Japanese Tax Refund Application

Please fill out this simple form with as much information as possible - it will take just 4 minutes! Once you complete this form, our representative will contact you within 8 hours !

CONTACT DETAILS
( * - mandatory fields )

Title

First Name *

Middle Name

Surname *

Postal Address *

Email address *

Phone number *

Line Type *

Country Code *

Area Code *

Phone number *

Please send confirmation via SMS to this number

Date of Birth *

DD/MM/YYYY

Which country are you from? *


State *
City *

How did you hear about our service? *

What is the name of that person/organisation? *

EMPLOYMENT INFORMATION

Year of Employment *

Approximate first date of arrival in Japan *

DD/MM/YYYY

Approximate last date of departure from Japan *

DD/MM/YYYY

Visa Type and Programme:

Have you ever filed a tax return with the Japanese Tax Office?

If yes, please give details:

Year:
Refund Amount: JPY

Have you received your pension refund?

Have you received a refund of the 20% tax taken out of your pension refund?

Pension Number (if known)

Do you have your pension book?

Your residing address in Japan *

How many employers did you work for? *


EMPLOYER 1

Company Name
Full Business Address


Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work	DD/MM/YYYY
Approximate date you finished work	DD/MM/YYYY
Do you have your Gensen Choshu-hyo (Statement of Income)?	If yes, please fax, scan and email or post to taxback.com today


EMPLOYER 2

Company Name
Full Business Address


Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work	DD/MM/YYYY
Approximate date you finished work	DD/MM/YYYY
Do you have your Gensen Choshu-hyo (Statement of Income)?	If yes, please fax, scan and email or post to taxback.com today


EMPLOYER 3

Company Name
Full Business Address


Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work	DD/MM/YYYY
Approximate date you finished work	DD/MM/YYYY
Do you have your Gensen Choshu-hyo (Statement of Income)?	If yes, please fax, scan and email or post to taxback.com today


EMPLOYER 4

Company Name
Full Business Address


Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work	DD/MM/YYYY
Approximate date you finished work	DD/MM/YYYY
Do you have your Gensen Choshu-hyo (Statement of Income)?	If yes, please fax, scan and email or post to taxback.com today


EMPLOYER 5

Company Name
Full Business Address


Telephone Number
Fax Number
E-mail Address / Website
Approximate date you began work	DD/MM/YYYY
Approximate date you finished work	DD/MM/YYYY
Do you have your Gensen Choshu-hyo (Statement of Income)?	If yes, please fax, scan and email or post to taxback.com today


Have you also worked in any of the following countries? to select multiple options, hold down the control key while selecting
Did you receive a tax refund?

YOUR FEEDBACK AND ADDITIONAL INFORMATION
Please enter any additional comments and information here:

Please read our terms and conditions and indicate that you accept them in order for your registration to proceed
Yes, I accept the Terms and Conditions *

DON'T FORGET-IMPORTANT!
Once you hit submit you will need to send us your Gensen Choshu-hyo (Statement of Income) from each of your employers (if you have them) - see details on the next page.