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Jushiro Ukitake called it a "Seal of Approval", and it is given to Substitute Shinigami who have both survived the process to become a Substitute Shinigami permanently and have gained acceptance and approval from Seiretei. If I'm not mistaken, Ichigo is one of the only people to have survived the process, and is therefore the only person to actually be a Substitute Shinigami and have a Seal of Approval.