Security Initial Listing Application Form

Month DD, YYYY

To

President & CEO, Tokyo Stock Exchange, Inc.

Address of Head Office or

Main Office of Business

Name of Company

Name (signature) and

Title of Representative

(Company Name) ("Company") understands the contents of the Special Regulations of Securities Listing Regulations Concerning Specified Listed Securities and other rules and regulations specified by TSE, and hereby applies for an initial listing in accordance with Rule 209, Paragraph 1 of such Special Regulations. All the descriptions included in this application form and other attached documents are true.

1.	Trade Name or Official Name

2.	Address of Head Office or Main Office of Business

Postal Code:
Tel.:	Fax:	Country of Establishment:
Email:

3.	Contact Person of Applicant

Name:
Title:
Tel.:
E-mail:

4.	Issue Name and Other Information of Bond pertaining to Initial Listing Application

Issue Name:	New Securities Code:
Type of Bond:	Total Issuance Value or Total Sale Value:
Date of Submission of Program Information:

5.	Preferred Date of Listing Approval:

6.	Other Confirmation Matters

Status of Obtaining Credit Rating

Name(s) of Lead Managing Underwriter(s)

7.	ESG Bond Information

We would like to post ESG Bond Information on the JPX website1:

Use of Proceeds and Information concerning Principles/Guidelines aligned to/referred to (e.g. Green Bond Principles (ICMA)/Green Bond Guidelines (Ministry of the Environment, Government of Japan))

Documents we would like to post on the JPX website, other than "Use of Proceeds" 2

External Review:	Reporting:
Other related information: If "Yes", please indicate the name(s) of the document(s):

Notes

If "Yes", please submit a document related to (a) in PDF format.

If "Yes", please submit the document(s) together with this application form, or separately, in PDF format.

Signed by a duly authorised officer (e.g. Director) for and on behalf of:

Legal Name of Company:

Signed:	Full Name in Print:
Title:	Date:

* Personal information provided in this application form and accompanying documents shall be used solely for the purpose of correspondence between TSE and your company.