When accepting nursing care workers as Specified Skilled Worker (i) (特定技能1号), in addition to the documents common to all fields, you submit the documents only for the nursing care field (Table 3 of the document checklist (提出書類一覧表)). The company prepares two of them: the written pledge (誓約書, Field Reference Form No. 1-1) and the facility outline (事業所の概要書, No. 1-2). The council certificate and the skills and Japanese-language proof are not documents you create; they are documents you “check before submitting.”
This article focuses on the following three points.
- The written pledge is a document where you fill in the addressee and the person responsible for preparing it, and confirm that you are able to keep the nine pledges
- The facility outline is about the facility where the foreign national will actually work. Mistakes are common in how nursing care staff are counted
- For the council certificate and the skills proof, you check that they match the facility name, the expiration date, and the person’s background
The conditions for acceptance and the overall process are in the parent article, and the documents for the whole application and where to submit them are in the list article.
→ Required Documents for Specified Skilled Worker “Nursing Care” | Attachments and Where to Submit for Certificate of Eligibility, Change, and Extension [2026 Edition](https://kisaragi-office.com/immigration_journal/en/archives/5167)
→ [2026 Edition Accepting Specified Skilled Workers in the “Nursing Care” Field: Requirements and Process | Tests, the Council, and Home-Visit Care](https://kisaragi-office.com/immigration_journal/en/archives/2886)
The contents were checked on October 12, 2026 against the Immigration Services Agency (出入国在留管理庁, ISA) document checklists (Table 1 revised October 1, 2026) and the operational guidelines (nursing care field, revised April 21, 2025).
Documents covered in this article and when to submit them
There are four types of documents only for the nursing care field. Which ones you submit depends on the type of application.
| Document | Form / issuer | Certificate of Eligibility / change | Extension | Notification when the workplace facility changes |
|---|---|---|---|---|
| Written pledge | Field Reference Form No. 1-1 | Required | No item in the checklist | － |
| Facility outline | Field Reference Form No. 1-2 | Required | Required | Attach |
| Certificate of membership in the council | The council | Required | Required | － |
| Proof of skills and Japanese | Test organizations, etc. | Those that apply | No item in the checklist | － |
The forms are available in PDF and Word in the nursing care field section of the ISA “Specified Skilled Worker operational guidelines” page. The forms are also posted on the Ministry of Health, Labour and Welfare (厚生労働省, MHLW) page. Old forms may come up in searches, so download the latest form again right before applying.
How to fill out the documents common to all fields, such as the employment contract, the employment conditions, and the support plan, is explained in the following articles.
(Sources: Table 3-1 Nursing Care Field (for Certificate of Eligibility), Table 3-1 Nursing Care Field (for change), Table 3-1 (for extension, excluding agriculture and fishery), Operational guidelines (nursing care field), Immigration Services Agency, “Specified Skilled Worker operational guidelines”)
How to fill out the written pledge (Field Reference Form No. 1-1)
The written pledge is a document in which the accepting company (the specified skilled worker’s affiliated organization (特定技能所属機関)) promises to follow the rules of the nursing care field. The addressee is the “Commissioner of the Immigration Services Agency,” which is printed on the form.
Fields to fill in
The parts you write on the form are the red frames (A to D) in the image below. The large frame in the middle is the printed list of pledges.
Sources: Immigration Services Agency, “Field Reference Form No. 1-1 Written pledge”
| Mark in the image | Field | What to write |
|---|---|---|
| A | Specified skilled worker’s affiliated organization | The company’s name and address |
| B | Specified skilled foreign worker | Name, sex, nationality/region, date of birth |
| C | Date of preparation | The date you prepared the written pledge |
| D | Person responsible for preparation | The person at the company responsible for preparing it |
The form has fields for one foreign national. Writing the foreign national’s name and date of birth exactly as on the passport and residence card helps prevent discrepancies between documents.
The nine pledges (summary)
There are nine pledges. Roughly divided into three groups, they are as follows.
- Work and working style: ① The work assigned is physical care (assistance with bathing, eating, toileting, etc.) and support work incidental to it (running recreation, assisting with functional training, etc.). ② When the worker works in users’ homes, comply with the matters set out in the public notice. ③ Specify in the employment contract that the worker will not be subject to worker dispatch
- Facility: ④ The accepting facility carries out nursing care work, etc. ⑤ The number of Specified Skilled Workers (i) at the facility does not exceed the total number of full-time nursing care staff who are Japanese nationals, etc.
- Council and cooperation with the government: ⑥ Be a member of the council. ⑦ Take the measures agreed upon in the council. ⑧ Cooperate with the council. ⑨ Cooperate with surveys, guidance, etc. conducted by the Minister of Health, Labour and Welfare and others
Things to check before writing
- ② is a promise that applies when you plan to have the worker work in home-visit services. For the conditions, see the following article.
- For ③, check that it does not conflict with the contents of the employment contract. In the nursing care field, workers cannot be accepted in the form of dispatch. The operational guidelines state that if a company dispatches a worker or accepts a dispatched worker, it will not be able to accept Specified Skilled Workers for 5 years thereafter
- ⑤ follows the same idea as the number of people written in the facility outline. Check that it matches the numbers in the outline
The notes on the form state that if you become unable to keep the pledges, you report it to the Commissioner of the Immigration Services Agency and the head of the administrative agency in charge of the field.
(Sources: Field Reference Form No. 1-1 Written pledge, Operational guidelines (nursing care field))
How to fill out the facility outline (Field Reference Form No. 1-2)
The facility outline is about the facility (establishment or service) where the foreign national will actually work. The important point is that you write it for each facility, not for the corporation as a whole.
Fields to fill in
The parts you write on the form are the red frames in the image below. They are ① to ③ in the upper table, “Other special notes” at the bottom, and the date and person responsible for preparation at the end.
Sources: Immigration Services Agency, “Field Reference Form No. 1-2 Facility outline”
| Field | What to write / check |
|---|---|
| ① Name of the facility (with furigana) | The name of the facility where the foreign national will actually work. Match it with the facility name on the back of the council certificate |
| ② Number of Specified Skilled Workers (i) currently accepted | The number of people accepted at that facility |
| ③ Number of full-time nursing care staff who are Japanese nationals, etc. | The total and the number for each of the 4 categories |
| 2 Other special notes | The form gives no instructions on what to write |
| End | The statement “This is true and correct,” the date, and the person responsible for preparation |
Whether to include the person currently applying in ② is not stated in either the form or the operational guidelines. If you are unsure, check with the Regional Immigration Services Bureau (地方出入国在留管理官署, regional immigration office) where you apply.
③ How to count nursing care staff
What you write in ③ is “full-time staff whose main work is nursing care, etc.” The four categories are: Japanese nationals, EPA certified care workers who have passed the national examination for certified care workers, people with the “Nursing Care” (介護) status of residence (在留資格), and people with a status of residence based on personal status or position, such as permanent residents and spouses of Japanese nationals. Under the public notice, special permanent residents are also included in “Japanese nationals, etc.”
| People who are counted | People who are not counted |
|---|---|
| Full-time Japanese nationals whose main work is nursing care, etc. | Technical intern trainees |
| EPA certified care workers who passed the national examination | EPA certified care worker candidates |
| People with the “Nursing Care” status of residence | International students |
| People with a status of residence based on personal status or position (permanent residents, spouses of Japanese nationals, etc.) | Office staff, staff who provide employment support |
| At medical institutions, nursing assistants (under medical fee rules) who provide care for patients’ daily life under the guidance of nurses and others | Nurses and assistant nurses who do nursing work |
| Nurses and assistant nurses who guide those nursing assistants in the same ward | － |
The limit on the number of workers is per facility. Staff at another facility of the same corporation are not counted for this facility.
The specific judgment of “full-time” (such as how to treat part-time staff or staff with multiple roles) is not written in the form or the operational guidelines. If there are staff you are unsure about, check with the MHLW or the regional immigration office before writing. The idea of the limit on the number of workers is also explained in the following article.
Compare ② and ③
Check that the number in ② does not exceed the total in ③. This is the same condition as pledge ⑤. If it exceeds, the facility cannot accept the worker.
When the workplace facility changes
If the facility where the foreign national works changes after acceptance, you submit a notification of change to the specified skilled worker employment contract. The notification is due within 14 days from the date of the change. In the nursing care field, you attach the facility outline for the new facility in addition to a copy of the employment conditions.
With the council, before having the worker work at a facility not registered on the certificate, you apply to register the facility’s information. For the procedure, see the following article.
(Sources: Field Reference Form No. 1-2 Facility outline, Operational guidelines (nursing care field), Operational guidelines on accepting Specified Skilled Workers)
The council certificate: what to check before submitting to immigration
The certificate of membership in the council is issued by the council. It is not a document the company creates, but check the following points before submitting it. Since June 15, 2024, this certificate is required at the time of the residence application even when accepting a worker for the first time.
| What to check | Details |
|---|---|
| Expiration date | 1 year for the first certificate, 4 years after renewal. Renewal is possible from 4 months before the expiration date |
| Back side | Whether the name of the facility where the worker works, the type code, etc. are written (note in the checklist) |
| Facility name | Whether it is the same facility as ① of the outline |
| New workplace | Whether the facility where the worker will newly work is registered. A facility that is not registered cannot accept the worker |
| Name of the certificate | If you join or renew by May 31, 2027, it is issued as the “Certificate of the Specified Skilled Worker Council in the Nursing Care Field” |
The type code is the number in the “Facility Type Code Table,” an attachment to the council’s membership rules. Codes 61 to 74 are “facilities where workers can engage in home-visit services.” When having the worker work in home-visit services, a certificate of conformity for each foreign national is required in addition to the council certificate.
The types of eligible facilities are also explained in the following article.
(Sources: Table 3-1 Nursing Care Field (for Certificate of Eligibility), MHLW, “Acceptance of Specified Skilled Foreign Workers in the Nursing Care Field”, Facility Type Code Table, Specified Skilled Worker Council in the Nursing Care Field: flow of procedures)
Proof of skills and Japanese: what to prepare for each background
The proof of skills and Japanese differs depending on the person’s background. For a Certificate of Eligibility or change, submit whichever of the following four applies.
| Person’s background | Documents to submit | What to check |
|---|---|---|
| Completed a training school for certified care workers | Copy of the graduation certificate | － |
| Completed the 4-year period of stay (在留期間) as an EPA certified care worker candidate | Copy of the result notice of the most recent national examination for certified care workers | Whether they completed work and training for 3 years and 10 months or more, scored at least 50% of the passing score, and scored in all subject groups |
| Satisfactorily completed Technical Intern Training (ii) in nursing care (2 years and 10 months or more) | Copy of the pass certificate for the practical test of the Nursing Care Technical Intern Training Evaluation Test (specialist level); if they did not pass, an evaluation report | See the “Evaluation report” section below |
| None of the above | Copies of the proof of the nursing care skills test and Japanese test, plus a copy of the pass certificate for the Japanese-Language Proficiency Test (N4 or higher) or the result notice of the Japan Foundation Test for Basic Japanese | The name of the test (explained below) |
Test names and the result notice
In the checklist and the operational guidelines, the tests are still called the “Nursing Care Skills Evaluation Test” and the “Nursing Care Japanese Language Evaluation Test,” and the document to submit is written as a “copy of the pass certificate.” On the MHLW page, from the tests held in April 2026 onward, the names became the “Nursing Care Specified Skills Evaluation Test (Skills)” (介護特定技能評価試験（技能）) and the “Nursing Care Specified Skills Evaluation Test (Japanese)” (介護特定技能評価試験（日本語）).
In the new tests, the result appears on the screen when the test ends. Within about 5 business days, you get a “result notice” on a dedicated website. The result notice is valid for 10 years from the test date, and during that period you can get it again from the website.
We could not yet find any ISA guidance on how to submit the result notice of the new tests. It is safer to check with the regional immigration office before applying.
Other things to check
- People who satisfactorily completed Technical Intern Training (ii) in an occupation other than nursing care can omit the documents for the Japanese-Language Proficiency Test and the Test for Basic Japanese. However, a document proving that they satisfactorily completed it is required. The nursing care Japanese test is not exempted
- Documents submitted in a past residence application can be omitted if their contents have not changed and they are still valid. The checklist has a field for writing the date and receipt number of the past application
- If the result notice of the national examination is lost, the MHLW page has information on reissuance
For detailed conditions under which tests are exempted, see the following article.
(Sources: Table 3-1 Nursing Care Field (for Certificate of Eligibility), Operational guidelines (nursing care field), MHLW, “Acceptance of Specified Skilled Foreign Workers in the Nursing Care Field”, Nursing Care Specified Skills Evaluation Test (Skills): test implementation guidelines, Nursing Care Specified Skills Evaluation Test (Japanese): test implementation guidelines)
Evaluation report on technical intern trainees (Reference Form No. 1-2)
The evaluation report is submitted for a person who completed Technical Intern Training (ii) in nursing care but did not pass the practical test of the Nursing Care Technical Intern Training Evaluation Test (specialist level). If the person applied for the test but could not take it because of unavoidable circumstances such as illness, the reason is explained in the evaluation report or other documents.
The evaluation report is prepared by the implementing organization of the training at the time. For supervised-type training, there is also a field for the supervising organization. It is not a document that the company that will now accept the worker prepares itself.
Fields of the evaluation report
| Field | What is written |
|---|---|
| 1 Technical intern trainee | Name, sex, date of birth, nationality/region, implementing organization, supervising organization, occupation, and work |
| 2 Status of the technical intern training | For each month, planned training days, days attended, attendance rate, days absent, and paid leave days taken |
| 3 Skills test / technical intern training evaluation test | Test name, organization, test date, and result; if not taken, the reason |
| 4 to 7 Observations | Observations by the technical intern training instructor, life instructor, person responsible for technical intern training, and supervision manager |
The form has a note that the observation fields should describe specifically what the person has become able to do and to what extent, and their attitude in daily life, while also mentioning their Japanese ability.
When it can be omitted
If the accepting company is the implementing organization that accepted the person as a technical intern trainee, and it has not received an improvement order (改善命令) (including improvement guidance under the old system) within the past year, the pass certificate and the evaluation report can be omitted.
When you cannot get one
The implementing organization at the time may not provide an evaluation report. In that case, it is stated that you can submit the following documents and the ISA may evaluate the case comprehensively. First, consult the regional immigration office.
- A statement of reasons explaining why the evaluation report cannot be submitted (any format)
- A document explaining how the training was carried out, prepared by someone who knows the training situation, such as the technical intern training instructor at the time (any format)
(Sources: Operational guidelines on accepting Specified Skilled Workers, Reference Form No. 1-2 Evaluation report on technical intern trainees, Immigration Services Agency, “List of application and notification forms related to Specified Skilled Worker”, Table 3-1 Nursing Care Field (for Certificate of Eligibility))
Checklist before submitting
- Is the facility name the same in ① of the outline, on the back of the council certificate, and in the place of work in the employment conditions?
- Does ② in the outline not exceed the total in ③? Have you avoided including technical intern trainees, EPA certified care worker candidates, international students, office staff, or nurses in ③?
- Are the foreign national’s name and date of birth in the written pledge the same as on the passport and residence card? Have you written the person responsible for preparation?
- Is the council certificate within its validity period, and is the workplace facility registered?
- Does the skills proof match the person’s background? Are the observations in the evaluation report specific?
Removing discrepancies between documents reduces the causes of being asked for additional submissions (追完, submitting additional documents).
Frequently asked questions
Q. Do we also submit the written pledge for an extension? A. Table 3 for extension lists only the facility outline and the council certificate as documents for the nursing care field. There is no item for the written pledge.
Q. What do we do when moving the worker to another facility of the same corporation? A. Register the new facility with the council, and submit a notification of change to the specified skilled worker employment contract to immigration within 14 days. Attach the facility outline for the new facility to the notification.
Q. Are part-time staff included in the number of nursing care staff in the outline? A. The form and the operational guidelines say “full-time staff,” but the specific treatment of part-time staff is not written. If you are unsure, check with the MHLW or the regional immigration office.
Q. Who can submit the documents to immigration? A. For a Certificate of Eligibility, an agent such as a staff member of the accepting organization can submit. For a change or an extension, in addition to the person themselves, a company staff member who has been approved as an application agent can submit on the person’s behalf. Lawyers and gyoseishoshi lawyers who have filed a notification with the Regional Immigration Services Bureau can also submit on the person’s behalf.
→ How to get and renew the Application Agent Certificate | Application form, required documents, and what registered support organizations can submit [Updated for the revised Gyoseishoshi Lawyer Act](https://kisaragi-office.com/immigration_journal/en/archives/4582)
(Sources: Table 3-1 (for extension, excluding agriculture and fishery), Operational guidelines (nursing care field), Operational guidelines on accepting Specified Skilled Workers, Application for Certificate of Eligibility, Application for Permission to change status of residence, Application for Permission to extend period of stay)
Summary
- There are four types of documents only for the nursing care field: the written pledge, the facility outline, the council certificate, and the proof of skills and Japanese
- The company prepares the written pledge and the outline. Write the outline for the facility where the worker actually works, and be careful about how to count in ③
- Submit the council certificate and the skills proof after checking that they match the facility name, the expiration date, and the person’s background
- When you cannot get an evaluation report or are unsure about a judgment, consult the regional immigration office before applying. When the conclusion changes due to individual circumstances, consulting a professional is also an option
→ Required Documents for Specified Skilled Worker “Nursing Care” | Attachments and Where to Submit for Certificate of Eligibility, Change, and Extension [2026 Edition](https://kisaragi-office.com/immigration_journal/en/archives/5167)
→ [2026 Edition Accepting Specified Skilled Workers in the “Nursing Care” Field: Requirements and Process | Tests, the Council, and Home-Visit Care](https://kisaragi-office.com/immigration_journal/en/archives/2886)
Primary Sources Referenced in Article Creation
- Immigration Services Agency, “Specified Skilled Worker operational guidelines”
- Operational guidelines on accepting Specified Skilled Workers in specific fields (nursing care field, revised April 21, 2025)
- Field Reference Form No. 1-1 Written pledge on accepting Specified Skilled Workers in the nursing care field
- Field Reference Form No. 1-2 Outline of the facility where nursing care work is performed
- Document checklist Table 3-1 Nursing Care Field (for Certificate of Eligibility)
- Document checklist Table 3-1 Nursing Care Field (for change)
- Document checklist Table 3-1 (for extension, excluding agriculture and fishery)
- Operational guidelines on accepting Specified Skilled Workers (main volume)
- Immigration Services Agency, “List of application and notification forms related to Specified Skilled Worker”
- Reference Form No. 1-2 Evaluation report on technical intern trainees
- Immigration Services Agency, “Application for Certificate of Eligibility”
- Immigration Services Agency, “Application for Permission to change status of residence”
- Immigration Services Agency, “Application for Permission to extend period of stay”
- MHLW, “Acceptance of Specified Skilled Foreign Workers in the Nursing Care Field”
- Nursing Care Specified Skills Evaluation Test (Skills): test implementation guidelines
- Nursing Care Specified Skills Evaluation Test (Japanese): test implementation guidelines
- Specified Skilled Worker Council in the Nursing Care Field: flow of procedures (overview)
- (Attachment to the membership rules) Facility Type Code Table
This article is a translation of the original Japanese version.
