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Notation based on the Specified Commercial Transactions Act (example)

Distributor

The method of filling out the form differs depending on whether you are a corporate business owner or a sole proprietor.

Entry field (e.g., for corporate business owners)

- Sample Co., Ltd.

Column to fill in (e.g., for sole proprietors)

- Sample site Sample Hanako

*Please specify the site name and the contract holder's name (same as on your resident card)

Name of the general manager

Sample Hanako

post code

〒000-000

location

Sample 1-1-1, Shibuya-ku, Tokyo

Explanation of fees other than the product price

Shipping fee: 500 yen nationwide Cash on delivery fee: 315 yen

Delivery time

We will ship within 7 days of your order

Payment Methods

Credit card

telephone number

12-3456-7890

email address

Return period: Within 7 days of receiving the product

Returns, exchanges, cancellations, etc.

Return shipping costs: If the product is defective, we will cover the cost. If the product is returned for personal reasons, the customer will be responsible for the shipping costs.

Qualifications and licenses

・Secondhand goods dealer license No. ●●●● Tokyo Metropolitan Public Safety Commission

・Liquor sales license Shibuya Law ●●● Shibuya Tax Office

・Specially controlled medical device sales license

Permit number No.●●●

Sales Manager Name: Wicks Taro

Shibuya Public Health Center

© Kazu Yoshida / Unauthorized reproduction or use of images and text is prohibited. 2025

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