서류 · 한국어
비용 납부 양식
Fee payment request and receipt form for consultation or certification services.
- Form type
- fee
- Language
- Korean (한국어)
- Archive source
- AMDA-IMIC Japan forms library, 2013–2024
About This Form
This page documents the 비용 납부 양식 as provided in Korean through AMDA-IMIC's multilingual forms library. The form is used for: fee payment request and receipt form for consultation or certification services..
Medical fee transactions in Japan involve a standardized receipt and payment documentation trail, especially when costs are later submitted to insurers or reimbursed by employers. AMDA-IMIC's fee payment form was used for services where the center itself charged a nominal fee — such as interpreter coordination or document certification assistance — as well as to document fees the patient paid to third-party providers as part of a consultation organized through the center.
For the original administrative forms in active use, contact the relevant Japanese institution directly — a hospital, employer, local health center, or labor bureau — depending on which form is needed. This reference documents the structure and purpose of the forms as they were used during the 2013–2024 period when AMDA-IMIC was operating.
Form Sections and Fields
The following sections and fields appear in the Korean version of this form. Field labels are rendered here in English for reference; the original form presents them in Korean (한국어).
- Service date
- Service type (consultation coordination / certification / interpretation / documentation)
- Patient or client full name
- Patient date of birth
- Fee amount in Japanese yen (JPY)
- Fee breakdown (service fee / documentation fee / interpreter fee / other)
- Payment method (cash / bank transfer / insurance direct billing)
- Receipt number
- Issuing institution name and contact
- Authorized officer name and signature
- Institution seal
How to Obtain This Form
The forms documented on this site were originally distributed by AMDA-IMIC through its consultation service and language-specific subdomains. Since the center closed in 2024, the forms are no longer distributed through that channel. Equivalent forms for current use are available from the relevant Japanese institution: municipal health centers issue administrative forms, hospitals provide their own registration and appointment materials, and the Labor Standards Inspection Office supplies labor insurance documentation.