ESOP - Notification of Temporary Departure

1. Name as appears on passport (BLOCK CAPITALS)　　パスポート英語姓名required

SURNAME 姓

GIVEN NAMES 名

MIDDLE NAME ミドルネーム (If Applicable)

2. Email Address　メールrequired

Re-enter

3. Departure Date　出国日required

Year Month Day

4. Return Date　帰国日required

Year Month Day

5. Destination 行き先required

Example: Shanghai, China

6. Flight Number of Depature & Return　行きと帰りのフライトナンバーrequired

Describe the flight number of all the flights you are planning to take, including the connecting flights.
Normally, it should consist of 2~3-digit alphabets and 3~4-digit numbers.

Example: JAL46, NH919
Depature Flight
Return Flight 　

7.Purpose of Departure　出国理由required

Please briefly tell us the purpose of your trip.　一時出国の理由や目的を簡潔にお教えください。