Credit card company: Epos Card Co. Guarantor Company: Global Trust Networks Co. (GTN)
申込日 ２０ 年 月 日
㈱エポスカード御中
㈱グローバルトラストネットワークス御中
（ＦＡＸ送付先：ＲＯＯＭ ｉＤサポートデスク）
グローバル 申込書
（立替払委託契約兼保証委託契約申込書）
管理会社記入欄 | 提携先 管理会社 ＴＥＬ 契約予定日 | - | 月 | 日 | - | 支 店営業所名 賃料等合計額/月 | ＦＡＸ | 円 | 担当者 - 前家賃 | - 月分まで受領予定 | |
x x会社 | 仲介会社名 | 担当者 | ＴＥＬ | ＦＡＸ |
Credit card company: Epos Card Co.
Guarantor Company: Global Trust Networks Co. (GTN)
■ A documentary examination and a telephone screening is required. It is not possible to proceed with the examination in case of
insuficient documentation. Please cooperate with us by sending the required documents.
■ The required documents depend on the applicant's type of visa status.
■ We will give calls to the applicant,tenants,family, domestic emergency contact. (Please fill in the following without any omission) Examination time: 10:00~18:00(JST) Our phone number: 00-0000-0000
※Depending on our screening criteria, we may refuse to provide advanced payment. It is not possible to cancel your credit card after signing a contract.
・ The contractor can only apply after agreeing on the (terms and conditions for the use of personal information of the contract for advanced payment on behalf of the customer ) and (terms and conditions for collection, use and provision of personal information ) given in a separate paper. We will perform the examination based on the application contents. The information of your application form and contract will be registered in the Epos Card Co.
associated personal credit information agencies for the purposes of credit decisions and credit management. This information is used by the associated members of the concerned agencies.
・ In case false and misleading information is provided, the application will be dismissed. It is impossible to raise any objections even when the contract is terminated.
※If you are an Epos Card (hereinafter referred to as "Card") member, the payment date and method will be the card payment method.
The applicant (contractor) signs below after agreeing on the terms and conditions for the application mentioned in the separate paper.
(English, Chinese, Korean permitted)
Contractor | FURIGANA | SEX・AGE | NATIONALITY | VISA TYPE | LANGUAGE | |||||
M ・ F Age | JAPANESE ・ ENGLISH | |||||||||
APPLICANT | CHINESE ・ KOREAN | |||||||||
（ ） | ||||||||||
BIRTHDAY | YY | MM | DD | LANDLINE （ ） - | ||||||
ＳＮＳ | □LINE □Skype □WhatsApp □KakaoTalk □WeChat □Viber | MOBILE NO. - - | ||||||||
ID | No phone number Current address Check "✔"if applicable. □ contracted in □ is overseas Japan | |||||||||
Emergency Contact | FURIGANA | RELATIONSHIP | NATIONALITY | LANGUAGE | ||||||
FAMILY EMERGENCY CONTACT | NAME | JAPANESE ・ ENGLISH CHINESE ・ KOREAN （ ） | ||||||||
ADDRESS | Tｅｌ - - | |||||||||
Ｅｍａｉｌ | ||||||||||
※If you do not have a domestic emergency contact information before entering Japan, please submit it to GTN within one month after the contract. | ||||||||||
FURIGANA | RELATIONSHIP | NATIONALITY | LANGUAGE | |||||||
DOMESTIC EMERGENCY CONTACT | NAME | JAPANESE ・ ENGLISH CHINESE ・ KOREAN （ ） | ||||||||
ADDRESS | 〒 | LANDLINE （ ） - | ||||||||
MOBILE NO. - - | ||||||||||
Other Tenant | FURIGANA | SEX | BIRTHDAY | CONTACT INFORMATION | ||||||
NAME | M ・ F | YY （ | MM DD Age) | LANDLINE （ ） - MOBILE NO. - - | ||||||
COMPANY NAME | RELATIONSHIP | |||||||||
PHONE NO | ADRESS | |||||||||
以下、該当箇所にレ点チェックをお願いします
商品種別 【2205】 | □ グローバルプラン６０ | □ グローバルプラン８０ | □ グローバルプラン１００ |
オプション | □ ALL （月次保証料 ＋ １％） | ||
※2022年5月23日より申込可
必要書類 | 基本 | □ 在留カード（裏・表） ※拡大コピーのご協力をお願いします □ 入居申込書 ※貴社仕様の書式で結構です ※ 在留カードがまだ交付されていない方は、代わりに パスポート （顔写真ページ） のコピーをご提出ください | |||||
補足 | 学生 | 在学中 | □ 学生証 | 就労者 | 在職中 | □ 社会保険証または給与明細３ヵ月分 | |
入学前 | □ 入学許可書又は合格通知書 | 入社前 | □ 内定通知書または雇用契約書 | ||||
複数入居の場合 | □ 入居者全員の在留カード | 未就労者（転職中含む） | □ 通帳コピー（名義ページ＋最新の残高ページ） | ||||
※申込者様のビザによって追加書類が必要な場合があります
▽メモ・通信欄
(2022.5)
Epos Card Co., Ltd.
Agreement on the Handling of Personal Information in terms of the Payment Consignment Agreement（Excerpt）
Article 1 （Collection, possession and use of personal information）
[1]The applicant (hereinafter referred to as "B" after the conclusion of this contract) for the advance payment consignment contract (hereinafter referred to as "this contract") agree that Epos Card Co., Ltd. (hereinafter referred to as "C") shall subject to collect, hold, and use the following information after taking protective measures for the credit judgment and post-credit management of this contract (including the application; the same shall apply hereinafter).
If the applicant is already a credit card member at the time of application and the information in (1) is different from the information registered as a credit card member, the application for this contract will also serve as a notification of change and the registered information shall be changed. （１）In regards to this contract, all the information provided on this contract's application, this contract, moving in application and the lease contract such as the applicant's name, gender, age, date of birth, address, telephone number, place of work, phone number of the place of work, family structure, housing status, email address etc. and others information that C could know based on the information provided on the application. （２）Location of rental property, property name, rent, security deposit, and other contract conditions.（３）Information that C could know accompanying with this contract such as the applicant, planned roommate, emergency contact or joint guarantor information, etc.,（４） Information contained in the identity verification documents submitted by B responding to C's request.（５） Transaction information such as monthly repayment status after the conclusion of this contract.（６)The credit usage history of the applicant collected when C was investigating about the applicant's solvency , the past debt repayment status, and the withholding slip, etc. submitted by B responding to C's request, etc.（７）Recorded information about all the communications when receiving contacts and inquiry from the applicant.（８）Information written on the applicant's residence certificate, etc. acquired by C for purpose of contract management after the conclusion of this contract.（９）Information that is open to the public such as official bulletins and telephone directories.[2] Applicant agree that the personal information in paragraph 1 (1) shall be used for the following purposes which is apart from the purpose in the Article 1 Paragraph (1). (1)Notification of new product information in terms of C's business, related after-sales service. (2)Market research and product development in term of C's business. (3) Business activities such as sending promotional materials and printed materials in terms of C's business .C's specific business contents is posted on the homepage. (xxxx://xxx.xxxxxxxx.xx.xx). [3]When C entrusts a part of the administrative duties related to this contract to an outsourcing company (computer office work, payment settlement and related works, etc.) , C shall take necessary measures before providing the applicant's information to that company and the entrusted company shall use it only within the consigned scope.[４] B agrees to the following matters in addition to the provisions of [1].
1. When C wants to notify B of important matters, if B‘s cell phone number is registered, C may use Short Message Service (SMS) to get in touch if necessary. 2. When payment is delayed, contacting to cell phone shall be prioｒized with B's agreement. Besides,
if C cannot contact with B using the contact information that C accepted such as home phone or mobile phone, C may contact B's place of work or home country.
Article 2 （Usage and registration to the Credit Information Bureaus）
[1]The applicant agrees that in case the applicant's personal information is registered, C shall inquire of
the personal credit information institution (a party engaged in collecting information on the solvency of an individual and providing the information to the members of the institution) as described in Section 3 to which C is a member, and the personal credit information institution affiliated with the mentioned institution, that use those information for the purpose of investigation on the applicant's solvency.
[2]The applicant agrees that the application's information in terms of this contract, objective transaction facts shalled be registered to the in the personal credit information institution to which C is a member for the period specified in the table below, and shall be used by the the members of the personal credit information agency to which C is a member and of the personal credit information agencies affiliated with that institution to investigate the solvency of the applicant.
[3]The names of the personal credit information agencies that C is a member of are as follows. CIC Co., Ltd., Japan Credit Information Reference Center Corp.
Article 3 （Provision of personal information）
[1]The applicant agrees that C shall provide his/her personal information to the government institutions ,etc. when requested under the provisions of various laws and regulations or when it is necessary for the public benefits.
[2]Since this contract is based on the lease contract between the applicant and the lessor regarding the object property of this contract, the applicant agrees that C shall provide information (1) to the third party and applicant's information on the application in terms of this contract described in (2) to a reasonable extent when requested.（１）Restriction of Provision to a Third Party ①Object Property's Owner （Including new owner）②The lessor of the object property (including those who will become new lessors)③Person who is entrusted with the management of the object property.（２）Information to be provided ① Contents of this contract② Applicant's performance status of this contract ③ Screening result at the time of application for this contract
Article 4（Disclosure / correction / deletion of personal information）
[1]The applicant may request the the personal credit information institution described in Article 2 to disclose personal information about himself / herself in accordance with the provisions of the Act on the Protection of Personal Information.
[2]In the unlikely event that the registered contents of personal information are found to be false, C shall promptly correct or delete it.
Article 5 （In case of disagreement with this agreement）
C may decline this contract if the applicant does not wish to provide the necessary information (on the application form) or if he / she cannot agree to all or a part of this agreement.
Article 6 （Notice of Suspension of use）
Even if C is using the information within the scope of the consent of Article 1 [2], if the applicant requests to stop using, C shall stop using it applicant's personal information after that.
Article 7（Inquiry desk in regard to handling of personal information）
For inquiries about disclosure, correction, deletion of personal information, discontinuation of use, other opinions, etc., please contact the following center. Epos Customer Center x000-00000-00-00 Minamicho, Kokubunji-shi, Tokyo TEL 00-0000-0000
※Personal Information Protection Manager （Representative ）Chief of Customer Center
Article 8（Use of personal information when this contract is not established and after the termination of this contract）
[1]Even if this contract is not established, the fact that this application was made will be used for a certain period of time based on Article 1 [1] and Article 2 [2] (1) regardless of the reason for the failure. However, it will not be used for any other purpose.
[2Even after the termination of this contract, C will retain and use personal information for the specified period specified by law to the extent necessary for the purpose and disclosure request specified in Article 1 [1] and [2].
Global Trust Networks Co.,Ltd.
Provisions regarding collection, use, provision, etc. of personal information
Applicants for warranty assignment contracts (hereinafter referred to as "this contract") (including contractors; hereinafter referred to as “applicant") and potential emergency contacts (including emergency contacts; hereinafter referred to as "emergency contacts"), agree to handle information personal data in accordance with this clause.
Article 1 (Personal information)
1. Personal information refers to the information described in (1) to (3) below. (1) Name, age, gender, date of birth, address, telephone number, registered domicile, work name / address / telephone number, years of service, monthly income stated in the guarantee consignment application form (hereinafter referred to as "application form") prescribed by the Company. , "Attribute information" such as family structure (including change information obtained by the Company after the conclusion of this contract, etc.) (2) "Contract" such as application form, guarantee contract date, lease application property details, etc. regarding this contract "Information" ③ "Transaction information" such as rent payment status after the conclusion of this contract (including change information obtained by receiving notification after the conclusion of this contract) In addition, personal information to the Company by the applicant. Provision is voluntary, but if the specified requirements are not provided to us, we may not be able to carry out the procedures related to this agreement.
Article 2 (Purpose of use)
1. The Company collects and uses personal information regarding the applicant of this contract within the scope of the following purposes of use. (1) For credit judgment regarding "guarantee consignment application" (2) For fulfillment of "guarantee consignment contract" and implementation of after-sales service (3) For reimbursement or advance reimbursement of claims related to fulfillment of guarantee contract (4) Our company that seems to be useful for customers To introduce and provide services (5) In order to carry out other business incidental to the above business In addition, the personal information is to be disclosed to the Company as notification of the purpose of use, disclosure, correction, addition or deletion of the content, You can request suspension of use, erasure, and suspension of provision to a third party.
Article 3 (Sensitive Information)
I agree to send documents of the applicant and emergency contact to the that company intends to enter into this agreement that certify individuals, such as driver's licenses and passports, including to confirm that people's information is true.
Article 4 (Agreement to provide personal information to a third party)
1. The Company will not provide the collected personal information to a third party without the prior consent of the individual, except in the following cases. (1) When required by law (2) When it is necessary to protect the life, body or property of a person and it is difficult to obtain the consent of the person (3) National agency or local public When it is necessary for an organization or a person entrusted with it to cooperate in carrying out the affairs stipulated by law, and there is a risk that obtaining the consent of the person will hinder the performance of the affairs.
2. The applicant and emergency contact agree that we will provide personal information to a third party in accordance with the following provisions. <Purpose of use> (1) Renewal / management of lease contract (2) Performance / management of this contract (3) If the rental property covered by this contract is securitized, etc., in order to carry out the securitization business (4) In order to carry out other business incidental to the above purpose Trust bank, etc.), new lessor (special purpose company), management company (property manager), asset management company (asset manager), storage agency, partner of our group company, Epos Card Co., Ltd. (Nakano-ku, Tokyo) Nakano 4-3-2) <Information provided> Personal information stipulated in Article 1
Article 5 (Outsourcing)
We may outsource all or part of the handling of personal information to the extent necessary to achieve the purpose of use stipulated in Article 2. In that case, we will supervise the contractor as necessary and appropriate so that personal information will be managed safely.
Article 6 (Personal information protection measures)
1. In order to protect personal information, we regularly educate our employees and strictly manage the handling of personal information. 2. We will also take necessary security measures such as restricting and managing access to our database system. 3. When providing personal information to a third party based on the consent of the applicant and emergency contact information, we will carry out necessary and appropriate supervision so that personal information will not be leaked.
Article 7 (Disclosure / correction / deletion of personal information, etc.)
1. The applicant can request a suspension of notification of purpose of use, disclosure, correction, addition or deletion of content, suspension of use, erasure and provision to third parties of information regarding the personal information collected by the Company regarding the applicant and emergency contact . For inquiries, the following "Customer Personal Information Section" will be in charge. 2. If the personal information we hold is found to be inaccurate or incorrect, we will promptly correct or delete it to the latest information. 3. When personal information is used beyond the restrictions of the purpose of use, when personal information is illegally acquired, or when personal information is illegally provided to a third party. We will suspend the use of the personal information or the provision to third parties (hereinafter referred to as "suspension of use, etc.") at the request of the person or emergency contact. However, this does not apply if it is difficult to suspend the use of the service and if necessary alternative measures are taken to protect the rights and interests of the person. 4. The Company will safely and completely erase the applicant and emergency contact information 5 years after the end of the transaction (from the examination result date if the contract is not reached), without obtaining the prior consent of the applicant and emergency contact.
Article 8 (Emergency contact information and its authority)
1. In case of an emergency, our company may not be able to contact the applicant even if we goes to the address notified by the applicant in advance or calls the telephone number. Considering this cases, the applicant shall notify the emergency contact in advance of the address, telephone number, etc. and the purpose of the notification, and obtain consent, and regarding the use of the notification and notification items, etc. We guarantee to the Company that no objection, etc. will be made to the Company regarding the notification and the use of the notification items.
2. The applicant has the authority to cancel this contract, the authority to accept the cancellation from the Company, the authority to surrender the property related to this contract, and the carry-out, transportation, and storage of movables left in the property to the emergency contact.・ The authority to dispose of the property shall be granted in a superimposed manner, and the applicant shall notify the emergency contact in advance to that effect.
Article 9 (Action in case of disagreement with this clause)
If the applicant and emergency contact do not wish to include the necessary articles (matters to be stated on the application form and the contract surface) in this contract, or if all or part of this clause cannot be approved, the Company Shall be able to refuse this agreement. However, if you do not agree to Article 2 (4), we will not refuse this agreement for this reason.
Article 10 (Notification of examination results / expiration date)
The applicant and the emergency contact agree that the Company will notify the management company or the intermediary company of the examination result at the time of the examination by the Company based on the application from the applicant and the emergency contact. In addition, the examination result is given based on the information provided at the moment of the examination, and if there is a significant change in information or changes in the application contents in the applicant and emergency contact information at the time of contract, we will not file an objection even if the contract may not be possible.
Article 11 (Change of Terms)
The Company shall notify the Applicant and the Emergency Contact or notify them in an appropriate manner if the changes may have a significant impact on the Applicant and the Emergency Contact.
Article 12 (Inquiry counter)
For inquiries about personal information, the following "Customer Personal Information Section" will be in charge. (Customer Personal Information Section) Personal Information Protection Manager: General Manager, Finance and General Affairs Department TEL: 00-0000-0000
【Special contract regarding ALL plan]
(1) Persons involved in insurance accidents (repairers, medical institutions, etc.) for the purpose of fulfilling insurance contracts (damage investigation, availability of insurance claims, calculation of insurance claims paid, etc.), judgment of insurance underwriting, provision of various services, etc. Providing or receiving provision to non-life insurance companies / mutual aid, parties to insurance accidents, etc.), business consignees (including insurance agents), and other necessary related parties.
(2) For the sound management of insurance claims payment, provide or register with the General Insurance Association of Japan, General Insurance Rating Organization of Japan, other non-life insurance companies, mutual aid, etc., or receive provision from these persons.
(3) May be provided to the reinsurance underwriter for the purpose of concluding a reinsurance contract, notifying / reporting based on the reinsurance contract, claiming reinsurance, etc.
(4) Special non-public information (sensitive information) such as health care will be acquired, used and provided only to the extent deemed necessary, such as ensuring the proper operation of the insurance business based on the Insurance Business Law Enforcement Regulations.
（2019.1）