ࡱ > I K H R $8 bjbj <> . . u u 8 , = d f r Q u u T = = = u 8 = = = = PͿy. L = 6 0 f = , , = , = | = f , . ; : Hitachi Solutions, Ltd. Information Security Administration Division Request Form for Disclosure, etc. of Personal Information Based on Article 29 of Personal Information Protection Law, I am making the following request. --Details-- DateAddress Name 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0( a n d s i g n a t u r e / p e r s o n a l s e a l ) T e l . N u m F a x . N u m E m a i l A d d r e s s R e l a t i o n t o H i t a c h i S o l u t i o n s , L t d . %I n d i v i d u a l C u s t o m e r P u r c h a s e d p r o d u c t n a m e 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 %S t a f f m e m b e r o r w o r k e r f o r p u r c h a s e 00T h e i r c o m p a n y o r o r g . n a m e 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00W o r k l o c a t i o n r e l a t e d t o H i t a c h i S o l u t i o n s , L t d . 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 %S t o c k h o l d e r %H i t a c h i S o l u t i o n s , L t d . e m p l o y e e E m p l o y e e n u m b e r 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 %R e t i r e d s t a f f F o r m e r e m p l o y e e n u m b e r 0 0 0 0 0 0 0 0 0 0 0 0 %O t h e r ( P l e a s e b e s p e c i f i c ) R e q u e s t c o n t e n t s %P u r p o s e - o f - u s e R e p o r t %R e v e a l %C o r r e c t , a d d , o r d e l e t e %S t o p u s a g e o r e r a s e %S t o p p r o v i s i o n t o a t h i r d p a r t y R e q u e s t d e t a i l s R e q u e s t b a s i s B a s i s f o r c u s t o m e r b e l i e v i n g t h a t H i t a c h i S o l u t i o n s , L t d . M a i n t a i n s p e r s o n a l i n f o r m a t i o n C a u t i o n a r y n o t e s 1 P l e a s e a t t a c h c o p i e s o f d o c u m e n t ( s ) p r o v i n g y o u r i d e n t i t y . 2 W h e n s o m e o n e ( s u b s t i t u t e p e r s o n ) i s m a k i n g t h e r e q u e s t o n y o u r b e h a l f , p l e a s e i n c l u d e ( 1 ) C o p i e s o f d o c u m e n t s p r o v i n g t h e i d e n t i t y o f D E ~ 2 z | ~ ȺqdqdWIqd hM h_0 CJ QJ aJ o(hM h_0 CJ QJ aJ h_0 CJ KH QJ aJ o(hM h_0 CJ KH QJ aJ hM h_0 CJ QJ aJ hdb h_0 CJ QJ aJ hM hmJ CJ QJ aJ h_0 CJ QJ aJ o(hmJ CJ QJ hmJ 5>*CJ QJ \o( hJ` hJ` 5>*CJ QJ \h= CJ QJ aJ o(h= h= CJ QJ aJ h` h` B*CJ aJ o(ph333 E d $If $ d $If a$ gdE2 $d a$gdm0 $d a$ d gd= d y p p d $If d $If gd_0 y kd $$If c $0 `' . 0 '6 4 4 c a n | x l Z d $If WD`gdM d $If gd d $If gd_0 z kd $$If c 0 `'. 0 '6 4 4 c a yt_0 | ~ u l d $If $ d $If a$ gdE2 z kdd $$If c 0 `'. 0 '6 4 4 c a yt_0 x o d $If $ d $If a$ gdE2 w kd $$If c 0 `' . 0 '6 4 4 c a < > @ l D H | ( 䤗udd h` h B*CJ aJ o(ph333 h CJ QJ aJ h CJ QJ aJ o(hdb h CJ QJ aJ h5 h_0 CJ QJ aJ h` h_0 B*CJ aJ o(ph333 h_0 CJ QJ aJ o(h_0 CJ QJ aJ hM h_0 CJ QJ aJ hdb h_0 CJ QJ aJ h_0 CJ KH QJ aJ o(hM h_0 CJ KH QJ aJ & x o d $If $ d $If a$ gdE2 w kd $$If c 0 `' . 0 '6 4 4 c a > F { o ] o o o K Jd $If WD `Jgd d $If WDd ` gd d $If gd d $If gdE2 w kdY $$If c 0 `' . 0 '6 4 4 c a < V X z g [ R d $If d $If gd_0 y kd $$If c o 0 `'. 0 '6 4 4 c a d $If WDd ` gd d $If gd ( : < > \ h * , T V X x z | T V X v γre h_0 CJ KH QJ aJ o(h h_0 CJ QJ aJ hM h_0 CJ QJ aJ hdb h_0 CJ QJ aJ h_0 CJ QJ aJ o(hM h_0 CJ KH QJ aJ hM h_0 CJ QJ aJ o(hdb h CJ QJ aJ h CJ QJ aJ o(h CJ QJ aJ h5 h B*CJ aJ ph333 h B*CJ aJ o(ph333 " V X x z y m d $If gd_0 | kd $$If c 0 `'. 0 '6 4 4 c a yt_0 d $If v z | " H J N P R r z 0 0 0 1 L2 R2 2 3 4 4 ̵̪̜̿䒪xkx`U h CJ QJ aJ o(hmJ CJ QJ aJ o(hm0 hm0 CJ QJ aJ hm0 CJ QJ aJ o(Uh hmJ CJ QJ aJ hj.5 CJ QJ aJ hM hmJ CJ QJ aJ o(hj.5 CJ QJ aJ o(h CJ QJ aJ h h CJ QJ aJ h CJ QJ aJ o(h_0 CJ KH QJ aJ o(hM hmJ CJ KH QJ aJ hM hmJ CJ QJ aJ z | N y p d $If d $If gd_0 y kd\ $$If c 0 `'. 0 '6 4 4 c a N P v 0 N2 4 n \ J d WDj^`gdm0 d WDj^`gdj.5 d WDj^`gd d y kd $$If c 0 `'4 0 '6 4 4 c a b o t h y o u a n d t h e s u b s t i t u t e p e r s o n , ( 2 ) D o c u m e n t p r o v i n g p o w e r o f a t t o r n e y . 3 W h e n r e q u e s t i n g a p u r p o s e - o f - u s e r e p o r t o r r e q u e s t i n g r e v e a l i n g o f i n f o r m a t i o n , p l e a s e p a y t h e t r a n s a c t i o n f e e b e f o r e h a n d . P l e a s e a t t a c h p r o o f o f f e e p a y m e n t ( e . g . , w h e n u s i n g a b a n k t r a n s f e r , a t t a c h t h e A T M r e c e i p t ) 4 H i t a c h i S o l u t i o n s , L t d . w i l l s e n d t h e r e p l y t o t h e a d d r e s s w r i t t e n i n t h e d o c u m e n t p r o v i n g t h e i d e n t i t y o f t h e r e q u e s t e r . O n l y t h e r e q u e s t e r c a n r e c e i v e t h i s l e t t e r ( i . e . , t h e r e c i p i e n t o f t h e l e t t e r i s s p e c i f i e d ) . 5 P e r s o n a l i n f o r m a t i o n e n t e r e d i n t o t h i s r e q u e s t w i l l b e u s e d o n l y f o r t h e p u r p o s e o f c a r r y i n g o u t t h e r e q u e s t e d t a s k s ( s u c h a s r e v e a l i n g i n f o r m a t i o n , e t c . ) . 6 A s a r e s u l t o f H i t a c h i S o l u t i o n s , L t d . s s e a r c h f o r t h e c u s t o m e r s p e r s o n a l i n f o r m a t i o n , i f t h e r e i s a h i g h p o s s i b i l i t y t h a t H i t a c h i S o l u t i o n s , L t d . d o e s n o t p o s s e s s t h i s i n f o r m a t i o n a n d o t h e r H i t a c h i g r o u p c o m p a n i e s d o p o s s e s s t h i s i n f o r m a t i o n , t h e n H i t a c h i S o l u t i o n s , L t d . m i g h t p r o v i d e p e r s o n a l i n f o r m a t i o n o n t h i s f o r m t o t h e H i t a c h i g r o u p c o m p a n i e s 4 :5 @5 ^5 5 5 5 5 :6 h6 6 67 d7 7 7 8 8 8 8 8 8 8 8 8 8 "8 $8 Ǻǰ騤 hmJ h~ j h~ Uh CJ QJ aJ h h CJ QJ aJ h CJ QJ aJ o(hC} CJ QJ aJ hC} hC} CJ QJ aJ h CJ QJ aJ o(hC} CJ QJ aJ o( 4 <5 8 8 8 8 8 8 8 8 8 8 8 "8 $8 gd J d WDj^`gd d WDj^`gdC} : &P 1H2P :p . 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