戸籍 全部事項証明(試訳)

CERTIFICATE OF FAMILY REGISTER
Certificate of All Records                               
Registered Domicile


x-x,xx-machi,Onojo City, Fukuoka Prefecture, Japan

Particulars of Register

Amendment of Register Date of Amendment:
Reason of Amendment:

Person Recorded in the Register
Name:
Date of Birth:         Marital Status:
Father:
Mother:
Relationship:
Personal Particulars

  Birth
Date of Birth:
Place of Birth:
Date of Birth Notification:
Notified by:
Marriage Date of Marriage:
Name of Spouse:
Date of Receipt:
Received by:
Previous Family Register:
Person Recorded in the Register
Name:
Date of Birth:         Marital Status:
Father:
Mother:
Relationship:
Personal Particulars
  
Birth
Date of Birth:
Place of Birth:
Date of Birth Notification:
Notified by:
Marriage Date of Marriage:
Name of Spouse:
Date of Receipt:
Received by:
Previous Family Register:
Person Recorded in the Register
Name:
Date of Birth:
Father:
Mother:
Relationship:
Personal Particulars
  
Birth
Date of Birth:
Place of Birth:
Date of Birth Notification:
Notified by:
Issue No:

( 2/2 ) Certificate of All Records
Person Recorded in the Register
Name:
Date of Birth:        
Father:
Mother:
Relationship:
Personal Particulars
  
Birth
Date of Birth:
Place of Birth:
Date of Birth Notification:
Notified by:
Person Recorded in the Register
Name:
Date of Birth:        
Father:
Mother:
Relationship:
Personal Particulars
  
Birth
Date of Birth:
Place of Birth:
Date of Birth Notification:
Notified by:
From here down blank

Issue No:
    
This document is an authentic description of all particulars recorded in the Family Register.

Month Date, Year
○○ City,○○ Prefecture