司法書士宮城事務所　

・ 戸籍証明書Certificate of Family Register
・全部事項証明Certificate of All Records
・ 個人事項証明Certificate of Individual Records
・ 本籍Registered Domicile
・ 氏名Name
・ 戸籍事項Matters of the Family Register
・ 戸籍改製Revision of the Family Register
・ 改製日：平成25年5月15日Date of Revision:May 15th, 2013 
・改製事由：平成6年法務省令第51号附則第2条1項による改製
Reason of Revision: Revision of Family Register pursuant to Article 2, paragraph 1of Supplementary Provisions, Ordinance of the Ministry of Justice
・ 戸籍編製Compilation of the Family Register
・ 編製日Date of Compilation 
・ 戸籍謄本Cerｔified copy of Family Register
・ 改製原戸籍謄本Certified copy of Invalidated Family Register
・ 除籍謄本Certified copy of Closed Family Register
・ 転籍Transfer of the Registered Domicile
・ 転籍日Date of Transfer 
・ 氏変更日Date of Surname Change
・ 氏変更の事由Reason of Surname Change
・ 従前の記録Previous Record
・ 戸籍法107条1項の届出
Notification pursuant to Article 107, paragraph 1 of Family Registration Act
・ 戸籍法77条の2の届出
Notification pursuant to Article 77, paragraph 2 of Family Registration Act
・ 更正日Date of Correction
・ 更正事由Reason of Correction
・ 地番号の変更Change of Area Number
・ 行政区画の変更Change of Administrative District
・ 土地の名称の変更Change of Land Name
・ 街区符号の変更Change of District Sign
・ 従前本籍Previous Reｇｉｓｔｅｒｅｄ　Record 
・ 戸籍に記録されている者Person Recorded in the Family Register
・ 生年月日Date of Birth 
・ 配偶者区分Marital Status 夫：Husband 妻：Wife

・ 父Father
・ 母Mother
・ 続柄Relationship
・長男　First Son 　 長女 First Daughter
・二男　Second Son 　 二女 Second Daughter
・三男　Third Son 　 三女 Third Daughter
・ 身分事項Matters of the Personal Status / Personal Particulars
・ 出生Birth
・ 出生日Date of Birth
・ 出生地Place of Birth 
・ 届出日Date of Notification
・ 届出人Person Who Made the Notification / Notified by
・ 認知日Date of Affiliation
・ 胎児認知日Date of Affiliation Before Birth
・ 認知者氏名Person who affiliated　/ Affiliated by Affiliated 
・ 認知者の戸籍Family Register of the person who affiliated
・ 送付を受けた日
Date When the Forwarded Notification Was Received/ Date of Receipt
・ 受理者Person Who Accepted the Notification / Received by
・ 国籍留保Reservation of Nationality
・ 国籍留保の届出日Date of Notification for Reserving Nationality 
・ 国籍選択Selection of Nationality
・ 国籍喪失Loss of Nationality
・ 婚姻Marriage
・ 婚姻日Date of Marriage
・ 離婚Divorce
・ 離婚日Date of Divorce
・ 配偶者氏名Nama of the Spouse
・ 従前戸籍Previous Family Register 
・ 入籍戸籍Next Family Register
・ 除籍Removed
・ 分籍Establishment of Branch Family

・ 新本籍New Registered Domicile 
・ 称する氏Adopted Surname 夫の氏　Surname of the Husband 　　妻の氏　Surname of the Wife
・ 発行番号Number of Issue
・これは、戸籍に記録されている事項の全部を証明した書面である。
This is a document certifying all matters recorded in the Family Register.
・これは、戸籍中の一部の者について記録されている事項の全部を証明した書面である。
This is a document certifying all matters recorded with regard to one/some of the persons recorded in the Family Register.
・ 調停成立日Date of Mediation Settlement
・ 和解成立日Date of Court-Mediated Settlement
・ 裁判確定日Date of Final Court Decision
・ 養子縁組Adoption
・ 養子Adopted son
・ 養女Adopted daughter
・ 養父Adoptive father
・ 養母Adoptive mother
・ 養親Adoptive parents
・ 共同縁組者Joint adopter
・ 親権者父Father as custodial parent
・ 親権者母Mother as custodial parent
・ 代諾者Legal representative

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