Letter Of Attorney (Notification Of Appointment Of Agent)

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To: Personal information counter, Mobilityland Co., Ltd
Letter of attorney (notification of appointment of agent)
Year
Month
Day
Address
Agent
Name
Telephone
I hereby appoint the above person as my agent and delegate the following authority.
Authorization to delegate
- As requested in the separate request, the authority to make requests for disclosure etc. based on the
Personal Information Protection Law
*When delegating the authority to receive the result of disclosure etc, please state that fact within the frame.
Address
Principal
Name
A seal
※To fill in the form
- Please fill in all necessary items.
- Please stamp the seal and submit a seal imprint certificate.
- Personal information entered in this document will not be used for purposes other than responding to
requests for disclosure etc.
Letter of attorney 20060601

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