Online Application Form for Disclosure of “Qualifications Obtained in Examinations for Sales Representatives, etc.” and “Disciplinary Action Against a Sales Representative” (including incident reports received), etc.
Please fill in the fields below with the required information.
A field marked with is mandatory.
JSDA shall appropriately handle personal information such as your name that you provide in accordance with JSDA’s “Handling of Personal Information” policy.
Please click on the “Submit” button if you agree to our “Handling of Personal Information” policy.
Please be noted that your input data may be lost, resulting in an error, if you do not fill out the form within a certain period of time (about 30 minutes).
Please fill in the following fields, and upload an application form with the identity confirmation documents, etc.
Mandatory field:
(1)Name
(2)E-mail
(3)Your comments (Please enter “Request for disclosure of personal information” in
“Your comments” field)
*Please enter the same e-mail address as that provided in the “Application Form for Disclosure of Personal Information (Qualifications Obtained in Examinations for Sales Representatives, etc.)”
and “Application Form for Disclosure of Personal Information (Disciplinary Action Against a Sales Representative, Incident Reports Received, etc.).”
Optional field:
Organization, Department, and Telephone
*You can submit an application form, etc. even if you do not enter these items.
[Points to note about the identity confirmation documents to be uploaded in the “attached file(s)” field]
- Please submit an image of the identity confirmation document(s) that is clear enough
that the information for identification is legible.
- Please note that only the files in formats of PDF files (.pdf) / MS-Word files (.docx) /
MS-Excel files (.xlsx) can be attached.
- When making a request by an agent, please submit the image data of a letter
granting power of attorney, etc., by attaching in the “attached file(s)” field below.
- If you cannot upload image data such as identity confirmation document(s) and a
letter granting power of attorney, etc., please send the identity confirmation
documents by post separately to the [Point of Contact] below.
[Point of Contact]
Sales Representative Examination & Registration Division,
Japan Securities Dealers Association
Address: 2-11-2, Nihombashi, Chuo-ku, Tokyo 103-0027 JAPAN
Operating Hours: 9am to 5pm JST
(closed from December 31 through January 3, weekends and holidays)
