Types of vaccination certificates

There are two types, one for Japan, one for overseas, and one for Japan, and the description is different.
記載内容の詳細 [67KB pdfファイル] 

* For use in Japan, you can still use the vaccination certificate and vaccination record.

Obtain an inoculation certificate at a store such as a convenience store

The vaccination certificate for those who have registered as a resident in Shiki City at the time of vaccination can be obtained from the terminal in the store such as a convenience store from Tuesday, July 26th.

What you need to use

  • マイナンバーカードと暗証番号4桁(券面事項入力補助用の数字)
    My number card and PIN 4 digits (a number for assisting in entering information on the face of the ticket)
  • 発行料:証明書1通当たり120円(消費税及び地方消費税を含む)。発行枚数に応じた額を要します。印刷不良の場合を除き、発行後の返金には対応できません。
    Issuance fee: 120 yen per certificate (including consumption tax and local consumption tax). It costs an amount according to the number of issued sheets. We do not accept refunds after issuance, except in the case of printing defects.

Available time

From 6:30 to 23:00 (including weekends and holidays, excluding maintenance time including troubleshooting)

Available stores in Shiki city(From Wednesday, August 17th)

店舗名 住所
セブン-イレブン 志木上宗岡4丁目店 上宗岡4-13-12
セブン-イレブン 志木上宗岡5丁目店 上宗岡5-9-12
セブン-イレブン 志木中宗岡店 中宗岡4-20-6
セブン-イレブン 志木大原店 本町4-11-15
セブン-イレブン 志木本町5丁目店 本町5-12-11
セブン-イレブン 志木駅東口店 本町5-24-23
セブン-イレブン 志木幸町3丁目店 幸町3-4-36
セブン-イレブン 志木愛宕通り店 幸町1-6-11
セブン-イレブン 志木柏町4丁目店 柏町4-2-4
セブン-イレブン 志木柳瀬川駅前店 柏町6-29-44


Get the vaccination certificate with the smartphone app

 If you use the smartphone's dedicated app, an inoculation certificate (electronic version) with a two-dimensional code will be issued on your smartphone.You will need to verify your identity with your Individual Number Card before applying. Please see the Digital Agency website for details on how to obtain the dedicated app.

Obtain a written vaccination certificate 

How to apply

志木市新型コロナウイルス感染症ワクチン接種室(〒353-0005 志木市幸町3-4-70)への来所または郵送で、申請書と添付書類を提出。
Submit the application form and attached documents by visiting or mailing to Shiki City COVID-19 Vaccination Support Office(3-4-70 Saiwaicho, Shiki-shi,353-0005). 

It takes about a week to publish.

In principle, one copy will be issued for each application.

The vaccination certificate will be issued by the local government of the place of residence registration as of the date of vaccination.


Example) Shiki citizens first inoculated on June 1 → moved to X city on June 5 → second inoculation on July 1
In this case, apply for the first inoculation to Shiki City and the second inoculation to X City.

The vaccination certificate is for those who have been vaccinated based on the Japanese Vaccination Law, so it is not for those who have been vaccinated overseas.

Application form

新型コロナウイルス感染症予防接種証明書交付申請書 [686KB pdfファイル] 

Attached document

  • [日本国内用の場合Domestic use in Japan]本人確認書類(写しでも可)
    identification document(Can be copied)
  • [海外用及び日本国内用の場合International travel & domestic use in Japan]旅券等の渡航書類(写しでも可)
    present travel document (i.e. passport)(Can be copied)
  • 新型コロナウイルスワクチン接種券(予防接種済証)または接種記録書 (写しでも可)
    Vaccination Ticket for COVID-19(Certificate of Vaccination for COVID-19), or Vacctinated record (Can be copied)
  • 郵送での返信をご希望の方は、返信用封筒(返送先の宛先を記載し、切手を貼り付けたもの)
    If you would like to reply by mail, please send a reply envelope.(The return address is stated and a  stamp is attached.)
Documents required in some cases
  • 旧姓・別姓・別名の併記を求める場合は、旧姓・別姓・別名が確認できる「本人確認書類」例:マイナンバーカード、運転免許証、戸籍、住民票の写し、当該別名・別姓の記載のある外国の旅券
    If you want to write the old surname, another surname, and another name together, you can check the old surname, another surname, and another name. Example: My number card, driver's license, family register, copy of resident's card, foreign passport with the alias and surname
  • 郵送による申請の場合は、住所の記載された「本人確認書類」
    In the case of application by mail, "identification document" with the address. 

If you notice that your vaccination record is missing or incorrect

If you notice that the vaccination record registered at the vaccination medical institution is missing or incorrect, please refer to the "For those who wish to register / correct the new corona vaccination record" page.