昭和二十年勅令第五百四十二號 ｢ポツダム｣宣言ノ受諾ニ伴ヒ發スル命令ニ關スル件ニ基ク衆議院議員ノ議員候補者タルベキ者ノ資格確認ニ關スル件
内務省令第二號

昭和二十年勅令第五百四十二號 ｢ポツダム｣宣言ノ受諾ニ伴ヒ發スル命令ニ關スル件ニ基ク衆議院議員ノ議員候補者タルベキ者ノ資格確認ニ關スル件左ノ通定ム

昭和二十一年一月三十日
内務大臣　三土　忠造

第一條　次ノ衆議院議員ノ總選擧ニ衆議院議員選擧法六十七條第一項又ハ第二項ノ規定ニ依ル議員候補者ノ届出又ハ推薦届出（以下届出又ハ推薦届出ト稱ス）ヲ為サントスル者ハ内務大臣ニ對シ議員候補者タルベキ者ガ昭和二十一年一月四日附聯合國最高司令官覺書公務従事ニ適セザル者ノ公職ヨリノ除去ニ關スル件ニ掲グル條項ニ該當スル者ニ非ザル旨ノ確認ヲ求ムルコトヲ得

第二條　前條ノ確認ヲ求メントスル者ハ速ニ別記様式一ニ依リ議員候補者タルベキ者ノ経歴等ヲ記載セル書面四通ヲ添ヘ其ノ者ノ住居地ヲ管轄スル地方長官ヲ經テ内務大臣ニ其ノ旨ノ申請ヲ為スベシ

第三條　前條ノ申請アリタル場合ニ於テハ内務大臣ハ内閣總理大臣ト協議シ議員候補者タルベキ者ガ第一條ノ覺書ニ該當スル者ニ非ザル者ナルコトヲ確認シタルトキハ別記様式二ノ確認書ヲ公附ス

前項ノ確認者ハ前條ノ規定ニ依ル本人ノ提出ニ係ル書面ニ虚偽ノ記載又ハ事實ヲ隠蔽シテル記載アリタルトキハ其ノ効ナキモノトス

附　則
本令ハ公布ノ日ヨリ之ヲ施行ス

別　記
様式一（議員候補者タルベキ者ノ經歴等ヲ記載セル書面様式）

議員候補者タルベキ者ノ經歴等ヲ記載セル書面　　（記載上ノ一般的注意）

一、書面ハ四通作成ノ上提出スベシ
二、書面ノ記載ハ日文及英文ニテ作成スルモノトシ英文記載事項ハ之ト反對項ノ日文ニ對照スルモノトス日英兩文間ニ於テ相違アル場合ハ英文ニ依ル
三、記載事項ハ楷書（英文ノ場合ハ大文字活字體）ヲ以テ明瞭ニ記入スルヲ要ス
四、各記載事項ハ空白ノ儘之ヲ残サザル様正確ニ且良心的ニ記載スベシ
五、各記載事項中該當事項ナキ場合ハ「該當セズ」又ハ「該當事項無シ」等ノ字句ヲ用ヒ記入シ置クベシ
六、記載スベキ空欄ニ充分ノ餘白無キ場合ハ別添補助紙ヲ用ヒ何レノ記載欄ノ補助紙トシテ用ヒタルカ明ニシ例ヘバ「補助紙ニ續ク」等ノ字句ヲ用ヒ記入シ置クベシ

QUESTIONNAIRE

1.This Questionnaire shall be submitted in four copies.
2.This Questionnaire shall be filled out in both Japanese and English and English version is collated with the Japanese on the opposite page.The English version will prevail if discrepancies exist between it and the Japanese version.
3.Answers must be entered clearly in block letters.
4.Every question must be answered precisely and conscientiously and no space is to be left blank.
5.If the question is inapplicable, so indicate by some appropriate word or phrase such as "none" or #not applicable".
6.Add supplementary sheets if there is not enough space in the Questionnaire. In this case, reference must be made in the space by some appropriate word such as "continued to supplementary sheet".

第一項
（記載項目）
イ　個人的事項
一、氏名　（振假名ヲ附スルコト）

二、従來使用シ又ハ一般ニ通用シタル他ノ名稱（通稱、筆名等）

三、生年月日

四、出生地

五、現住所　（略記セザルコト）

六、本籍地　（略記セザルコト）

七、逮捕セラレタルコトアルノ一切ノ事例及其ノ理由竝ニ有罪ノ判決ヲ受ケタルコトアル犯罪ノ列記

八、議員候補者ノ届出又ハ推薦届出ヲ為サントスル選擧區

（記載欄）

A. PERSONAL
1.Name:　 (Surname)  (First and Middle Name)

2.Other name which you have used or by which you have been known:

3.Date of Birth:

4.Place of Birth:

5.Present address:  (in full)

6.Permanent address:  (in full)

7.List any instances when you have been arrested, together with the reasons therefore, and any crimes of which you have been convicted:

8.Report the electoral district, where you desired file notification of candidacy or where you are going to be recommend for candidacy.

第二項
（記載項目）
ロ　職業及ビ軍務ノ履歴
九、職業ノ履歴　昭和六年一月一日以後在任シタル一切ノ地位ヲ含ム官職又ハ軍務ヲ報告スルニ當リテハ時期ノ如何ヲ問ハズ其ノ占メタルコトアル總テノ官等ヲ記載スベシ

（記載欄）

B. CHRONOLOGICAL RECORD OF EMPLOYMENT AND MILITARY SERVICE

9.In the space below, give s chronological history of your employment, including all of the positions which you have held, since 1 January 1931. In reporting either governmental or military positions, be sure to give all of the ranks which you may, at any time, have held:

第三項
（記載項目）
ハ　國體ノ會員
一〇、大政翼賛會翼賛政治會又ハ大日本政治會トノ關係

各會ノ本部又ハ都道府縣支部ノ會員、創立者、組織者又ハ役員タリシコトノ有無及其ノ他地位

更ニ此等ノ團體ノ刊行物ノ編輯者トシテ活動シタルコトノ有無又ハ此等ノ團體ノ爲何等カノ支部若ハ特別ノ活動ヲ組織シタルコトノ有無及其ノ事實

（記載欄）

C.MEMBERSHIP IN ORGANIZATIONS

10.In the space below, report whether or not you were a member or a founder or organizer or an officer of a national office or of a prefectural or metropolitan sub-division of the Imperial Rule Assistance Association, the Imperial Rule Assistance Political Society, or the Political Association of  Great Japan.Report also whether or not these associations or organized any branches or special activities for any of them:

第四項
（記載項目）
一一、社交、政治、軍事、愛國、職業、文化、名譽、體育、其ノ他ノ諸團體トノ關係

所掲以外ノ一切ノ黨、結社、協會、懇親團體、倶楽部、組合、學會等ノ會員タルカ又ハ會員タリシコトアラバ其ノ團體名尚右ガ秘密結社ナルヤ否ヤヲモ記載スベシ

右團體ニ於テ創立者、組織者、指導者其ノ他ノ要職ヲ占メタルコトノ有無及其ノ地位竝ニ刊行物ノ編輯者タリシコトノ有無

（記載欄）

11.In the space below, report any other party, association, society,fraternity, club, union, institution, whether social, political, military, patriotic, professional, cultural, honorary, athletic or otherwise of which you are or were a member.Make this report whether or not this society was secret.State whether or not you were a founder or organizer or leader, or occupied any post of authority in any such organization and whether you have been an editor of any its publications:

第五項
（記載項目）
一二、家族ノ各種團體ニ對スル關係

家族（父母、配偶者、兄弟姉妹及子）ノ中一〇及一一所掲ノ諸團體ニ於テ――権威アル職務、階級、又ハ地位ヲ占メ其ノ他勢力ヲ有シタル者ノ有無若シ有ラバ其ノ姓名、住所、続柄竝ニ其ノ團體名及地位

（記載欄）

12.Has any member of your family (including your parents, wife or husband, brother or brothers, sister or sisters, or child or children) held office, ranks or post of authority, or been otherwise influential, in any of the organizations listed above? If so give his name and address, his relationship to you and a description of the position which he held and of the organization:

第六項
（記載項目）
一三、各種團體ニ對スル寄附

正規ノ會費ヲ除ク外一〇及一一所掲ノ諸團體ニ對シ直接又ハ間接ニ金銭又ハ財産ノ寄附ヲ爲シタルコトノ有無及其ノ詳細自己ニ代リ又ハ自己ノ慫慂若ハ勢力ニ依リ個人、法人又ハ法的團體ノ爲シタル一切ノ寄附ヲ含ムモノトス

（記載欄）

13.With the exception of regular membership dues, list and give details of any contributions of money or property which you have made, directly or indirectly, to any of the organizations listed above, including any contributions made by any natural or juridical person or legal entity on your behalf or through your solicitation or influence:

第七項
（記載項目）
一四、各種團體ヨリ受ケタル榮譽

一〇及一一所掲ノ諸團體ヨリ何等カノ稱號、階級、徽章、賞状又ハ其ノ他ノ榮譽ヲ受ケタルコトノ有無若シ有ラバ其ノ榮譽ノ種類竝ニ之ヲ受ケタル年月日及其ノ理由

（記載欄）

14.Have your ever been the receipient of any titles, ranks, medals, testimonials, or other honors from any of the above organizations? If so, state the nature of honor, the date conferred and the reason:

第八項
（記載項目）
ハ　其ノ他ノ職務履歴
一五、ロ項及ハ項ニ特記シタル以外ノ職務履歴

（イ）兼務、名譽職等ノ地位

陸海軍若ハ各省其ノ他ノ中央官廰ヲ代表シテ又ハ大政翼賛會、翼賛政治會若ハ大日本政治會又ハ此等ノ機關、關係團體ヲ代表シテ昭和六年一月一日以後、兼務、無給又ハ名譽職トシテ占メタル権威又ハ信用アル地位

（ロ）其ノ他ノ職務

軍事、警察、法律執行、保安若ハ諜報ニ關スル機關、保護観察ニ關スル機關、又ハ思想、言論、宗教、若ハ集會ノ統制ニ關係アル機關ニ於テ昭和六年一月一日以降従事シタル一切ノ職務

（記載欄）

在職期間　　自年月日　　至年月日

團體又ハ機關ノ名稱及種類

占メタル最高ノ地位若ハ階級又ハ勤務ノ種類

右最高ノ地位又ハ階級ニ就ツキタル日

職務

D.RECORD OF OTHER SERVICE

15.With exceptions of those you have specifically mentioned in Section B and C above, list:

(a)Any part time, unpaid or honorary position of authority or trust you have held since 1 January 1931 as a representative of the Army or Navy or of any National Ministry or other Central Government agency or as a representative of the Imperial Rule Assistance Association, the Imperial Rule Assistance Political Society, the Political Association of Great Japan, or their agencies, affiliates, or successor organization:

(b)Any service of any kind you have rendered, since 1 January 1931, in any military, police, law enforcement, peace protection, or intelligence organization or in any organization concerned with Protection and Surveillance and control of thought, speech, religion or assembly.

From:    To:

Name and type of Organization

Highest office or rank you held or type of your service

Date of appointment to highest office or rank

Duties

第九項
（記載項目）
ホ　著述及演説
一六、昭和六年一月一日以降全部又ハ一部ヲ著述シ又ハ編輯シタル一切ノ刊行物ニ付其ノ名稱、出版ノ日、出版者名及概略ノ發行部数數竝ニ右期日後爲シタル一切ノ公開演説ニ付其ノ主題、演説ノ日及概略ノ聴衆數右出版又ハ演説ガ何等カノ機關ノ後援ニ依リタル場合ハ右機關ノ名稱

（記載欄）

（本項ノ記載ハ補助紙ニ之ヲ爲スベシ若シ出版物又ハ演説無キトキハ本欄ニ無ト記載スベシ）

E.WRITING AND SPEECHES

16.List on a separate sheet the titles and publishers of all publications from 1 January 1931 to the present which were written in whole or in part or compiled or edited by you, and all public addresses made by you, giving subject, date and approximate circulation and in the case of speeches, the number in audience. If such publication and speeches were sponsored by any organization give its name. If no speeches or publications write "None" in this space:

第一〇項
（記載項目）
ヘ　法人ニ於ケル地位
一七、記載済ノモノヲ除クノ外昭和六年一月一日以後就職シタル一切ノ法人ノ理事其ノ他ノ執行機關ノ地位及勤務ノ場所（日本本土又ハ海外ノ別）

（記載欄）

法人名

地位

就職ノ日

F.CORPORATE POSITIONS

17.With the exception of those you have specifically mentioned above, list any corporate directorship or executive positions held by you since 1 January 1931 and where you served whether in Japan proper or outside of japan:

(Corporation)

(Position Held)

(Dates)

第一一項
（記載項目）
ト　備考
一八

（記載欄）

G.REMARKS

18.

第一二項

本書面ニ記載ハ眞實ナリ虚僞ノ記載又ハ事實ヲ隱蔽シタル記載ナキコトヲ確認ス
昭和　　年　　月　　日
（署名）　　　（捺印）

I swear that the statements on this Questionnaire are true and that there is no wilful false entries, nor failure to make full and complete disclosures in the above statements.

Signed:　　　　Seal:

(Signature of individual to whom the Questionnaire relates.)

Date:

様式二（確認書様式）

第　　號
議員候補者タルベキ者
住居
生年月日

右ノ者昭和二十一年内務省令第二條ノ規定ニ依リ提出セル書面ニ依リ審査ヲ遂グルニ昭和二十一年一月四日附聯合國最高司令官覺書公務従事ニ適セザル者ノ公職ヨリノ除去ニ關スル件ニ掲グル條項ニ該當スル者ニ非ザル者ナルコトヲ確認ス
　　年　　月　　日
内務大臣　（印）

備考
本確認書ハ本人ノ提出ニ係ル内務省令第二號第二條ノ書面ニ虚僞ノ記載又ハ事實ヲ隱蔽シタル記載アリタルトキハ其ノ効ナキモノトス

昭和21年の省令