Please fill out the form in order to submit a certificate of lost time damage to the insurance company.
Updated
An employee of HQ, Japan or GIC : Please send the original form to Shiseido Astech via internal mail or post. When requesting to Shiseido Astech, please attach a document that shows the date of the accident and the month and day when the employee was absent from work due to the accident. And also if you need a withholding tax certificate, please request it together.
An employee of Nasu factory : Please send the original form and a document that confirms the attendance and days off to Shiseido Astech via internal mail or post.
An employee of other affiliated office⇒ please contact HR staff at your office.