 41 | Compound services (post offices, agricultural, forestry and fishery cooperatives, business cooperatives <not elsewhere classified>) |
| 10 | Manufacturing (electrical machinery and equipment) | 26 | Retail (other) | 42 | Employment placement and worker dispatching |
| 11 | Manufacturing (transportation equipment) | 27 | Finance and insurance | 43 | Other business services (stenography, word processing, and copying; building services; security services, etc.) |
| 12 | Manufacturing (other <not elsewhere classified>) | 28 | Real estate and goods rental and leasing | 44 | Other services (not elsewhere classified) |
| 13 | Electricity, gas, heat supply, and water | 29 | Scientific research, professional and technical services (academic and development research institutions) | 45 | Religion |
| 14 | Information and communications | 30 | Scientific research, professional and technical services (professional services <not elsewhere classified>) | 46 | Government (except those classified elsewhere) |
| 15 | Transport and correspondence delivery | 31 | Scientific research, professional and technical services (advertising) | 47 | Industries unable to classify |
| 16 | Wholesale (general merchandise <general trading companies, etc.>) | 32 | Scientific research, professional and technical services (technical services <not elsewhere classified>) |
For nursing care facilities and nursing care workplaces, “40 Social insurance, social welfare, and nursing care business” (社会保険・社会福祉・介護事業) is considered the closest, and if the main business is a hospital, “38 Medical services” (医療業). However, there is no material from the ISA indicating the number for nursing care workplaces. Choose according to the organization’s actual business.
(5)–(9) Address, capital, sales, number of full-time employees, and representative
- (5) Address: Location and telephone number of the head office or main office
- (6) Capital, and (7) Annual sales (most recent fiscal year)
- (8) Number of full-time employees: As the note says, write the number of full-time employees at the workplace where the person will mainly work
- (9) Name of the representative
The “number of full-time care workers who are Japanese nationals, etc.” in the workplace overview (Field Reference Form No. 1-2) is limited to staff whose main job is nursing care and does not include technical intern trainees, etc. The scope of counting differs from (8), so do not confuse them.
(10) Workplace where the person will work
Write the name and address of the workplace where the foreign national will actually work. Make it the same as the workplace name on the back of the council certificate and the workplace name in the workplace overview.
In the same field, answer whether the workplace is covered by health insurance and employees’ pension insurance, and whether it is covered by industrial accident insurance and employment insurance, and write the labor insurance number. Write the last 4 digits of the labor insurance number only if they have been assigned. If there are several numbers, write the workplace names, addresses, and labor insurance numbers on a separate sheet (filled-in sample).
If the workplace where the person works is changed after acceptance, file a notification of change to the specified skills employment contract within 14 days of the change and attach the workplace overview. The council procedures are explained in the following article.
(11)–(21) Confirmation of grounds for disqualification, etc.
Answer Yes or No to questions such as violations of labor, social insurance, and tax laws; involuntary separations or missing persons within 1 year; and criminal penalties, bankruptcy, revocation of technical intern training plan certification, misconduct, and relationships with organized crime group members of the accepting organization, its officers, the support manager, and the support staff. These fields are common to all fields. To avoid writing “No” contrary to the facts, check this for the officers as well.
(Sources: Application for Certificate of Eligibility (Specified Skilled Worker, Excel), Application for Certificate of Eligibility (Filled-In Sample), Operational Guidelines (Nursing Care Field), Operational Guidelines for the Acceptance of Specified Skilled Worker Foreign Nationals (Main Text))
For the affiliated organization, etc. 3: system for honoring the contract and system for support
The 3rd page is for the system for honoring the employment contract and the system for support when the company provides support itself. The fields filled in differently for nursing care are (27), (28), and (33).
Sources: Immigration Services Agency, “Application for Certificate of Eligibility”
- (22)–(26): Answer Yes or No as to whether organized crime group members, etc. control the business activities, whether documents on the activities will be kept for at least 1 year from the end of the contract, whether the organization has not concluded a contract while aware of a contract for a deposit or penalty, whether it has not concluded a penalty contract, and whether it will not have the foreign national bear support costs
- (27) and (28): Fields for cases where the foreign national is made subject to worker dispatch. Leave them blank for nursing care
- (29)–(32): Measures such as enrollment in industrial accident insurance (in the filled-in sample, “enrollment in industrial accident insurance”), a system for continuously performing the contract, paying pay by bank transfer, etc., and cooperation with local governments’ measures for an inclusive society. In (32), write whether a confirmation of cooperation has been submitted to the heads of the municipalities of the workplace location and the place of residence, and the date and destination of submission
- (33): Public notice standards field; for nursing care, “Yes” if all the matters in the written pledge are met
- (34)–(38): Names, affiliations, and positions of the support manager and support staff, support achievements and experience, the system for providing support in a language the foreign national can fully understand, etc. If implementation of the entire support plan is entrusted to a registered support organization, (34)–(42) do not need to be filled in
(Sources: Application for Certificate of Eligibility (Specified Skilled Worker, Excel), Application for Certificate of Eligibility (Filled-In Sample))
For the affiliated organization, etc. 4: support plan, registered support organization, and name entry
The 4th page is for the content of the support plan, the registered support organization, and the final name entry.
Sources: Immigration Services Agency, “Application for Certificate of Eligibility”
- (39)–(41): Neutrality of the support manager and support staff, whether the organization has failed to provide support within the past 5 years, and the system for regular interviews. Not required if everything is entrusted
- (42): Public notice standards field; not required for nursing care
- 4 Support plan (Support plan for Specified Skilled Worker (i) foreign nationals): Answer Yes or No as to whether pre-arrival guidance, airport pick-up and drop-off, securing housing, contracts necessary for daily life, orientation on daily life, opportunities to learn Japanese, responding to consultations and complaints, regular interviews, etc. will be carried out. Make it the same as the support plan document. For nursing care, 4(14) and 4(16) are not required
- 5 Registered support organization: If implementation of the entire support plan is entrusted, write the name, corporate number, registration number, registration date, office providing support, support manager and support staff, available languages, support commission fee (monthly / per person), etc.
The support plan in the extension form has no field for the pre-arrival or pre-change guidance, so the field numbers differ from those in the Certificate of Eligibility and change forms. Look for the 2 fields that are not required by the wording in the table under the public notice standards heading. Finally, enter the name of the Specified Skilled Worker affiliated organization and the name of the representative, and write the date of preparation of the application.
(Sources: Application for Certificate of Eligibility (Specified Skilled Worker, Excel), Application for Extension of Period of Stay (Specified Skilled Worker, Excel), Application for Certificate of Eligibility (Filled-In Sample))
When you finish: a checklist for comparing with the attached documents
So that there are no inconsistencies between the application form and the attached documents, check them against each other with the following table when you finish.
| Field on the application form | Document to compare | What should match |
|---|---|---|
| Person’s name, date of birth, passport number | Passport (for change and extension, also the residence card) | Spelling and numbers |
| Test names and test locations for skill level and Japanese language ability | Pass certificates and result notices | Test names and the country where the test was taken |
| Technical Intern Training (ii) completed with good results | Pass certificate for the specialist-level practical test, evaluation report | Job category “Nursing care” and work “Nursing care” |
| “Yes” for public notice standards | Written pledge (Field Reference Form No. 1-1) | Whether all the pledges are met |
| Name and address of the workplace where the person will work | Back of the council certificate, workplace overview | Workplace name |
| Period of employment contract, working hours, pay | Employment conditions document, wage payment document | Figures and periods |
| Support fields, registered support organization | Support plan, support entrustment contract | Scope of entrustment and fees |
Frequently asked questions
Q. Do people who have obtained the certified care worker qualification also use this application form? A. For people who work as certified care workers, there is a separate status of residence, “Nursing Care” (介護), and the application form is also different. Which one to choose depends on individual circumstances, so consult a specialist or the Regional Immigration Services Bureau.
Q. Where on the application form do we write that we plan to have the person work in home-visit care? A. There is no dedicated field on the application form. The Operational Guidelines state that the matters to be observed for home-visit services are checked not at the time of the application to the Regional Immigration Services Bureau, but by the organization conducting patrol visits, etc. before the person is engaged in the work.
Q. Do we fill in the skills and Japanese fields for an extension too? A. The extension application form also has these fields, and they are filled in in the filled-in sample. However, the only field-specific attachments listed in the List of Documents to Be Submitted for extension (nursing care) are the workplace overview and the council certificate.
Q. Is a seal required on the application form? A. The ISA’s page listing the forms states that, in principle, a seal is not required on submitted documents, including the application form.
(Sources: Operational Guidelines (Nursing Care Field), Application for Extension of Period of Stay (Filled-In Sample), Table 3-1 (for extension, excluding agriculture and fisheries), Immigration Services Agency, “List of Application and Notification Forms Related to Specified Skilled Worker”)
Summary
- The application form has 7 pages: For the applicant, etc. 1–3 are prepared by the person, and For the affiliated organization, etc. 1–4 are prepared by the accepting organization
- The purpose of entry and desired status of residence is “Specified Skilled Worker (i).” There is no (ii) in the nursing care field
- People who prove their Japanese by test write 2 test names. The filled-in sample is an example from another field, so do not copy the test names
- For public notice standards, 32 in For the applicant, etc. 3 and (33) in For the affiliated organization, etc. 3 are “Yes,” and the others are not required. The condition for “Yes” is that all 9 pledges in the written pledge are met
- The work category is “Nursing care,” and the occupation and industry are chosen by number from the lists on the form. Leave the dispatch destination field blank
- When you finish, compare it with the attached documents. If you are unsure because of individual circumstances, consult the Regional Immigration Services Bureau or a specialist (administrative scrivener)
Primary Sources Referenced in Article Creation
- Immigration Services Agency, “Status of Residence ‘Specified Skilled Worker'”
- Application for Certificate of Eligibility (Specified Skilled Worker, Excel)
- Application for Certificate of Eligibility (Filled-In Sample)
- Application for Change of Status of Residence (Specified Skilled Worker, Excel)
- Application for Change of Status of Residence (Filled-In Sample)
- Application for Extension of Period of Stay (Specified Skilled Worker, Excel)
- Application for Extension of Period of Stay (Filled-In Sample)
- Operational Guidelines on the Acceptance of Specified Skilled Worker Foreign Nationals in Specific Fields (Nursing Care Field, revised April 21, 2025)
- Field Reference Form No. 1-1, Written Pledge Concerning the Acceptance of Specified Skilled Worker Foreign Nationals in the Nursing Care Field
- Immigration Services Agency, “Specified Skilled Worker Operational Guidelines” (Field Reference Forms No. 1-1 and No. 1-2)
- Operational Guidelines for the Acceptance of Specified Skilled Worker Foreign Nationals (Main Text)
- List of Documents to Be Submitted, Table 1 (for Certificate of Eligibility, revised October 9, Reiwa 8)
- List of Documents to Be Submitted, Table 3-1 (for extension, excluding agriculture and fisheries)
- Immigration Services Agency, “List of Application and Notification Forms Related to Specified Skilled Worker”
- Ministry of Health, Labour and Welfare, “Acceptance of Specified Skilled Worker Foreign Nationals in the Nursing Care Field”
This article is a translation of the original Japanese version.
