Personal information protection policy, etc.
＜Procedures for Requests for Disclosure, etc.＞
●Method of request
To make a request, please fill out the prescribed request form, attach the necessary documents for identification, and mail it to the address below.
Requests by telephone, fax, e-mail, or in person will not be accepted.
Please note that requests will only be accepted by our Personal Information Consultation Service.
<Destination>
Toranomon Towers Office, 7th floor, 4-1-28 Toranomon, Minato-ku, Tokyo 105-0001, Japan
SymBio Pharmaceuticals Limited Personal Information Consultation Desk
●Required documents for identification
Please prepare the following documents (both (1) and (2)) for each request. However, if you are making multiple requests at the same time, you do not need to prepare duplicate documents. These documents will be returned when we send you our response.
(1) One copy of a "driver's license" or "passport
(2) One original of a "certificate of residence" or "certificate of seal registration" (issued within the last three months) .
*If you do not have (1), a copy of your "health insurance card" or "pension book" and an original of your "certificate of residence" or "certificate of seal registration" (issued within the last 3 months)
* "Resident's card" does not include my number (personal number) or registered domicile
●Request by proxy
In the case of a request by a representative (please enclose the following documents)
Documents verifying the identity of the person making the request → Same as the above-mentioned documents required to verify the identity of the person making the request
One of the above-mentioned documents for identification of the representative
Confirmation of authority of representation
Legal representative: Documents confirming the right of legal representation (copy of family register, copy of a written judgment)
Voluntary representative: A letter of attorney with the claimant's personal seal affixed and the claimant's certificate of seal registration
*If any of the above documents (including a return postage stamp in the case of a request for disclosure or notification of purpose of use) are missing or incomplete, we will not be able to respond to your request.
*Please be advised that we may contact you by telephone or other means to confirm any unclear points regarding the contents of your request or the application form.
*Please be advised that we may not be able to respond to your request due to reasons stipulated by laws and regulations.
●Fees and Method of Collection for Requests for Disclosure, etc.
A handling fee of 800 yen per request for "Notification of Purpose of Use" and "Disclosure" is required for each case, as the fee will be used to send a written response. Please enclose a self-addressed stamped envelope for 800 yen with the requestor's address written on it. Please note that the amount of the fee is subject to change without notice.
●Response
Based on your request, we will respond to you in writing, or by e-mail. Please note that the written response will be sent within one month of receipt of the request, but may be delayed due to circumstances.
●Cases in which we cannot respond to your request
Please note that we will not respond to requests for disclosure, etc., if any of the following circumstances apply. If we decide not to respond to your request for disclosure, etc., we will notify you to that effect with the reason.
- If we are unable to confirm the identity of the individual making the request or his/her representative.
- When we are unable to confirm the right of representation of the representative when the request is made by the representative.
- When there is a deficiency in the prescribed request documents
- If the fee is not paid within the prescribed period
- When the requested information items do not fall under the category of retained personal data
- When the request for disclosure, etc. is not necessary in accordance with the provisions of the "Act on the Protection of Personal Information"
- If the request is in violation of other laws or ordinances
●Application form (Japanese only)
① Request for “notification of purpose of use” → “(Japanese) Request for notification of purpose of use of retained personal data”
WORD 30KB PDF 90KB
② Request for “disclosure” → “(Japanese) Request for Disclosure of Retained Personal Data”
WORD 30KB PDF 78KB
③ Request for "correction, addition or deletion of content" → "(Japanese) Request for Correction, etc. of Retained Personal Data"
WORD 32KB PDF 81KB
④ Request for “suspension of use or deletion” → “(Japanese) Request for suspension of use, etc. of retained personal data”
WORD 34KB PDF 77KB
⑤ Request for “suspension of provision to third parties” → “(Japanese) Request for suspension of provision of retained personal data to third parties”
WORD 35KB PDF 75KB