민원서식

외국어 해석본(영어)

Translated forms for foreigner(English)

민원서식 외국어 해석본 (영어) Translated forms for foreigner (English)
연번 (No.)	민원사무명 (Name of a civil affair document)
1	사망신고서 / Report of Death
2	출생신고서 / Report of birth
3	개명신고서 / Report of Name Change
4	혼인신고서 / Report of Marriage
5	이혼신고서 / Report of divorce
6	가족관계등록부 등의 증명서 교부 등 신청서 / Application for Certificates of Family Register
7	인감보호(해제)신청 / Application for the Protection(cancellation the protection) of Personal seal
8	인감(변경)신고서 [서면신고용] / Application for Registration (or Change) of Personal Seal [for written registration]
9	인감증명발급 위임장 및 법정대리인 동의서 / Power of Attorney/Consent of a Legal Representative, Limited guardian or Adult guardian for Certificate of Personal Seal / Written Confirmation by a Diplomatic Mission (Consul) or Prison(Prison Officer) / Written Confirmation by the District Tax Office (Head of the Tax Office)

민원서식 외국어 해석본 (영어) Translated forms for foreigner (English)
연번 (No.)	민원사무명 (Name of a civil affair document)
10	인감(사망·실종신고, 신고사항의 변경, 말소·부활) 신고서 / Application to (Undo the Registration of Personal Seal of the Deceased or the Missing/Change Information of Registered Personal Seal/Undo the Registration of Personal Seal/Re-register a Former Personal Seal)
11	통합신청서(신고서) / Application Form (Report Form)
12	사실증명 발급·열람 신청서 / Application for Issuance of / Access to Certificate of Fact
13	주민등록표 열람 또는 등·초본 교부 신청서 / Application for information on a resident register or for issuance of its copy or abstract
14	전입세대 확인서 / Application for Information on a Household Register or for Issuance of its Cerified Copy
15	주민등록신고서 / Resident Registration on Report
16	주민등록증 분실(철회)신고서 / Resident Registration Card Loss Report(Withdrawal) Application
17	주민등록증 재발급신청서 / Re-issuance Application for Resident Registration Card

[Form No. 19]

Report of Death (..... Day ..... Month ........ Year)	※ Please write after reading the guidelines on the back and, when required to select one option, please circle the number as follows "○".
① Deceased	Name	Korean or English		Sex	Resident Registration No.	-
Chinese characters		□ Male □ Female
Permanent domicile Address
Address		HouseholderㆍRelationship
Date and time of Death	..... Minute ..... Hour ..... Day ..... Month ........ Year (Time at place of death : According to the twenty-four hour clock)
Place of Death	Address	Beonji Ri Dong(Eup,Myeon) Gu(Gun) Si(Do)
Type of location	□ House □ Medical institution □ Social welfare facilities (Home for the aged, Orphanage etc) □ Public establishment (School, Playground etc) □ Road □ Business ▪ Service facilities (Store, Hotel etc) □ Industrial facility □ Farm (Rice paddy, field, barn, fishfarm) □ D.O.A (Dead on arrival) Other
② Other facts
③ Reporter	Name	Seal or signature	Resident Registration No.	-
Relationship	□ Cohabiting blood relative □ Non-cohabiting blood relative □ Cohabitant □ Other (Head of institution /Administrator at place of death)	Relationship
Address		Tel.		E-Mail address
④ Submitter	Name		Resident Registration No.	-

※ The following information is needed for establishing population policies, so you are obliged to declare truth fully under Articles 32 and 33 of the Statistics Law. Please only write the truth your privacy will be strictly protected.

⑤ Cause of death		□	Immediate cause of death									Period from start of disease till death
		□	The cause of □
		□	The cause of □
		□	The cause of □
		Other related physical condition							Diagnostician					□ Doctor □ Oriental Doctor □ Other
⑥ Type of death		□ Death from an illness □ Violent death (Accidental death) □ Other and non-specific ( )
⑦ Details of violent death	Type of Accident	□ Transportation(Traffic) □ Poisoning □ Death from a fall □ Drowning □ Fire □ Other ( )								Intention or not			□ Unintended accident □ Suicide □ Murder □ Unsure
	Date of Accident	..... Minute ..... Hour ..... Day ..... Month ........ Year (According to the twenty-four hour clock)
	Region of Accident	□ Same SiㆍGunㆍGu as current address □ Other SiㆍGunㆍGu( SiㆍDo, SiㆍGunㆍGu) □ Other (please state : )
	Place of Accident	□ House □ Medical institution □ Social welfare facilities (Home for the aged, Orphanage etc) □ Public establishment (School, Playground etc.) □ Road □ Business ▪ Service facilities (Store, Hotel etc) □ Industrial facility □ Farm (Rice paddy, field, barn, fishfarm) □ Other
⑧ Deceased	Nationality			□ Korean □ Naturalized Korean citizen (Previous nationality : )
	Level of completed education			□ Uneducated □ Elementary school □ Middle school □ High school □ University / College □ Graduate school
	Occupation at time of accident or onset of disease							Marital status			□ Single □ Married □ Divorced □ Widowed

※ For official use only

읍면동접수	가족관계등록관서 송부		가족관계등록관서 접수 및 처리
	주민등록 번 호
	년 월 일(인)

Report of Death

(사망신고서)

① Deceased  (사망자)

￭ Please write a deceased's Korean or English name and in Chinese characters.

(사망자의 한글 이름과 한자로 쓰세요.)

￭ Please write a deceased's sex and resident registration number.

(사망자의 성별과 주민등록번호를 쓰세요.)

□ Resident registration number  (주민등록번호)

If a deceased is a foreigner, please write an alien registration number.

(Domestic residency registration number or the date of birth)

(해당자가 외국인인 경우에는 외국인 등록번호(국내거소신고번호 또는 출생연월일)를

기재합니다.)

￭ Please write a deceased's Permanent domicile address.

(사망자의 등록기준지를 쓰세요.)

□ Permanent domicile address: (등록 기준지)

If a deceased is a foreigner, please write the nationality.

(사망자가 외국인인 경우에는 그 등록기준지에 국적을 기재해 주세요.)

￭ Please write a deceased's address. (사망자의 주소를 쓰세요.)

￭ Please write the relations between a householder and a deceased.

(세대주 관계와 사망자의 관계를 쓰세요.)

￭ Please write the date and time at place of death according to the twenty-four

hour clock.

(사망지의 시간을 24시각제로 기재해 주세요.)

□ Date and time of death  (사망 일시)

<Example> PM 2hours 30minutes (X) →14hours 30minutes (O)

Night 1hour 30minutes (X) → Next day 0hour 30minutes (O).

□ If Korea citizens passed away overseas, please write the dead time of local by

A.D.(Anno Domini) and the solar calendar. And when he/she died a period of

summertime, please write the"period of summertime" by the dead time of local.

(우리나라 국민이 외국에서 사망한 경우, 현지 사망시각을 서기 및 태양력으로

기재하시고 서머타임 기간 중에 사망하였다면 사망자 시각 옆에 "서머타임 적용"

이라고 표시하세요.)

￭ Please write an address of deathplace

(사망지 주소를 기재해주세요.)

￭ Please select the deathplace out of following number

(아래의 숫자 중 사망지를 선택해주세요.)

※ Classification of deathplace

□ House 주택

※ The house include the house of deceased, parent and relative.

(주택은 사망 장소가 사망자의 집이거나 부모. 친척 등의 집에서 사망한 경우를

포함합니다.)

□ Medical institution 의료기관

□ Social welfare institution [Home for the aged, Orphanage etc]

(사회복지시설 [양로원, 고아원 등])

□ Public establishment(School, Playground etc) (공공시설(학교, 운동장 등))

□ Road  도로

□ Business ▪ Service facilities.(Store, Hotel etc) 상업 ▪ 서비스시설 (상점, 호텔 등)

□ Industrial facility 산업장

□ Farm(Rice paddy, field, barn, fishfarm) 농장 (논밭, 축사, 양식장 등)

□ D.O.A (Dead on arrival) 병원 이송 중 사망

Other (               )  기타

※ Please write the place included a plane, a vessel, a train etc except above

example. (기타는 예시 외에 비행기, 선박, 기차 등을 포함합니다.)

② Other facts

￭ Please write the reason that a medical certificate of death is not affixed.

(사망진단서를 첨부하지 않은 이유를 기재해 주세요.)

※ If a medical certificate of death is not affixed, please write the reason and

the special requirements for a clear record on a certificate of family relations.

(사망진단서(시체검안서) 미 첨부 시 그 사유 등 가족 관계 등록부에 기록을

분명히 하는데 특히 필요한 사항을 기재한다.)

③ Reporter

￭ Please write the reporter's name, sign or seal and resident registration number.

(신고인의 성명, 사인이나 도장을 찍고 주민등록번호를 기재해주세요.)

￭ Please select the relationship with reporter out of following number.

(아래의 번호 중 신청인의 자격을 선택해 주세요.)

□ Cohabiting relative 동거 친족  □ Non-cohabiting blood relative 비동거 친족

□ Cohabitant 동거자

□ Other [Head of Protective institution/Director at place of death, etc.]

(기타 [보호 시설장/ 사망 장소 관리장 등])

￭ Please write the relations between the applicant and deceased.

(신고인과 사망자와의 관계를 기재해주세요.)

￭ Please write the reporter's address, phone number and e-mail.

(신고인의 주소, 전화번호, 이메일을 기재해 주세요.)

※ Please mark the applicable relationship with the "O" and other includes the

management chief of the deathplace, etc.

(해당되는 자격에 “○”으로 표시하시고 기타는 사망 장소를 관리하는 자 등이

포함됩니다.)

④ Submitter  제출인

￭ Please write a submitter's name and resident registration number.

(제출인의 성별과 주민등록번호를 쓰세요.)

※ (Regardless of the declarer is true or not) 신고인 여부와 관계없음.

[An acceptable official in charge identify the submitter].

([접수한 담당 공무원은 제출인의 신원을 확인한다.])

□ The following information is needed for establishing population policies, so you

are obliged to declare truth fully under Articles 32 and 33 of 「The Statistics

Law」. Please only write the truth your privacy will be strictly protected.

(다음은 국가의 인구정책 수립에 필요한 자료로「통계법」제32조 및 제33조에

의하여 성실응답 의무가 있으며 개인의 비밀사항이 철저히 보호되므로 사실대로

기입하여 주시기 바랍니다.)

⑤ The Cause of Death 사망의 원인

￭ Please write a dead cause as a medical certificate of death.

(사망자의 직접적인 사망 원인을 기재해 주세요.)

□ Immediate cause of death.  사망의 직접적인 원인

□ The cause of □            □ 의 원인

□ The cause of □            □ 의 원인

□ The cause of □            □ 의 원인

□ Please write the same that a medical certificate of death is all cause of death

and another physical condition.

(사망진단서(시체검안서)에 기재된 모든 사망의 원인 및 그 밖의 신체상황 내용을

동일하게 기재합니다.)

※ Period from start of disease till death.  발병부터 사망까지 기간

￭ Please write the period from start of disease till death.

(사망자의 병이 발병부터 사망까지 기간을 기재해주세요.)

※ Another physical condition

￭ Please write another physical condition of deceased as a medical certificate of death.

(사망자의 또 다른 신체상황을 기재해 주세요.)

￭ Please select the diagnosable doctor out of following number.

(아래의 번호 중 사망자의 진단자를 선택해 주세요.)

※ Diagnostician  진단자

□ Doctor 의사  □ Oriental Doctor 한의사  □ Other  기타

⑥ Type of Death  (사망의 종류)

￭ Please select the type of death out of following number.

□ Death from an illness 병사

□ Violent death [Accidental death, etc]  외인사 (사고사, 등)

□ Other and non-specific  기타 및 불상

□ Please write type of death on certificate of death as reference and a violent death of

number includes only accidental death except disease. Also if you select No, please write its contents concretely.

(사망 진단서(시체검안서)에 기재된 사망의 종류는 사망진단서를 참고로 기재하고,

사고사는 진단서상에 외인사에 해당되며, 기타인 경우 그 내용을 구체적으로 기재합니다.

⑦ Details of a violent death  (외인사 사항)

￭ Please select details of a violent death out of following number.

(아래 번호 중 외인사 사항을 선택해 주세요.)

※ Type of an accident  (사고 종류)

□ Transportation(Traffic)  운수(교통)    □ Poisoning  중독

□ Death from a fall  추락             □ Drowning  익사

□ Fire  화재                          □ Other  기타

※ Intentional or not  (의도성 여부)

□ Unintended accident  비의도적 사고   □ Suicide  자살

□ Murder  (타살)                      □ Unsure  미상

※ Date and time of accident  (사고 일시)

￭ Please write the date and time of accident according to twenty-four hour clock.

(사망 일시를 24시각제로 기재해 주세요.)

※ Region of accident  사고 지역

￭ Please select the region of accident out of following number.

(아래의 번호 중에 사고 지역을 선택해 주세요.)

□ A city, country and district like the current address (현주소지와 같은 시군구)

□ Other city, country and district (다른 시군구)

￭ If you select number 2, please write the concrete city, provinces, country, district.

(만약 2번을 선택했다면 자세한 시, 도, 군, 구 기재해주세요.)

(         City/provinces,         country/district)

□ Other  기타

※ Place of accident  (사고 장소)

￭ Please select the place of accident out of following number.

(아래의 번호 중에 사고 장소를 선택해 주세요.)

□ House  주택        □ Medical institution  의료 시설

□ Social welfare institution [Home for the aged, Orphanage etc]

(사회 복지 시설 [양로원, 고아원 등])

□ Public establishment(School, Playground etc.)  공공시설 (학교, 운동장 등)

□ Road  도로

□ Business ▪ Service facilities(Store, Hotel etc)  상업 ▪ 서비스 시설 (상점, 호텔 등)

□ Industrial facility (산업장)

□ Farm(Rice paddy, field, barn, fishfarm)  농장 (논밭, 축사, 양식장 등)

□ D.O.A (Dead on arrival).  병원 이송 중 사망

Other  기타

□ In case of an accidental death write as certificate of death equally. If it is not

recorded the contents, please write type of accident, region and place of

accidental occurrence concretely.

(사고사로 사망한 경우에는 사망 진단서와 동일하게 기재한다. 기재할 내용이

없는 경우 사고의 종류, 사고 발생지역 및 장소를 구체적으로 기재해 주세요.)

⑧ Deceased  사망자

※ Nationality  국적

￭ Please select the nationality of deceased out of following number.

(아래의 번호 중 사망자의 국적을 선택해 주세요.)

□ Korean  한국인

□ Naturalized Korean (Previous nationality :     ) 귀화한 한국인 (이전의 국적 :   )

￭ Please select the graduate school out of following number.

(아래의 번호 중 최종 졸업 학교를 선택해 주세요.)

□ Uneducated 무학             □ Elementary school  초등학교

□ Middle school  중학교        □ High school  고등학교

□ University /College  대학(교)  □ Graduate school  대학원 이상

□ The graduate school of deceased should be recorded all formal organizations

that Ministry of Education, Science and Technology recognizes. And a student

(dropout)of each school mark the relevant number of the last graduation school with "O".

(사망자의 최종 졸업 학교는 교육과학기술부장관이 인정하는 모든 정규기관을

기준으로 기재되어야 하고, 각급 학교의 재학(중퇴)자는 졸업한 최종학교의       해당 번호에○표시를 합니다.)

<Example> Dropout of junior in college → Mark a high school of number 4 with "O"

(<예시> 대학교 3학년 중퇴 → 4번 고등학교에 “O" 표시)

※ Then occupation on starting of disease(accident)  발병(사고) 당시 직업

￭ Please write the occupation on starting of disease(accident).

(발병(사고) 당시의 직업을 기재해 주세요.)

□ The occupation on starting of disease(accident) of deceased is written

concretely the occupation on occurrence of disease or accident make to die.

(사망자의 발병(사고)당시 직업은 사망의 원인이 되는 질병 또는 사고가 발생 한 때의

직업을 구체적으로 기재합니다.)

<Example>  Employee  → Detailer. department of business, ○○company (ㅇ).

(<예시> 회사원(×) → ○○회사 영업부 판촉사원(○)

공무원(×)→ ○○ 청 건축허가 업무담당(○))

※ Marital status  혼인 상태

□ Single  미혼         □ Married  배우자 있음

□ Divorced  이혼      □ Widowed  사별

□ Required Document(s)

1. Certificate of Death or Medical certificate of death about deceased 1 copy

(사망자에 대한 진단서나 검안서 1부.)

2. Document(s) be proved fact of death (사망의 사실을 증명할 만한 서면)

(If a medical certificate of death can not be affixed) : 1 copy out of following)

(진단서나 검안서를 첨부할 수 없을 때): 아래 중 1부.

￭ Certificate of Death (Head of Dong and Ri or neighborhood more than 2

people recorded certificate of death). If the provable people are neighborhood

(more than 2 people), it should be affixed 1 copy among their certificate of

seal impression, copy of resident register, copy of a driving license, copy of

passport, identification of public official should be affixed. In event of head of Dong/Ri is enough to prove just 1 person, it should be affixed the provable

document of head of Dong/Ri in principle.

(사망증명서(동·리·통장 또는 인우 2명 이상이 작성한 사망증명서) : 증명인이 인우인(2명 이상)인 경우에는 증명인의 인감증명서, 주민등록증사본, 운전 면허증사본, 여권사본, 공무원증사본 중 1부 첨부하여야 하며, 증명인이 동·리·통장일 때에는 1명의 증명으로 족하고 원칙적으로 동·리·통장임을 증명하는 서면 첨부해야 한다.)

￭ Certificate of death in government office or a certificate of burial

(관공서의 사망증명서 또는 매장인허증)

￭ Certificate for report process of death  (사망신고수리증명서)

(In case of the report in government office of overseas)

(외국관공서에 사망 신고한 경우)

※ Under 3 clause can be omitted if the department in charge of family relation

certification can check this information.

(아래 3항은 가족관계등록관서에서 전산으로 그 내용을 확인할 수 있는 경우

첨부를 생략합니다.)

3. Basic certificate of the deceased's a family relation register 1 copy

(사망자의 가족관계등록부의 기본증명서 1통)

4. Identification  (신분확인)

[In accordance with Article 23 in a certificate of family relations register]

([가족관계등록예규 제23호에 의함])

￭ Application by visit : Certificate of identification

(신고인이 출석한 경우 : 신분증명서)

￭ Submitter by visit : Copy of an applicant's identification certificate, a submitter's        identification certificate

(제출인이 출석한 경우 : 신고인의 신분증명서 사본 및 제출인의 신분증명서)

￭ Application by mail : Copy of an applicant's identification certificate

(우편제출의 경우 : 신고인의 신분증명서 사본)

5. If a deceased is foreigner, it should be submitted writing(passport or alien

registration card) copy about nationality.

(사망자가 외국인이라면 국적에 관한 서면 (여권 또는 외국인 등록증) 사본 제출)

[Form No.1]

Report of birth ( ..... Day ..... Month .......... Year)	※ Please write after reading the guidelines on the back and, when required to select one option, please circle the number as follows "○".
① Person of birth (Child)	Name	Korean or English		Place of family origin		Sex	□ Male □ Female	□ Birth under marriage □ Birth out of wedlock
Chinese characters
Time & Date of birth	..... Minute ..... Hour .....Day .....Month ..... Year (Korean standard time's : twenty-four hour clock)
Place of birth	□ Own house □ Hospital □ The others	Beonji Dong(Eup,Myeon) Gu(Gun) Si(Do)
Fixed permanent domicile address by parents
Address		Householder and relation
In case the child has dual nationality, please write this fact and the other nationality.
② Parents	Father	Name	(Chinese characters: )	Place of family origin		Resident Registration No.	-
Mother	Name	(Chinese characters: )	Place of family origin		Resident Registration No.	-
Permanent domicile address of father
Permanent domicile address of mother
On reporting the marriage, did you submit the agreement that your child's surname and place of family origin should follow the mother's surname and place of family origin? Yes⎕ No⎕
③ In the event of re-reporting a birth, after having cancelled previously the family relation register because of a declaratory judgement of non-existent real biological relation between a parent and the child.
Particular details of the cancelled register	Name		Resident Registration No.	-
Permanent domicile address
④ Others
⑤ Declarer	Name	(Seal or) Signature	Resident Registration No.	-
Qualification (Relationship)	□ Father □ Mother □ Cohabiting relative □ The others(Please state : )
Address
Telephone No.		E-mail address
⑥ Submitter	Name		Resident Registration No.	-

※ The following information is needed for establishing population policies, so you are obliged to declare truth fully under Articles 32 and 33 of the Statistics Law. Please only write the truth your privacy will be strictly protected.

	Details of the birth
⑦ Length of pregnancy	Pregnancy □□ Weeks □ Days	⑧ New born baby's weight	□.□□□ ㎏
⑨ Multiple birth or not and birth order	□ Single birth □ Twin birth (Twins) → □ First □ Second of the twins □ Triple birth of more → No. □ of □

	Father's details (of person of birth)		Mother's details (of person of birth)
⑩ Nationality	□Korean □Naturalized Korean(Previous nationality: ) □Foreigner(Nationality: )		□Korean □Naturalized Korean(Previous nationality: ) □Foreigner(Nationality: )
⑪ Real date of birth	Solar / Lunar Day Month Year		Solar / Lunar Day Month Year
⑫ Level of completed education	□Uneducated □Elementary school □Middle school □High school □(College) University □Graduate school		□Uneducated □Elementary school □Middle school □High school □(College) University □Graduate school
⑬ Occupation	* Please write type and details of main occupation.		* Please write type and details of main occupation.
⑭ Start date of cohabitation	From ...... Day ..... Month ........ Year
⑮ Total number of children born to the mother		Number of children until this baby□□ (Surviving□□, Died□□ )

※ For official use only (Please don't write below details)

읍면동접수	가족관계등록관서 송부		가족관계등록관서 접수 및 처리
	주민등록 번 호
	년 월 일(인)

Report of birth

(출생신고서)

※ Writing method (작성방법)

￭ Permanent domicile address (등록기준지)

If you are a foreigner, please write your nationality.

(각 란의 해당자가 외국인인 경우에는 그 국적을 기재합니다)

￭ Resident registration No. (주민등록번호)

If you are a foreigner, please write alien registration No.

(Domestic residence registration number or date of birth).

(각 란의 해당자가 외국인인 경우에는 외국인등록번호(국내거소신고번호 또는

출생연월일)를 기재합니다.)

1. Person of birth (출생자)

※ Writing method (작성방법) :

￭ Chinese characters of name must be within the bounds of the supreme court' rule

(usable Chinese character as name). The name characters haven't to be exceeded 5          characters(not included the surname). Please check the usable characters in the electronic civil service center of the supreme court.

(출생자의 이름에 사용하는 한자는 대법원규칙이 정하는 범위내의 것으로,

이름자는 5자(성은 포함하지 않는다)를 초과하지 않아야 합니다.

￭ Please write person of birth's name in Korean or English and in Chinese characters.

(출생자의 성명을 한글과 한자로 쓰세요.)

￭ Please write person of birth's place of family origin. (출생자의 본을 쓰세요.)

￭ Please write person of birth's sex(gender). (출생자의 성별을 쓰세요.)

￭ Please check belows. 아래에 체크하세요.

(Was person of birth born under marriage or not?)

(혼인중의 출생자입니까 아닙니까?)

1) Birth under marriage(혼인중의 출생)

2) Birth out of wedlock(혼인외의 출생)

￭ Please write the time and the date of birth according to twenty-four hour clock of

birthplace. (출생일시를 쓰세요. (출생지 시각 : 24시각제))

※ Writing method(작성방법)

￭ When our nation(people) bore a baby in abroad, please write the local birth

time by year of grace and the solar calendar. If the baby was born during summertime,

please write "Period of summertime" in the side of the birthplace time.

(우리나라 국민이 외국에서 출생한 경우에는 그 현지 출생시각을 서기 및 태양력으로

기재하되, 서머타임 실시기간 중 출생하였다면 그 출생지 시각 옆에“(서머타임 적용)”

이라고 표시합니다.)

￭ Please check place of birth. (출생장소를 체크하세요.)

□ Own's house (자택)   □ Hospital (병원)   □ Other (기타)

￭ Please write person of birth's permanent domicile address where is fixed

by parents. (출생자의 부모가 정한 등록기준지를 쓰세요.)

￭ Please write person of birth's address. (출생자의 주소를 쓰세요.)

￭ Please write person of birth's householder and relation with person of birth.

(출생자의 세대주를 쓰고 출생자와의 관계를 쓰세요.)

￭ In case your baby is dual nationality, please write the fact and the acquired

foreign nationality.

(자녀가 이중국적자인 경우 그 사실 및 취득한 외국 국적을 쓰세요.)

2. Parents(부모)

※ Writing method (작성방법) :

￭ Regarding to father  (부에 관한 사항)

Please don't write, in case of registering the mother the baby who was born out

of wedlock. Please write "Father wasn't decided", in case of registering the birth as

mother who remarried woman within 100days previous postmarital who has given

birth after 200days from establishing remarriage and within 300days after finishing

previous marriage.

(혼인외 출생자를 모가 신고하는 경우에는 기재하지 않으며, 전혼 해소 후 100일 이내에

재혼한 여자가 재혼성립 후 200일 이후, 직전 혼인의 종료 후 300일 이내에 출산하여 모가

출생 신고를 하는 경우에는 부의 성명란에 “부미정” 으로 기재합니다.)

￭ Please write parents's names in Korean or English and Chinese characters.

(부모의 성명을 한글과 한자로 쓰세요.)

￭ Please write parents's place of family origin. (부모의 본을 쓰세요.)

￭ Please write parents's resident registration numbers.

(부모의 주민등록번호를 쓰세요.)

￭ Please write parents's permanent domicile addresses.

(부모의 등록기준지를 쓰세요.)

￭ When you registered your marriage, did you submit the agreement that your

child's surname and place of family origin follow as mother's surname and

place of family origin?

(혼인신고시 자녀의 성.본을 모의 성.본으로 하는 협의서를 제출하였습니까?)

3. In case of re-reporting of birth, after having cancelled previously the family relation

register because of a declaratory judgement of non-existent real biological relation

between a parent and the child.

(친생자관계 부존재확인판결 등에 따른 가족관계등록부 폐쇄 후 다시 출생신고 하는 경우)

￭ Please write particular name, resident registration number and permanent domicile address

on the cancelled family relation register.

(폐쇄등록부상 특정사항을 쓰세요 - 이름, 주민등록번호, 등록기준지)

4. Other (기타)

※ Writing method (작성방법)

￭ Please write below facts and especially necessary informations for clarifying the family

relation register.

(아래의 사항 및 가족관계등록부에 기록을 분명하게 하는 데 특히 필요한 사항을 기재합니다.)

￭ In case low priority reporting obligor reports the birth : Please write the reason why high

priority obligor(parents) can't report.

(후순위 신고의무자가 출생신고를 하는 경우 : 선순위자(부모)가 신고를 못하는 이유)

￭ The fact that you recognized the fetus before birth and the government office where

you reported the fact.

(출생전에 태아인지 한 사실 및 태아 인지 신고한 관서)

￭ In case of the birth registration as Korean name but the person who is registered in foreign

government office as foreign type following the foreign father's surname :

The registered name in abroad

(외국인이 부의 성을 따라 외국식 이름으로 외국의 등록관서에 등재되어 있으나 한국식

이름으로 출생신고 하는 경우 : 외국에서 신고된 성명)

￭ In case of the agreement that baby's surname and place of family origin follow as

the baby's mother's surname and place of family origin according to the Article 781

Section 1 of the Civil Law, please write the purpose.

("민법“ 제781조제1항 단서에 따라 혼인신고시 모의 성.본을 따르기로 협의한 경우 그 취지)

5. Reporter (신고인)

￭ Please write reporter's name and resident registration No.

(신고인의 성명과 주민등록번호를 쓰세요)

￭ Please check reporter's relationship.(신고인의 자격에 체크하세요.)

□ Father(부)  □ Mother(모)  □ Living together relative(동거친족)

□ Other(기타) (Please state(자격) :  )

￭ Please write reporter's address, telephone No. and e-mail address.

(신고인의 주소, 전화번호, 이메일을 쓰세요.)

6. Submitter (제출자)

※ Writing method (작성방법)

￭ Please write submitter‘s name and resident registration No. (Regardless of declarer)

(제출자의 성명과 및 주민등록번호를 기재하세요.)(신고인 여부 불문)

([접수담당공무원은 신분증과 대조])

￭ Please write submitter's name and resident registration No.

(제출자의 이름, 주민등록번호를 쓰세요.)

※ The following information is needed for establishing population policies, so you are

obliged to declare truth fully under Articles 32 and 33 of the 「Statistics law」. Please

only write the truth your privacy will be strictly protected.

(다음은 국가의 인구정책 수립에 필요한 자료로(통계법) 제32조 및 제33조에 따라 성실응답

의무가 있으며 개인의 비밀사항이 철저히 보호되므로 사실대로 기입하여 주시기 바랍니다.)

□ Details of the birth (출생자에 관한 사항)

※ Writing method (작성방법)

￭ Please write details of the birth from No. ⑦ to No. ⑨.

(7번~9번은 출생자에 대한 사항을 쓰세요.)

7. Please write length of pregnancy. (임신주수를 쓰세요.)

8. Please write weight of new born baby. (신생아의 체중을 쓰세요.)

9. Please write multiple birth or not and birth order.

(다태아 여부 및 출생순위를 쓰세요.)

1) Single birth (단태아)

2) Twin birth (Twins) (쌍태아 (쌍둥이)) - 1. First (첫째) 2. Second (둘째)

3) Triple birth or more (삼태아 (세쌍둥이)) 이상 -

Please write which order in the middle of multiple birth

(쌍둥이 중의 몇째인지 쓰세요.)

※ Writing method (작성방법)

￭ Multiple birth(More than twins) or not has to be marked as “○” on fetus's number

at pregnant regardless of real number of birth and marked the birth order on each

reporting of birth in the middler of multiple birth.

(다태아(쌍둥이 이상)여부는 실제로 출생한 아이의 수와 관계없이 임신하고 있던 당시의 태아

수에 “○”표시하며, 다태아 중 출생신고 대상 아이마다 출생순위가 몇 번째인지를 표시합니다.)

□ Parents's details (출생자의 부.모에 관한 사항)

※ Writing method (작성방법)

Please write details about parents of the birth at birth time from No.⑩ to No.⑮.

(10번~15번은 출생당시 출생자 부모에 관한 사항을 기재합니다.)

10. Please write nationality. (국적을 쓰세요)

1) Korean (한국인)

2) Be naturalized as a Korean (귀화한 한국인) : Previous nationality (이전국적)

3) Foreigner (외국인) : Nationality (국적)

11. Please write real date of birth. (실제생년월일) :

Solar(양력) / Lunar(음력)      Year(년)    Month(월)    day(일)

12. Please write final graduate school (최종졸업학교)

1) Uneducated (무학)        2) Elementary school (초등학교)

3) Middle school (중학교)    4) High school (고등학교)

5) University (대학교)        6) Graduate school (대학원이상)

※ Writing method (작성방법)

￭ As standard the admitted all regular education institute by Ministry of Education,

Science and Technology, if 'in' or 'dropout' of each school, mark as “○” on number

of final graduated school.

<Ex.>Junior dropout of University : please mark as “○” on high school.

(교육과학기술부장관이 인정하는 모든 정규교육기관을 기준으로 기재하되, 각급 학교의

재학 또는 중퇴자는 최종 졸업한 학교의 해당번호에 “○”으로 표시합니다

<예시> 대학교 3학년 중퇴 : 고등학교에 “○”표시)

13. Please write main occupation's type and details. (직업)

(주된 일의 종류와 내용을 기입하세요.)

※ Writing method (작성방법) :

￭ Please write type and details of main occupation with company's name of the

parents on birth of baby.

<Ex.> Detailer of sales department for ○○company, clothes salesperson at

○○shopping store , farmer in our rice paddy

(아이가 출생할 당시의 부모의 주된 직업을 말하며 주된 일의 종류와 내용을 사업장명과

함께 기재합니다.

<예시> ○○회사 영업부 판촉사원, ○○상가에서 의류판매, 우리 논에서 논농사)

14. Please write start date of cohabitation.

(실제 결혼생활 시작일을 쓰세요)

Year (년)    Month (월)   Day (일)

15. Please write total number of children born to the mother including this birth.

(모의 총 출산아 수를 쓰세요) Survivor (생존) / Death (사망)

※ Writing method

Total number of children born to the mother - Please write total number of children

including this child on report and the number of surviving and died children of them.

If the mother was second marriage, please include before marriage's childbirth.

(모의 총 출산아수 - 신고서상 아이를 포함하여 모두 몇 명의 아이를 출산했고 그 중 생존아와

사망아 수를 기재하며, 모가 재혼인 경우에는 이전의 혼인에서 낳은 자녀까지 포함합니다.)

For official use only (Please don't write below details).

공용란 (아래사항은 기재하지 마세요)

□ Attached documents 첨부서류

1. Birth certification 1set(One of the belows). 출생증명서 1통(다음 중 하나).

￭ Has to be written by Doctor or midwife. 의사나 조산사가 작성한 것.

￭ If the baby wasn't born in Hospital or the other medical institute, it has to be written

by person who know the birth. (This form is fixed separately by Article 283 of the

family relation register established rule).

(출생자가 병원 등 의료기관에서 출생하지 않은 경우에는 출생사실을 알고 있는 자가 작성한 것

(이 출생증명서 양식은 가족관계등록예규 제283호에 따로 정함).

￭ The written by foreign public office the accepted certificate of birth register

(or birth certificate) and translation.

(외국의 관공서가 작성한 출생신고수리증명서(또는 출생증명서)와 번역문.)

※ If the details of the below No. 2 and No. 3 is checked by data processing at office

of family relation register, the attached certificate for each register case can be omitted.

(아래 2항 및 3항은 가족관계등록관서에서 전산으로 그 내용을 확인할 수 있는 경우에는

등록사항별 증명서의 첨부를 생략합니다.)

2. One set the certificate of marriage relation for mother or father of the baby

(출생자의 부(父) 또는 모(母)의 혼인관계증명서 1통)

￭ If the father reports the birth of wedlock, must attach the certificate of marriage

relation for mother certainly

(부(父)가 혼인외의 자를 출생신고하는 경우에는 반드시 모(母)의 혼인관계증명서 첨부.)

￭ If the family relation register of baby's mother isn't existence or the register isn't

clearly, please attach the paper to notarize the mother isn't a married woman or

guarantee letter of companions for more than two persons.

(출생자의 모의 가족관계등록부가 없거나 등록이 되어 있는지가 분명하지 아니한 사람인

경우에는 그 모가 유부녀(有夫女)가 아님을 공증하는 서면 또는 2명 이상의 인우인

보증서.)

3. Please attach one set the paper(ex. mother's basic certificate) to prove the mother is

Korean at baby birth time

(자녀의 출생당시 모(母)가 한국인임을 증명하는 서면(예: 모의 기본증명서) 1통)

(In case of reporting the birth of the baby was born between foreigner father and

Korean mother after 1998. 6. 14.)

(1998. 6. 14. 이후에 외국인 부와 한국인 모 사이에 출생한 자녀의 출생신고를 하는 경우).

4.   At baby birth time, if the family relation register of Korean father or mother isn't

existence or isn't clearly, please attach one set the copy of official document including

personal data with name and date of birth for father or mother issued by our

government office

(자녀의 출생당시에 대한민국 국민인 부(父) 또는 모(母)의 가족관계등록부가 없거나  분명

하지 아니한 사람인 경우 부(父) 또는 모(母)에 대한 성명, 출생연월일 등 인적사항을 밝힌 우리

나라의 관공서가 발행한 공문서 사본 1부)

(ex: passport, copy of resident register and the other certificate)

(예: 여권, 주민등록등본, 그 밖의 증명서)

5. If the child is dual nationality, please attach one set the proving documents about the

acquired nationality.

(자녀가 이중국적자인 경우 취득한 국적을 소명하는 자료 1부)

6. Please check the identification 신분확인

[According to Article 23 of the family relation register established rule]

([가족관계등록예규 제23호에 의함])

￭ In case of declarer's attendance : Identification card

(신고인이 출석한 경우 : 신분증명서)

￭ In case of submitter's attendance : Copy of declarer's identification card and

submitter's identification card

(제출인이 출석한 경우 : 신고인의 신분증명서 사본 및 제출인의 신분증명서)

￭ In case of postal submission : Copy of declarer's identification card

(우편제출의 경우 : 신고인의 신분증명서 사본)

[Form No. 27]

Report of Name Change (..... Day ..... Month ........ Year)						※ Please write after reading the guidelines below and, when required to select one option, please circle the number as follows "○".
① Person changing name	Name	Present name							② New name
		Korean name			Chinese characters				Korean name						Chinese characters
	Place of family origin (Chinese characters)								Resident Registration No.						-
	Permanent domicile address
	Address
	Parents' names	Father							Mother
③ Date of permission		..... Day ..... Month ........ Year							Court's name
④ Other relevant facts
⑤ Reporter	Name	Seal or signature				Resident Registration No.							-
	Relationship	□ Self □ Legal representative □ Other (Please state : )
	Address					Tel. No.				E-mail
⑥ Submitter	Name					Resident Registration No.								-

How to fill out
※ This should be reported within one month from the date to receive the copy of permitted decision for changed name. ① : Please write to separate present name and new name. ② : Please write the name(Permitted name on copy of permitted decision for changed name) which want to change and write only on section of Korean name if the name haven't Chinese characters. ③ : Please write the permitted date(D/M/Y) of changed name on copy of permitted decision for changed name. ④ : Please write especially necessary informations for clarifying the family relation register. ⑤ : Please write the present(not new) name of reporter. ⑥ : Please write the name and resident registration number of submitter. (Regardless of declarer is true or not) [An acceptable official in charge identify the submitter]
Required Document(s)
1. Copy of permitted decision for change of a name 1 copy. 2. Identification. [In accordance with Article 23 in a certificate of family relations register] - In case of reporter's attendance : Identification card - In case of submitter's attendance : Identification card of submitter. - In case of postal submission : Copy of identification card for reporter

Report of Name change

(개명신고서)

□ This should be reported within one month from the date to receive the copy of permitted decision for name change.

(이 신고는 개명허가결정등본을 받은 날로부터 1개월 이내에 신고하여야 합니다.)

① Person changing name  (개명자)

□ Present name  (현재의 이름)

￭ Please write the present name in Korean or English and in Chinese characters.

(현재의 이름을 한글과 한자로 기재하세요.)

※ Please write present and new name in each.

(개명전의 현재의 이름과 개명하고자 하는 이름을 각각 기재하세요.)

② New name  개명하고자 하는 이름

￭ Please write the new name in Korean or English and in Chinese characters.

(개명하고자 하는 이름을 한글과 한자로 기재해 주세요.)

※ Please write the new name (Permitted Name as copy of permitted decision for         changed name). and write only Korean name if there isn't in Chinese characters.

(변경하고자 하는 이름 (개명허가결정등본에 기재된 개명허가를 받은 이름)을

기재 하며, 한자가 없는 경우는 한글 란에만 기재합니다.)

□ Place of family origin [Chinese characters]  본[한자]

￭ Please write the place of family origin in Chinese characters.

(본을 한자로 기재하세요.)

￭ Please write the resident register number.

(주민등록번호를 기재해 주세요.)

□ Permanent domicile address (등록 기준지)

￭ Please write the permanent domicile address.

(등록 기준지를 기재하세요.)

※ In event of a foreigner, please write in nationality on permanent domicile address.

(외국인의 경우 등록기준지에 국적을 기재해 주세요.)

□ Address  (주소)

￭ Please write the current address.  (현재의 주소를 기재해 주세요.)

□ Parent's names.  (부모의 이름)

￭ Please write each name of father and mother.

(부와 모의 이름을 각각 기재해 주세요.)

③ Date of permission.  (허가 일자)

￭ Please write the date of permission as copy of permitted decision for name change.

(개명허가일자는 개명허가결정등본에 기재된 연월일을 기재합니다.)

￭ Please write the court's name.  (법원명을 기재해 주세요.)

④ Other relevant facts  (기타 사항)

￭ Please write other relevant facts. (기타 사항을 기재해 주세요.)

※ Please write especially necessary informations for clarifying the family relation

register.

(가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재합니다.)

⑤ Reporter  (신고인)

□ Name / Resident registration number  이름 / 주민등록번호

￭ Please write reporter's previous name and resident registration number.

(신고인의 개명전 이름과 주민등록번호를 기재해 주세요.)

□ Relationship (자격)

￭ Please check on relationship out of following number.

(아래의 번호 중 자격을 선택해 주세요.)

□ Self 본인  □ Legal representative 법정 대리인  □ Other 기타

□ Address & Phone Number & E-mail  주소 / 전화번호 / 이메일

￭ Please write the address, phone number and E-mail of reporter.

(신고인의 주소, 전화번호와 이메일 주소를 기재해 주세요.)

⑥ Submitter  제출인

￭ Please write the name and resident register number of submitter.

(제출인의 이름과 주민등록번호를 기재해 주세요.)

□ Required Document(s)  첨부서류

1. Copy of permitted decision for changed name 1 copy

(개명허가결정등본  1부)

2.  Identification  (신분 확인)

[In accordance with Article 23 in a certificate of family relations register]

([가족관계등록예규 제23호에 의함])

￭ If an applicant visits : then Certificate of identification.

(신고인이 출석한 경우 : 신분증명서)

￭ If a submitter visits : then identification certificate of submitter.

(제출인이 출석한 경우 : 제출인의 신분증명서)

￭ Application by mail: copy of applicant's Identification certificate.

(우편제출의 경우 : 신고인의 신분증명서 사본)

[Form No. 10]

Report of Marriage ( ) (.... Day .... Month ........ Year)										※ Please write after reading the guidelines on the back and, when required to select one option, please circle the number as follows "○".
Section						Husband							Wife
① Contracting Parties in the Marriage (Reporter)	Name	Korean or English								Seal or signature								Seal or signature
		Chinese characters
	Place of Family Origin									Tel.			Place of Family Origin					Tel.
	Date of Birth					Day Month Year							Day Month Year
	Resident Registration No.
	Permanent Domicile Address
	Address
② Parents (Adoptive Parents)	Father's Name
	Resident Registration No.
	Permanent Domicile Address
	Mother's Name
	Resident Registration No.
	Permanent Domicile Address
③ In the event of remarriage, date of divorce				Day Month Year									Day Month Year
④ Date of foreigner's marriage (submission of original marriage certificate required)									Day Month Year
⑤ Agreement of surname and place of family origin									Have you agreed that your baby will take the mother's surname and place of family origin ? Yes⎕ No⎕
⑥ Intermarriage (Marriage between close relatives)									Are you in a third cousin blood relationship or closer ? Yes⎕ No⎕
⑦ Other facts
⑧ Witness	Name		Seal or signature								Resident Registration No.
	Address
	Name		Seal or signature								Resident Registration No.
	Address
⑨ Consenter	Husband		Father		Name		Seal or signature				Guardian		Name	Seal or signature
			Mother		Name		Seal or signature						Resident Registration No.
	Wife		Father		Name		Seal or signature						Name	seal or signature
			Mother		Name		Seal or signature						Resident Registration No.
⑩ Submitter	Name										Resident Registration No.

※ Below questions are needed for establishing the population policy, so you have obligation to write with sincerely under Articles. 32 and 33 of the Statistics law. Please write only truth(facts) that your private secrets will be

⑪ Start date of cohabitation			From .... Day .... Month ........ Year
⑫ Nationality	Husband	□ Korean □ Naturalized Korean citizen (Previous Nationality: ) □ Foreigner (Nationality: )		Wife	□ Korean □ Naturalized Korean citizen (Previous Nationality: ) □ Foreigner (Nationality: )
⑬ Type of marriage	Husband	□ First marriage □ Remarriage after bereavement □ Remarriage after divorce		Wife	□ First marriage □ Remarriage after bereavement □ Remarriage after divorce
⑭ Level of completed education	Husband	□ Uneducated □ Elementary school □ Middle school □ High school □ University / College □ Graduate school		Wife	□ Uneducated □ Elementary school □ Middle school □ High school □ University / College □ Graduate school
⑮ Occupation	Husband	* Please write type and details of main occupation.		Wife	* Please write type and details of main occupation.

protected thoroughly.

Report of marriage

(혼인신고서)

※ Please write the reporter on No. of ①,② and ⑥,⑦,⑧,⑨,⑩,⑪,⑫,⑬,⑭ and the

other No. (③,④,⑤) is filled in relevant person only.

(1, 2란 및 6, 7, 8, 9, 10, 11, 12, 13, 14란은 신고인 모두가 기재하며, 나머지란

3, 4, 5은 해당되는 사람만 기재합니다.)

※ A report of transfer of resident registration should be declared apart from a

report of registration of family relations.

(주민 등록 전입신고는 본 가족관계등록신고와는 따로 하여야 합니다.)

① The contracting parties in a marriage (Reporter) 혼인당사자 (신고인)

Bridegroom(husband) 남편(부) / Bride(wife) 아내(처)

￭ Please write each Korean or English name and in Chinese characters of the husband

and wife. (남편과 아내의 한글 이름과 한자를 각각 기재하세요.)

￭ Please seal or sign of the husband and wife.

(남편과 아내의 도장을 찍거나 사인을 하세요.)

￭ Please write place of family origin of the husband and wife in Chinese characters.

(남편과 아내의 본을 한자로 쓰세요.)

￭ Please write each phone number of the husband and wife.

(남편과 아내의 전화번호를 각각 기재하세요.)

￭ Please write the date of the husband and wife's birth.

(남편과 아내의 생년월일을 기재하세요.)

￭ Please write each resident registration number(or alien registration number) of the

husband and wife.

(남편과 아내의 주민등록번호(또는 외국인 등록 번호)를 각각 기재하세요.)

￭ Please write each permanent domicile address of husband and wife.

(남편과 아내의 등록 기준지를 쓰세요.)

□ If the contracting parties in a marriage are a foreigner, write in nationality.

(혼인 당사자가 외국인인 경우에는 그 등록기준지에 국적을 기재해 주세요.)

￭ Please write the current address of  the husband and wife.

(남편과 아내의 현재 주소를 쓰세요.)

② Parents (Adoptive parents)

□ If the contracting parties in a marriage are an adopted child, write personal

data of their adoptive parents and in event that their's parents are a foreigner,

enter the date of birth and in nationality on the resident registration number blank.

(혼인당사자가 양자인 경우 양부모의 인적사항을 기재하며, 혼인당사자의 부모가

외국인인 경우에는 주민등록 번호란에 출생년월일 및 국적을 기재합니다.)

￭ Please write the name of husband's father and mother

(남편의 아버지와 어머니의 이름을 기재하세요.)

￭ Please write the resident registration number of husband's father and mother.

(남편의 아버지와 어머니의 주민등록 번호를 기재하세요.)

￭ Please write the permanent domicile address of husband's father and mother.

(남편의 아버지와 어머니의 등록 기준지을 기재하세요.)

￭ Please write the name of wife's father and mother.

(아내의 아버지와 어머니의 이름을 기재하세요.)

￭ Please write the resident registration number of wife's father and mother.

(아내의 아버지와 어머니의 주민등록 번호를 기재하세요.)

￭ Please write the permanent domicile address of wife's father and mother.

(아내의 아버지와 어머니의 등록 기준지를 기재하세요.)

③ In the event of remarriage, date of divorce 직전 혼인 해소 일자

￭ Please write the date of divorce.

(남편과 아내의 직전 혼인 해소 일자를 기재하세요.)

□ If you've ever been  the divorcement or nullify of marriage, it write the date.

(이혼 또는 혼인 취소가 있었던 사람의 경우 그 일자를 기재합니다.)

④ Date of foreigner's marriage  외국방식에 의한 혼인성립일자

￭ Please write the date of foreigner's marriage.

(외국방식에 의한 혼인성립일자를 기재하세요.)

□ In the event that submit a original copy of a marriage certificate, please write the

date. (외국방식에 의한 혼인증서 등본 제출의 경우 혼인 성립 일을 기재합니다.)

⑤ Agreement of surname and place of family origin 성 ▪ 본의 협의

￭ Have you agreed that your baby will take the mother's surname and place of family

origin? (자녀의 성 ▪ 본을 모의 성 ▪ 본으로 하는 협의를 하겠습니까?)

□ Yes  예                □ No  아니오

□ In accordance with the Proviso of Article 781, Paragraph 1 of the Civil Law:

If the couple agreed that their child will take the mother's surname and place of

family origin, Please write the fact.

([민법] 제 781조 제1항의 단서에 따라 자녀의 성·본을 모의 성·본으로 하는 협의가

있는 경우에는 그러한 사실을 표시합니다.)

⑥ Intermarriage  근친혼 여부

￭ Are you in a third cousin blood relationship or closer?

(혼인 당사자들이 8촌 이내의 혈족 사이에 해당됩니까?)

□ Yes  예                □ No  아니오

□ In accordance with the Proviso of Article 809, Paragraph 1 of the Civil Law :           Please mark the fact the contracting parties in the marriage aren't the applicable to

intermarriage [bloodline within third cousin (Include before the adaptability of paternal

adopted child)].

(혼인당사자들이「민법」제809조 제1항에 따른 근친혼에 해당되지 아니한다는

사실[8촌 이내의 혈족 (친양자의 입양전의 혈족을 포함한다)]을 표시합니다.)

⑦ Other facts  기타 사항

□ Please write the special requirements for a clear record on following matters and a

register of family relations.

(아래의 사항 및 가족관계등록부에 기록을 분명하게 하는데 필요한 사항을 기재하세요.)

(If the space is not enough, you can write on an annexed paper.)

(기재 란이 부족한 경우에는 별지를 붙여서 추가 기재할 수 있습니다).

□ In the event of a register of marriage based on judgment on the certification the

existence of common-law marriage relationship : the court name of judgment & confirmed

date. (사실상 혼인관계 확인판결에 의한 혼인신고의 경우에는 판결법원 및 확정일자)

⑧ The witness  증인

□ The witness must be a person of legal age and have the signatures of 2 people.

(증인은 성년자이어야 하고 2명의 사인이 있어야 한다.)

￭ Please write the witness's name and please seal or sign.

(증인의 이름을 기재하고 도장이나 사인을 하세요)

￭ Please write the resident registration number of witness

(증인의 이름을 기재하고 도장이나 사인을 하세요.)

￭ Please write the address of witness.

(증인의 주소를 기재하세요.)

⑨ Consenter  동의자

￭ Please write name of the husband and wife's parent.

(남편과 아내의 부모의 이름을 기재하세요.)

￭ Please seal or sign of the husband and wife's parent.

(남편과 아내의 부모의 도장이나 사인을 하세요.)

□ In the event of a marriage of a minor, please write the contents of consent from their parent.

(미성년자 혼인하는 경우에 동의내용을 기재합니다.)

□ Guardian  후견인

￭ Pleas write the name and resident registration number of guardian.

□ In the event of a marriage of an incompetent, please write the guardian.

(금치산자가 혼인하는 경우에 후견인을 기재합니다.)

Submitter  제출인

￭ Please write the name and resident registration number of submitter

(제출인의 이름과 주민등록번호를 기재해주세요.)

※ (Regardless of the declarer is true or not) 신고인 여부와 관계없음

[접수한 담당 공무원은 제출인의 신원을 확인한다.]

□ The following information is needed for establishing population policies, so you are

obliged to declare truth fully under Articles 32 and 33 of the Statistics Law. Please

only write the truth your privacy will be strictly protected.

(다음은 국가의 인구정책 수립에 필요한 자료로「통계법」제32조 및 제33조에 의하여

성실응답 의무가 있으며 개인의 비밀사항이 철저히 보호되므로 사실대로 기입하여 주시기

바랍니다.)

Start date of cohabitation  실제 결혼 생활 시작일

￭ Please write the starting date of cohabitation.

(실제 결혼 생활 시작일자를 기재해 주세요.)

□ Please write the starting date of actual marriage(cohabitation) with couple regardless

of wedding day

(결혼일자와 관계없이 실제 부부가 결혼(동거)생활을 시작한 날을 기입합니다.)

Nationality  국적

￭ Please select the nationality of husband and wife out of following number.

(아래의 번호 중 남편과 아내의 국적을 선택해 주세요.)

□ Korean  한국인

□ Naturalized Korean (Previous nationality :    ) 귀화한 한국인 (이전의 국적 :    )

□ Foreigner(Nationality :             )  외국인  (국적 :                  )

Type of marriage

￭ Please select the type of marriage of husband and wife out of following number.

(아래의 번호 중 남편과 아내의 혼인 종류를 선택해 주세요.)

□ First marriage  초혼

□ Remarriage after bereavement  사별 후 재혼

□ Remarriage after divorce  이혼 후 재혼

￭ Please select the last graduate school out of following number.

(아래의 번호 중 최종 졸업 학교를 선택해 주세요.)

□ Uneducated  무학            □ Elementary school  초등학교.

□ Middle school  중학교        □ High school  고등학교

□ University /College  대학(교)

□ Graduate school  대학원 이상

□ As standard the admitted all regular education institute by Ministry of Education,

Science and Technology, if 'in' or 'dropout' of each school, mark as “○” on

number of graduate school.

(교육과학기술부장관이 인정하는 모든 정규기관을 기준으로 기재하되, 각급 학교의

재학 또는 중퇴자는 최종 졸업한 학교의 해당 번호에 “○”으로 표시합니다.)

Occupation  직업

￭ Please write main occupation's type and details of the husband and wife.

(남편과 아내의 주된 일의 종류와 내용을 기재해 주세요.)

□ Please write main occupation's type and details at marriage time concretely.

(결혼할 당시의 직업에 대한 일의종류와 내용을 사업체이름과 함께 구체적으로

기재합니다.)

<Wrong Example>  <잘못된 예시>

Employee, Public official, Business, Transportation business.

회사원, 공무원, 사업, 운수업

<Correct Example>  <올바른 예시>

Detailer. department of business, ○○company, Carpentry of architecture, architectural

permission in charge in ○○ district office, Sales of cloth in ○○shopping district,

Farming in our rice paddy field.

○○회사 영업부 판촉사원, 건축목공, ○○구청 건축허가 업무담당, ○○상가에서

의류판매, 우리 논에서 논농사.

※ Required Document(s)

□ Under 1 clause can be omitted if the department in charge of family relation

certification can check this information.

(아래 1항은 가족관계등록관서에서 전산으로 그 내용을 확인할 수 있는 경우 첨부를

생략합니다.)

1. The basic certificate of the family relationship register of the contracting parties in a

marriage, certificate of marriage, certificate of family relationship. Each 1 copy.

(혼인 당사자의 가족관계등록부의 기본증명서, 혼인관계증명서, 가족관계증명서 각1통)

2. Written consent of marriage 1 copy[In event that a minor or an incompetent of the

contracting parties in a marriage is signed(or sealed) a consent of report, this case is

excepted.]

(혼인동의서 1부[미성년자 또는 금치산자의 혼인의 경우 신고서 동의란에 기재하고 서명

(또는 날인)한 경우는 예외])

3. In the event of a register of marriage based on judgment on the certification the

existence of common-law marriage relationship : copy of a written judgment and a

irrevocable certificate each 1 copy

(사실혼관계 존재확인의 재판에 의한 혼인신고의 경우 그 재판서의 등본과 확정증명서 각 1부)

[In the event that reconciliation and mediation is established: a copy of the protocol of reconciliation and mediation and certificate of delivery Each 1 copy].

([조정, 화해성립의 경우 조정(화해)조서 및 송달증명서 각 1부].)

4. In the event of a marriage based on the Act on Special Cases Concerning Marriage     Registration : a certified copy of court judgment and conclusive judgment 1 copy

(혼인신고특례법에 의한 혼인의 경우 심판서의 등본 및 확정증명서 1부)

5. In the event that the requesting person is an alien and married through Korean

formality: an affidavit of eligibility for marriage (in the case of a Chinese, an

unmarried certificate and certificate of relative relationship) and a genuine copy of the

document(s) that prove his/her nationality (copy a family register, certificate of birth,

copy of passport or copy of alien identification registration) 1 copy

(한국에서 외국인과 한국인이 혼인하는 경우 외국인인 남자 또는 여자의 혼인성립 요건

구비 증명서(중국인인 경우 미혼증명서 및 친족관계증명서인 경우도 가능) 및 국적

증명 서면(예: 호적등본, 출생증명서, 여권사본, 신분등록부등본 등) 1부)

6. In the event that the couple agreed to make their child’s family name and family

origin follow the child’s mother’s family name and family origin, in accordance with

the Proviso of Article 781, Paragraph 1 of the Civil Law: a copy of the agreement

between the married couple. 1 copy.

(「민법」제781조 제1항의 단서에 따라 자녀의 성·본을 모의 성·본으로 하는 협의를 한

경우에는 협의 사실을 증명하는 혼인당사자의 협의서 1부)

7. Identification  (신분확인)

[In accordance with Article 23 in a certificate of family relations register]

([가족관계등록예규 제23호에 의함])

￭ Application by visit :

￭ If all applicants (couple) visit, then identification of both persons is required.           신고인이 출석한 경우 : 신고인 모두의 신분증명서

￭ If a representative visits, then the representative’s ID, identification of the applicants

(couple), notarized signatures or certificate of seal impression are required.

(제출인 출석의 경우 : 제출인의 신분증명서 및 신고인 모두의 신분증명서 또는 서면공증 또는 인감증명서(신고인의 신분증명서 없이 신고서에 신고인이 서명한

￭ Application by mail: notarized signatures or certificate of seal impression of

both applicants are required.

(우편제출의 경우 : 신고인 모두의 서명공증 또는 인감증명서(신고서에 서명한 경우 서명공증, 인감을 날인한 경우는 인감증명서))

□ In the event of a register of marriage based on judgment on the certification the existence of common-law marriage relationship: applicant's identification of visiting(one side in the parties of event) can instead of applicant's identification of nonappearance.

(사실혼관계존재확인의 확정판결에 의한 혼인신고의 경우에는 출석한 신고인

(사건본인들 중 일방)의 신분확인으로 불출석한 신고인의 신분확인에 갈음할 수 있습니다.)

[Form No.11]

Report of divorce (Designation of parental authority) ( ..... Day ..... Month .......... Year)										※ Please write after reading the guidelines on the back and, when required to select one option, please circle the number as follows "○".
Section					Husband						Wife
① Divorcing person	Name		Korean						(Seal) or signature								(Seal) or signature
			Chinese characters
	Place of family origin						Telephone No.				Place of family origin				Telephone No.
	Resident Registration No.				-						-
	Date of birth
	Permanent domicile address
	Address
② Parents (Adoptive parents)	Father name (Adoptive father)
	Resident Registration No.
	Mother name (Adoptive mother)
	Resident Registration No.
③ Other
④ Date of judgement ( )					..... Day ..... Month ........ Year						Court name	court
Below blank(thick line) for parental authority have to be written after confirming the agreement divorce intention of court in case of divorce by agreement.
⑤ Designation of parental authority (right)		Minor's name
		Resident registration No.			-						-
		Parental authority			□ Father □ Mother □ Parents	Valid date for designation		..... Day ..... Month ........ Year			□ Father □ Mother □ Parents		Valid date for designation			..... Day ..... Month ......... Year
						Reason		□Agreement □Judgement					Reason			□ Agreement □ Judgement
⑥ Reporter		Name				Relationship					□Husband □ Wife
⑦ Submitter		Name				Resident Registration No.					-

※ The following information is needed for establishing population policies, so you are obliged to declare truth fully under Articles 32 and 33 of the Statistics Law. Please only write the truth your privacy will be strictly protected.

⑧ Starting date of real marital(cohabitation) life			From .....Day .....Month ......Year		⑨ End date of cohabitation			From .....Day ......Month .........Year
⑩ Number of children under twenty years of age			.........		⑪ Kind of divorce			□ Divorce by agreement □ Divorce by judgement
⑫Reason for divorce (Choose one)				□ Marital infidelity □ Physical and mental abuse □ Family trouble □ Economic problems □ Personality differences □ Health problems □The others
⑬Nationality	Husband	□Korean □Naturalized Korean (Previous nationality: ) □Foreigner(Nationality: )				Wife	□Korean □Naturalized Korean (Previous nationality: ) □Foreigner(Nationality: )
⑭ Level of completed education	Husband	□ Uneducated □ Elementary school □ Middle school □ High school □ (College) University □ Graduate school				Wife	□ Uneducated □ Elementary school □ Middle school □High school □ (College) University □ Graduate school
⑮Occupation	Husband	* Please write type and details of main occupation.				Wife	* Please write type and details of main occupation.

Report of divorce /

Report for designation of parental authority

(이혼신고서 / 친권자 지정 신고서)

※ Writing method (작성방법)

￭ Permanent domicile address (등록기준지)

If you are a foreigner, please write your nationality.

(각 란의 해당자가 외국인인 경우에는 그 국적을 기재합니다)

￭ Resident registration number (주민등록번호)

If you are a foreigner, please write foreigner registration number

(domestic residence registration number or date of birth).

(각 란의 해당자가 외국인인 경우에는 외국인등록번호(국내거소신고번호 또는

출생연월일)를 기재합니다.)

① Divorcing person (Husband / Wife ) 이혼당사자 (남편/아내)

※ Writing method (작성방법) :

￭ In case of reporting by agreement divorce, must certainly sign(signature and seal)

both parties directly but in case of reporting by judgement divorce, can sign

(signature and seal) one party.

(협의이혼신고의 경우 반드시 당사자 쌍방이 서명(또는 기명날인) 하여야 하나,             재판상 이혼신고의 경우에는 일방이 서명(또는 기명날인)하여 신고할 수 있습니다.)

￭ Please write name in Korean or English and in Chinese characters.

(이혼당사자의 성명을 한글과 한자로 쓰세요.)

￭ Please write place of family origin and telephone No.

(이혼당사자의 본과 전화번호를 쓰세요.)

￭ Please write divorcing person's resident registration No.

(이혼당사자의 주민등록번호를 쓰세요.)

￭ Please write date of birth(Year / Month / day).

(이혼당사자의 출생연월일을 쓰세요.)

￭ Please write divorcing person's permanent domicile address.

(이혼당사자의 등록기준지(본적)를 쓰세요.)

￭ Please write divorcing person's address.

(이혼당사자의 주소를 쓰세요.)

② Parents (Adoptive parents) 부모 (양부모)

※ Writing method (작성방법) :

￭ If the parents of the divorcing person haven't resident registration No, please

write the permanent domicile address. If divorcing person is the adopted child,

please write the personal information of the adoptive parents and if the parents

of the divorcing person is a foreigner, please write the alien registration No.(or

date of birth) and nationality.

￭ 이혼당사자의 부모가 주민등록번호가 없는 경우에는 등록기준지(본적)를 기재합니다.            이혼당사자가 양자인 경우 양부모의 인적사항을 기재하며, 이혼당사자의 부모가

외국인인 경우에는 주민등록 번호란에 외국인등록번호(또는 출생연월일) 및 국적을

기재합니다.

￭ Please write father(adoptive father)'s name and resident registration number.

(부(양부)의 성명과 주민등록번호를 쓰세요.)

￭ Please write mother(adoptive mother)'s name and resident registration number.

(모(양모)의 성명과 주민등록번호를 쓰세요.

③ Other (기타사항)

※ Writing method (작성방법) :

￭ Please write especially necessary informations for clarifying the family

relation register.

(가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재 합니다.)

￭ If there are a person who the status is changed by declared incident, please write

name of the person, date of the birth, permanent domicile address and the reason of

the status changing.

(신고사건으로 인하여 신분의 변경이 있게 되는 사람이 있을 경우에 그 사람의 성명,

생년월일, 등록기준지 및 신분변경의 사유)

￭ If an incompetent have an agrement divorce, please write assentient's name,

signature(or seal) and date of birth.

(금치산자가 협의상 이혼을 하는 경우에는 동의자의 성명, 서명(또는 날인) 및 생년월일)

④ The confirmed date of judgment (재판확정일자)

￭ Please write the confirmed date(Year/Month/day) of judgment and name of court.

(재판확정 일자(년,월,일)와 법원명을 쓰세요.)

※ Writing method (작성방법)

￭ Please write only in case of divorce by judgment(reconciliation, arbitration) and

don't write in case of divorce by agreement .

(이혼판결(화해, 조정)의 경우에만 기재하고, 협의이혼의 경우에는 기재하지 않습니다.)

￭ In case of reporting the divorce according to valid arbitration, to decision for

substituting the arbitration, to valid reconciliation or to decision for recommending the

reconciliation, please write on below (  ) of the judgement confirmed date as

"Valid arbitration", "Decision confirmation for substituting the arbitration" or "Valid

reconciliation", "Decision confirmation for recommending the reconciliation" and write date

of valid(confirmation).

(조정성립, 조정에 갈음하는 결정, 화해성립이나 화해권고결정에 따른 이혼신고의 경우에

는 “재판확정일자” 아래의 ( )안에 “조정성립”, “조정에 갈음하는 결정확정” 또는 “화해성

립”, “화해권고결정”이라고 기재하고, “년월일”란에 그 성립(확정)일을 기재합니다.)

Please write below blank(parental authority) after confirming the agreement divorce

intention of the Court in case of the agreement divorce.

(아래 친권자란은 협의이혼 시에는 법원의 협의 이혼의사확인 후에 기재합니다.)

⑤ Designation of parental authority (친권자 지정)

※ Writing method (작성방법)

￭ If child is more than three persons, please attach after writing on annexed paper

with connection seal. In case of during pregnancy, please register the parental

authority on registering of the birth.

(임신 중인 자의 경우에는 출생신고 시 친권자 지정 신고를 합니다. 자녀가 3명

이상인 경우 별지 기재 후 간인하여 첨부합니다.)

￭ Please write minor's name and resident registration No.

(미성년인 자의 성명과 주민등록번호를 쓰세요)

￭ Please check the parental authority.(친권자를 선택하세요)

1) Father(부)    2)Mother(모)    3)Parents(부모)

※ Writing method (작성방법)

￭ Please don't write in case of appling for intention confirmation of agreement

divorce, write the decided parental authority after confirming the intention of

divorcing of the court.

￭ 협의이혼의사확인 신청시에는 기재하지 아니하며, 법원의 이혼의사확인 후에 정하여진

친권자를 기재합니다.

￭ Please write the valid date(day/month/year).(효력 발생일을 쓰세요)

※ Writing method (작성방법)

￭ The effective date for appointing is the divorce reported date in case of agreement           divorce and the judgment confirmed date in case of judgment divorce.

(지정효력발생일은 협의이혼의 경우 이혼신고일, 재판상이혼의 경우에는 재판 확정일을

기재합니다.)

￭ Please write the reason. (원인을 쓰세요)

1) Agreement (협의)   2) Judgment (재판)

※ Writing method (작성방법)

￭ The reason is marked by “○” on 1)Agreement in case of appointment by

agreement and on 2)Judgement in case of court decision by authority or

application and please must attach the paper for proving the contents.

(원인은 당사자의 협의에 의해 지정한 때에는 “□협의”에, 직권 또는 신청에 의해

법원이 결정한 때에는 “□재판”에 “○”으로 표시하고, 그 내용을 증명하는 서면을 첨부

하여야 합니다.)

⑥ Reporter (신고인)

￭ Please check 1) Husband (남편) 2) Wife (아내)

(신고인을 체크하세요 1) 남편   2) 아내)

※ Writing method (작성방법) :

￭ Please write personal data of submitting person(husband and wife) the divorce report

at family relation register office after confirming the agreement divorce intention of

the court. Please mark as “○” on relevant number of present declarer.

￭ 법원의 협의이혼의사 확인 후 가족관계등록관서에 이혼 신고서를 제출하는 당사자

(남편 또는 아내)의 인적사항을 기재합니다. 출석한 신고인 의 번호에 “○”를 하세요.

⑦ Submitter (제출인)

￭ Please write submitter's name and resident registration number.

(제출인의 이름, 주민등록번호를 쓰세요.)

※ Writing method (작성방법)

￭ Please write submitter's(regardless of declarer) name and resident registration No.

(제출자(신고인 여부 불문)의 성명 및 주민등록번호 기재 [접수담당공무원은 신분증과 대조])

※ The following information is needed for establishing population policies, so you are

obliged to declare truth fully under Articles 32 and 33 of the Statistics Law. Please

only write the truth your privacy will be strictly protected.

(다음은 국가의 인구정책 수립에 필요한 자료로(통계법) 제32조 및 제33조에 따라 성실

응답의무가 있으며 개인의 비밀사항이 철저히 보호되므로 사실대로 기입하여 주시기

바랍니다.)

※ Writing method(No. 8~9) (작성방법 8~9번)

￭ Please write the starting date of cohabitation and the ending date of cohabitation

without relation of the registered date or the

judgment confirmed date on the family relation register.

￭ 가족관계등록부상 신고일이나 재판확정일과는 관계없이 실제로 결혼(동거)생활을 시작한

날과 사실상 이혼(별거)생활을 시작한 날을 기재합니다.

⑧ Starting date of real marital(cohabitation) life (실제 결혼(동거)생활 시작일)

￭ Please write starting date of real marital(cohabitation) life.

(실제 결혼(동거)생활 시작일을 쓰세요.)

From ....day.....month......year

⑨ Ending date of cohabitation (실제이혼연월일)

￭ Please write the ending date of cohabitation. (실제 이혼연월일을 쓰세요.)

From ....day .... month .... year

Number of children under twenty years of age (20세미만 자녀수)

￭ Please write number of children under twenty years of age.

(20세 미만 자녀의 수를 쓰세요.)

Type of divorce (이혼의 종류)

￭ Please check the type of divorce. (이혼의 종류를 쓰세요.)

1) Divorce by agreement (협의이혼)

2) Divorce by judgement (재판에 의한 이혼)

Reason for divorce (이혼사유) Choose one (택일)

￭ Please choose one for reason of divorce in belows.

(이혼 사유를 하나만 선택하세요.)

1) Marital infidelity (배우자 부정)

2) Physical and mental abuse (정신적, 육체적 학대)

3) Family trouble (가족간 불화)

4) Economic problems (경제문제)

5) Personality differences (성격차이)

6) Health problems (건강문제)

7) Other (기타)

Nationality (Husband / Wife) 국적 (남편/처)

￭ Please write nationality of husband and wife. (남편과 처의 국적을 쓰세요.)

1) Korean (한국인)

2) Be naturalized as a Korean (귀화한 한국인) :

Previous nationality (이전국적)

3) Foreigner (외국인) : Nationality (국적)

Graduate school (Husband / Wife) 최종졸업학교 (남편/처)

￭ Please write husband and wife's graduate school. (최종졸업학교)

1) Uneducated (무학)  2) Elementary school (초등학교)  3) Middle school (중학교)  4) High school (고등학교)  5) University (대학교)  6) Graduate school (대학원이상)

※ Writing method (작성방법)

￭ As standard the admitted all regular education institute by Ministry of Education, Science

and Technology, if 'in' or 'dropout' of each school, mark as “○” on number of

final graduated school.

<Ex.>Junior dropout of University : please mark as “○” on high school.

(교육과학기술부장관이 인정하는 모든 정규교육기관을 기준으로 기재하되 각급 학교의

재학 또는 중퇴자는 졸업한 최종 학교의 해당번호에 ○표시를 합니다.

<예시> 대학교 3학년 중퇴 → 고등학교에 ○표시)

Occupation (Husband / Wife) 직업 (남편/처)

￭ Please write kind and details of main occupation.

(주된 일의 종류와 내용을 기입하세요.)

※ Writing method (작성방법)

￭ Please write kind of main occupation and details with name of company of the

parents on birth of baby.

<Wrong Ex.> Employee, civil servant, businessman, transportation businessman

<Correct Ex.> Detailer of sales department for ○○company, architectural

carpenter, active partner of building permission at ○○gu office, clothes

salesperson at ○○shopping store , farmer in our rice paddy

(결혼할 당시의 직업에 대한 일의종류와 내용을 사업체이름과 함께 구체적으로 기재합니다.)

<잘못된 예시> 회사원, 공무원, 사업, 운수업

<올바른 예시> ○○회사 영업부 판촉사원, 건축목공, ○○구청 건축허가 업무담당, ○○상가에서

의류판매, 우리 논에서 논농사

□ Attached documents 첨부서류

1. Agreement divorce : One set a confirmation copy for agreement divorce intention

(협의이혼 : 협의이혼의사확인서 등본 1부)

2. Judgement divorce : Each one set a certified copy of judgement and decision

certificate (재판이혼 : 판결등본 및 확정증명서 각 1부)

(in case the arbitration and the reconciliation were established, report copy

and dispatch certificate). (조정․화해 성립의 경우는 조서등본 및 송달증명서).

3. Judgement divorce by decision of foreign court

(외국법원의 이혼판결에 의한 재판상 이혼)

￭ Each one set the original or copy of divorce decision and certificate of

confirmed decision.

(이혼판결의 정본 또는 등본과 판결확정증명서 각 1부.)

￭ One set the certifying paper the acceptance of lawsuit fact, in case the defeated

defendant is our nation(people), if he received the necessary summon or

conveyance of command for beginning the lawsuit without conveyance by

public announcement or not.

(패소한 피고가 우리나라 국민인 경우에 그 피고가 공시송달에 의하지 아니하고

소송의 개시에 필요한 소환 또는 명령의 송달을 받았거나 또는 이를 받지

아니하고도 응소한 사실을 증명하는 서면 1부)

(This is only in case of not clear by decision).

(판결에 의하여 이점이 명백하지 아니한 경우에 한한다).

￭ One set translation for above each papers.

(위 각 서류의 번역문 1부.)

※ If the details of below No. 4 is checked by data processing at office of family

relation register, omit to attach.

(아래 4항은 가족관계등록관서에서 전산으로 그 내용을 확인할 수 있는 경우 첨부를 생략합니다.)

4. Each one set the family relation certificate and marriage relation certificate of

family relation register for each divorcing person

(이혼 당사자 각각의 가족관계등록부의 가족관계증명서, 혼인관계증명서 각 1통)

5. Documents for explaining to be related the appointed of parental authority

(친권자지정과 관련한 소명자료)

￭ One set the copy of parental authority appointing agreement in case of agreement

(협의에 의한 경우 친권자지정 협의서등본 1부)

￭ One set the original of judgment and decision certificate in case of court's decision

(법원이 결정한 경우 심판서 정본 및 확정 증명서 1부)

6. Identification 신분확인

[according to Article 23 of the family relation register established rule]

[가족관계등록예규 제23호에 의함]

① Report for divorce on judgment  재판상 이혼신고

￭ In case of declarer's attendance : Identification card

(신고인이 출석한 경우 : 신분증명서)

￭ In case of submitter's attendance : Submitter's identification card

(제출인이 출석한 경우 : 제출인의 신분증명서)

￭ In case of postal submission : Copy of declarer's identification card

(우편제출의 경우 : 신고인의 신분증명서 사본)

② Report for divorce on agreement 협의이혼신고

￭ In case of declarer's attendance : Identification card for declarer unilateral

(신고인이 출석한 경우 : 신고인 일방의 신분증명서)

￭ In case of declarer's nonappearance and submitter's attendance :

Submitter's identification card and identification card for declarer unilateral or

notarized signature or certificate of seal impression(If declarer signed on report

without identification card, attach a notarized signature and sealed on report, a

certificate of seal impression)

(신고인 불출석, 제출인 출석의 경우 : 제출인의 신분증명서 및 신고인 일방의 신분증

명서 또는 서명공증 또는 인감증명서(신고인의 신분증명서 없이 신고서에 신고인이 서명

한 경우 서명공증, 신고서에 인감 날인한 경우 인감증명)

￭ In case of postal submission : Notarized signature or certificate of seal

impression for declarer unilateral(In case of signing on report, a notarized

signature and sealing on report, a certificate of seal impression).

(우편제출의 경우 : 신고인 일방의 서명공증 또는 인감증명서(신고서에 서명한 경우

서명공증, 인감을 날인한 경우는 인감증명서).

■ 인감증명법 시행령 [별지 제15호의4서식] <개정 2020. 2. 18.>
■ Enforcement Decree of The Personal Seal Act [Form an enclosure No. 15 4]
[ ] Application for the Protection of Personal Seal [ ] Application for Cancelling the Protection of Personal Seal
※ Fill out this form and check where appropriate according to the instructions on the back of the form.									(Front)
Application No.			Date			Processing Time		Immediate
Applicant		Name			Resident Registration No. -			Nationality
		Address						Right Thumb print
		Description for Application
Consent of a Legal Representative, Limited guardian or Adult guardian		Name			Relationship to Applicant			Personal seal or Signature ※ Attach the certificate of personal signature at the time of signing
		Date of Birth
		Address
Confirmation of Diplomatic Mission (Consul), Prison (Prison Officer), Town Government(Civil Servant)
I certify	[ ] the application for the protection of the personal seal. [ ] the application for cancelling the protection of the personal seal of the applicant. [ ] the consent of a legal representativeㆍlimited guardianㆍadult guardian.
Date (YYYY/MM/DD) [ ] Diplomatic Mission (Consul) (Signature or Seal) [ ] Prison (Prison Officer) (Official Seal) (Signature or Seal) [ ] Town Government(Civil Servant) (Signature or Seal) ※ Civil Servant only writes when declarant cannot visit the Town Government because of serious case
I apply for the protection of personal seal or for cancelling the protection of personal seal according to Article 17-2 of the Enforcement Decree of the Seal Imprint Certification Act.
Date (YYYY/MM/DD)
Applicant:				(Signature or Seal)
Representative:				(Signature or Seal)
Resident Registration No.:
Address:
For the Head of the City/County/District/Town/Local Government of
210mm×297mm[white paper (80g/㎡) or middle quality paper(80g/㎡)]

(Back)
Notes and Instructions
1. All representatives visiting a government office and applying for the protection (or cancelling the protection) of a personal seal on behalf of an applicant who is an overseas Korean national, a person residing (visiting) abroad, or a prisoner must bring a form of identification such as a resident registration card. 2. For resident registration number: If you are an overseas Korean national and do not have a resident registration number, enter your passport number; if you are a foreigner, enter your alien registration number; and if you are a registered domestic resident, enter your domestic residence report number. 3. Applying for the protection (or cancelling the protection) of a personal seal allows you to protect (or cancel the protection of) your personal seal by ensuring that only you or a person authorized by you can be issued the certificate of your personal seal. Describe what you are applying for in the "Description for Application" section, referring to the following examples. [Examples] □ Do not issue the certificate of personal seal to anyone but myself. □ Do not issue the certificate of personal seal to anyone except myself and my spouse (name, resident registration number). □ Do not issue the certificate of personal seal to anyone except myself, my spouse (name, resident registration number), and my mother (name, resident registration number). □ The certificate of my personal seal shall only be issued at (the city/county/district/town/local government relevant to the address); do not issue at other locations of government office. □ Other description that is necessary for the protection or cancelling the protection of personal seal. 4. If you are not able to affix your thumbprint, affix any other fingerprint instead; the print must be neatly and clearly affixed. 5. If an overseas Korean national, a person residing (visiting) abroad, or a prisoner designates a representative to apply on his/her behalf, the applicant must receive a confirmation from one of the following organizations as applicable. a. Overseas Korean national, person residing (visiting) abroad: Diplomatic mission (Consul); or b. Prisoner: Prison (Prison Officer). 6. Check where appropriate to indicate whether you are applying for the protection or cancelling the protection of a personal seal. If the applicant is a minor, limited wards or adult wards, also check the legal representativeㆍlimited guardianㆍadult guardian section. 7. Check where appropriate to indicate whether the organization is a diplomatic mission or a prison.
Procedure
This application form will be processed as follows.
	Applicant						1. A minor, limited wards or adult wards must get the consent of their legal representativeㆍlimited guardianㆍadult guardian. 2. An overseas Korean national (person visiting abroad) or a prisoner must receive confirmation from a diplomatic mission or a prison.
	Submitting Application		▲		Accepting Application
		▼
	Government office receiving personal seal registration (if this is government office in charge, it manages the register of personal seals)				Reporting Application				▶		Government office in charge (manages the register of personal seals)

□ Application for protecting the seal impression (인감보호 신청)

□ Application for cancellation the protection of seal impression (인감보호 해제 신청)

□ Applicant (신청인)

￭ Please write name with Chinese characters.

(신청인의 성명을 한글과 한자로 쓰세요.)

￭ Please write resident registration No. (신청인의 주민등록번호를 쓰세요.)

￭ Please write nationality. (신청인의 국적을 쓰세요.)

￭ Please write address in Korea. (신청인의 국내주소를 쓰세요.)
￭ Please write overseas address. (신청인의 국외주소를 쓰세요.)

￭ Please write the reason to apply protection of seal impression (cancellation of protection) (인감보호(보호해제) 신청사유를 쓰세요.)

￭ Please put the right fingerprint. (신청인의 우무인을 찍으세요.)

□ Consent of legal representative (법정대리인의 동의)

￭ Please write name of legal representative. (법정대리인의 성명을 쓰세요.)

￭ Please put seal impression of legal representative. (법정대리인의 인감을 날인하세요.)

￭ Please write resident registration No. of legal representative.

(법정대리인의 주민등록번호를 쓰세요.)

￭ Please write address in Korea of legal representative.

(법정대리인의 국내주소를 쓰세요.)

￭ Please write overseas address of legal representative.

(법정대리인의 국외주소를 쓰세요.)

￭ Please write relationship with reporter. (신고인과의 관계를 쓰세요.)

□ Confirmation of the diplomatic establishment abroad (consulate)·jurisdiction office (재외공관(영사관)·수감기관의 확인)

※ I hereby confirm the facts checked below about the above applicant.

□ Application for protection of the seal impression

□ Application for cancellation of the protection of seal impression

□ Consent of legal representative

(위 신고인의 [□인감보호신청  □인감보호해제신청 □법정대리인 동의]사실을 확인합니다.)

￭ Please reactive the signature from diplomatic establishment abroad(consulates) and receive the seal from jurisdiction office. (재외공관(영사관)·수감기관의 확인을 받으세요.)

※ I hereby apply for a protection seal impression or for a cancellation of the protection of seal impression as above in accordance with Article 7 Section 2 of the 「Enforcement Ordinance of the Law for Seal Impression’s Certification」.

(「인감증명법 시행령」 제7조의2에 따라 위와 같이 인감보호 또는 인감보호해제를 신청합니다.)

￭ Please write date of application. (신청일을 쓰세요.)

￭ Please write name of applicant and signature and seal.

(신청인의 성명을 쓰고 서명날인 하세요.)

￭ Please write name of proxy and signature and seal.

(대리인의 성명을 쓰고 서명날인 하세요.)

□ NOTES 유의사항

1. The proxy who visit to certifying office in order to apply the protection(cancellation to protect) of seal impression for overseas nation or resident(sojourner) abroad or termer must submit identification card certainly.

(재외국민 또는 해외거주(체류)자 또는 복역자의 인감보호(보호해제)신청을 하기 위하여 증명청을 방문하는 대리인은 반드시 주민등록증 등을 제시하여야 합니다.)

2. In case of an overseas residents, please write passport No.(date of birth) on section of resident registration No. and in case of a foreigner, write alien registration No. and in case of a domestic residence declarer, write domestic residence report No.

(재외국민의 경우에는 여권번호(생년월일). 외국인의 경우에는 외국인등록번호, 국내거소신고자의 경우에는 국내거소신고번호를 주민등록번호란에 기재합니다.)

3. System for application to protect(cancellation to protect) of seal impression is able to limit the issuance recipient of seal impression as the own or person who is fixed by own in order to protect(cancel the protection) of own’s seal impression or be prohibited to issue ny online and so on. Please write the contents to want like below example on section of reasons for application to protect(cancellation to protect) of seal impression reason of and then submit.

[Example to write]

① Prohibit to issue except own.

② Prohibit to issue except own and wife(ㅇㅇㅇ: resident registration No.).

③ Prohibit to issue except own, wife(ㅇㅇㅇ: resident registration No.) and, mother(ㅇㅇㅇ: resident registration No.).

④ Prohibit to issue in the other eup·myeon·dong(ny online).

⑤ Additional necessary contents for protection of seal impression or cancellation to protect seal impression.

(인감보호(보호해제)신청은 본인의 인감을 보호(보호해제)하기 위하여 인감증명의 발급대상을 본인 또는 본인이 지정하는 대상으로 제한하거나, 온라인 발급 등을 금지시킬 수 있는 제도입니다. 원하는 내용을 아래 예시와 같이 인감보호(보호해제) 신청사유란에 기재하여 제출하시면 됩니다.)

[기재 예시]

① 본인외 발급금지  ② 본인, 처(ㅇㅇㅇ: 주민등록번호)외 발급금지 ③ 본인, 처(ㅇㅇㅇ: 주민등록번호) ④ 본인, 처(ㅇㅇㅇ: 주민등록번호), 모(ㅇㅇㅇ: 주민등록번호)외 발급금지 ④ 다른 읍·면·동에서의 발급금지(온라인 발급금지) ⑤ 그 밖에 인감보호(보호해제)에 필요한 내용

4. If it is difficult to put right fingerprint, please put left fingerprint. Fingerprint has to be put cleanly and clearly.

(우무인 날인이 곤란한 경우에는 좌무인을 날인하며, 무인은 선명하고 깨끗하게 날인하여야 합니다.)

5. Application of seal impression’s protection(cancellation to protect) can all si·gun·gu office and eup·myeon·dong office of whole country. Only, overseas nation or resident(sojourner) abroad have to be confirmed by head of diplomatic offices and termer or prisoner have to be confirmed by prison governor and then submit.

(인감보호(보호해제) 신청은 전국의 모든 시·군·구청 및 읍·면·동사무소에서 할 수 있습니다. 다만, 재외국민 또는 해외거주(체류)자인 경우에는 재외공관장의 확인, 복역자 또는 수감자는 교도소장 등의 확인을 받아 제출하여야 합니다.)

6. In case of application to protect to cancel the protection of seal impression, please check on section of relevant matters and then submit. In this case, minors have to be checked on section of legal representative, also.

(인감의 보호 신청이나 보호해제 신청을 하려는 경우에는 해당사항란에 체크 표시를 한 후 제출합니다. 이 경우 미성년자인 때에는 법정대리인란에 체크 표시를 함께 하여야 합니다.)

7. Please check on section of relevant matters between diplomatic office and jurisdiction office.

(재외공관 또는 수감기관 해당사항란에 체크표시를 합니다.)

■ 인감증명법 시행령 [별지 제9호의2서식] <개정 2020. 2. 18.>
■ Enforcement Decree of The Personal Seal Act [Form an enclosure No. 9 2]
Application for Registration (or Change) of Personal Seal (for written registration)
※ Fill out this form and check where appropriate according to the instructions on the back of the form.	(Front)
Application No.		Date		Processing Time	Immediate
Applicant	Name	Resident Registration No.	Nationality(The address on the family relations registration)
Address	Personal Seal to Register
Reason for Written Registration	For Preservation	Attach seal impression on paper.
Supporting Documents (Attachment)
Guarantor	Name	Personal seal or Signature ※ Attach the certificate of personal signature at the time of signing
Resident Registration No. (Date of Birth)
Relationship to Applicant
Address
Consent of a Legal Representative, Limited guardian or Adult guardian	Name	Relationship to Applicant	Personal seal or Signature ※Attach the certificate of personal signature at the time of signing
Date of Birth
Address
I certify	[ ] the registration (or change) of the personal seal. [ ] the consent of a legal representativeㆍlimited guardianㆍadult guardian.
Date (YYYY/MM/DD) [ ] Diplomatic Mission (Consul) (Signature or Seal) [ ] Prison (Prison Officer) (Official Seal) (Signature or Seal)
I hereby apply for a written registration of my personal seal by submitting this form jointly signed with my guarantor (legal representative, limited guardian or adult guardian) according to Articles 3, 7, and 13 of the Seal Imprint Certification Act and Clauses 2, 3 and 4 of Article 8 of the Enforcement Decree of the Seal Imprint Certification Act. Date (YYYY/MM/DD)	Fee
Register	NONE
Change	600 won
Applicant: (Signature or Seal) Representative: (Signature or Seal) Resident Registration No.: Address: For the Head of the City/County/District/Town/Local Government of
210mm×297mm[white paper(80g/㎡)or middle quality paper(80g/㎡)]

(Back)
Notes and Instructions
1. If an applicant registering a personal seal for the first time or wishing to change the personal seal is unable to visit a government office in person, he or she may use this form to register or report the change of a personal seal in writing without visiting a government office. 2. The guarantor must be an adult with a registered personal seal and must certify and guarantee the applicant’s intention. The personal seal affixed by the guarantor must be a registered seal, and the government office may request the guarantor to submit his/her personal seal if it is difficult for a data processing organization to identify the seal. 3. A legal representative visiting the government office must be a different person from the guarantor and must bring his/her own ID. 4. In order to register a personal seal, affix the personal seal to be registered in the "For Preservation" box, and attach a clear impression of the seal on a piece of paper. The seal impression on paper may be waived if the seal stamp is submitted along with the form. 5. The public official in charge must attach the seal impression on paper to the register of personal seals and stamp an official seal where the edge of the attached paper meets the register. 6. If the applicant is an overseas Korean national and does not have a resident registration number, enter the address on the family relations registration in the "Nationality" section. 7. In the "Reason for Written Registration" section, enter the reason why the applicant is unable to visit the government office and attach the supporting documents at the time of the submission. If supporting documents are submitted, they are valid for three months from the date of confirmation of the reason (six months from the date of confirmation when certified by a diplomatic mission). 8. For resident registration number: If you are an overseas Korean national and do not have a resident registration number, enter your passport number; if you are a foreigner, enter your alien registration number; and if you are a registered domestic resident, enter your domestic residence report number. If you have your resident registration number, enter the number on a separate line underneath in a parenthesis, in the space provided. 9. Check where appropriate to indicate written registration of the personal seal or consent of a legal representativeㆍlimited guardianㆍadult guardian. 10. All persons authorized to apply on behalf of an overseas Korean national, a person residing (visiting) abroad, or a prisoner must receive a confirmation from one of the following organizations as applicable (not applied to an overseas Korean national who resides in Korea) a. Overseas Korean national, person residing (visiting) abroad: Diplomatic mission (Consul); or b. Prisoner: Prison (Prison Officer).
Procedure
This application form will be processed as follows.
	Applicant							In order to apply with a written form, a guarantor (a legal representative, limited guardian or adult guardian also needed in case of a minor, limited wards or adult wards) and supporting documents explaining why the applicant cannot come in person are needed.
	Submitting Application		▲		Accepting Application
		▼
	Government office receiving personal seal registration				Verification						▶	Register of personal seals
					◀
						Personal Seal (Change) Registration

Application for Registration (or Change) of Personal Seal

[for written registration] (인감(변경)신고서) [서면신고용]

□ Reporter (신고인)

￭ Please write name with Chinese characters.

(신고인의 성명을 한글과 한자로 쓰세요.)

￭ Please write resident registration No. (신고인의 주민등록번호를 쓰세요.)

￭ Please write nationality. (신고인의 국적을 쓰세요.)

￭ Please write address in Korea. (신고인의 국내주소를 쓰세요.)
￭ Please write overseas address. (신고인의 국외주소를 쓰세요.)

￭  Please write reason of a written report. (서면신고 사유를 쓰세요.)

￭ Please attach supporting evidence as an annexed. (입증자료를 첨부하세요.)

￭ Please affix the seal impression paper. (인감지를 붙이세요.)

□ Guarantor (보증인)

￭ Please write name and put seal impression. (보증인의 성명을 쓰고, 인감 날인하세요.)

￭ Please write address in Korea. (보증인의 국내주소를 쓰세요.)
￭ Please write overseas address. (보증인의 국외주소를 쓰세요.)

￭ Please write resident registration No. (보증인의 주민등록번호를 쓰세요.)

￭ Please write relationship with reporter. (신고인과의 관계를 쓰세요.)

□ Consent of legal representative (법정대리인의 동의)

￭ Please write name of legal representative. (법정대리인의 성명을 쓰세요.)

￭ Please put seal impression of legal representative. (법정대리인의 인감을 날인하세요.)

￭ Please write resident registration No. of legal representative.

(법정대리인의 주민등록번호를 쓰세요.)

￭ Please write address in Korea of legal representative.

(법정대리인의 국내주소를 쓰세요.)

￭ Please write overseas address of legal representative.

(법정대리인의 국외주소를 쓰세요.)

￭ Please write relationship with reporter. (신고인과의 관계를 쓰세요.)

□ Confirmation of the diplomatic establishment abroad (consulate)

(재외공관(영사관)의 확인)

※ I hereby confirm that this is the seal impression.

[□ Written report(Alteration)□ Consent of legal representative]

(위 신고인의 인감 [□서면 신고(변경) □법정 대리인의 동의]사실을 확인합니다.)

￭ Please receive the signature from diplomatic establishment abroad(consulate).

(재외공관(영사관)·수감기관의 확인을 받으세요.)

※ I hereby report by written form above by co-signing with the guarantor (legal representative) as in accordance with Article 3 and Article 7 (Article 13) of the 「Law for Seal Impression’s Certification」.

(「인감증명법」 제3조 및 제7조(제13조)의 규정에 의하여 위와 같이 보증인(법정대리인)과 연서하여 서면신고 합니다.)

※ Handing charge is nothing for report but 600won for alteration.

(수수료는 신고 시에는 없고, 변경 시에는 600원입니다.)

□ Reporter(신고인)

￭ Please write date of report. (신고일을 쓰세요.)

￭ Please write name of reporter and signature and seal.

(신고인의 성명을 쓰고 서명날인 하세요.)

￭ Please write address and and resident No. of reporter.

(신고인의 주소를 쓰고 서명날인 하세요.)

□ Proxy (대리인)

￭ Please write name of reporter and signature and seal.

(대리인의 성명을 쓰고 서명날인 하세요.)

￭ Please write address and and resident No. of reporter.

(대리인의 주소를 쓰고 주민등록번호를 쓰세요.)

￭ Please write relationship with reporter. (신고인과의 관계를 쓰세요.)

□ NOTES 유의사항

1. If the person who register seal impression firstly or registered already can’t visit to office of seal impression’s register personally, this form is used for registration seal impression or alteration of seal impression as written own’s visit to certifying office.

(이 서식은 인감을 처음 신고하거나 이미 신고한 자가 인감신고기관에 본인이 직접방문할 수 없는 경우에 본인이 증명청을 방문하지 아니하고 서면으로 인감신고 또는 인감변경신고를 할 때 사용합니다.)

2. The guarantor has to be an adult who registered seal impression and the used seal impression has to be a registered seal impression certainly. In this case, the proxy who visit to certifying office must submit own’s identification can also the seal impression of guarantor has to be checked by data processing organization but if it’s difficult, a seal impression can be required to submit.

(보증인은 인감이 신고된 성년자이어야 하며, 사용인감은 반드시 신고된 인감이어야 합니다. 이 경우 증명청을 방문하는 대리인은 본인의 신분증을 제시하여야 하며, 또한 보증인의 인감은 증명청이 전산정보처리조직에 의하여 확인을 하므로 이의 확인이 어려울 경우 그 인감제출을 요구할 수 있습니다.

3. The guarantor must vouch for applicant after checking true or not of real intention.

(보증인은 신고인의 진위여부를 확인하고 보증하여야 합니다.

4. Applicant must seal on section for preservation in order to register of seal impression and must attach ‘one sheet of seal impression paper’. Only, if seal for seal impression is enclosed, can omit the paper of seal impression.

(신고인의 인감신고는 신고인감의 보존용란에 날인하고, ‘인감지 1매’를 첨부하여야 합니다. 다만, 인감인을 동봉한 때에는 인감지를 생략할 수 있습니다.)

5. A concerned public servant must affix the paper of seal impression on prescribed seal impression section of seal impression register and then seal by official seal on overlapped part between seal impression register and seal impression paper.

(관계공무원은 인감대장의 소정인감란에 인감지를 첨부한 후 인감대장과 인감지의 겹치는 부분에 직인으로 간인하여야 합니다.)

6. In case of oversea nation, write the permanent domicile address on section of applicant’s nationally and via(confirm) diplomatic establishment abroad (consulate) and then submit.

(재외국민의 경우에는 신고인의 국적란에 본적을 기재하여 재외공관(영사관)을 경유(확인)한 후 제출하여야 합니다.)

7. On section of report reason, write the reason why applicant can’t visit personally and submit together provable documents about the fact. In this case, expiration period of the submitted documents is 3months(confirmation of diplomatic establishment abroad is 6months from checked date) from checked date the reason.

(신고 사유란에는 신고자가 방문할 수 없는 사유를 기재하고, 그 사실을 증명할 수 있는 서류를 함께 제출하여야 합니다. 이 경우 제출하는 서류의 유효기간은 그 사유 확인일부터 3월(재외공관의 확인은 확일부터 6월)입니다.)

8. In case of overseas nation, write passport No. on section of resident registration and in case of foreigner, write alien registration No. and in case of domestic residence declarer, write domestic residencs report No. and write in the below blank (  ) the resident registration No.

(재외국민의 경우에는 여권번호, 외국인의 경우에는 외국인등록번호, 국내거소 신고자의 경우에는 국내거소신고번호를 주민등록번호란에 기재하고, 주민등록번호는 그 아래의 여백을 이용하여 (  ) 안에 표기합니다.)

9. If it is via diplomatic establishment abroad, check on relevant section.

(재외공관 경유시 해당사항란에 체크표시를 합니다.

■ 인감증명법 시행령 [별지 제13호의2서식] <개정 2020. 2. 18.>
■ Enforcement Decree of The Personal Seal Act [Form an enclosure No. 13 2]									(Front)
[ ] Power of Attorney/Consent of a Legal Representative, Limited guardian or Adult guardian for Certificate of Personal Seal [ ] Written Confirmation by a Diplomatic Mission (Consul) or Prison (Prison Officer) [ ] Written Confirmation by the District Tax Office (Head of the Tax Office)
※ Fill out this form and check where appropriate according to the instructions on the back of the form. The "Nationality" section is only for written confirmation by a diplomatic mission (consul). Anyone who applies for a certificate of personal seal that belongs to a deceased person may be denounced to the authorities. ※ Those who apply for a certificate of personal seal may request for text message notification of whether their certificate has been issued.
[Power of Attorney for Certificate of Personal Seal ]
Authorizer	Name			(Signature or Seal)		Resident Registration No.
	Nationality			［ ］Address
	Type of Identification Card			Purpose of Issuance			No. of Copies
Authorized Person (Applicant)	Name			Resident Registration No.
	［ ］Address						Relationship
Mandate reason
I authorize the above-named person to be issued with a certificate of my personal seal. Date (YYYY/MM/DD)
[Consent of a Legal Representative, Limited guardian or Adult guardian]
Legal Representative, Limited guardian or Adult guardian	Name					Resident Registration No.
	Address
	Relationship				No. of Copies		Personal seal or Signature ※ Attach the certificate of personal signature at the time of signing
I agree on the issuance of a certificate of the personal seal of this person (Name: ). Date (YYYY/MM/DD)
I certify that the authorization above is true and accurate. Date (YYYY/MM/DD) [ ] Diplomatic Mission (Consul) (Signature or Seal) [ ] Prison (Prison Officer) (Official Seal) (Signature or Seal)
Confirmation of the Head of Tax Office			Type of Real Estate
			Location of Real Estate
I confirm the information above. Date (YYYY/MM/DD) Head of Tax Office (Signature or Seal)
210mm×297mm[white paper(80g/㎡)]

(Back)

Notes and Instructions

1. For the "Power of Attorney" or "Consent of a Legal Representative, limited guardian or adult guardian", enter the date on which the issuance is authorized. The Power of Attorney shall remain effective for six months from the date of authorization or consent.

2. If you wish to receive two or more copies of the certificate, specify the number of copies needed in the "No. of Copies" section. If left blank, one copy will be issued.

3. In the "Purpose of Issuance" section, enter why a certificate of the personal seal is needed (e.g. for real estate sales, for collateral security, for car sales, etc.), and print your name in the "signature" section.

※ In the "Purpose of Issuance" section, do not put a statement such as "I give this person full authority to sell my real estate".

4. If you are authorized to be issued with a certificate of a personal seal for a minor, limited wards or adult wards, you must fill out both "Power of Attorney" and "Consent of a Legal Representative, limited guardian or adult guardian".

5. A person whose resident registration has been cancelled(exclusive of emigration) or who does not have a registered address cannot be authorized to be issued a certificate of the personal seal. The authorized person must show his/her ID if requested for the purpose of checking the accuracy of the information submitted from the following list of an acceptable ID: resident registration card,  driver’s license, passport, registration card for people with disabilities [(welfare card) welfare cards without resident registration number and address on them are excluded].

6. For resident registration number: if you are an overseas Korean national and do not have a resident registration number, enter your passport number;  if you are a registered domestic resident, enter your domestic residence report number; and if you are a foreigner, enter your alien registration number.

7. If an overseas Korean national, a person residing (visiting) abroad, or a prisoner authorizes a person to be issued with a certificate of the personal seal, he/she must receive a confirmation from one of the following organizations as applicable (not applied to an overseas Korean national who resides in Korea) In addition, if an overseas Korean national wishes to be issued with a certificate of his/her personal seal for the purpose of a transfer of real estate property rights, he/she must enter the type and location of the real estate concerned and receive a confirmation from the head of the tax office in the jurisdiction in which the real estate belongs.

a. Overseas Korean national, person residing (visiting) abroad: Diplomatic mission (Consul); or

b. Prisoner: Prison (Prison Officer).

8. Those who counterfeit the signature or seal of someone else or use it in a fraudulent manner (e.g. applying for or being issued with a certificate of personal seal of someone else or a deceased person by false entry of information) are subject to punishment in accordance with Articles 231 through 240 of the criminal law.

□ Power of attorney/Consent of a Legal Representative, Limited guardien or Adult guardian for Certificate of Personal Seal (인감증명 위임장 또는 법정대리인 동의서)

□ Written Confirmation by a Diplomatic Mission (Consul) / by the District Tax Office (Head of the Tax Office) (재외공관(영사관) 및 세무서 확인서)

□ Letter of attorney 위임장

※ Person to be delegated(Proxy) 위임을 받은 자

￭ Please write name in Korean or English and in Chinese characters.

(위임을 받은 자의 성명을 한글과 한자로 쓰세요.)

￭ Please write resident registration No. (위임을 받은 자의 주민등록번호를 쓰세요.)

￭ Please write address. (위임을 받은 자의 주소를 쓰세요.)

￭ Please write number of issuance. (인감증명의 발급통수를 쓰세요.)

￭ Please write usage of seal impression certification.

(인감증명의 사용용도를 쓰세요.)

￭ Please write reason to delegate. (위임사유를 쓰세요.)

￭ Please write relationship with mandator. (위임자와의 관계를 쓰세요.)

※ I hereby delegate the above person to receive a certification of seal impression on

my behalf. (본인의 인감증명서 발급을 위 사람에게 위임합니다.)

￭ Please write date( ..... day ..... month ........ year). 날짜를 쓰세요.

￭ Please write name, resident registration No. and address of mandator.

(위임자의 성명, 주민등록번호, 주소를 쓰세요.)

□ Consent of legal representative 법정대리인의 동의

※ I hereby consent to be issued with a certification on behalf of (name:        ).

((성명:          )에 대한 증명서 발급을 동의합니다.)

￭ Please write number of issuance. (증명서 발급통수를 쓰세요.)

￭ Please write date( ..... day ..... month ........ year). 날짜를 쓰세요.

￭ Please write name and resident registration No. of legal representative.

(법정대리인의 성명과 주민등록번호를 쓰세요)

￭ Please write relationship with mandator. (위임자와 관계를 쓰세요.)

￭ Please write address of legal representative. (법정대리인의 주소를 쓰세요.)

￭ Please put seal impression of legal representative. (법정대리인의 인감을 날인하세요.)

□ Confirmation of head of overseas diplomatic and consular mission

재외공관장 확인

※ I hereby confirm the above delegation facts. 위 위임사실을 확인합니다.

￭ Please write date( ..... day ..... month ........ year). 날짜를 쓰세요.

￭ Please affix the signature of overseas diplomatic and consular.

(재외공관(영사관)의 서명을 받습니다.)

□ Confirmation of tax office's superintendent 세무서장의 확인

￭ Please write type of real estate. 부동산의 종류를 쓰세요.

￭ Please write location of real estate. 부동산의 소재지를 쓰세요.

※ I hereby confirm above facts. 위 사항에 대하여 확인합니다.

￭ Please write date( ..... day ..... month ........ year). 날짜를 쓰세요.

￭ Please put seal for superintendent of tax office. 세무서장의 도장을 날인하세요.

□ NOTES 유의사항

1. Please write the written date(day, month, year) on the letter of attorney or on the

consent of legal representative and the available date is 6months to compute from

date of delegation or consent.

(위임장 또는 법정대리인의 동의서에는 작성연월일을 기재하며, 유효기간은 위임 또는

동의일 부터 기산하여 6월입니다.)

2. If you want to issue more over 2sets, please write on the letter of attorney or

consent's issuing number section.

(2부 이상의 인감증명서를 발급받고자 하는 경우에는 위임장 또는 동의서의 발급 통수란에

기재하여 신청하여야 합니다.)

3. If you apply to issue the certification of overseas residents or domestic residence

declarer through delegation, it must be confirmed through embassies and legation

abroad. In this case, if it is for transferring of rights of real estate, please write type

and location of real estate and then must be confirmed by superintendent of tax

office which has competence over the location of jurisdiction certifying office or

real estate.

(재외국민이나 국내거소신고자의 증명발급을 위임하여 신청하는 경우에는 재외공관의

확인을 받아야 합니다. 이 경우 재외국민의 부동산권리 이전용인 경우에는 부동산의 종류와

소재지를 기재하여 소관증명청의 소재지 또는 부동산 소재지를 관할하는 세무서장의 확인을

받아야 합니다.)

4. If you want to be issued seal impression certification of minor or quasi-incompetent as to

delegate, you must make both the letter of attorney and consent of legal

representative.

(미성년자 또는 한정치산자의 인감증명을 위임 발급 받고자 하는 경우에는 위임장과 법정대리인의 동의서를 모두 작성하여야 합니다.)

5. Resident registration eraser can't be delegated. Proxy(mandator) submit own's identification

card which is chosen by one of [identification card, driver's license, passport and

disabled registration(except disabled registration which isn't written the resident

registration No. and address)].

(주민등록 말소자는 위임을 받을 수 없으며, 피위임자(위임자)가 제출하는 신분증은 [주민

등록증, 자동차운전면허증, 여권, 장애인등록증(주민등록번호 및 주소가 기재되어 있지 아니한

장애인등록증을 제외한다)] 중 하나를 선택하여 제출합니다.)

6. Person(ex. person who apply or is issued seal impression certification according as

letter of attorney for death make falsely and so on) who counterfeit seal or

signature of the other person or use illicitly can be punished in accordance with

Article 231 or Article 240 of the 「Criminal Law」.

(다른 사람의 인장이나 서명을 위조 또는 부정사용한 자(예 : 사망한 자의 위임장을 허위로

작성하여 인감증명서를 신청하거나 발급받은 자 등)는 「형법」제231조 내지 제240조의

규정에 의하여 처벌을 받게 됩니다.)

7. Person who want to be issued by proxy, please apply after sealing own's.

(대리발급을 받고자 하는 자는 본인의 인장을 날인하여 신청하여야 합니다.)

■ 인감증명법 시행령 [별지 제12호의2서식] <개정 2020. 2. 18.>
■ Enforcement Decree of The Personal Seal Act [Form an enclosure No. 12 2]
Application to	[ ] Undo the Registration of Personal Seal of the Deceased [ ] Undo the Registration of Personal Seal of the Missing [ ] Change Information of Registered Personal Seal [ ] Undo the Registration of Personal Seal [ ] Re-register a Former Personal Seal
※ Fill out this form and check where appropriate according to the instructions on the back of the form.	(Front)
Application No.		Date		Processing Time	Immediate
Applicant	Name		Personal seal
Resident Registration No.
Nationality
Address
Description of Application
Reason for Written Registration
Supporting Documents (Attachment)
Consent of a Legal Representative, Limited guardian or Adult guardian	Name		Relationship	Personal seal or Signature ※ Attach the certificate of personal signature at the time of signing
Date of Birth
Address
I certify that the information provided is true and accurate. Date (YYYY/MM/DD) [ ] Diplomatic Mission (Consul) (Signature or Seal) [ ] Prison (Prison Officer) (Official Seal) (Signature or Seal)
I hereby submit a registration (application) of a personal seal (to undo the registration of a personal seal of the deceased/missing, to change information of a registered personal seal, to undo the registration of a personal seal, or to re-register a former personal seal) according to Articles 8, 9, and 11 of the Seal Imprint Certification Act and Articles 11 and 12 of the Enforcement Decree of the Seal Imprint Certification Act.	Fee
NONE
Date (YYYY/MM/DD) Applicant: (Signature or Seal) Address: (Resident Registration No.: ) Representative: (Signature of Seal) Address: (Resident Registration No.: ) Relationship: For the Head of the City/County/District/Town/Local Government of
210mm×297mm[white pape(80g/㎡)or middle quality paper(80g/㎡)]

(Back)
Notes and Instructions
1. All legal representatives visiting a government office must bring a form of identification. 2. An application to undo the registration of a personal seal of the deceased or the missing must be submitted by an heir of the deceased or the missing; if, however, the heir is unable to visit a government office in the relevant jurisdiction, he/she may authorize another person (using the Power of Attorney in Form No. 13 - the annex for the Enforcement Decree of the Seal Imprint Certification Act) to submit the application. 3. For resident registration number: if you are an overseas Korean national and do not have a resident registration number, enter your passport number; if you are a foreigner, enter your alien registration number; and if you are a registered domestic resident, enter your domestic residence report number. 4. Check where appropriate (undo the registration of personal seal of the deceased/missing, change information of a registered personal seal, undo the registration of a personal seal, or re-register a former personal seal) when submitting the application for a personal seal. ※ If you wish to register a change of a personal seal, use Form No. 9 in the annex for the Enforcement Decree of the Seal Imprint Certification Act. 5. All legal representatives registering (applying) on behalf of an overseas Korean national, a person residing (visiting) abroad, or a prisoner must receive confirmation from one of the following organizations as applicable (not applied to an overseas Korean national who resides in Korea): a. Overseas Korean national, person residing (visiting) abroad: Diplomatic mission (Consul); or b. Prisoner: Prison (Prison Officer).
Procedure
This form will be processed as follows.
	Applicant								Description of Registration (Application) 1. For the deceased 2. For the missing 3. Change of registered information (name, DOB, etc.) 4. Cancellation 5. Re-registration
	Submitting Application		▲			Accepting Application
		▼
	Government office (city/county/district or town)					◀			Processing submitted information

□ Report(Application) of seal impression for

[□Death  □Confirmation of missing person □Alteration of report contents □Cancellation □Reinstatement]

인감 신고(신청)서 [□사망 □실종신고 □신고사항의 변경 □말소 □부활]

※Please check in □. (□ 안에 표시를 합니다.)

□ Applicant (대상자)

￭ Please write name with Chinese characters.

(대상자의 성명을 한글과 한자로 쓰세요.)

￭ Please write resident registration No. (대상자의 주민등록번호를 쓰세요.)

￭ Please put seal impression. (대상자의 인감을 날인하세요.)

￭ Please write address in Korea. (대상자의 국내주소를 쓰세요.)
￭ Please write overseas address. (대상자의 국외주소를 쓰세요.)

￭ Please write nationality. (대상자의 국적을 쓰세요.)

※ Please write matters to report(apply). (신고사항을 쓰세요.

※ Please write reason for written report. (서면신고 사유를 쓰세요.)

※ Please attach supporting evidence as an annexed. (입증자료를 첨부하세요.)

□ Consent of legal representative (법정대리인의 동의)

￭ Please write name of legal representative. (법정대리인의 성명을 쓰세요.)

￭ Please put seal impression of legal representative. (법정대리인의 인감을 날인하세요.)

￭ Please write resident registration No. of legal representative.

(법정대리인의 주민등록번호를 쓰세요.)

￭ Please write address of legal representative.

(법정대리인의 주소를 쓰세요.)

￭ Please write relationship with applicant. (대상자과의 관계를 쓰세요.)

□ Confirmation of the diplomatic establishment abroad (consulate)

(재외공관(영사관)의 확인)

￭ Please receive the signature from diplomatic establishment abroad(consulate).

(재외공관(영사관)·수감기관의 확인을 받으세요.)

※ I hereby report(apply) a seal impression (Death, Confirmation of missing person, Alteration of report contents, Cancellation, Reinstatement) according to Article 8(Article 9, Article 11) of the 「Law for Seal Impression’s Certification」 and Article 11(Article 12) of 「Enforcement ordinanace of Law for Seal Impression’s Certification」.

(「인감증명법」 제8조(제9조, 제11저) 및 「인감증명법 시행령」제11조(제12조)에 의하여 인감(사망, 실종선고, 신고사항의 변경, 말소, 부활)신고(신청)합니다.)

□ Reporter(applicant) 신고(신청)인

￭ Please write date of reporr(application). (신고(신청)일을 쓰세요.)

￭ Please write name of reporter(applicant) and signature and seal.

(신고(신청)인의 성명을 쓰고 서명날인 하세요.)

￭ Please write address and and resident No. of reporter(applicant).

(신고(신청)인의 주소와 주민등록번호를 쓰세요.)

□ Proxy (대리인)

￭ Please write name of reporter and signature and seal.

(대리인의 성명을 쓰고 서명날인 하세요.)

￭ Please write address and and resident No. of reporter.

(대리인의 주소를 쓰고 주민등록번호를 쓰세요.)

￭ Please write relationship with reporter(applicant). (신고(신청)인과의 관계를 쓰세요.)

□ NOTES 유의사항

1. The proxy who visits at certifying office must certainly submits the idenrification card.

(증명청을 방문하는 대리인은 반드시 신분증을 제시하여야 합니다.)

2. In case of notifying a death or confirmation of missing person, only heir must submit the notification form. But if the heir can’t visit at jurisdiction certifying office, can submit with his delegation.

(사망 또는 실종선고를 신고하는 때에는 상속인이 신고서를 제출하여야 합니다. 다만, 상속인이 소관증명청을 방문할 수 없는 경우에는 위임하여 제출할 수 있습니다.)

3. In case of an overseas residents, please write passport No. on section of resident registration No. and in case of a foreigner, write alien registration No. and in case of a domestic residence declarer, write domestic residence report No.

(주민등록번호 란에 재외국민의 경우에는 여권번호, 외국인의 경우에는 외국인등록번호, 국내거소신고자의 경우에는 국내거소신고번호를 기재하여야 합니다.)

4. If you want to submit a report of seal impression, please check on related items and then submit. (인감신고서를 제출하고자 하는 경우에는 해당사항란에 체크표시를 한 후 제출합니다.)

■ 출입국관리법 시행규칙 [별지 제34호서식] <개정 2022. 4. 12.>
통합신청서 (신고서) APPLICATION FORM (REPORT FORM)
※ 신청서는 한글 또는 영문으로 작성하시기 바랍니다. (Please complete this form in Korean or English.)
□ 신청/신고 선택 SELECT APPLICATION/REPORT
[ ] 외국인 등록 FOREIGN RESIDENT REGISTRATION	[ ] 체류자격 외 활동허가	(희망 자격 : )	PHOTO 여권용 사진(35㎜×45㎜) * 촬영일부터 6개월이 지나지 않아야 함 taken within last 6 months * 외국인 등록 및 등록증 재발급 시에만 사진 부착 Photo only for Foreign Resident Registration (Reissued)
ENGAGE IN ACTIVITIES NOT COVERED BY THE STATUS OF SOJOURN / Status to apply for ( )
[ ] 등록증 재발급 REISSUANCE OF REGISTRATION CARD	[ ] 근무처 변경ㆍ추가허가 / 신고 CHANGE OR ADDITION OF WORKPLACE
[ ] 체류기간 연장허가 EXTENSION OF SOJOURN PERIOD	[ ] 재입국허가 (단수, 복수) REENTRY PERMIT (SINGLE, MULTIPLE)
[ ] 체류자격 변경허가	(희망 자격 : )	[ ] 체류지 변경신고 ALTERATION OF RESIDENCE
CHANGE OF STATUS OF SOJOURN / Status to apply for ( )
[ ] 체류자격 부여	(희망 자격 : )	[ ] 등록사항 변경신고 CHANGE OF INFORMATION ON REGISTRATION
GRANTING STATUS OF SOJOURN / Status to apply for ( )
성명 Name In Full	성 Surname	명 Given names
생년월일 Date of Birth	년 yyyy	월 mm	일 dd	성 별 Sex	[ ]남 M [ ]여 F	국적 Nationality
외국인등록번호 Foreign Resident Registration No.
여권번호 Passport No.		여권 발급일자 Passport Issue Date		여권 유효기간 Passport Expiry Date
대한민국 내 주소 Address In Korea
전화번호 Telephone No.		휴대전화 Cell phone No.
본국 주소 Address In Home Country		전화번호 Phone No.
재학 여부 School Status	미취학[ ], 초[ ], 중[ ], 고[ ] Non-school[ ], Elementary[ ], Middle[ ], High[ ]	학교 이름 Name of School		전화번호 Phone No.
학교 종류 Type of School	교육청 인가[ ], 교육청 비인가, 대안학교[ ] Accredited school by Education Office[ ], Non-accredited, Alternative school[ ]
근무처 Workplace	원 근무처 Current Workplace		사업자등록번호 Business Registration No.		전화번호 Phone No.
예정 근무처 New Workplace		사업자등록번호 Business Registration No.		전화번호 Phone No.
연 소득금액 Annual Income Amount	만원(ten thousand won)		직업 Occupation
재입국 신청 기간 Intended Period Of Reentry		전자우편 E-Mail
반환용 계좌번호(외국인등록 및 외국인등록증 재발급 신청 시에만 기재) Refund Bank Account No. only for Foreign Resident Registration
신청일 Date of application		신청인 서명 또는 인 Signature/Seal
신청인 제출서류 (담당공무원 확인사항) Required documents for applicants (Matters to be checked by officer in charge)	「출입국관리법 시행규칙」 별표 5의2의 체류자격별ㆍ신청구분별 첨부서류 참고 Please refer to the attached documents for each status of stay and each application type in Annex 5-2 of the Enforcement Rule of the Immigration Act.
행정정보 공동이용 동의서 (Consent for sharing of administrative information)
본인은 이 건 업무처리와 관련하여 담당 공무원이 「전자정부법」 제36조에 따른 행정정보의 공동이용을 통하여 위의 담당 공무원 확인 사항을 확인하는 것에 동의합니다. *동의하지 않는 경우에는 신청인이 직접 관련 서류를 제출해야 합니다. I, the undersigned, hereby consent to allow all documents and information required for the processing of this application to be viewed by the public servant in charge as specified in Article 36 of the Electronic Government Act. * If you disagree, you are required to present all related documents in person.
신청인 Applicant		서명 또는 인 Signature/Seal	신청인의 배우자 Spouse of applicant		서명 또는 인 Signature/Seal	신청인의 부 또는 모 Father/Mother of applicant		서명 또는 인 Signature/Seal
공 용 란 (For Official Use Only)
기본 사항	최초입국일		체류자격		체류기간
접수 사항	접수일자		접수번호
허가(신고) 사항	허가(신고) 일자		허가번호		체류자격
체류기간
결 재	담 당				청장ㆍ소장
				가 / 부
수입인지는 뒷면에 첨부(Revenue Stamp on the Backside) / 수수료 면제(exemption) [ ] (면제사유: )
210㎜×297㎜[백상지(80ｇ/㎡) 또는 중질지(80ｇ/㎡)]

■ 출입국관리법 시행규칙 [별지 제138호의2서식] <개정 2022. 12. 29.>	(앞쪽)
사실증명 발급ㆍ열람 신청서 APPLICATION FOR ISSUANCE OF / ACCESS TO CERTIFICATE OF FACT
※ 본인이 직접 증명발급을 신청하는 경우 정부24(www.gov.kr)에서 무료로 발급받을 수 있으며, 방문 신청 시에는 신청서를 작성하지 않고 신분증만 제시하면 됩니다. Free online application available at the government website (www.gov.kr) for the issuance of your own Certificate of Fact. Those visiting an immigration office will be required to present only their ID cards without having to complete this form.
※ 뒤쪽의 유의사항을 참고하여 작성하기 바랍니다.(Please fill out this form by referring to the notes on the back page.)
접수번호 (Receipt No.)		접수일 (Date of Receipt)		발급일 (Date of Issuance)		처리기간 (Processing Period)	즉시 (Immediately)
발급대상자 (위임한 사람) Principal (Authorizing Person)	성명 (Full Name)	연락처 (Phone No.)
주민등록번호(외국인등록번호 또는 국내거소신고번호) Resident Registration No.(Foreign Resident Registration No. or Overseas Korean Resident No.)
증명종류 Type of Certificate	[ ] 출입국에 관한 사실증명 ( )통 Certificate of Fact on Entry and Departure ( ) copy(ies) [ ] 외국인등록 사실증명 ( )통 Certificate of Fact on Foreign Resident Registration ( ) copy(ies) [ ] 외국인등록 열람 ( )건 Access to Foreign Resident Registration ( ) time(s)
출입국에 관한 사실증명의 영문 성명 병기 신청 여부 (국민만 해당) * This field is only for Korean citizens.	[ ]포함 [ ]미포함
외국인등록 사실증명의 경우, 과거 등록번호(외국인등록번호ㆍ국내거소신고번호), 성명, 체류지 및 체류자격 변경 이력 포함 여부 Previous registration number (Foreign resident registration number or Overseas Korean Resident number), name, address or status of sojourn to be shown on the Certificate of Fact on Foreign Resident Registration	- 과거 등록번호 Previous Registration Number [ ]포함 Yes [ ]미포함 No - 과거 성명 변경 사항 Previous Name [ ]포함 Yes [ ]미포함 No - 과거 체류지 변동 사항 Previous Address [ ]포함 Yes [ ]미포함 No - 과거 체류자격 변동 사항 Previous Status of Sojourn [ ]포함 Yes [ ]미포함 No
출입국 조회기간 (Reference Period for Entry and Departure Record) . . . 부터(from) . . . 까지(to)
용도 (Purpose)
신청인 (위임받은 사람) Applicant (Authorized Person)	성명 (Full Name)	생년월일(Date of Birth)
연락처 (Phone No.)	발급대상자와의 관계 (Relationship to Principal)
「출입국관리법」 제88조 및 같은 법 시행규칙 제75조에 따라 위와 같이 사실증명의 발급ㆍ열람을 신청합니다. I hereby apply for the issuance of / access to Certificate of Fact in accordance with Article 88 of the Immigration Act and Article 75 of the Enforcement Rule of the Immigration Act.
년(Year) 월(Month) 일(Day)
신청인 (Name of Applicant)	(서명 또는 인) (Signature or Seal)
○○출입국ㆍ외국인청(사무소ㆍ출장소)장 / ○○시장ㆍ군수ㆍ구청장 또는 읍ㆍ면ㆍ동의 장 / 재외공관장 귀하 To the Chief of ○○ Immigration Office(Branch Office) / the Head of ○○ SiㆍGunㆍGu or EupㆍMyeonㆍDong / the Head of Overseas Diplomatic Mission
위 임 장 (Power of Attorney)
위 발급대상자(위임한 사람)는 위와 같은 사실증명의 발급ㆍ열람 신청 및 수령에 관한 사항을 위 신청인(위임받은 사람)에게 위임합니다. I, the above Principal (authorizing person), hereby authorize the above applicant (authorized person) to apply for and receive the issuance of / access to the Certificate of Fact.
년(Year) 월(Month) 일(Day)
	발급ㆍ열람 대상자(위임한 사람) Name of Principal(Authorizing Person)		(서명 또는 인) (Signature or Seal)
210㎜×297㎜[백상지(80ｇ/㎡) 또는 중질지(80ｇ/㎡)]

(뒤쪽)

유의사항 Notice

1. 색상이 어두운 란은 신청인이 작성하지 않으며, [ ]에는 해당되는 곳에 ‘점검표(V)’로 표시합니다.

Do not complete the shaded sections, and please place a check mark for applicable brackets[ ].

2. 신청인이 법인인 경우에는 앞쪽 신청인의 성명란에 법인명 및 대표자 성명을, 주민등록번호란에 법인등록번호를, 전화번호란에 연락 가능한 담당자의 성명과 전화번호를 각각 적기 바랍니다.

If you are a corporate applicant, please write the name of the corporation and the president for the “Full Name“ of applicant, corporation registration number for “Resident Registration No.“, and name and telephone number of the person in charge for “Telephone No.“ on the front side of the application form.

3. 사실증명의 발급 신청 및 외국인등록 열람은 본인이나 그 법정대리인 또는 그로부터 위임을 받은 사람만 신청할 수 있습니다.

Eligible applicants for the issuance of Certificate of Fact or access to Foreign Resident Registration shall be limited to the principal, his/her legal representative or authorized person.

4. 다음의 경우에는 「출입국관리법 시행규칙」 제75조제3항 및 제4항에 따라 다음의 사람이 출입국에 관한 사실증명의 발급이나 외국인등록 사실증명의 발급ㆍ열람을 신청할 수 있습니다.

In accordance with Article 75(3, 4) of the Enforcement Rule of the Immigration Act, those falling under the following categories may apply for the issuance of Certificate of Fact on Entry and Departure or for the issuance of or access to Certificate of Fact on Foreign Resident Registration.

가. 행방불명, 사망 등으로 본인 또는 법정대리인이 의사표시를 할 수 없는 상태이거나 명백하게 본인의 이익을 위해 사용될 것으로 인정되는 경우

1) 본인의 배우자, 본인의 직계 존ㆍ비속 또는 형제ㆍ자매

2) 본인의 배우자의 직계 존ㆍ비속 또는 형제ㆍ자매[본인의 배우자가 사망한 경우로서 1)에 해당하는 사람이 없는 경우만 해당한다]

Where a principal is incapable of expressing intentions due to his/her unknown whereabouts or death, or where it is obvious that the certificate will be used for benefits of the principal:

1) Spouse, immediate relatives or siblings of the principal

2) Immediate relatives or siblings of the principal’s spouse [only when the spouse is deceased and the principal does not have any of those listed in the category 1)]

나. 본인인 외국인이 완전 출국한 경우: 본인인 외국인을 고용하였던 자 또는 그 대리인

Where a non-Korean principal has permanently left Korea:

- An employer of the principal or the authorized agent of the employer

다. 채권ㆍ채무관계에 관한 재판에서 승소판결이 확정된 경우, 「주민등록법 시행령」 별표 2 제3호 각 목의 어느 하나에 해당하는 금융회사 등이 연체채권 회수를 위하여 필요로 하는 경우, 해당 외국인과 채권ㆍ채무 관계에 있는 경우(기한 경과나 기한의 이익 상실 등으로 변제기가 도래한 경우에 한정하며, 채무금액이 100만 원 이하인 경우는 제외합니다) : 외국인등록 사실증명을 발급받거나 열람하려는 채권자

Where a favorable ruling is confirmed in a trial on a debtor and creditor relationship, where the Certification is needed by financial companies that fall under any of the items of the subparagraph 3 of the attached table 2 of the Enforcement Decree of Resident Registration Act for the purpose of collecting overdue debts, or where there is a debtor and creditor relationship with the foreigner concerned (only when a debt becomes overdue or an event of default occurs that allows a lender to demand full repayment earlier than an original due date, and the amount of debt is more than 1 million KRW):

- Creditor who intend to receive or access the Certificate of Fact on Foreign Resident Registration of the foreigner concerned

※ 채권ㆍ채무 관계를 입증할 수 있는 계약서, 차용증, 어음 등은 송금 영수증, 공증, 확정일자 등의 공적 증거를 담보할 수 있는 서류를 함께 첨부하여야 합니다.

※ The contract paper, promissory note and note that prove the debtor and creditor relationship shall be attached by the collateral documents that may guarantee official evidence such as remittance receipt, notarization and fixed date stamp affixed on the agreement, etc.

라. 그 밖에 법무부장관이 공익상 필요하다고 인정하는 사람

Other persons deemed necessary by the Minister of Justice for the public interest.

5. 위임을 받은 경우에는 위임장과 위임한 사람의 신분증(사본)을 첨부하고 신청인의 신분증을 제시하여야 합니다.

Authorized persons shall present his/her own ID card and the application shall be presented with the Power of Attorney and the ID card (or a copy) of the authorizing person.

※ 다른 사람의 서명 또는 인장의 도용 등으로 허위의 위임장을 작성하여 증명서를 신청 또는 수령한 경우에는 관련 법률에 따라 처벌받을 수 있습니다.

※ You may be subject to punishment under applicable laws, if you apply for or receive the Certificate of Fact by submitting a fraudulent Power of Attorney signed by another individual or falsely done with a stolen seal.

6. 위임은 작성한 날부터 6개월까지만 유효합니다.

The Power of Attorney shall remain effective for six months from the day of authorization.

7. 국민은 1961.1.1.부터, 외국인은 1979.1.1.부터 출입국에 관한 사실증명이 가능합니다.

Records on this certificate only cover the entry/departures from January 1, 1961, for Korean nationals and from January 1, 1979, for Foreigners.

210㎜×297㎜[백상지(80ｇ/㎡) 또는 중질지(80ｇ/㎡)]

■ 주민등록법 시행규칙 [별지 제7호의2서식] <개정 2020. 11. 30.>					You can also visit GOV.KR(www. gov.kr) to apply.
Application for information on a resident register or for issuance of its copy or abstract
※ Please read the guidance notes on the back of this form before you fill out the form, and check( √ ) where appropriate. (Front)
Applicant (Individual)	Name		(Seal or signature)			Resident Registration No.
	Address (District) (City) (Province) ※ Insert your district, city, and province only. (Detailed address not required)
	Relationship (to the person whose info is requested)					Phone No.
	[ ] Apply for fee exemption ※ Regarding eligibility for fee exemption, please refer to Note 3 on the back page.
Applicant (Business)	Name of Business					Business Registration No.
	CEO		(Seal or signature)			Contact No. (Business)
	Address
	Name of Visitor			Resident Registration No.		Contact No. (Visitor)
Person Whose Information Is Being Requested	※ Leave this section blank if you are requesting your own information or copy/abstract.
	Name					Resident Registration No.
	Address
Information to be Provided	Request	[ ]A copy of the resident register [ ]An abstract of the resident register
	※ In order to protect personal information, one can request for necessary information only from the list below of information provided on a copy or an abstract of the resident register. If you do not choose either "Included" or not, only the basic information such as name, date of birth and address of the applicant or the person concerned will be provided. [ ]All items of a copy included [ ] All items of an abstract included
	Copy Issuance [ ]copy (ies)	1. Records of change of address [ ]All included [ ] Fill in : the last years included
		2. Reason for household registration [ ]Included
		3. Date of household registration [ ]Included
		4. Date of event / Date of report [ ]Included
		5. Reason for change [ ]Included(□Household, □Members)
		6. Names of householder, members and foreigner other than the person concerned [ ]Included
		7. Last 7 digits of resident registration no. [ ]Included(□Self, □Members)
		8. Members’ relationship to the householder [ ]Included
		9. Cohabitants [ ]Included
	Abstract Issuance [ ]copy (ies)	1. Personal information changes [ ]Included
		2. Records of change of address [ ]All included [ ] Fill in : the last years included
		3. Name of and relationship to the previous householders in the records of change of address [ ]Included
		4. Last 7 digits of resident registration no. [ ]Included
		5. Names of householder, relationship to the householder [ ]Included
		6. Date of event / Date of report [ ]Included
		7. Reason for change [ ]Included
		8. Military service records [ ]Included(□Basic(Date of enlistment/discharge), □All included)
		9. Domestic residence report no. / Alien registration no. [ ]Included
Purpose
Evidentiary documents
I hereby apply for information on a resident register or for issuance of its copy or abstract in accordance with Articles 47 and 48 of the Enforcement Decree of the Resident Registration Act.
Day Month Year
To the Head of the City/County/District/Town/Local Government
210㎜×297㎜[White paper 80g/㎡ or Medium quality paper 80g/㎡]

(Back)
Items to be checked by relevant public authorities	Whether the applicant is exempt from fees for falling under any of subparagraph of Article 18(1) of the"Enforcement Rule of the Resident Registration Act"
Consent to Sharing Administrative Information
I hereby give my consent for abovementioned relevant public authorities to check out my administrative information on whether I am exempt from fees for the providing information on my resident register or issuing its copy or abstract, through administrative information sharing, in accordance with Article 36(1) of the "Electronic Government Act." ※ In case you do not agree to the verification by relevant public authorities, you must submit documents that verifies the information concerned.
Applicant		(Signature or Seal)
Notes
1. When you request information on a resident register or its copy or abstract, you must submit a form of identification such as a resident registration card; If you are a foreigner who is registered in accordance with the Article 31 of the "Immigration Act" or a foreign national Korean who reported your domestic residence in accordance with the Article 6 of the "Act on the Immigration and Legal Status of Overseas Koreans", you must submit an alien registration card or domestic resident report card. If you visit as a representative of your company, you must bring a form of identification as well as your employment ID or a proof of employment. 2. When you or a member of your household wishes to check your or his/her resident register or to be issued with the copy or abstract only by submitting a form of identification such as a resident registration card, you or he/she can do so by printing your or his/her name on a digital signature pad. 3. Those who are eligible for fee exemption for information on a resident register or for issuance of its copy or abstract in accordance with Article 18(1) of the Enforcement Rules of the Resident Registration Act are as follows: a. Where the State or local government applies for it to provide public services in accordance with the Paragraph 1 of Article 29(2) of the Resident Registration Act; b. Where a recipient under Article 2(2) of the National Basic Living Security Act applies for it; c. Where the Minister of the Interior and Safety, Metropolitan City Mayor/Do Governor or the Head of the City/Country/District/Town/ Local Government deems it necessary such as in the event of disasters; d. Where fee exemption for providing resident registration data is prescribed in any relevant Acts and subordinate statues; e. Where a person of distinguished services to national independence or his/her bereaved family (a person with first priority only) registered under Article 6 of the Act on the Honorable Treatment of Persons of Distinguished Service to Independence applies for it; f. Where a person who has rendered distinguished service to the State or his/her bereaved family (a person with first priority only. If the person granted priority is the father or mother, the mother or father not granted priority shall be included.) registered under Article 6 of the Act on Honorable Treatment of and Support for Persons, Etc. of Distinguished Service to the State applies for it; g. Where a patient suffering from potential aftereffects of defoliants registered under Article 4 of the Act on Assistance to Patients Suffering from Actual or Potential Aftereffects of Defoliants, Etc. and Establishment of Related Organizations applies for it; h. Where a war veteran registered under Article 5 of the Act of Honorable Treatment of War Veterans and Establishment of Related Associations applies for it; i. Where a person of distinguished service to the May 18 Democratization Movement or his/her bereaved family (a person with first priority only. If the person granted priority is the father or mother, the mother or father not granted priority shall be included.) registered and determined under Article 7 of the Act on Honorable Treatment of Persons of Distinguished Service of the May 18 Democratization Movement applies for it; j. Where a person who performed special missions or his/her bereaved family (a person with first priority only. If the person granted priority is the father or mother, the mother or father not granted priority shall be included.) registered under Article 6 of the Act on Honorable Treatment of Persons of Distinguished Service During Special Missions and Establishment of Related Organizations applies for it; k. Where a person eligible for support under Article 5 or Article 5-2 of the Single-Parent Family Support Act applies for it; l. Where fee exemption is prescribed by ordinance of relevant local governments; and m. Where the first copy of abstract of a person whose birth has been registered is issued. 4. Select either "Included" or not for each numbered item on the "Information to be Provided" section. 5. In some cases, such as when you need an abstract of the resident register of a debtor in order to register his/her inheritance by subrogation, you may request or be provided with the records of change of address. 6. As for the "Records of change of address", when you choose "Fill in", the period should be filled out by the year. 7. For the issuance of an abstract of resident register: As for the "3. Name of and relationship to the previous householders in the records of change of address" information, if the person whose information is being requested is a legal adult, the person concerned or a person entrusted with the power can choose "Included." And, if the person whose information is being requested is a minor, a householder, a lineal ascendant, or the state or a local government (for public affairs only) can choose "Included."; as for the "8. Military service records" information, only the person concerned or a member of your household (or a person entrusted with the power) as well as your family member referred to in the Article 29 (2) 5 of the "Resident Registration Act" and the state or a local government (for public affairs only) can choose "Included." 8. If a person other than the person concerned or a member of your household wishes to be issued with a copy or abstract of your resident register, he/she must fill out the "Purpose" section because the purpose shall be printed on the issued copy or abstract, and in case of applying for a copy of the resident register, he/she must submit separate evidentiary documents. 9. In accordance with subparagraph 5 of Article 37 of the " Resident Registration Act," if you are provided with information on a resident register or its copy/abstract by fraud or other improper means, you shall be sentenced to less than three years in prison or fined less than thirty million won. 10. If you wish to request information on the register of more than one person or receive their copies/abstracts with the same evidentiary documents for the same purpose, you may apply for them all at once by using Form 7 and Form 8. In that case, you must put the two forms together in order, fold the first page (Form 7) in half, and stamp your personal seal in the center where the edge of the folded paper meets the next page (Form 8). 11. If you are a foreigner who is registered in accordance with the Article 31 of the "The Immigration Act" or a foreign national Korean who reported your domestic residence in accordance with the Article 6 of the "The Act on the Immigration and Legal Status of Overseas Koreans", enter your alien registration number or domestic residence report number on the "Resident Registration No" section.

Application for information on a resident register or for issuance of its copy or abstract

(주민등록표 열람 또는 등ㆍ초본 교부 신청서)

※ Please write after reading the notes overleaf and check(√) the relevant spaces [  ].

(뒤쪽의 유의사항을 읽고 작성하여 주시기 바라며, [ ]에는 해당되는 곳에 √표를 합니다.)

□ Applicant(Individual) 신청인(개인)

￭ Please write name with seal or signature of applicant(Individual).

(신청인(개인)의 서명 또는 인과 함께 성명을 쓰세요.)

￭ Please write resident registration No. of applicant(Individual).

(신청인(개인)의 주민등록번호를 쓰세요.)

￭ Please write address of applicant(Individual). (신청인(개인)의 주소를 쓰세요.)

￭ Please write relationship with subject and applicant(Individual).

(대상자와 신청인(개인)과의 관계를 쓰세요.)

￭ Please write telephone No. of applicant(Individual).

(신청인(개인)의 전화번호를 쓰세요.)

￭ Please check on being exempt from any handling charge.

(수수료 면제 대상에 체크하세요.)

[  ]Qualified recipient of national basic living stipend 국민기초생활수급자

[  ]National patriot and veteran  국가보훈대상자

[  ]Other (                )  그 밖의 대상자

□ Applicant(Business) 신청인(법인)

￭ Please write name of institution for applicant(Business).

(신청인(법인)의 기관명을 쓰세요.)

￭ Please write business license No. of applicant(Business).

(신청인(법인)의 사업자등록번호를 쓰세요.)

￭ Please write name with seal or signature of representative.

(법인의 대표자 성명과 함께 서명이나 인을 하세요.)

￭ Please write main contact No. (대표전화번호를 쓰세요.)

￭ Please write location of applicant(Business). (신청인(법인)의 소재지를 쓰세요.)

￭ Please write name of visitor. (방문자의 성명을 쓰세요.)

￭ Please write resident registration No. of visitor. (방문자의 주민등록번호를 쓰세요.)

￭ Please write position of visitor. (방문자의 직위를 쓰세요.)

￭ Please write tel. No. of visitor. (방문자의 전화번호를 쓰세요.)

□ Subject of inspection or issuance of certified copyㆍabstract

(열람 또는 등ㆍ초본 교부 대상자)

￭ Please write name of subject. (대상자의 성명을 쓰세요.)

￭ Please write resident registration No. of subject. (대상자의 주민등록번호를 쓰세요.)

￭ Please write address of subject and. (대상자의 주소를 쓰세요.)

￭ Please write name of administrative agency. (행정기관명을 쓰세요.)

□ Contents of application 신청내용

￭ Please check on which want to inspect in belows. (열람하고자 하는 곳에 체크하세요.)

[  ]Records of certified copy 등본사항

[  ]Records of abstract       초본사항

※ In order to protect personal information, only fill out the parts you need in records of below certified copy․abstract. If you don't select any, the ones marked in bold will be automatically "Included".

(개인정보 보호를 위하여 아래의 등․초본 사항 중 필요한 사항만 선택하여 신청할 수 있습니다. 선택사항을 표시하지 않는 경우에는 “포함”으로 굵게 표시된 사항만 포함하여 교부해 드립니다.)

￭ Please write numbers[  ]set of issuance for the certified copy. (등본 교부수[  ]통 를 쓰세요.)

￭ Please check on which want to issue in belows. (발급을 원하는 곳에 체크하세요.)

1. Address change records of past 과거의 주소변동 사항

[  ]Included all   전체 포함

[  ]Included the last five year  최근 5년 포함

[  ]Not included   미포함

2. Reason of household make-up (세대구성 사유)

[  ]Included 포함    [  ]Not included  미포함

3. Relation with householder and members (세대원의 세대주와의 관계)

[  ]Included 포함    [  ]Not included   미포함

4. Moving-in date of members / Date of change, Reason of change

(세대원의 전입일 / 변동일, 변동 사유)

[  ]Included 포함    [  ]Not included   미포함

5. Name of the other members except subject to issue

(교부 대상자 외 다른 세대원의 이름)

[  ]Included 포함    [  ]Not included   미포함

6. The last digits of resident registration No. of the other members except subject to issue (교부 대상자 외 다른 세대원의 주민등록번호 뒷자리)

[  ]Included 포함    [  ]Not included   미포함

7. Cohabitant 동거인

[  ]Included 포함    [  ]Not included   미포함

8. Foreigner spouse 외국인 배우자

[  ]Included 포함    [  ]Not included   미포함

￭ Please write numbers[  ]set of issuance of abstract [  ] set  초본 교부 [  ] 통

￭ Please check on which want to issue in belows. (발급을 원하는 곳에 체크하세요.)

1. Changed contents of personal information 개인 인적사항 변경 내용

[  ]Included 포함    [  ]Not included   미포함

2. Address change records of past 과거의 주소 변동사항

[  ]Included all   전체 포함

[  ]Included the last five year  최근 5년 포함

[  ]Not included   미포함

3. Name of householder and relation with householder in address change records of past

과거의 주소변동 사항 중 세대주의 성명과 세대주와의 관계

[  ]Included  [  ]Not included

4. Military service records 병역사항

[  ]Included  [  ]Not included

□ Usage and purpose 용도와 목적

￭ Please write usage and purpose. (용도 및 목적을 쓰세요.)

□ Place of submission  제출처

￭ Please write place of submission. (제출처를 쓰세요.)

□ Evidential matters  증거자료

￭ Please write evidential matters. (증거자료를 쓰세요.)

※ I hereby apply for issuance of a certified copyㆍabstract or inspection of Resident Registration Table in accordance with Article 47 and 48 of the 「Enforcement Decree of Resident Registration Law」.

(「주민등록법 시행령」 제47조와 제48조에 따라 주민등록표의 열람 또는 등ㆍ초본 교부를 신청합니다.)

￭ Please write date of application. (신청일을 쓰세요.)

□ Attached documents 첨부서류

(We will give you back after confirmation. 확인 후 돌려 드립니다.)

1. Identification card 주민등록증 등 신분증명서

2. In case of corporate visitor, office badge or proof of employment status of visitor (법인 방문자인 경우는 방문자의 사원증 또는 재직증명서)

3. In case of being exempt from handling charges, please provide necessary evidential documents. (수수료 면제 대상자인 경우는 필요한 증명자료)

□ NOTES 유의사항

The personㆍconstituent is the personㆍinspection of resident registration table or issuance of certified copyㆍabstract of constituent, in case of application by only submission of identification card, must sign in own handwriting Korean name on 「Electronic image sign input」. 본인ㆍ세대원이 본인ㆍ세대원의 주민등록표 열람 또는 등ㆍ초본 교부를 주민등록증 등 신분증명서 제시만으로 신청하는 경우에는 「전자이미지서명입력기」에 자필 한글 성명으로 서명하여야 열람 또는 교부받을 수 있습니다.

Applicant can apply by selection "Included", "Not included" of each item on section "contents of application", if you don't select, only deal with the marked "Included" records in bold. 신청인은 “신청내용”란의 각 항목에 대하여 “포함”, “미포함”을 선택하여 신청할 수 있으며, 선택하지 않은 경우에는 “포함”으로 굵게 표시된 사항만 “포함”으로 처리됩니다.

When you apply to issue the certified copy, in case of foreigner spouse who haven't register the resident, the item of No.8 foreigner spouse can select as "Included" only the person or constituent(include with the delegated person). 등본 교부를 신청할 때 주민등록을 하지 못한 외국인 배우자의 경우 8. 외국인 배우자 항목은 본인이나 세대원(그 위임을 받은 자 포함)만 “포함”을 선택할 수 있습니다.

When you apply to issue the abstract, the section of name of householder and relation with householder in item of No.3 address fluctuation records of past can select as "Included" only the person or constituent(include with the delegated person), in case of public necessary by nation or local government, the item of No.4 military service can select as "Included" only the person or constituent(include with the delegated person), family in accordance with article 29 section 2 No. 5 of「Law of resident registration」, in case of public necessary by nation or local government. 초본 교부를 신청할 때 3. 과거의 주소변동 사항 중 세대주의 성명과 세대주와의 관계 항목은 본인이나 세대원(그 위임을 받은 자 포함), 국가나 지방자치단체가 공무상 필요로 한 경우에만 “포함”을 선택할 수 있고, 4. 병역사항 항목은 본인이나 세대원(그 위임을 받은 자 포함), 「주민등록법」 제29조제2항제5호에 따른 가족, 국가나 지방자치단체가 공무상 필요로 한 경우에만 “포함”을 선택할 수 있습니다.

If the public servant in charge requires to you the necessary evidential documents in order to confirm the subject to the exemption of handling charge, you have to submit them. 담당 공무원이 수수료 면제 대상자임을 확인하기 위하여 필요한 증명자료를 요구할 경우에는 제시해야 합니다.

Visitor of corporation must submit office badge(or proof of employment) and identification card. 법인방문자는 사원증(또는 재직증명서)과 주민등록증 등의 신분증명서를 함께 제시해야 합니다.

Usage and object marked on the issued the certified copyㆍabstract to the other person who isn't the person or constituent so certainly, must write "usage and object", in case of application of the certified copy, must submit special evidential documents. 본인이나 세대원이 아닌 자가 교부받는 등ㆍ초본에는 기재하신 용도 및 목적이 표시되니 반드시 “용도 및 목적”을 기재하여야 하며, 등본을 신청하는 경우에는 별도의 증명자료를 제출하여야 합니다.

In accordance with article 37 section 5 of 「Law of resident registration」, if you inspect the resident registration table or receive the certified copyㆍabstract of the other person by false or the other illegal method, shall be sentenced to less than three years in prison or to a fine less than ten millions won. 「주민등록법」제37조제5호에 따라 거짓이나 그 밖의 부정한 방법으로 다른 사람의 주민등록표를 열람하거나 등ㆍ초본을 교부받은 경우에는 3년 이하의 징역이나 1천만원 이하의 벌금형에 처해질 수 있습니다.

If same applicant inspects resident registration table of several person or applies to issue the certificated copyㆍabstract in accordance with same evidential documents with same object, can apply to use with annexes No.7 form and No.8 form as blanket and there must confirm(seal between page) between annexes No.7 form and No.8 form. 동일 신청자가 동일 증명자료에 따라 같은 목적으로 여러 사람의 주민등록표를 열람하거나 등ㆍ초본 교부를 신청하는 경우에는 별지 제7호서식과 별지 제8호서식을 함께 사용하여 일괄 신청할 수 있으며, 이 경우 별지 제7호서식과 별지 제8호서식 사이에는 신청인의 확인(간인)이 있어야 합니다.

■ 주민등록법 시행규칙 [별지 제15호의2서식] <신설 2024. 6. 25.>
Application for Information on a Household Register or for Issuance of its Certified Copy
※ Please read the guidance notes on the back of this form before you fill it out.	(Front)
Application Number	Date	Processing Time Immediately
Application Details	Viewing	[ ]	Issuance	[ ]
Applicant (Individual)	Name	(Seal or Signature)	Resident Registration Number
Address (District) (City) (Province)	Contact Number
Applicant (Corporate)	Name of Company	Business Registration Number
Representative	(Seal or Signature)	Contact No. (Business)
Address
Name of Visitor	Resident Registration No.	Contact No. (Visitor)
Location of the Building/Property Being Requested
Whether to show the full name of the expunged or unregistered person and the date of transfer	Displayed □ / Not displayed □
Purpose
I, the undersigned, hereby apply for the issuance of a Certificate of Moved-in Household in accordance with Article 29-2(1) of the Resident Registration Act, Article 49-2(1) of the Enforcement Decree of the same Act, and Article 14(2) of the Enforcement Rules of the same Act as above.
Day Month Year
Name/Name of Company	(Seal or Signature)
To the Head of the City/County/District/Town/Local Government
※ The Power of Attorney is only completed if you are applying by proxy.
Power of Attorney
I authorize the above-named applicant to be issued with a Certificate of Moved-in Household in accordance with subparagraph 2 of Article 29-2(2) of the Resident Registration Act.
Day Month Year
Delegator (Individual)	Name	(Seal or Signature)	Resident Registration No.
Address	Contact No.
Delegator (Corporate)	Name of Company	Business Registration No.
Representative	(Seal or Signature)	Contact No.
Address

(Back)
Documents requesting the provision of personal information	Applicant’s Identification Card ※ In case of Corporate applicants, submit a Representative’s ID, Corporate Seal Certificate or Seal of Use.		Fee ·Viewing: 300 KRW per view ·Issuance: 400 KRW per issuance ※ 500 KRW if falls under subparagraph 3 of Article 29-2(2) of the Resident Registration Act
Documents to be verified by official in charge	※ If you agree to allow the official in charge to check the following documents through administrative information sharing, please check [√].
	[ ] 1. Documents in accordance with Appendix 2 of the Enforcement Rules of the Resident Registration Act proving that the applicant is entitled to view or apply for the issuance of a Certificate of Moved-in Household [ ] 2. Documents to confirm whether the applicant falls under any of subparagraph of Article 18(1) of the Enforcement Rules of the Resident Registration Act
Consent to Sharing Administrative Information
I hereby give my consent for the abovementioned relevant public authorities to check my administrative information on whether I am exempt from fees for providing information on my resident register or issuing its certified copy or abstract through administrative information sharing, in accordance with Article 36(1) of the Electronic Government Act. ※ If the applicant does not consent to the verification by official in charge, the applicant must submit the relevant document in person.
Applicant		(Seal or Signature)
Notes
1. The 'Signature or seal' field must be signed or stamped, and fingerprints cannot be used. In this case, the signature must be a handwritten Korean full name. 2. Foreigners who have registered as aliens or foreign nationality Koreans who have reported their domestic place of residence must present their alien registration card in accordance with Article 33(1) of the Immigration Act or domestic the report card of the place of residence in accordance with Article 7(1) of the Act on the Immigration and Legal Status of Overseas Koreans. Their resident registration number can be replaced with their alien registration number or report number of the domestic place of residence. 3. For Corporate applicants, the ‘Representative’ field must be signed by a representative or stamped with the corporate seal. 4. If the same applicant applies for viewing or issuance of a Certificate of Moved-in Household for multiple buildings or facilities for the same purpose based on the same document, he or she may apply in bulk in accordance with Appendix Forms No. 15-2 and No. 16 of the Enforcement Rules of the Resident Registration Act. In this case, you must put the two forms together in order, fold the first page (Form No. 15-2) in half, and seal between pages with your seal or signature, where the center fold meets the next page (Form No. 16). 5. Only the owner, tenant, leaseholder, lessee, or sales contractor of the relevant building/property can delegate an application to view or issue a Certificate of Moved-in Household In this case, the person applying on behalf of the delegate must submit a power of attorney and proof of identity of the person and the delegate (In the case of Corporate applicants, proof of the identity of the Representative, Corporate Seal Certificate or Seal of Use). 6. Anyone who falsely completes an application or power of attorney, such as forging or fraudulently using another person's signature or seal, will be punished under the Criminal Act. 7. If the address of the building/property you wish to verify is incorrect, the relevant household cannot be confirmed through the Certificate of Moved-in Household. 8. Foreigners and Koreans with foreign nationality cannot be the head of household or a cohabitant on the resident registration card, so it is not possible to verify whether they are the head of household or a cohabitant through a Certificate of Moved-in Household. 9. Those who are eligible for fee exemption for information on a resident register or for issuance of its certified copy or abstract in accordance with Article 18(1) of the Enforcement Rules of the Resident Registration Act are as follows: a. Where the State or a local government applies for official purposes in accordance with item (e) of subparagraph 3 of Article 29-2(2) of the Resident Registration Act; b. Where a recipient under Article 2(2) of the National Basic Living Security Act applies for it; c. Where the Minister of the Interior and Safety, Metropolitan City Mayor/Do Governor or the Head of the City/County/District/Town/ Local Government deems it necessary such as in the event of disasters; d. Where fee exemption for providing resident registration data is prescribed in any relevant Acts and subordinate statues; e. Where a person of distinguished services to national independence or his/her bereaved family (a person with priority only) registered under Article 6 of the Act on the Honorable Treatment of Persons of Distinguished Service to Independence applies for it; f. Where a person who has rendered distinguished service to the State or his/her bereaved family (a person with priority only. If the person granted priority is the father or mother, the mother or father not granted priority shall be included.) registered under Article 6 of the Act on the Honorable Treatment of and Support for Persons of Distinguished Service to the State applies for it; g. Where a patient suffering from potential aftereffects of defoliants registered under Article 4 of the Act on Assistance to Patients Suffering from Actual or Potential Aftereffects of Defoliants and Establishment of Related Organizations applies for it; h. Where a war veteran registered under Article 5 of the Act on Honorable Treatment of War Veterans and Establishment of Related Associations applies for it; i. Where a person of distinguished service to the May 18 Democratization Movement or his/her bereaved family (a person with priority only. If the person granted priority is the father or mother, the mother or father not granted priority shall be included.) registered and determined under Article 7 of the Act on the Honorable Treatment of Persons of Distinguished Service to the May 18 Democratization Movement and Establishment of Related Organizations applies for it; j. Where a person who performed special missions or his/her bereaved family (a person with priority only. If the person granted priority is the father or mother, the mother or father not granted priority shall be included.) registered under Article 6 of the Act on Honorable Treatment of Persons of Distinguished Service During Special Missions and Establishment of Related Organizations applies for it; k. Where a person eligible for support under Article 5 or Article 5-2 of the Single-Parent Family Support Act applies for it; and l. Where fee exemption is prescribed by ordinance of relevant local governments.

[Annex form No.10][별지 제10호서식]
Resident Registration Report 주민등록신고서 ※ Please complete after reading the notes below. 아래의 유의사항을 읽고 적어주시기 바랍니다.
House holder 세대주	Name 성명	(Seal or signature) (서명 또는 인)	Reason of Resident Registration 주민등록 사유
Resident Registration No. 주민등록번호	-	Reporter 신고인	Name 성명
(Seal or signature) (서명 또는 인)
Resident Registration No. 주민등록번호	-
Address 주소
Relation with householder 세대주와의관계
Tel. No. 전화번호
Personal information of person being registered 등록할 사람의 인적사항
Relationship with householder 세대주와의 관계	No. 번호	Name 성명	Sex 성별	Date of Birth 생년월일	Military Service Details 병역사항	Permanent domicile address 등록기준지
	1		M남 W여
	2		M남 W여
	3		M남 W여
※ For official use only 아래 사항은 민원인이 적지 않습니다.
Report handling process 신고처리사항	Receptionist 접수인		Handling of resident registration table 주민등록표 처리	Notice of permanent domicile address 등록기준지 통보
Seal 인	Seal 인
Letter of attorney 위임장	I hereby delegate the report of resident registration to above reporter in accordance with conditions of Article 11 section 1 of the 「Law of Resident Registration」 and the Enforcement Ordinance of the same Law. 「주민등록법」 제11조제1항 단서 및 같은 법 시행령 제19조에 따라 주민등록신고를 위 신고인에게 위임합니다. 년 월 일 Day Month Year Mandator (Householder) (Seal or signature) 위임한 사람(세대주) (서명 또는 인)
	Confirmation of resident registration report 주민등록 신고확인서 Receipt No. 접수번호 제 호		※ NOTES 유의사항 1. Reporter can sign instead of seal on section of "Reporter" and please must receive the confirmation(seal or signature of householder) of householder on section of householder name. Spouse or lineal relation of householder who report and is delegated from householder must receive the delegation of householder on section of letter of attorney and must submit together the resident registration certificate and etc. identification certificate of householder. (※ If you made fake letter of attorney, you should be punished in accordance with 「Criminal Law」.) “신고인”란에 신고인은 도장을 찍는 대신에 서명을 해도 되며， 세대 주의 성명란에 세대주의 확인(세대주의 서명 또는 날인)을 받아야 합니 다. 세대주의 위임을 받아 신고하는 세대주의 배우자나 직계혈족께서는 위임장란에 세대주의 위임을 받고， 세대주의 주민등록증 등 신분증명 서를 함께 제시해야 합니다. (※ 거짓 위임장을 작성하는 경우에는 「형법」에 따라 처벌을 받게 됩니다) 2. If the person of more than 17 years old register newly, after finishing to check a certificate about information of family relation register and a background, the resident registration certificate is issued. 17세 이상인 사람이 신규등록을 하는 경우에는 가족관계기록사항에 관한 증명서 확인 및 신원조사가 완료된 후에 주민등록증이 발급됩니다. 3. If person who hasn't the family relation register report newly, must have the process for registering with "confirmation for report of the resident registration" after reporting the register. 가족관계등록부가 없는 사람이 신규등록을 하는 경우에는 등록신고 접수 후 “주민등록신고확인서”를 받아 등록절차를 밟아야 합니다. 4. If dual nationality report newly, must certificate about person of nation treatment. 이중국적자가 신규등록을 하는 경우에는 국민처우자임을 증명하여야 합니다. 5. A copy and abridgment of resident registration table isn't issued to unconfirmed person of family relation register. 가족관계등록부 미확인자에게는 주민등록표 등ㆍ초본이 교부되지 않습니다. 6. True or not of resident registration report is confirmed through head of Tong and head of a village after reporting. If it was reported falsely, you could be sentenced to a maximum of three years in prison or ten million in fines(Article 37 of 「Law of Resident Registration 」). 주민등록신고의 사실 여부는 통장ㆍ이장을 통하여 사후확인되며, 거짓으로 신고하는 경우에는 3년 이하의 징역 또는 1천만원 이하의 벌금형을 받게 됩니다(「주민등록법」 제37조).
Reporter 신고인	Name 성명		House holder 세대주
Address주소
Date of report 신고일자	Day Month Year 년 월 일
	We hereby accept the Report of Resident Registration as above. 위와 같이 주민등록신고서를 접수하였습니다. Day Month Year 년 월 일 Head of eup, myeon, dong (Seal) 읍ㆍ면ㆍ동장 □
210㎜ × 297㎜[Paper for newspaper 신문용지 54g/㎡(Recycled material 재활용품)]

Resident registration report

(주민등록신고서)

※ Please complete after reading the notes below.

아래의 유의사항을 읽고 적어주시기 바랍니다.

□ NOTES 유의사항

1. Reporter can sign instead of sealing on section of "Reporter" and please must receive the confirmation(seal or signature of householder) of householder on section of householder name.

(“신고인”란에 신고인은 도장을 찍는 대신에 서명을 해도 되며，세대주의 성명란에 세대주의 확인(세대주의 서명 또는 날인)을 받아야 합니다. )

Spouse or lineal relation of householder who report and is delegated from householder must receive the delegation of householder on section of letter of attorney and must submit together the resident registration certificate and etc. identification certificate of householder.

(세대주의 위임을 받아 신고하는 세대주의 배우자나 직계혈족께서는 위임장란에 세대주의

위임을 받고, 세대주의 주민등록증 등 신분증명서를 함께 제시해야 합니다.)

(※ If you made fake letter of attorney, you should be punished in accordance with「Criminal law」.)

(※ 거짓 위임장을 작성하는 경우에는 「형법」에 따라 처벌을 받게 됩니다.)

2.  If the person of more than 17 years old register newly, after finishing to check a certificate about information of family relation register and a background, the resident registration certificate is issued.

(17세 이상인 사람이 신규등록을 하는 경우에는 가족관계기록사항에 관한 증명서 확인 및 신원조사가 완료된 후에 주민등록증이 발급됩니다.)

3.  If person who hasn't the family relation register report newly, must have the process for registering with "confirmation for report of the resident registration" after reporting the register.

(가족관계등록부가 없는 사람이 신규등록을 하는 경우에는 등록신고 접수 후 “ 주민등록신고 확인서”를 받아 등록절차를 밟아야 합니다.)

4. If dual nationality report newly, must certificate about person of nation treatment.

(이중국적자가 신규등록을 하는 경우에는 국민처우자임을 증명하여야 합니다.)

5. A copy and abridgment of resident registration table isn't issued to unconfirmed person of family relation register.

(가족관계등록부 미확인자에게는 주민등록표 등ㆍ초본이 교부되지 않습니다.)

6. True or not of resident registration report is confirmed through head of Tong and head of a village after reporting. If it was reported falsely, you could be sentenced to a maximum of three years in prison or ten million in fines(Article 37 of the「Law of Resident Registration 」).

(주민등록신고의 사실 여부는 통장ㆍ이장을 통하여 사후 확인되며, 거짓으로 신고 하는 경우에는 3년 이하의 징역 또는 1천만원 이하의 벌금형을 받게 됩니다. (「주민등록법」제37조)

□ Householder 세대주

￭ Please write name with seal and signature.

(세대주의 성명을 서명날인과 함께 쓰세요.)

￭ Please write resident registration No. 세대주의 주민등록번호를 쓰세요.

￭ Please write address and tel. No. 세대주의 주소와 전화번호를 쓰세요.

□ Please write the reason to register a resident registration.

주민등록을 등록하는 사유를 쓰세요.

□ Reporter 신고인

￭ Please write name with seal and signature.

(신고인의 성명을 서명날인과 함께 쓰세요.)

￭ Please write resident registration No. (신고인의 주민등록번호를 쓰세요.)

￭ Please write relationship with householder.

(신고인과 세대주와의 관계를 쓰세요.)

□ Personal information of person to register 등록할 사람의 인적사항

￭ Please write relationship with householder. 세대주와의 관계를 쓰세요.

￭ Please write name and check on sex(M/F).

(성명을 쓰고 성별(남/여)에 체크하세요.)

￭ Please write date of birth. (생년월일을 쓰세요.)

￭ Please write about military service. (병역사항에 대하여 쓰세요.)

￭ Please write permanent domicile address. (등록기준지를 쓰세요.)

□ Letter of attorney 위임장

※ I hereby delegate the report of resident registration to above reporter in accordance with condition of Article 11 second 1 of the 「Law of Resident Registration」 and the Enforcement Ordinance of the same Law.

(「주민등록법」 제11조제1항 단서 및 같은 법 시행령 제19조에 따라 주민등록신고를 위 신고인에게 위임합니다.)

￭ Please write date(Day /Month /Year). 날짜(년월일)를 쓰세요.

￭ Please write name with seal and signature of mandator(Householder).

(위임한 사람(세대주)의 성명을 서명날인과 함께 쓰세요.)

□ Please receive a confirmation of resident registration report.

(주민등록신고 확인서를 받으세요.)

[Annex form No.34] <Revision 2016.12.30> [별지 제34호서식] <개정 2016.12.30>			민원24(www.minwon.go.kr)에서도 신고할 수 있습니다. You can also report on minwon 24(www.minwon.go.kr).
Resident Registration Card 주민등록증 [ ]Loss Report 분실신고서 [ ]Withdrawal Application 철회신청서
Receipt No. 접수번호			Receipt date 접수일자
Loser 분실자	Name 성명			Resident Registration No. 주민등록번호
	Address 주소			Tel. No. 전화번호
Contents to report (withdrawal) 신고(철회) 내용	Date of loss 분실일자
	Reason of loss (withdrawal) 분실(철회) 사유
Date of finding resident registration card 주민등록증의 습득 Day Month Year 년 월 일
I hereby report the loss [ ] withdraw the loss report [ ] of a resident registration card as above. 위와 같이 주민등록증의 분실을 신고 [ ] 분실신고를 철회 [ ] 합니다.
Day Month Year 년 월 일
Reporter (Withdrawer) 신고(철회)인	Name (Korean or English) 성명(한글)	(Seal or signature) (서명 또는 인)		Resident Registration No. 주민등록번호
	Tel. No. 전화번호			Relation with Loser 분실자와의 관계
Attached documents 첨부서류	Nothing 없음				Handling charge 수수료
					Nothing 없음
NOTES 유의사항
1. Please use this report only on loss reporting of resident registration card. If you want to re-issue the resident registration card, please write "Re-issuance application of resident registration card". 이 신고서는 주민등록증 분실신고만 하려고 할 때에 사용하시고, 주민등록증을 재발급 받으려면 “주민등록증 재발급 신청서”를 작성하시기 바랍니다. 2. If you reported the loss of resident registration card, you can check the handling process of the reported matters by ARS("1382" without a telephone exchange number). 분실신고를 하신 분은 주민등록증 진위확인 ARS(국번 없이 “1382”)를 이용하여 신고사항의 처리 여부를 확인하실 수 있습니다. 3. When the loser report directly, don't write on section of 'reporter(retractor)' and on section of "the found of resident registration card", the relevant civil servant will write on it. 분실자가 직접 신고할 때에는 ‘신고(철회)인’란은 적지 않으며, "주민등록증의 습득"란은 담당 공무원이 기재하는 난이므로 신고인은 기재하지 않습니다. 4. If you found the lost resident registration card, please report to withdraw at eup, myeun office or dong community center. 분실된 주민등록증을 되찾았을 때에는 읍ㆍ면사무소 또는 동주민센터에 철회신고를 해 주시기 바랍니다.
210㎜×297㎜[Plain paper 일반용지 60g/㎡]

Resident registration card (주민등록증)

[  ]Loss report 분실신고서

[  ]Withdrawal application 철회신청서

□ Loser 분실자

￭ Please write name in Korean or English of loser.

(분실자의 한글 성명을 쓰세요.)

￭ Please write resident registration No. of loser.

(분실자의 주민등록번호를 쓰세요.)

￭ Please write telephone No. and address of loser.

(분실자의 전화번호와 주소를 쓰세요.)

□ Contents to report(withdrawal) 신고(철회) 내용

￭ Please write date of loss(withdrawal). 분실(철회)일을 쓰세요.

￭ Please write reason of loss(withdrawal). 분실(철회) 사유를 쓰세요.

□ Date a finding resident registration card 주민등록증의 습득

￭ Please write date of find of resident registration card.

(주민등록증 습득일을 쓰세요.)

※ I hereby report the loss(withdraw the loss report) of resident registration card as

above. (위와 같이 주민등록증의 분실을 신고(분실신고를 철회)합니다.)

￭ Please write date of report. 신고일을 쓰세요.

□ Reporter(Withdrawer) 신고(철회)인

￭ Please write name with seal and signature of reporter(withdrawer).

(신고(철회)인의 성명과 함께 서명날인을 하세요.)

￭ Please write relation with reporter(withdrawer) and loser.

(신고(철회)인과 분실자와의 관계를 쓰세요.)

￭ Please write resident registration No. of reporter(withdrawer).

(신고(철회)인의 주민등록번호를 쓰세요.)

￭ Please write telephone No. of reporter(withdrawer).

(신고(철회)인의 전화번호를 쓰세요.)

□ Attached documents 첨부서류

※ - Nothing 없음

※ Handling charge 수수료 - Nothing 없음

□ NOTES 유의사항

1. Please use this report only on loss reporting of resident registration card.

If you want to re-issue the resident registration card, please write

"Re-issuance application of resident registration card".

이 신고서는 주민등록증 분실신고만 하려고 할 때에 사용하시고, 주민등록증을 재발급 받으려면 “주민등록증 재발급 신청서”를 작성하시기 바랍니다.

2. If you reported the loss of resident registration card, you can check the handling process of the reported matters by ARS("1382" without a telephone exchange number).

분실신고를 하신 분은 주민등록증 진위확인 ARS(국번 없이 “1382”)를 이용하여 신고사항의 처리 여부를 확인하실 수 있습니다.

3. When the loser report directly, don't write on section of 'reporter (withdrawer)' and on section of "the found of resident registration card", the relevant civil servant will write on it.

분실자가 직접 신고할 때에는 ‘신고(철회)인’란은 적지 않으며, "주민등록증의 습득"란은 담당 공무원이 기재하는 난이므로 신고인은 기재하지 않습니다.

4. If you found the lost resident registration card, please report to withdraw at eup, myeun office or dong community center.

(분실된 주민등록증을 되찾았을 때에는 읍ㆍ면사무소 또는 동주민센터에 철회 신고를 해 주시기 바랍니다.)

[Annex form No.32] <Revision 2023.4.5> [별지 제32호서식] <개정 2023.4.5>
Re-issuance Application for Resident Registration Card 주민등록증 재발급 신청서
※ Please complete after reading the notes below, check √ in the box [ ] of each relevant section. 아래의 유의사항을 읽고 작성하여 주시기 바라며, [ ]에는 해당되는 곳에 √표를 합니다.
Receipt No. 접수번호			Receipt date 접수일자		Handling period 처리기간 Immediately 즉시
Applicant 신청인		Name(Korean or English) 성명(한글)			Resident Registration No. 주민등록번호
		Address 주소
		Tel No. 전화번호
Reason for re-issuance 재발급 사 유		[ ]Loss분실 [ ]Damage훼손 [ ]Change of name 성명변경 [ ]Change of Resident Registration No.주민등록번호 변경
		[ ]Shortage of space for changing address 주소변경란 부족 [ ]Permanent homecoming 영주귀국 [ ]Change of appearance(photo) 용모(사진) 변경 [ ]Returnedㆍdestruction by not received 미수령으로 회수ㆍ파기 [ ]Other 기타
Confirmation sheet of application to issue the resident registration card 주민등록증 발급 신청 확인서 [ ]Issuance 교부 [ ]No issuance 미교부
Receiving method of resident registration card 주민등록증 수령방법 [ ]By visiting the application office 신청기관 방문 [ ]By visiting the resident registration office 주민등록기관 방문 [ ]By registered mail 등기우편 수령
Address for receiving registered mail (Zip code - ) 등기우편 수령 주소 (우 - )						Mobile Phone No.휴대전화번호
I hereby apply for a re-issuance of the resident registration card as above. 위와 같이 주민등록증의 재발급을 신청합니다.
Day Month Year 년 월 일
Applicant 신 청 인				(Seal and signature) (서명 또는 인)
Attached documents 첨부서류	1. One sheet of photo(3cm × 4cm) to be taken by barehead of upper body within six months. 6개월 이내 촬영한 본인의 탈모(脫帽) 상반신 사진(3cm × 4cm) 1장 2. Previous resident registration card 종전의 주민등록증 (Please except, if it is one of next each items.)(다음 각목의 어느 하나에 해당하는 경우는 제외합니다) A. In case of losing the resident registration card, but if you found previous resident registration card after re-issuing the resident registration card, must return to eupㆍmyeun office or dong community center without delay. 가. 주민등록증을 분실한 경우. 다만, 주민등록증을 재발급 받은 후에 구(舊) 주민등록증을 찾았을 때에는 지체 없이 읍ㆍ면사무소 또는 동주민센터에 구 주민등록증을 반납하여야 합니다. B. The emigrated person to overseas returned home for permanent residence and in case of return the resident registration certificate before emigrating to overseas. 나. 국외로 이주한 사람이 영주(永住)하기 위해 귀국한 경우로서 국외로 이주하기 전에 주민등록증을 반납한 경우 C. The resident registration card was issued but it hasn't picked up three years since then. 다. 주민등록증을 발급하였으나 3년이 지나도 찾아가지 않아 해당 행정기관이 파기한 경우 D. It was informed to receive the found resident registration card but it hasn't picked up one year since then so in case it was destroyed by administrative agency. 라. 습득 주민등록증의 수령을 안내하였으나 1년이 지나도 찾아가지 않아 해당 행정기관이 파기한 경우						Handling charge 수수료
							Won 원
NOTES 유의사항
If you want to withdraw the re-issuance of resident registration card, you have to apply the withdrawal within work hours of the applying day. You can't withdraw after finishing the work hours. 주민등록증 재발급 신청을 철회하려면 그 신청을 한 날의 근무시간이 끝나기 전에 하여야 합니다. 그 근무시간이 끝난 후에는 철회할 수 없습니다. Receipt means of resident registration card 주민등록증 수령방법 A. If you chose "Receiving by visiting", please pick up the resident registration card within three years after application. It will be destroyed, if you don't pick up the resident registration card until three years from application. If application office of issuance is not resident registration place, after application until six months, please pick up the resident registration card at application office and from after six months, please pick up the resident registration card at eupㆍmyeun office or dong community center of resident registration place. 가. “방문 수령”을 선택한 경우에는 신청 후 3년 내에 주민등록증을 받아 가시기 바랍니다. 3년이 지나도 찾아가지 않은 주민등록증은 파기됩니다. 발급 신청기관이 주민등록지가 아닌 경우에는 신청 후 6개월까지는 발급 신청기관에서 주민등록증을 찾아가시고, 6개월이 지난 후부터는 주민등록지인 읍ㆍ면사무소 또는 동주민센터에서 주민등록증을 찾아가시기 바랍니다. B. If you want to receive by "Registered mail", please pay the registered fee when you apply it and if you want to receive the text message service by mobile phone when the resident registration card dispatched by registered mail, please write mobile phone No. certainly. 나. “등기우편 수령”을 원하는 사람은 신청할 때 등기우편료를 납부하셔야 하며, 주민등록증을 등기우편으로 발송하였을 때 휴대전화 문자전송(SMS) 안내를 받으려는 경우에는 반드시 휴대전화번호를 기재하여 주시기 바립니다. C. In case of "Receiving by registered mail", the resident registration card is dispatched to address of "Receiving address by registered mail" but if it was received by the other person not applicant so if any incident was occurred, the issuance office hasn't any responsibility. Although it sent three times within five days from first dispatching date, if couldn't receive the resident registration card due to reason of applicant, please pick it up directly to visit at issuance office. 다. “등기우편 수령”을 선택한 경우, “등기우편 수령 주소”란에 기재된 주소로 발송한 주민등록증을 신청인이 아닌 다른 사람이 대리 수령하여 발생한 사고에 대해서 발급 신청기관은 책임을 지지 않음을 알려드리며, 최초 발송일부터 5일 이내 3회 발송하였음에도 신청인의 사정으로 주민등록증을 받지 못한 때에는 직접 발급 신청기관을 방문하여 찾아가셔야 합니다. In case of payment the handling charge 수수료를 내는 경우 A. In case of re-issuance due to loss or destruction(Except the destruction by natural) 가. 주민등록증을 분실하거나 훼손(자연적인 훼손은 제외)하여 재발급 신청을 하는 경우 B. In case of re-issuance because the appearance was changed by surgical procedure(Except the case of due to disasterㆍcalamity) and etc. 나. 외과적 시술(재해ㆍ재난으로 인한 경우는 제외) 등으로 용모가 변하여 재발급 신청을 하는 경우 C. In case of re-issuance due to not pick up the issued and the found resident registration card. 다. 발급 및 습득된 주민등록증의 미수령으로 인한 파기로 재발급 신청을 하는 경우 제출하신 사진으로 본인임을 확인하기 곤란한 경우 발급기관은 신청인에게 보완을 요구할 수 있습니다. If you and your photo isn't matched very much, the issuance office can demand to complement about your submitted photo.

(Back page 뒤 쪽)
Attached documents 첨부서류	1. One sheet photo in person 본인 사진 1장 A. The photo(3㎝×4㎝) has to be taken by bareheaded of upper body within six months. 6개월 이내에 촬영한 탈모(脫帽) 상반신 사진(3㎝×4㎝)이어야 합니다. B. If you want to issue the confirmation for applying of resident registration card, must attach two photos. 주민등록증 발급신청 확인서를 발급받으려는 경우에는 사진을 2장 첨부해야 합니다. 2. The student card or the certificate(has to be attached a photo) issued by country, local government or public institution. 학생증이나 국가ㆍ지방자치단체 또는 공공기관에서 발급한 증명서(사진이 부착된 것이어야 합니다)	Handling charge 수수료
		Nothing 없음
NOTES 유의사항
1. Personally must apply to issue and must submit the issuance application within relevant issuance period. 본인이 직접 발급신청을 해야 하며, 해당 발급기일 내에 발급신청서를 제출해야 합니다. 2. If isn't in person or dual application to issue, the fact is proved by fingerprint. In this case, shall be punished by imprisonment for not more than three years or by a fine not exceeding ten million won. 본인이 아니거나 이중으로 발급신청을 하게 되면 지문에 의하여 그 사실이 판명되며, 이 경우 3년 이하의 징역 또는 1천만원 이하의 벌금형을 받게 됩니다.(「Law of Resident Registration 주민등록법」 Article 37 제37조) 3. If you chose to receive by "Visiting the Office of Resident Registration", please pick the resident registration card up within three years after applying. If you don't pick it up after three years, the resident registration is destroyed. “주민등록기관 방문” 수령을 선택한 경우에는 신청 후 3년 내에 주민등록증을 찾아가시기 바랍니다. 3년이 지나도 찾아가지 않은 주민등록증은 파기 됩니다. 4. If you chose to receive by "Registered mail", you have to pay the registration fee on applying. Although the resident registration card was sent three times within five days from the first dispatched date, if could not receive the resident registration card by the reason of applicant, the applicant must visit directly to issuance office and must receive the resident registration card. “등기우편” 수령을 원하는 사람은 신청할 때 등기우편료를 납부하셔야 하며, 최초 발송일부터 5일 이내 3회 발송을 하였음에도 신청인의 사정으로 주민등록증을 받지 못한 경우에는 신청인이 직접 발급신청기관을 방문하여 주민등록증을 찾아가셔야 합니다. 5. If the resident registration card which is dispatched by registered mail was received by the other person not applicant, so if any incident occurred, the issuance office has no responsibility. 등기우편으로 발송한 주민등록증을 신청인이 아닌 다른 사람이 대리 수령하여 발생한 사고에 대해서 발급신청기관은 책임이 없음을 알려드립니다. 6. If you and your photo isn't matched very much, the issuance office can demand to complement about your submitted photo. 제출하신 사진으로 본인임을 확인하기 곤란한 경우 발급기관은 신청인에게 보완을 요구할 수 있습니다.
How to fill out the form 작성방법
1. Please must submit to leave a blank the section of "The relevant civil servant" and the section of "The relevant document confirming identity" in front page. 앞쪽 중 “담당 공무원”란과 “소명 관계 서류”란은 비워둔 채로 제출해야 합니다. 2. Please write all items by black ball pen or by writing instrument with ink in Korean or English, and only the items to be marked as "Chinese characters" write in Chinese characters. 모든 항목은 검정색 볼펜이나 잉크가 나오는 필기구를 사용하여 한글로 기재하고, “한자”라고 표시된 항목만 한자로 기재해야 합니다. 3. In case of receiving by "Registered mail", the resident registration card is dispatched as written address on "Receiving address by registered mail", so you have to write the address exactly. When the resident registration card is dispatched, if you want to receive the text massage service by mobile phone, certainly you have to write the number of mobile phone. “등기우편” 수령을 선택한 경우에는 “등기우편 수령 주소”란에 기재된 주소로 주민등록증이 발송되므로 주소를 정확하게 기재해야 하며, 주민등록증을 등기우편으로 발송하였을 때 휴대전화 문자전송(SMS) 안내를 받으려는 경우에는 반드시 휴대전화번호를 기재하여 주시기 바립니다. 4. The section of "Head of the tong, head of a village" and "Family" are written only if applicant can't submit the student card or the issued certificate(the photo must affix) from country, local government or public institution for identification. If more than 17 years old member of same household, spouse, lineal relation or brother, sister were accompanied with identification certificate, please write relation with a companion and applicant on section of "family". “통장ㆍ이장”란과 “가족”란은 신청인이 본인임을 확인하기 위하여 학생증이나 국가ㆍ지방자치단체 또는 공공기관에서 발급한 증명서(사진이 부착된 것이어야 합니다)를 제시할 수 없는 경우에만 작성하는 난입니다. “가족”란은 17세 이상의 같은 세대원, 배우자, 직계혈족 또는 형제ㆍ자매가 신분증명서를 지참하여 동행한 경우에 동행자와 신청인과의 관계를 기재합니다.
210㎜×297㎜[File paper 파일지 170g/㎡]

Re-Issuance application for resident registration card

(주민등록증 재발급 신청서)

※ Please complete after reading the notes below, check √ in the box [  ] of each relevant section.

아래의 유의사항을 읽고 작성하여 주시기 바라며, [ ]에는 해당되는 곳에 √표를 합니다.

□ Applicant 신청인

￭ Please write applicant's name in Korean or English. (신청자의 성명을 한글로 쓰세요.)

￭ Please write applicant's resident registration No. (신청자의 주민등록번호를 쓰세요.)

￭ Please write applicant's telephone No. (신청자의 전화번호를 쓰세요.)

￭ Please write applicant's address. (신청자의 주소를 쓰세요.)

□ Reason of re-issuance 재발급사유

￭ Please check on proper reason for re-issuance. (적절한 재발급 사유에 체크하세요.)

[  ]Loss분실  [  ]Damage훼손   [  ]Change of name 성명변경

[  ]Change of resident registration No. 주민등록번호 변경

[  ]Shortage of space for changing address 주소변경란 부족

[  ]Permanent homecoming 영주귀국

[  ]Change of apparence(photo) 용모(사진) 변경

[  ]Returnedㆍdestruction by not received 미수령으로 회수ㆍ파기

[  ]Other 기타

□ Confirmation sheet of application to issue the resident registration card

( 주민등록증 발급 신청 확인서)

￭ Please check on issuance or no issuance of confirmation sheet of application

to issue the resident registration card.

(주민등록증 발급신청 확인서 발급 혹은 미발급에 체크하세요.)

□ Receiving method of the resident registration card

(주민등록증 수령방법)

￭ Please check on receiving method of the resident registration card.

(주민등록증 수령방법에 체크하세요.)

[  ]By visiting the application office 신청기관 방문

[  ]By visiting the resident registration office 주민등록기관 방문

[  ]By registered mail 등기우편 수령

￭ Please write applicant's address with zip code for registered mail.

(등기우편 주소를 우편번호와 함께 쓰세요.)

￭ Please write applicant's mobile phone No. 신청자의 휴대전화번호를 쓰세요.

※ I hereby apply for a re-issuance of the resident registration card as above.

(위와 같이 주민등록증의 재발급을 신청합니다.)

￭ Please write date of application. 신청일을 쓰세요.

￭ Please write applicant's name with seal and signature.

(신청인의 성명을 서명날인과 함께 쓰세요.)

□ NOTES 유의사항

If you want to withdraw the re-issuance of resident registration card, you have to apply the withdrawal within work hours of the applying day. You can't withdraw after finishing the work hours. 주민등록증 재발급 신청을 철회하려면 그 신청을 한 날의 근무시간이 끝나기 전에 하여야 합니다. 그 근무시간이 끝난 후에는 철회할 수 없습니다.

2. Receiving method of the resident registration card 주민등록증 수령방법

A. If you chose "Receiving by visiting", please pick up the resident registration card within 1 years after application. It will be destroyed, if you don't pick up the resident registration card until 1 years from application. If application office of issuance is not resident registration place, after application until six months, please pick up the resident registration card at application office and from after six months, please pick up the resident registration card at eupㆍmyeun office or dong community center of resident registration place.

(“방문 수령”을 선택한 경우에는 신청 후 1년 내에 주민등록증을 받아 가시기 바랍니다. 1년이 지나도 찾아가지 않은 주민등록증은 파기됩니다. 발급 신청 기관이 주민등록지가 아닌 경우에는 신청 후 6개월까지는 발급 신청기관에서 주민등록증을 찾아가시고, 6개월이 지난 후부터는 주민등록지인 읍ㆍ면사무소 또는 동주민센터에서 주민등록증을 찾아가시기 바랍니다.

B. If you want to receive by "Registered mail", please pay the registered fee

when you apply it and if you want to receive the text message service by

mobile phone when the resident registration card dispatched by registered mail,

please write mobile phone No. certainly.

(“등기우편 수령”을 원하는 사람은 신청할 때 등기우편료를 납부하셔야 하며, 주민등록증을 등기우편으로 발송하였을 때 휴대전화 문자전송(SMS) 안내를 받으려는 경우에는 반드시 휴대전화번호를 기재하여 주시기 바립니다.)

C. In case of "Receiving by registered mail", the resident registration card is dispatched to address of "Receiving address by registered mail" but if it was received by the other person not applicant so if any incident was occurred, the issuance office hasn't any responsibility. Although it sent three times within five days from first dispatching date, if couldn't receive the resident registration card due to reason of applicant, please pick it up directly to visit at issuance office.

(“등기우편 수령”을 선택한 경우, “등기우편 수령 주소”란에 기재된 주소로 발송한 주민등록증을 신청인이 아닌 다른 사람이 대리 수령하여 발생한 사고에 대해서 발급 신청기관은 책임을 지지 않음을 알려드리며, 최초 발송일 부터 5일 이내 3회 발송하였음에도 신청인의 사정으로 주민등록증을 받지 못한 때에는 직접 발급 신청기관을 방문하여 찾아가셔야 합니다.)

3. In case of payment the handling charge 수수료를 내는 경우

A. In case of re-issuance due to loss or destruction(Except the destruction by natural)

(주민등록증을 분실하거나 훼손(자연적인 훼손은 제외)하여 재발급 신청을 하는 경우)

B. In case of re-issuance because the appearance was changed by surgical procedure

(Except the case of due to disasterㆍcalamity) and etc.

(외과적 시술(재해ㆍ재난으로 인한 경우는 제외) 등으로 용모가 변하여 재발급 신청을 하는 경우)

C. In case of re-issuance due to not pick up the issued and the found resident         registration card.

(발급 및 습득된 주민등록증의 미수령으로 인한 파기로 재발급 신청을 하는 경우)

4. If you and your photo isn't matched very much, the issuance office can demand to complement about your submitted photo. 제출하신 사진으로 본인임을 확인하기 곤란한 경우 발급기관은 신청인에게 보완을 요구할 수 있습니다.

□ Attached documents 첨부서류

1. One sheet of photo(3cm × 4cm) to be taken by barehead of upper body within six months.

(6개월 이내 촬영한 본인의 탈모(脫帽) 상반신 사진(3cm × 4cm) 1장)

2. Previous resident registration card 종전의 주민등록증

(Please except, if it is one of next each items.)

(다음 각목의 어느 하나에 해당하는 경우는 제외합니다)

A. In case of losing the resident registration card, but if you found previous resident registration card after re-issuing the resident registration card, must return to eupㆍmyeun office or dong community center without delay.

(주민등록증을 분실한 경우. 다만, 주민등록증을 재발급 받은 후에 구(舊) 주민등록증을 찾았을 때에는 지체 없이 읍ㆍ면사무소 또는 동주민센터에 구 주민등록증을 반납하여야 합니다.)

B. The emigrated person to overseas returned home for permanent residence and in case of return the resident registration card before emigrating to overseas.

(국외로 이주한 사람이 영주(永住)하기 위해 귀국한 경우로서 국외로 이주하기 전에 주민등록증을 반납한 경우)

C. The resident registration card was issued but it hasn't picked up three years since then.

(주민등록증을 발급하였으나 3년이 지나도 찾아가지 않아 해당 행정기관이 파기한 경우)

D. It was informed to receive the found resident registration card but it hasn't picked up one year since then so in case it was destroyed by administrative agency.

(습득 주민등록증의 수령을 안내하였으나 1년이 지나도 찾아가지 않아 해당 행정기관이 파기한 경우)