- 외국인을 위한 영어 -

민원서식 외국어 해석본

Translated forms for foreigner(English)

	진 도 군 ( 민원봉사과 )

목차 Contents

가족관계등록 창설 신고서	1

(Creation report of a new family relation register)

사망신고서	5

(Report of Death)

인지(친권자지정) 신고서	14

(Report of recognition(Designation of parental authority)

출생신고서	23

(Report of birth)

파양신고서	32

(Report for dissolution of adoption)

개명신고서	41

(Report of Name Change)

성본 변경신고서	44

(Alteration report of surname ․ place of family origin)

입양신고서	48

(Report of adoption)

친양자 파양신고서	57

(Dissolution of adoption report for parental adopted child)

혼인신고서	62

(Report of Marriage)

등록부 정정신청서	71

(Revision report of register)

이혼신고서	75

(Report of divorce)

창성신고서	85

(Report of creating a new surname)

친양자 입양신고서	88

(Adoption report for paternal adopted child)

혼인신고 시 자녀의 성과본에 대한 협의서	92

(Written Agreement)

가족관계증명서	95

(Family Relation Certificate)

기본증명서	96

(Basic Certificate)

입양관계증명서	97

(Adoptive Relation Certificate)

친양자입양관계증명서	98

(Adoptive Relation Certificate of Paternal Adopted Child)

혼인관계증명서	99

(Marital Relation Certificate)

국내거소이전 신고서	100

(Report on alteration of domestic residence)

인감보호신청, 인감보호해제 신청	102

(Application for protecting the seal impression)

(Application for cancellation of the protection of seal impression)

정정신고서	106

(Report of correction)

(Report(Alteration) of seal impression [For written report]

인감신고서	108

(Report(Application) of seal impression)

인감증명위임장 또는 법정대리인 동의서	114

(Letter of attorney for seal impression or consent of

legal representative)

체류지변경 신고서	118

(Report on alteration of residence)

체류지변경 및 국내거소이전 위임장	120

(Letter of Attorney)

출입국사실증명서 등 발급신청서	123

(Application form for issuance of Certification of Fact)

출입국사실증명서 등 발급신청서 위임장	126

(Letter of attorney for issuance of Certification of Fact)

주민등록표 열람 또는 등초본교부 신청서	129

(Application for inspection of resident registration table or

for issuance of certified copyㆍabstract)

주민등록신고서	136

(Resident Registration Report)

주민등록증 분실신고서, 철회신청서	139

(Letter of attorney for inspection of resident registration

table or for issuance of certified copyㆍabstract)

주민등록표 열람 또는 등초본 교부 신청 위임장	142

(Letter of attorney for inspection of resident registration

table or for issuance of certified copyㆍabstract)

주민등록증 발급 신청서	148

(Issuance Application for Resident Registration Card)

주민등록증 재발급 신청서	154

(Re-issuance Application for Resident Registration Card)

이륜자동차 사용 신고서	159

(Reporting the usage of a two-wheeled vehicle)

이륜자동차 사용 폐지 신고서	162

(Reporting the revocation of usage of a two-wheeled vehicle)

이륜자동차신고사항 변경 신청서	164

(Application form for altering the reported details a

two-wheeled vehicle)

자동차 양도 증명서	167

(Transfer certificate of vehicle ownershi)

이륜자동차 사용신고필증 재교부 신청서	170

(Application form for re-issuance the completion certificate

of usage report of two-wheeled motorcycle)

[Form No.29]

Creation report of a new family relation register ( ..... Day ..... Month .......... Year)	※ Please write after reading the guidelines belows and, when required to select one option, please circle the number as follows "○".
① Originator of the family relation register	Name	Korean or English		Place of family origin		Sex	□ Male □ Female
Resident Registration No.	-
Chinese characters
Date of birth
Permanent domicile address
Address
Parents	Father	Name		Permanent domicile address
Resident registration No.	-
Mother	Name		Permanent domicile address
Resident registration No.	-
② Details for status
③ Permission or trial decision date	...... Day ..... Month .......... Year	Court name
④ Other
⑤ Declarer	Name	(Seal) or signature	Resident Registration No.	-
Qualification	□Self □Spouse □Lineal blood relation □Other (Please state: )
Address		Telephone No.		E-mail address
⑥ Submitter	Name		Resident Registration No.	-

How to fill out
※ This has to be reported within one month from receiving the copy of permission for establishing the family relation register. ① : In principle, this has to be reported by each affair's person with the permission for establishing the family relation register. : If you wrote the resident registration number, you can omit the date of birth according to the Article 25 Section 2 of the Law. ② : Please write all other details about status except the required informations in this report and can substitute as attached the written decision (status chart) for permission of establishing the family relation register. ④ : Please write especially necessary informations for clarifying the family relation register. ⑥ : Submitter(Regardless of the declarer is true or not)'s name and resident registration number. [접수담당공무원은 신분증과 대조]
Attached documents
1. One set the copy of permission decision for establishing the family relation register.(If you report the foundation of the family relation register by decree absolute, the copy of decree and decision certificate.) 2. Identification [according to Article 23 of the family relation register established rule] - In case of declarer's attendance : Identification card - In case of submitter's attendance : Submitter's identification card - In case of postal submission : Copy of declarer's identification card

Creation report of a new family relation register

(가족관계등록 창설신고서)

※ Writing method (작성방법)

￭ This has to be reported within one month from receiving the copy of permission

for establishing the family relation register.

(가족관계등록창설허가등본을 받은 날부터 1개월 이내에 신고하여야 합니다.)

① Originator of the family relation register (가족관계등록창설자)

※ Writing method (작성방법)

￭ In principle, this has to be reported by each affair's person with the permission for

establishing the family relation register. If you wrote the resident registration number,

you can omit the date of birth according to the Article 25 Section 2 of the Law.

(가족관계등록창설신고는 원칙적으로 사건본인 각자가 가족관계등록창설 허가와

함께 가족관계등록창설신고를 하여야 합니다. 법 제25조제2항에 따라 주민등록

번호란에 주민등록번호를 기재한 때에는 출생연월일의 기재를 생략할 수 있습니다.)

□ Originator (창설자 본인)

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

(창설자 본인의 성명을 한글과 한자로 쓰세요.)

￭ Please write originator's place of family origin in Chinese characters.

(창설자의 본을 한자로 쓰세요.)

￭ Please check originator's sex. 1)Male  2)Female

(창설자의 성별을 체크하세요. 1)남    2)여)

￭ Please write originator's resident registration No.

(창설자의 출생연월일을 쓰세요.)

￭ Please write originator's permanent domicile address and address.

(창설자의 등록기준지와 주소를 쓰세요.)

□ Originator's parents(father/mother) 창설자의 부모

￭ Please write parents(father/mother)'s name and permanent domicile address.

(창설자 부모의 성명과 등록기준지를 쓰세요.)

￭ Please write parents(father/mother)'s resident registration No.

(창설자 부모의 주민등록번호를 쓰세요.)

② Details for status (신분에 관한 사항)

※ Writing method (작성방법)

￭ Please write the other all details about status except the required informations

in this report and can substitute as attached the written decision (status chart)

for permission of establishing the family relation register.

(이 신고서에서 정한 이외의 신분에 관한 모든 사항을 기재하여야 하며, 별지로

첨부한 가족관계등록창설허가결정서(신분표)로 대신할 수 있습니다.)

③ Permission or trial decision date (허가 또는 재판확정일자)

￭ Please write the date(day/month/year) and the court name.

(날짜와 법원명을 쓰세요.)

④ Other (기타사항)

※ Writing method (작성방법) :

￭ Please write especially necessary informations for clarifying the family relation register.

(가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재합니다.)

⑤ Declarer (신고인)

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

(신고인의 성명을 쓰고 서명날인하세요.)

￭ Please write declarer's resident registration No.

(신고인의 주민등록번호를 쓰세요.)

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

1. Self  2. Spouse  3. Lineal blood relation  4. Other (Please state:        )

1. 본인  2. 배우자  .3.직계혈족  4.기타 (자격:             )

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

(신고인의 주소, 전화번호, 이메일 주소를 쓰세요.)

⑥ Submitter (제출인)

※ 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])

￭ Please write name and resident registration number.

(제출인의 성명과 주민등록번호를 쓰세요.)

□ Attached documents 첨부서류

1. One set the copy of permission decision for establishing the family relation

register (가족관계등록창설허가결정의 등본 1부)

(If you report the foundation of the family relation register by decree absolute, the copy of decree and decision certificate.)

(확정판결로 인하여 가족관계등록창설신고를 할 경우에는 판결등본 및 확정증명서).

2.  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 : 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)

[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

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)

Writing Method		※ You should submit to write a report of death.
① Deceased	□ Permanent domicile address: If a deceased is a foreigner, write the nationality. □ Resident registration number: If a deceased is a foreigner, please write an alien registration number(Domestic residence registration number or the date of birth). □ Date and time of death : <Example> PM 2hours 30minutes (X) →14hours 30minutes (O) Night 12hours 30minutes (X) → Next day 0hour 30minutes (O) □ If our people passed away abroad, write the dead time of local by A.D. (Anno Domini) and the solar calendar. When he/she died in period of summertime, please write the"summertime application" by the dead time of local. □ Section of deathplace : □ The house include the houses of deceased, parent and relation. The others include a plane, a vessel, a train and etc. except example.
② The other facts	□ If a medical certificate of death(death certificate of dead) isn't attached, write the reason and requirements for a clear record on a certificate of family relations.
③ Reporter	□ Mark on applicable qualification with the "O" and □ Other is included the administration of the deathplace and etc.
④ Submitter	□ Please write the submitter's(Regardless of the declarer is true or not) name and resident registration number.[An acceptable official in charge identify the submitter]
⑤ Cause of Death	□ Please write all causes of death on medical certificate of death(death certificate of dead) and the other body conditions.
⑥ Type of death	□ Please write a type of death on medical certificate of death(death certificate of dead) for reference. □ violent death is relevant with accidental death and etc. except disease. In case of □ other and non-specific, enter its contents concretely.
⑦ Clause of violent death	□ In case of an accidental death, write equally as certificate of death . If there aren't the recorded items, enter type of accident, a occurred region and place of accident concretely.
⑧ Deceased	□ Final graduated school of deceased should be recorded as standard all regular organizations which is approved by the Ministry of Education, Science and Technology. In(dropout) student of each school mark as "O" the relevant number of the graduated final school. <Example> Dropout of junior in college → Mark a high school of number □ with "O" □ The occupation of deceased on occurring of disease(accident) has to be written thoroughly the occupation at occurrence of disease and accident of dead cause time. <Example> Employee → Detailer. department of business, ○○company (O)
Required Document(s)
1. Medical certificate or death certificate of deceased. 1 copy. 2. A written to be proved the fact of death. (If can't attach medical certificate or death certificate): One set of belows - Certificate of Death(Certificate of death to be written by head of DongㆍRiㆍTong or more than two companions): If the certifier is companion(more than two persons), it should be attached one set of among their certificate of seal impression, copy of identification card, copy of driver's license, copy of passport and copy of public official card. If head of DongㆍRiㆍTong is certifier, is enough to be proved by one person and in principle, it should be attached a written for certifying head of DongㆍRiㆍTong . - Death certificate of government office or burial permit and approval. - Acception certificate for report of death (In case of death report at foreign government office) ※ Below No. 3 can be omitted if the contents is checked by computer at office of family relation registration. 3. Basic certificate of the deceased's family relation register. 1 set. 4. Identification. [In accordance with Article 23 of the established rule for family relation register] - In case of reporter's attendance : Identification card - In case of submitter's attendance : Copy of reporter's identification card, a submitter's identification card - In case of postal submission : Copy of reporter's identification card. 5. If a deceased is foreigner : Written(passport or alien registration card) for certifying the nationality.
※ Information of limited approval and inheritance waiver of property		* This information is the contents regardless of a death report. Please ask detail information to public service center of family or district court.
1. Meaning : Limited approval - To approve an inheritance within limit of the inherited property. Waiver - To waive the succession of all right and obligation about inheritance property 2. Method : Limited approval - Please report to family court with inheritance property list. Waiver - Please report to family court the waiver. 3. Period of report : Within 3 months from the day to be known the start of inheritance (In accordance with the Proviso of Article 1019, Paragraph 1 of the Civil Law) If the heir don't know that the inherited debt is over the inherited property during period of report without gross negligence and if he approved as simple(Include the case of simple approval in accordance with Article 1026 section 1 and 2 of civil law) can approve as limit within 3 months from day to be known the fact. 4. Jurisdiction : Competent court in starting region of inheritance [(Last) address of inheritee]

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 등록 기준지를 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.2]

Report of recognition (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 "○".
① The affiliated person (Child)	Name	Korean or English		Place of family origin		Sex	□ Male □ Female
Resident Registration No.	-
Chinese characters
Date of birth
Permanent domicile address
Address
Mother's name and permanent domicile address	Name		Resident Registration No.	-
Permanent domicile address
② Recognizer (Parent)	Name	Korean or English		Resident Registration No.	-
Chinese characters
Permanent domicile address
③ Confirmation date for recognizing judgment ( )	Day Month Year	Name of court	court
④ Person with parental authority	Name		Resident Registration No.	-	Relationship with the affiliated person (Child)	□ Father □ Mother
Date of designation	Day Month Year	Cause of designation	□ Agreement □ Decision of ( )court
⑤ Continuous usage of surname․ place of family origin	Date of designation	Day Month Year	Cause of designation	□ Agreement □ Decision of ( )court
⑥ Other
⑦ Declarer	Name	Seal or signature	Resident Registration No.	-
Relationship	□ Father □ Mother □ Executor(Legal representative) □ Propounder of trial(Plaintiff) □ Opponent of trial(Defendant) □ Other(Relationship : )
Address
Tel. No.		E-mail address
⑧Submitter	Name		Resident Registration No.	-

Written method
※ Please write the nationality on section of permanent domicile address if the affiliated person or recognizer is foreigner. No. ① : Only if father recognized, please write mother's name and permanent domicile address. : If the fetus was recognized: please write as "The fetus of ○months in pregnant" on section of name(Korean) but if there are a name for fetus, also please write the name. : If you wrote the resident register No. on section of resident register No., can omit to write the date of birth in accordance with Article 25. section 2 of law. No. ③ : Please write only in case of report for recognition in accordance with confirmation of judgment for recognition. : In case of report for recognition according to conclusion of the arbitration, to decision for replacing the arbitration, to conclusion of the reconciliation or to decision for adjuring the reconciliation, please write on below ( ) of the confirmed date of recognition judgement as "Conclusion of the arbitration", "Decision confirmation for replacing the arbitration" or "Conclusion of the reconciliation", "Decision confirmation for adjuring the reconciliation" and write date of the conclusion(confirmation) on section of date. No. ④ : Only in case the person of parental authority for the affiliated person is fixed, please write. : Date of designation - In case of agreement→Date of agreement, In case of court's decision →Date of judgment : Cause of designation - In case of court's decision, please write the name of court in ( ). No. ⑥ : Please write below items and specially necessary matters for registering to clear the family relation. - If the affiliated person known about father or mother after creating surname and place of family origin, please write the reason why follow surname and place of family origin of father or mother. - If you recognized the deceased child, please write the affiliated person's date of death, name of lineal descendant, date of birth and permanent domicile address. - If an incompetent recognize, please write name, signature(or seal) and resident register No. of assentient (guardian). - If the affiliated person has spouse or lineal descendant, please write their name(Korean with Chinese character), date of birth, name of parents and relation with the affiliated person. - If you recognized a will, please write the purpose and taken up date of executer. No. ⑧ : Please write name and resident register No. of submitter(Regardless of the reporter is true or not) [접수담당공무원은 신분증과 대조]
Attached documents
1. One set for copy of judgment and certificate of confirmation. - Please attach only in case of recognition report according to confirm of recognition judgment. - In case of recognition's report according to conclusion of the reconciliation or to conclusion of the arbitration, please attach the copy of reconciliation protocol (protocol of arbitration) and dispatch certificate.(In case of decision for replacing arbitration or decision for adjuring reconciliation, please attach copy of decision and confirmation certificate). ※ In case of below No. 2, if the contents is checked by computer at office of family relation register, omit to attach. 2. Each one set basic certificate, marriage relation certificate and family relation certificate of family relation register for mother at birth time of the affiliated person.(If mother of the affiliated person hasn't the family relation register or isn't clear to be registered or not, a written notarization of the fact that the mother wasn't a married woman at birth time of the affiliated person or a guarantee of companion of more two persons). 3. One set a written for certificating the designation of parental authority person(Please attach the relevant written according to the cause of designation). : The designation by agreement- Agreement, : The designation by decision of court-Copy of judgment for designation of parental authority person and certificate of decision 4. Copy of will(or a written paper of the recorded will) one set. 5. If the recognizer is foreigner, a written paper to certificate the nationality. 6. If a court permit to use surname․place of family origin continually - Each 1 set a copy of court records and certificate of decision. If the parents agree to use surname․place of family origin continually - If one side of parents report, please attach one set the certificating documents about agreement fact. 7. Identification[In accordance with Article. 23 the established rule of family relation register] ① In case of voluntary recognition - In case of attendance of declarer : Certificate of identification - In case of nonappearance of declarer and attendance of submitter : Certificate of identification for submitter and certificate of identification for reporter or a written notarization or certificate of seal impression(If the reporter signed on report without certificate of identification for reporter, notarize in signature and put the seal impression, attach a certificate of seal impression) - In case of submission by postal : Notarization of signature or certificate of seal impression(If you signed on report, attach a notarization of signature, if you put your seal impression, attach a certificate of seal impression) ② In case of recognition on trial - In case of attendance of reporter : Certificate of identification - In case of attendance of submitter : Certificate of identification for submitter - Copy for certificate of identification : In case of submission by postal ※ If you report the recognition as method of Korean law for person who was born without marriage between Korean mother and foreigner father, have to attach all next written paper. -The written paper one set for certificating relation with the chosen law as proper law of relevant recognition action and recognizer. Ex. : Basic certificate of family relation register for child and certificate of family relation or copy of resident register for certificating above address of child and etc. -One set of required certificate of the established requirement for stamp which is issued by authorized organization of the affiliated country of proper law. - The written paper one set for certificating the status for example father's nationality and etc.

Report of recognition

(Designation of parental authority)

(인지(친권자지정)신고서)

※ Writing method (작성방법)

￭ Please write the nationality on section of permanent domicile address if the affiliated

person(child) or recognizer(parent) is foreigner.

(피인지자 또는 인지자가 외국인인 경우에는 등록기준지란에 그 국적을 기재합니다.)

￭ Only if father recognized, please write mother's name and permanent domicile address.

(모의 성명 및 등록기준지는 부(父)가 인지한 경우에만 기재합니다.)

￭ If the fetus was recognized: please write as "The fetus of ○months in pregnant" on

section of name(Korean) but if there are a name for fetus, also please write the name.

(태아를 인지하는 경우: 성명(한글)란에 “임신 ○개월 중의 태아”라고 기재하되, 성명이

있는 경우에는 성명까지 기재합니다.)

￭ If you wrote the resident register No. on section of resident register No., can omit

to write the date of birth in accordance with Article 25 Section 2 of the Law.

(법 제25조제2항에 따라 주민등록번호란에 주민등록번호를 기재한 때에는 출생연월일의

기재를 생략할 수 있습니다.)

① The affiliated person(Child) (피인지자)

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

(피인지자의 성명을 한글과 한자로 쓰세요.)

￭ Please write place of family origin(Chinese characters).

(피인지자의 본(한자)을 쓰세요.)

￭ Please check sex on 1)Male 2)Female.

(피인지자의 성에 1)남자 2)여자를 체크하세요.)

￭ Please write resident registration No.

(피인지자의 주민등록번호를 쓰세요.)

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

(피인지자의 출생연월일을 쓰세요.)

￭ Please write permanent domicile address and address.

(피인지자의 등록기준지와 주소를 쓰세요.)

￭ Please write mother's name and permanent domicile address.

(피인지자의 모의 성명과 등록기준지를 쓰세요.)

￭ Please write mother's resident register No.

(피인지자의 모의 주민등록번호를 쓰세요.)

② Recognizer(Parent) (인지자)

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

(인지자의 성명을 한글과 한자로 쓰세요.)

￭ Please write resident registration No. and permanent domicile address.

(인지자의 주민등록번호와 등록기준지를 쓰세요.)

③ Confirmation date for recognizing judgment (인지판결확정일자)

※ Writing method (작성방법)

￭ Please write only in case of report for recognition in accordance with confirmation of

judgment for recognition.

(인지재판의 확정에 따른 인지신고의 경우에만 기재합니다.)

￭ In case of report for recognition according to conclusion of the arbitration, to

decision for replacing the arbitration, to conclusion of the reconciliation or to

decision for adjuring the reconciliation, please write on below (  ) of the

confirmed date of recognition judgement as "Conclusion of the arbitration",

"Decision confirmation for replacing the arbitration" or "Conclusion of the  reconciliation",

"Decision confirmation for adjuring the reconciliation" and write date of the

conclusion(confirmation) on section of date.

(조정성립, 조정에 갈음하는 결정, 화해성립이나 화해권고결정에 따른 인지신고의 경우에는

“인지판결확정일자”아래의(  ) 안에 “조정성립”, “조정에 갈음하는 .결정확정” 또는

“화해성립”, "화해권고 결정확정“이라고 기재하고, “년월일”란에 그 성립(확정)일을

기재합니다.)

￭ Please write confirmation date(Year/Month/day) for recognizing judgment and

name of court.

(인지판결확정일자(년,월,일)와 법원명을 쓰세요.)

④ Person of parental authority (친권자)

※ Writing method (작성방법)

￭ Only in case the person of parental authority for the affiliated person is fixed,

please write.

(피인지자에 대한 친권자가 정하여진 경우에만 기재합니다.)

￭ Date of designation  - In case of agreement→Date of agreement,

In case of court's decision →Date of judgment

(지정일자 - 협의에 의한 경우→협의일자, 법원의 결정에 의한 경우→심판일자)

￭ Cause of designation - In case of court's decision, please write the name of court in (  ).

(지정원인 - 법원의 결정에 의한 경우에는 (  )안에 그 결정법원명을 기재합니다.)

￭ Please write name and resident registration No.

(친권자의 성명과 주민등록번호를 쓰세요.)

￭ Please check on relation with the affiliated person(child) (1)Father 2)Mother).

(친권자와 피인지자의 관계에 체크하세요. 1)부 2)모)

￭ Please write the date of designation. (친권자 지정일을 쓰세요.)

￭ Please write the cause of designation. (친권자 지정원인에 체크하세요.)

(1) Agreement (협의)

(2) Decision of (Name of court ) court (법원(법원명을 쓰세요)의 결정)

⑤ Continuous usage surname․place of family origin (성.본 계속사용)

￭ Please write the date of designation. (친권자 지정일을 쓰세요.)

￭ Please write the cause of designation. (친권자 지정원인에 체크하세요.)

(1) Agreement (협의)

(2) Decision of (Name of court ) court. (법원(법원명을 쓰세요)의 결정)

⑥ Other (기타사항)

※ Writing method (작성방법)

￭ Please write below items and specially necessary matters for registering to clear

the family relation.

( 아래의 사항 및 가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을

기재합니다.)

￭ If the affiliated person known about father or mother after creating surname and

place of family origin, please write the reason why follow surname and place of

family origin of father or mother.

( 피인지자가 성과 본을 창설한 후 부 또는 모를 알게 된 때에는 부 또는 모의 성과 본을

따르는 사유)

￭ If you recognized the deceased child, please write the affiliated person's date of

death, name of lineal descendant, date of birth and permanent domicile address.

( 사망한 자녀를 인지하는 경우에는 피인지자의 사망연월일, 그 직계비속의 성명,

출생연월일 및 등록기준지)

￭ If an incompetent recognize, please write name, signature(or seal) and resident register

No. of assentient(guardian).

( 금치산자가 인지를 하는 경우에는 동의자(후견인)의 성명, 서명(또는 날인) 및

주민등록번호)

￭ If the affiliated person has spouse or lineal descendant, please write their name

(Korean with Chinese character), date of birth, name of parents and relation with

the affiliated person.

( 피인지자에게 배우자나 직계비속이 있는 경우에는 그 사람의 성명(한글․한자병기),

생년월일, 부모성명, 피인지자와의 관계)

￭ If you recognized a will, please write the purpose and taken up date of executer.

( 유언인지의 경우 그 취지 및 유언집행자의 취임연월일)

⑦ Declarer (신고인)

￭ Please write declarer's name and seal or signature.

(신고인 이름을 쓰고 서명날인하세요.)

￭ Please write declarer's resident register No.

(신고인의 주민등록번호를 쓰세요.)

￭ Please check on qualification of declarer. (신고인의 자격에 체크하세요. )

1) Father  2) Mother  3) Executor(Legal representative)  4) Propounder of trial

5) Opponent of trial  6) Other(Qualification:         )

(1) 부  2) 모  3) 유언집행자  4) 소 제기자  5) 소의 상대방  6) 기타(자격:   ))

￭ Please write declarer's address, tel No. and e-mail address.

(신고인의 주소, 전화번호, 이메일을 쓰세요.)

⑧ Submitter (제출자)

￭ Please write name and resident register No. of submitter.

(Regardless reporter is true or not)

(제출자(신고인 여부 불문)의 성명 및 주민등록번호 기재)

([접수담당공무원은 신분증과 대조])

□ Attached documents 첨부서류

1. One set for copy of judgment and certificate of confirmation

(판결등본 및 확정증명서 1통 )

￭ Please attach only in case of recognition report according to confirm of recognition

judgment.

(인지판결의 확정에 따른 인지신고의 경우에만 첨부합니다.)

￭ In case of recognition's report according to conclusion of the reconciliation or to

conclusion of the arbitration, please attach the copy of reconciliation protocol

(protocol of arbitration) and dispatch certificate. (In case of decision for replacing

arbitration or decision for adjuring) reconciliation, please attach copy of

decision and confirmation certificate)

( 화해성립이나 조정성립에 따른 인지신고의 경우에는 그 화해조서(조정조서)

등본과 송달증명서를 첨부합니다(조정에 갈음하는 결정 또는 화해권고결정의

경우에는 결정등본 및 확정증명서)

※ In case of below No. 2, if the contents is checked by computer at office

of family relation register, omit to attach.

(아래 2항은 가족관계등록관서에서 전산으로 그 내용을 확인할 수 있는 경우

첨부를 생략합니다.)

2. Each one set basic certificate, marriage relation certificate and family relation certificate

of family relation register for mother at birth time of the affiliated person

(If mother of the affiliated person hasn't the family relation register or isn't clear to be registered or not, a written notarization of the fact that the mother wasn't a married woman at birth time of the affiliated person or a guarantee of companion of more two persons)

(피인지자의 출생당시 모(母)의 가족관계등록부의 기본증명서 및 혼인관계증명서,     가족관계증명서 각 1통(피인지자의 모의 가족관계등록부가 없거나, 등록이 되어 있는지가 분명하지 아니한 사람인 경우에는 그 모가 피인지자의 출생당시 유부녀

(有夫女)가 아니었음을 공증하는 서면 또는 2명 이상의 인우인보증서).

3. One set a written for certificating the designation of parental authority person

(Please attach the relevant written according to the cause of designation)

(친권자지정내용을 증명하는 서면 1통(다음 중 그 지정원인에 따라 해당 서면 첨부)

￭ The designation by agreement- Agreement

￭ The designation by decision of court - Copy of judgment for designation of

parental authority person and certificate of decision

(협의에 의한 지정 - 협의서)

(법원의 결정에 의한 지정 - 친권자지정심판서등본 및 확정증명서)

4. Copy of will(or a written paper of the recorded will) one set

(유언서등본(또는 유언녹음을 기재한 서면) 1통)

5. If the recognizer is foreigner, a written paper to certificate the nationality

(인지자가 외국인인 경우 그 국적을 증명하는 서면)

6. If a court permit to use surname․place of family origin continually -

Each 1 set a copy of court records and certificate of decision

(법원이 성․본 계속사용을 허가한 경우 - 재판서등본 및 확정증명서 각 1부)

(If the parents agree to use surname․place of family origin continually -

If one side of parents report, please attach one set the certificating documents

about agreement fact)

(성․본 계속사용을 부모가 협의한 경우 - 부모 중 일방이 신고할 경우에는
협의사실을 증명하는 서류 1부.)

7. Identification[In accordance with Article. 23 the established rule of family relation register] 신분확인[가족관계등록예규 제23호에 의함]

① In case of voluntary recognition 임의인지의 경우

￭ In case of attendance of declarer : Certificate of identification

(신고인이 출석한 경우 : 신분증명서)

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

Certificate of identification for submitter and certificate of identification for

reporter or a written notarization or certificate of seal impression(If the

reporter signed on report without certificate of identification for reporter,

notarize in signature and put the seal impression, attach a certificate of

seal impression)

(신고인 불출석, 제출인 출석의 경우 : 제출인의 신분증명서 및 신고인의 신분

증명서 또는 서면공증 또는 인감증명서(신고인의 신분증명서 없이 신고서에

신고인이 서명한 경우 서명공증, 신고서에 인감 날인한 경우 인감증명)

￭ In case of submission by postal : Notarization of signature or certificate of

seal impression(If you signed on report, attach a notarization of signature,

if you put your seal impression, attach a certificate of seal impression)

(우편제출의 경우 : 서명공증 또는 인감증명서(신고서에 서명한 경우 서명공증,

인감을 날인한 경우는 인감증명서)

② In case of recognition on trial 재판상 인지의 경우

￭ In case of attendance of reporter : Certificate of identification

(신고인이 출석한 경우 : 신분증명서)

￭ In case of attendance of submitter : Certificate of identification for submitter

(제출인이 출석한 경우 : 제출인의 신분증명서)

￭ Copy for certificate of identification : In case of submission by postal

(신분증명서 사본 : 우편으로 제출하는 경우)

※ If you report the recognition as method of Korean law for person who was born   without marriage between Korean mother and foreigner father, have to attach all    next written paper.

(한국인 모와 외국인 부사이의 혼인외 출생자에 대하여 한국법의 방식에 의한

인지신고를 하는 경우에는 다음의 서면을 모두 첨부하여야 합니다.)

￭ The written paper one set for certificating  relation with the chosen law

as proper law of relevant recognition action and recognizer.

( 해당 인지행위의 준거법으로 선택한 법과 인지당사자와의 관련을 증명하는

서면 1통)

Ex. : Basic certificate of family relation register for child and certificate of family

relation or copy of resident register for certificating above address of

child and etc.

예 : 자녀의 가족관계등록부의 기본증명서 및 가족관계증명서 또는 현재 자녀의

거소지를  증명하는 주민등록등본 등

￭ One set of required certificate of the established requirement for stamp which

is  issued by authorized organization of the affiliated country of proper law.

( 준거법 소속국의 권한 있는 기관이 발행한 인지의 성립요건구비증명서 1통)

￭ The written paper one set for certificating the status for example father's

nationality and etc.

( 부(父)의 국적 등 신분을 증명하는 서면 1통)

[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)

Writing method
① : 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(www.scourt.go.kr/minwon). : Please write the time and the date of birth according to twenty-four hour clock. (ex: PM. 2hour 30minute → 14hour 30minute) : In case our nation(people) bore a baby in abroad, please write to convert the local birth time into Korean standard time. If the birth time was during summertime, please write the fact. : In case your baby is dual nationality, please write the fact and the other nationality. ② : Regarding to father - Please don't write, in case of registering the mother the baby who was born out of wedlock. Please write "Father was undecided", 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. : Permanent domicile address - If parents are all foreigners, please write each parent nationality at birth time and if one side in the middle of parents is a foreigner, please write foreigner father's nationality or foreigner mother's one. ③ : Please write only in the event of re-registering the birth report, after having cancelled previous the family relation register because of a declaratory judgement of non-existent real biological relations between a parent and the child and the denied decree of real biological relations and etc. ④ : Please write below facts and especially necessary informations for clarifying the family relation register. - In case low priority obligor report the birth register : Please write the reason why high priority obligor can't report. - The fact that you recognized the fetus before birth and the government office where you reported the fact. - In case of abroad birth : please write the local birth time. If the birth was during summertime, please write "During summertime" beside of the birth time. - In case the birth register as Korean name but the person who is registered in father's family as foreign name following the foreign father's surname : The registered name in abroad. -In case 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. ⑥ : Please write submitter‘s name and resident registration number. (Regardless of declarer). [접수담당공무원은 신분증과 대조] ⑦~⑨ A baby : Details for the baby. ⑨ : Multiple birth(More than twins) or not has to be marked as “○” on fetus's number at pregnant without real number of birth and marked the birth order on each birth of register in the middler of multiple birth. ⑩~⑮ A parents : Details for baby's parents at birth time. ⑫ : 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. <Ex.>Junior dropout of University : please mark as “○” on high school. ⑬ : Please write mainly job(occupation)'s type and details with company's name of the parents at birth time. <Ex.>Detailer of sales department for ○○company, clothes salesperson at ○○shopping store , farmer in our rice paddy ⑮ : Mother's total number of childbirth-Please write number of childbirth including the child on report and number of the surviving and died childbirth of them. If the mother is second marriage, please include before marriage's childbirth.

Attached documents
1. Birth certificate 1set(One of the belows). - Has to be written by Doctor or midwife. - 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). - The written by foreign public office the accepted certificate of birth register(or birth certificate) and translation. ※ 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. 2. One set the certificate of marriage relation for mother or father of the baby. - If the father reports the birth of wedlock, must attach the certificate of marriage relation for mother certainly. - 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. 3. Please attach one set the paper(ex. mother's basic certificate) to prove the mother is Korean at baby birth time.(In case of reporting the birth of the baby was born between foreigner father and Korean mother after 1998. 6. 14.) 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.(ex: passport, copy of resident register and the other certificate). 5. If the child is dual nationality, please attach one set the proving documents about the acquired nationality. 6. Identification check [according to Article. 23 of the family relation register established rule] - In case of declarer's attendance : Identification card - In case of submitter's attendance : Copy of declarer's identification card and submitter's identification card - In case of postal submission : Copy of declarer's identification card

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.6]

Report for dissolution of adoption ( 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	Adoptive father	Adoptive mother
① Adoptive Parents	Name	Korean or English		Place of family origin (Chinese characters)		Korean or English		Place of family origin (Chinese characters)
Chinese characters		Date of birth		Chinese characters		Date of birth
Resident Registration No.	-	Resident registration No.	-
Permanent domicile address
Address
② Adopted child	Name	Korean or English		Place of family origin (Chinese characters)		Resident registration No.
Chinese characters		Date of birth		-
Permanent domicile address
Address
③Real biological parents of adopted child	Father	Name		Permanent domicile address
Resident registration No.	-
Mother	Name		Permanent domicile address
Resident registration No.	-
④Other
⑤Confirmed date of judgment	Day Month Year	Name of court
⑥Witness	Name	Seal or signature	Resident registration No.	-
Address
Name	Seal or signature	Resident registration No.	-
Address
⑦Assentient	Father	Name	Seal or signature
Mother	Name	Seal or signature
Lineal ascendant	Seal or signature	Resident registration No.	-	Relationship
Guardian	Seal or signature	Resident registration No.	-	Court of Permission		Permission date
⑧Declarer	Adoptive father	Seal or signature	Tel. No.
E-mail address
Adoptive mother	Seal or signature	Tel. No.
E-mail address
Adopted child	Seal or signature	Tel. No.
E-mail address
□ Legal representative if aged under 15	□Father	Seal or signature	Tel. No.
E-mail address
□Mother	Seal or signature	Tel. No.
E-mail address
□Guardian	Seal or signature	Tel. No.
E-mail address
□ Lineal ascendant	Dissolution agreement for less than 15 years old	Permission court		Permission date
□Propounder of trial □Opponent of trial	Seal or signature	Tel. No.
E-mail address
⑨Submitter	Name		Resident registration No.	-

Written method
※ If adoptive parents or adopted child are foreigner, please write nationality on section of the permanent domicile address. No. ① and No. ② :If you wrote the resident registration No. on section of resident registration No., you can omit to write the date of birth in accordance with article 25 section 2 of the Law. No. ④ : Please write specially necessary matters for clearing to register of family relation with below matters. : If the adopted child of agreement dissolution is under 15 years old, person to permit the adoption at that time must agree the dissolution, but if he can't agree by death or by the other reason, must receive to agree from the other lineal ascendance of birthplace or guardian and in this case attach the reason. No. ⑦ : If the adopted child of agreement dissolution is minor(over full 15 years old and under full 20 years old), must receive the agreement from parents but if parents can't agree as death or the other reason, must receive to agree from the nearest and the eldest of the other lineal ascendance. : In case above item, if the minor hasn't parents or lineal ascendance for agreement, must receive to agree by guardian who is permitted from family court. : If adoptive parents or adoptive child are incompetent, must receive to agree from guardian. No. ⑧ : Dissolved child seal and signature(or sign) on section of adoptive child, but if dissolved child by agreement is under 15 years old, must seal and signature by the person who permitted on adopting the adoptive child but if he can't report by death or the other reason, the other lineal ascendance of birthplace or guardian who is permitted by family court must seal and signature(or sign) after marking as “○” on each relevant number, if judgment of dissolution is confirmed, can report propounder or opponent of trial as alone. also in this case, please seal and signature(or sign) after marking as “○” on relevant number. No. ⑨ : Please write name and resident register No. of submitter(Regardless of declarer) [접수담당공무원은 신분증과 대조]
Attached documents
※ Please can omit to attach below No.1 if the data is checked by computer processing at office of family relation register. 1. Each one set the relation of adoption certificate of family relation register for dissolution of adoption person. 2. Each one set the judgment copy and confirmation certificate in case of judicial dissolution of adoption. 3. If the conciliation(settlement) was established for dissolution of adoption, attach each one set of the copy for report of conciliation(settlement) and the certificate of delivery. 4. One set of written certificate for relevant person on Article 4. each section of exemption law(the adopted child in accordance with「Exemption law of promotion and procedure for adoption」was dissolved by dissolution report so if the adoptive child want to revive as original surname and place of family origin, attach on report of dissolution). 5. Each one set certificate for agreement fact which is written by person who agreed the dissolution and if guardian agreed the dissolution of adoption or if guardian or the other lineal ascendance of the birthplace agreed the dissolution of adoption, please attach each one set of the written permission. 6. Identification[According to Article 23. established rule of family relation register] ① In case of judicial dissolution of adoption - In case of declarer's attendance : Identification paper - In case of submitter's attendance : Identification paper of submitter - In case of postal submission : Copy of identification paper of declarer ② In case of agreement dissolution - In case of declarer's attendance : Identification paper of all declarer - In case of declarer's nonappearance and submitter's attendance : Identification paper of submitter and of all declarer or written notarization or certificate of seal impression(If declarer signed on report without identification paper, attach the sign notarization and if sealed on report, attach the certificate of seal impression) - In case of postal submission : Sign notarization or certificate of seal impression of all declarer(If signed on report, attach the sign notarization and if sealed on report, attach the certificate of seal impression) ※ On agreement dissolution of adoption, attendance of agreed person of Article 64. section 1 of the law or submission of identification paper or attachment of certificate of seal impression is same the submission of identification paper of declarer or the attachment of certificate of seal impression.

Report for dissolution of adoption

(파양신고서)

※ Writing method(작성방법)

￭ If adoptive parents or adopted child are foreigner, please write nationality

on section of the permanent domicile address.

(양친 또는 양자가 외국인인 경우에는 그 등록기준지란에 국적을 기재합니다.)

① Adoptive Parents(adoptive father / adoptive mother) 양친 (양부/양모)

※ Writing method (No. 1and 2) ( 작성방법 1번 ~ 2번)

￭ If you wrote the resident register No. on section of resident register No.,

you can omit to write the date of birth in accordance with Article 25 Section 2 of the Law.

(법 제25조제2항에 따라 주민등록번호란에 주민등록번호를 기재한 때에는 출생연월일의

기재를 생략할 수 있습니다.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s name in Korean

or English and in Chinese characters.

(양친(양부/양모)의 성명을 한글과 한자로 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s place of

family origin in Chinese characters. (양친(양부/양모)의 본을 한자로 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s date of

birth(day/month/year). (양친(양부/양모)의 출생연월일을 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s resident             registration No. (양친(양부/양모)의 주민등록번호를 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s permanent

domicile address and address.

(양친(양부/양모)의 등록기준지와 주소를 쓰세요.)

② Adopted child (양자)

￭Please write name in Korean or English and in Chinese characters of adopted child.     (양자의 성명을 한글과 한자로 쓰세요.)

￭ Please write place of family origin in Chinese characters of adopted child.

(양자의 본을 한자로 쓰세요.)

￭ Please write resident registration No. of adopted child.

(양자의 주민등록번호를 쓰세요.)

￭ Please write date of birth(Day/Month/Year) of adopted child.

(양자의 출생연월일을 쓰세요.)

￭ Please write permanent domicile address and address of adopted child.

(양자의 등록기준지와 주소를 쓰세요.)

③ Real biological parents of adopted child(Father/Mother)

양자의 친생부모(부/모)

￭ Please write name of real biological parents.

(친생부모의 성명을 쓰세요.)

￭ Please write resident registration No. of real biological parents.

(양자의 주민등록번호를 쓰세요.)

￭ Please write permanent domicile address real biological parents.

(양자의 등록기준지와 주소를 쓰세요.)

④ Other (기타)

※ Writing method(작성방법)

￭ Please write specially necessary matters for clearing to register of family relation

with below matters.

(아래의 사항 및 가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을

기재합니다.)

￭ If the adopted child of agreement dissolution is under 15 years old, person to

permit the adoption at that time must agree the dissolution, but if he can't

agree by death or by the other reason, must receive to agree from the other

lineal ascendance of birthplace or guardian and in this case attach the reason.

(협의파양을 하는 양자가 만15세 미만인 경우에는 양자의 입양 당시 입양을 승낙한

자가 파양의 협의를 하여야 하고, 그 자가 사망 그 밖의 사유로 협의를 할 수 없는

때에는 생가의 다른 직계존속 또는 후견인이 가정법원의 허가를 받아 협의를 하여야

하는데 그러할 경우에는 그 사유)

⑤ Confirmed date of judgment (재판확정일자)

￭ Please write the confirmed date(day/month/year) of judgement and the name

of court . (재판확정일자(년,월,일)와 법원명을 쓰세요.)

⑥ Witness (증인)

￭ Please write name with seal and signature.

(증인의 성명과 서명날인하세요.)

￭ Please write the resident registration No. of witness.

(증인의 주민등록번호를 쓰세요.)

￭ Please write address of witness.

(증인의 주소를 쓰세요.)

⑦ Assentient (동의자)

※ Writing method(작성방법)

￭ If the adopted child of agreement dissolution is minor(over full 15 years old

and under full 20 years old), must receive the agreement from parents but if

parents can't agree as death or the other reason, must receive to agree from

the nearest and the eldest of the other lineal ascendance.

(협의파양을 하는 양자가 미성년자(만15세 이상 만20세 미만)인 경우에는 부․모의 동의를

받아야 하며 부 ․모가 사망 그 밖의 사유로 인하여 동의를 할 수 없는 경우에는

다른 직계존속이 있으면 직계존중 제일 가까운 존속 중 ․연장자 순으로 동의를

받아야 합니다.)

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

(부의 성명과 서명날인하세요.)

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

(모의 성명과 서명날인하세요.)

￭ Please write lineal ascendance's name with seal and signature.

(직계존속의 성명과 서명날인하세요.)

￭ Please write the resident registration No. of lineal ascendance.

(직계존속의 주민등록번호를 쓰세요.)

￭ Please write the relation with adopted child.

(양자와의 관계를 쓰세요.)

※ Writing method(작성방법)

￭ In case above item, if the minor hasn't parents or lineal ascendance for agreement,

must receive to agree by guardian who is permitted from family court.

(전항의 경우 미성년자에게 동의할 부․모나 직계존속이 없으면 가정법원의 허가를

받은 후견인의 동의가 있어야 합니다.)

￭ If adoptive parents or adopted child are incompetent, must receive to agree

from guardian.

(양친이나 양자가 금치산자인 때에는 후견인의 동의를 받아야 합니다.)

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

(후견인의 성명과 서명날인하세요.)

￭ Please write the resident registration No. of guardian.

(후견인의 주민등록번호를 쓰세요.)

￭ Please write name of permission court.

(허가법원의 이름을 쓰세요.)

￭ Please write date of permission.

(허가날짜를 쓰세요.)

⑧ Declarer (신고인)

※ Writing method(작성방법)

￭ Dissolved child seal and signature(or sign) on section of adopted child, but if

dissolved child by agreement is under 15 years old, must seal and signature by

the person who permitted on adopting the adopted child but if he can't report

by death or other reason, other lineal ascendance of birthplace or guardian who

is permitted by family court must seal and signature(or sign) after marking as

“○” on each relevant number, if judgment of dissolution is confirmed, can

report propounder or opponent of trial as alone. also in this case, please seal and

signature (or sign) after marking as “○” on relevant number.

(양자란은 파양을 하는 양자가 기명날인(또는 서명)하며, 다만 협의 파양을 하는 양자가

15세미만인 때에는 그 양자 입양시 입양을 승낙한 자가, 그 자가 사망 그 밖의 사유로

신고할 수 없는 때에는 가정법원의 허가를 받은 생가의 다른 직계존속 또는 후견인이

각각 그 해당되는 항목번호에 “○”으로 표시한 후 기명날인(또는 서명)하여야 하며,

파양의 재판이 확정된 경우에는 소 제기자 또는 소의 상대방 단독으로 신고할 수

있습니다. 이 경우에도 해당 항목번호에 “○” 으로 표시한 후 기명날인(또는 서명)합니다.)

￭ Please write adoptive father's name with seal and signature.

(양부의 성명과 서명날인하세요.)

￭ Please write adoptive father's telephone number and e-mail address.

(양부의 전화번호와 이메일을 쓰세요.)

￭ Please write adoptive mother's name with seal and signature.

(양모의 성명과 서명 날인하세요.)

￭ Please write adoptive mother's telephone number and e-mail address.

(양부의 전화번호와 이메일을 쓰세요.)

￭ Please write adopted child's name with seal and signature.

(양자의 성명과 서명날인하세요.)

￭ Please write adopted child's telephone number and e-mail address.

(양자의 전화번호와 이메일을 쓰세요.)

□ Legal representative for under 15 years old (15세미만자의 법정대리인)

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

(부의 성명과 서명날인하세요.)

￭ Please write father's telephone number and e-mail address.

(부의 전화번호와 이메일을 쓰세요.)

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

(모의 성명과 서명날인하세요.)

￭ Please write mother's telephone number and e-mail address.

(모의 전화번호와 이메일을 쓰세요.)

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

(후견인의 성명과 서명날인하세요.)

￭ Please write guardian's telephone number and e-mail address.

(후견인의 전화번호와 이메일을 쓰세요.)

□ Lineal ascendant (직계존속)

※ Dissolution agreement for less than 15 years old (15세미만자의 파양협의)

￭ Please write name of permission court.

(허가법원의 이름을 쓰세요.)

￭ Please write date of permission.

(허가날짜를 쓰세요.)

￭ Please check on whether propounder of trial or opponent of trial.

(소의 제기자인지 소의 상대방인지 확인 하세요.)

￭ Please write telephone number and e-mail address.

(전화번호와 이메일을 쓰세요.)

⑨ Submitter (제출자)

※ Writing method(작성방법)

￭ Please write name and resident register No. of submitter

(Regardless of declarer)

(제출자(신고인 여부 불문)의 성명 및 주민등록번호 기재)

￭ Please write name and resident registration No. of submitter.

(제출자의 성명과 주민등록번호를 쓰세요.)

□ Attached documents 첨부서류

※ Please can omit to attach below No.1 if the data is checked by computer             processing at office of family relation register.

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

첨부를 생략합니다.)

1. Each one set the relation of adoption certificate of family relation register for       dissolution of adoption person.

(파양당사자의 가족관계등록부의 입양관계증명서 각 1통.)

2. Each one set the judgment copy and confirmation certificate in case of judicial      dissolution of adoption.

(재판상 파양의 경우 판결등본 및 확정증명서 각 1부.)

3. If the conciliation(settlement) was established for dissolution of adoption, attach

each one set of the copy for report of conciliation(settlement) and the certificate

of delivery.

(파양의 조정(화해)성립의 경우 조정(화해)조서등본 및 그 송달증명서 각 1부.)

4. One set of written certificate for relevant person on Article 4. each section of

Exemption Law(the adopted child in accordance with「Exemption law of promotion     and procedure for adoption」was dissolved by dissolution report so if the adopted     child want to revive as original surname and place of family origin, attach on         report of dissolution).

(특례법 제4조 각 호에 해당되었던 사람임을 증명하는 서면 1부(「입양촉진 및 절차에

관한 특례법」에 따라 입양된 양자가 파양으로 인한 파양신고를 하면서 양자의 본래의

성과 본을 회복하고자 하는 경우 파양신고서에 첨부합니다).

5. Each one set certificate for agreement fact which is written by person who agreed

the dissolution and if guardian agreed the dissolution of adoption or if guardian

or the other lineal ascendance of the birthplace agreed the dissolution of

adoption, please attach each one set of the written permission.

(파양을 동의한 사람이 작성한 동의사실을 증명하는 서면과 후견인이 파양 동의한 경우

이거나 후견인 또는 생가의 다른 직계존속이 파양협의를 한 경우에는 법원의 허가서 각 1부.)

6. Identification[According to Article 23 established rule of family relation register]

(신분확인[가족관계등록예규 제23호에 의함])

① In case of judicial dissolution of adoption 재판상 파양

￭ In case of declarer's attendance : Identification paper

(신고인이 출석한 경우 : 신분증명서)

￭ In case of submitter's attendance : Identification paper of submitter

(제출인이 출석한 경우 : 제출인의 신분증명서)

￭ In case of postal submission : Copy of identification paper of declarer

(우편제출의 경우 : 신고인의 신분증명서 사본)

② In case of agreement dissolution 협의파양의 경우

￭ In case of declarer's attendance : Identification paper of all declarer

(신고인이 출석한 경우 : 신고인 모두의 신분증명서)

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

paper of submitter and of all declarer or written notarization or certificate of

seal impression(If declarer signed on report without identification paper, attach

the sign notarization and if sealed on report, attach the certificate of seal impression)

(신고인 불출석, 제출인 출석의 경우 : 제출인의 신분증명서 및 신고인 모두의

신분증명서 또는 서면공증 또는 인감증명서(신고인의 신분증명서 없이 신고서에

신고인이 서명한 경우 서명공증, 신고서에 인감 날인한 경우 인감증명)

￭ In case of postal submission : Sign notarization or certificate of seal impression

of all declarer(If signed on report, attach the sign notarization and if sealed

on report, attach the certificate of seal impression)

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

경우 서명공증, 인감을 날인한 경우는 인감증명서)

※ On agreement dissolution of adoption, attendance of agreed person of Article 64 section

1 of the law or submission of identification paper or attachment of certificate of

seal impression is same the submission of identification paper of declarer or the

attachment of certificate of seal impression.

(협의파양에 있어서 법 제64조제1항의 협의를 한 사람의 출석 또는 신분증명서의 제시가

있거나 인감증명서의 첨부가 있으면 신고인의 신분증명서 제시 또는 인감증명서의

첨부한 것으로 볼 수 있습니다.)

[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.34]

Alteration report of surname ㆍ place of family origin ( 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 of affair (Subject)	Name		Korean or English								Resident registration No.				-
			Chinese characters
	Permanent domicile address
	Address
② Surname ㆍ Place of family origin	Previous surname(姓)		Korean or English			Chinese characters					Previous place of family origin(本)		Korean or English						Chinese characters
	Changed surname(姓)		Korean or English			Chinese characters					Changed place of family origin(本)		Korean or English						Chinese characters
③Permission date			Day Month Year								Name of court
④Other
⑤Declarer		Name	Seal or signature							Resident Registration No.								-
		Qualification	□Self □Legal representative □Other(Please state : )
		Address						Tel. No.						E-mail address
⑥Submitter		Name						Resident Registration No.								-

Written Method
※ This report has to be reported within one month after receiving the decision copy of permission for alteration of surnameㆍplace of family origin. No. ② : Please write to divide as before and after surname․place of family origin of the affair's person. No. ③ : Permission date for alteration of surname․place of family origin has to be written by the date on decision copy of permission for alteration of surname․place of family origin. No. ④ : Please write specially necessary matters for clearing the data on family relation register. No. ⑥ : Please write the name and the resident register No. of submitter(Regardless of declarer is true or not). [접수담당공무원은 신분증과 대조]
Attached documents
1. One set of the decision copy of permission for alteration of surnameㆍplace of family origin. 2. Identification [According to Article 23 the established rule of family relation register] - In case of declarer's attendance : Certificate of identification - In case of submitter's attendance : Identification of submitter - In case of postal submission : Copy of declarer's identification

Alteration report of surname ․ place of family origin

[성.본 변경신고서]

* Writing method (작성방법) :

- This report has to be reported within one month after receiving the decision copy of permission for alteration of surname․place of family origin.

- 본 신고는 성․본변경허가결정등본을 받은 날로부터 1개월 이내에 신고하여야 합니다.

1. Person of affair(Subject) (사건본인)

￭ Please write person of affair's name in Korean or English and in Chinese characters. (사건본인의 성명을 한글과 한자로 쓰세요.)

￭ Please write person of affair's resident registration No.

(사건본인의 주민등록번호를 쓰세요.)

￭ Please write person of affair's permanent domicile address and address.

(사건본인의 등록기준지와 주소를 쓰세요.)

2. Surname & place of family origin (성.본)

* Writing method (작성방법) :

- Please write to divide as before and after surname․place of family origin of the

affair's person.

- 사건본인의 성․본은 변경 전의 성․본과 변경한 성․본을 나누어 기재합니다.

￭ Please write previous surname in Korean or English and in Chinese characters.

(변경전의 성을 한글과 한자로 쓰세요.)

￭ Please write previous place of family origin in Korean or English and Chinese

characters. (변경전의 본을 한글과 한자로 쓰세요.)

￭ Please write the changed surname in Korean or English and in Chinese characters.

(변경된 성을 한글과 한자로 쓰세요.)

￭ Please write the changed place of family origin in Korean or English and Chinese

characters. (변경된 본을 한글과 한자로 쓰세요.)

3. Permission date (허가일자)

* Writing method (작성방법) :

- Permission date for alteration of surname․place of family origin has to be written by the date on decision copy of permission for alteration of surname․place of family origin.

- 성․본 변경허가일자는 성․본 변경허가결정등본에 기재된 연월일을 기재합니다.

￭ Please write permission date and name of court.

(허가일자와 법원명을 쓰세요.)

4. Other (기타사항)

* Writing method (작성방법)

- Please write especially necessary informations for clarifying the family relation register.

- 가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재합니다.

5. Declarer (신고인)

￭ Please write name with seal and signature and resident registration No.

(신고인의 성명과 함께 서명날인하고 주민등록번호를 쓰세요.)

￭ Please check on relationship. (신고인의 자격에 체크하세요.)

□Self  □Legal representative  □Other (Please state:          )

(□본인  □법정대리인  □기타 (자격:        ))

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

(신고인의 주소, 전화번호, 이메일 주소를 쓰세요.)

6. Submitter (제출인)

* Writing method (작성방법)

- Submitter(Regardless of declarer)'s name and resident registration No.

제출자(신고인 여부 불문)의 성명 및 주민등록번호 기재

[접수담당공무원은 신분증과 대조]

￭ Please write name and resident registration number.

(성명과 주민등록번호를 쓰세요.)

Attached documents 첨부서류

1. One set of the decision copy of permission for alteration of surname․place of family origin 성․본 변경허가결정등본 1부.

2.  Identification 신분확인

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

[가족관계등록예규 제23호에 의함]

- In case of declarer's attendance : Certificate of identification

신고인이 출석한 경우 : 신분증명서

- In case of submitter's attendance : Identification of submitter

제출인이 출석한 경우 : 제출인의 신분증명서

- In case of postal submission : Copy of declarer's identification

우편제출의 경우 : 신고인의 신분증명서 사본

[Form No.4]

Report of adoption ( 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	Adoptive father	Adoptive mother
① Adoptive parents	Name	Korean or English		Place of family origin (Chinese characters)		Korean or English		Place of family origin (Chinese characters)
Chinese characters		Date of birth		Chinese characters		Date of birth
Resident Registration No.	-	Resident Registration No.	-
Permanent domicile address
Address
② Adopted child	Name	Korean or English		Place of family origin (Chinese characters)		Resident Registration No.	-
Chinese characters		Sex	□ Male □ Female	Date of birth
Permanent domicile address
Address
③ Real biological parents of adopted child	Father	Name		Permanent domicile address
Resident Registration No.	-
Mother	Name		Permanent domicile address
Resident Registration No.	-
④ Other
⑤Witness	Name	Seal or signature	Resident Registration No.	-
Address
Name	Seal or signature	Resident Registration No.	-
Address
⑥Assentient	Father	Name	Seal or signature
Mother	Name	Seal or signature
Lineal ascendant	Seal or signature	Resident Registration No.	-	Relationship	Adopted child's.......
Spouse of adopted child	Seal or signature	Resident Registration No.	-
Guardian	Seal or signature	Resident Registration No.	-	Court of permission		Date of permission
⑦Declarer	Adoptive father	Seal or signature	Tel. No.
E-mail address
Adoptive mother	Seal or signature	Tel. No.
E-mail address
Adopted child	Seal or signature	Tel. No.
E-mail address
Legal representative	□ Parents	Father	Seal or signature	Tel. No.
E-mail address
Mother	Seal or signature	Tel. No.
E-mail address
□ Guardian	Seal or signature	Tel. No.
E-mail address
Permission of adoption if aged under 15	Court of permission		Date of permission
⑧Submitter	Name		Resident Registration No.	-

Written method
※ If real biological parents, adoptive parents or adoptive child are foreigner, please write the nationality on section of the permanent domicile address. No. ① and No. ② : If you wrote the resident register No. on section of the resident register No., can omit to write the date of birth in accordance with article 25. section 2 of the law. No. ④ : Please write below items and especially necessary informations for clarifying the family relation register. - If legal representative of adoptive child(Less than full fifteen years old) or guardian who is approved by family court permitted the adoption and reported in place of him, please write the reason. - In accordance with Article 8. section 1.「Exemption law for promotion and procedure of adoption」 if surname and place of family origin of adoptive child follow as surname and place of family origin of adoptive parents by demand of adoptive parents, please write about that. No. ⑥ : Please write like below on section of assentient. - The person who will be adopted, must receive the agreement from parents (but, if the parents was registered on family relation register who was lost by judgment the parental authority about him, the parents can't agree), if the parents can't agree by death or other reasons, must receive from the nearest and the eldest ascendant of the other lineal ascendant. - The person who will be adopted, if he is minor and if he hasn't anyone of above mentioned parents or lineal ascendant, must receive the agreement from the guardian who is permitted by family court. - Instead approval person of adoption don't have to write on section of assentient. - If person who has a spouse is to be adoptive child, must receive the agreement from the other person. - When an incompetent adopt or is adopted, must receive the agreement from guardian. No. ⑦ : Person to be adopted seal and signature(or sign) on section of adoptive child, but if he is under 15 years old, don't write on section of adoptive child and legal representative(the guardian who is permitted by family court, write name of permission court and permission date) seal and signature (or sign) after marking as “○” on relevant item number . : If you repot the adoption in accordance with 「Exemption law for promotion and procedure of adoption」, person to be adoptive parents and guardian of person to be adoptive child write together on section of declarer. No. ⑧ : Please write name and resident register No. of submitter(Regardless of the declarer is true or not) [접수담당공무원은 신분증과 대조]
Attached documents
※ Please can omit to attach below No.1 if the data is checked by computer processing. 1. Each one set of basic certificate, family relation certificate and adoption relative certificate of family relation register for adoptive person. 2. One set of agreement of adoption(In case of requirement of agreement of adoption, but except to agreement person wrote name and resident register No. on section of "assentient" and sealed and signatured). 3. Permission copy of family court about agreement of adoption or permission of adoption (In case person to be adoptive child is minor and he hasn't parents or the other lineal ascendant so in case he must receive the agreement of guardian, in case the guardian adopt a ward as adoptive chid and if the guardian approve the adoption). 4. If adoptive parents are foreigner, attach the certificate for nationality(Ex.: Copy of family register, certificate of birth, copy of pass port, copy of identification register and etc.) 5. If adoptive child is foreigner, if the law of the domicile for the child require permission or agreement of child or the third party for establishing the relevant identification act, attach the written for certificating that requirement is satisfy. 6. Identification [In accordance with Article. 23 of the family relation register established rule] - In case of declarer's attendance : Certificate of identification for all declarer - In case of declarer's nonappearance, submitter's attendance : Submitter's identification and certificate of identification for all declarer or the written notarization or certificate of seal impression.(If declarer signed on report without certificate of identification, attach signature notarization and if declarer sealed on report without certificate of identification, attach the certificate of seal impression) - In case of postal submission : Signature notarization or seal impression certificate for all declarer (If signed on report, attach signature notarization and if sealed on report, attach certificate of seal impression) ※ If adoptive child is under 15 years old, in case of attendance of legal representative or submission of identification or attachment of seal impression certificate are same case of submission of identification certificate of declarer or attachment of seal impression certificate.

[

[Report of adoption

[입양신고서]

* Writing method(작성방법) :

- If real biological parents, adoptive parents or adopted child are foreigner, please write the nationality on section of the permanent domicile address.

- 친생부모, 양친 또는 양자가 외국인인 경우에는 그 등록기준지란에 국적을 기재합니다.

① Adoptive parents (adoptive father / adoptive mother) 양친 (양부/양모)

* Writing method (No. 1and 2) ( 작성방법 1번 ~ 2번) :

- If you wrote the resident register No. on section of the resident registration No.,

can omit to write the date of birth in accordance with Article 25 Section 2 of the

Law.

- 법 제25조제2항에 따라 주민등록번호란에 주민등록번호를 기재한 때에는 출생연월일의

기재를 생략할 수 있습니다.

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s name in Korean or English and in Chinese characters.

양친(양부/양모)의 성명을 한글과 한자로 쓰세요.

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s place of family

origin in Chinese characters. 양친(양부/양모)의 본을 한자로 쓰세요.

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s date of birth

(day/month/year). 양친(양부/양모)의 출생연월일을 쓰세요.

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s resident

registration No. 양친(양부/양모)의 주민등록번호를 쓰세요.

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s permanent

domicile address and address. 양친(양부/양모)의 등록기준지와 주소를 쓰세요.

② Adopted child (양자)

￭ Please write the adopted child's name in Korean or English and in Chinese

characters. 양자의 성명을 한글과 한자로 쓰세요.

￭ Please write the adopted child's place of family origin in Chinese characters.

양자의 본을 한자로 쓰세요.

￭ Please write the adopted child's resident registration No.

양자의 주민등록번호를 쓰세요.

￭ Please check on sex of adopted child 1)Male 2)Female.

양자의 성별에 체크하세요. 1)남자 2)여자

￭ Please write the adopted child's date of birth(day/month/year).

양자의 출생연월일을 쓰세요.

￭ Please write the adopted child's permanent domicile address and address.

양자의 등록기준지와 주소를 쓰세요.

③ Real biological parents of adopted child(father/mother)

양자의 친생부모(부/모)

￭ Please write real biological parents(father/mother)'s name.

(친생부모(부/모)의 성명을 쓰세요.)

￭ Please write real biological parents(father/mother)'s permanent domicile address.

(친생부모(부/모)의 등록기준지를 쓰세요.)

￭ Please write real biological parents(father/mother)'s resident registration No.

(친생부모(부/모)의 주민등록번호를 쓰세요.)

4. Other (기타)

* Writing method (작성방법) :

- Please write below items and especially necessary informations for clarifying the

family relation register.

- 아래의 사항 및 가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재

합니다.

- If legal representative of adopted child(Less than full fifteen years old) or guardian

who is approved by family court permitted the adoption and reported in place of

him, please write the reason.

- 양자가 될 자(만 15세 미만)의 법정대리인 또는 가정법원의 허가를 받은 후견인이 그를

갈음하여 입양을 승낙하고 이를 신고하는 때에는 그 사유

- In accordance with Article 8. section 1.「Exemption law for promotion and

procedure of adoption」if surname and place of family origin of adopted child

follow as surname and place of family origin of adoptive parents by demand of

adoptive parents, please write about that.

-「입양촉진 및 절차에 관한 특례법」제8조제1항에 따라 양자의 성과 본을 양친의 원에

의하여 양친의 성과 본을 따르는 경우에는 그에 관한 사항

⑤ Witness(증인)

￭ Please write name with seal and signature of witness.

(증인의 성명을 쓰고 기명날인 하세요.)

￭ Please write resident registration No. and address of witness.

(증인의 주민등록번호와 주소를 쓰세요.)

⑥ Assentient(동의자)

* Writing method (작성방법) :

- The person who will be adopted, must receive the agreement from parents (but, if

the parents was registered on family relation register who was lost by judgment the

parental authority about him, the parents can't agree), if the parents can't agree by

death or other reasons, must receive from the nearest and the eldest ascendant of

the other lineal ascendant.

- 양자가 될 자는 부․모의 동의를 받아야 하며(다만, 가족관계등록부에 판결에 의하여

친권이 상실된 자로 기록된 부 또는 모는 동의할 수 없습니다), 부․모가 사망 그 밖의

사유로 인하여 동의를 할 수 없는 경우에 다른 직계존속이 있으면 직계존속 중 제일

가까운 존속․ 중 연장자의 순으로 동의를 받아야 합니다.

￭ Please write name with seal and signature of parents(father/mother).

(부모의 성명을 쓰고 기명날인 하세요.)

￭ Please write name with seal and signature of lineal ascendant.

(직계존속의 성명을 쓰고 기명날인 하세요.)

￭ Please write resident registration No. of lineal ascendant.

(직계존속의 주민등록번호를 쓰세요.)

￭ Please write relation with lineal ascendant and adopted child.

(직계존속과 양자와의 관계를 쓰세요.)

* Writing method (작성방법) :

- If person who has a spouse is to be adopted child, must receive the agreement

from the other person.

- 배우자 있는 자가 양자가 될 때에는 다른 한쪽의 동의를 받아야 합니다.

￭ Please write name with seal and signature of spouse.

(배우자의 성명을 쓰고 기명날인 하세요.)

￭ Please write resident registration No. of spouse.

(배우자의 주민등록번호를 쓰세요.)

* Writing method (작성방법) :

-  The person who will be adopted, if he is minor and if he hasn't anyone of above

mentioned parents or lineal ascendant, must receive the agreement from the

guardian who is permitted by family court.

- 양자가 될 자가 미성년자이고, 그 미성년자에 대하여 위에서 언급한 부․모나 직계존속

이 없는 경우에는 가정법원의 허가를 받은 후견인의 동의가 있어야 합니다.

- Instead approval person of adoption don't have to write on section of assentient.

- 입양대락자는 입양동의자란에 기재하지 않아도 됩니다.

- When an incompetent adopt or is adopted, must receive the agreement from

guardian.

- 금치산자가 양자를 입양시키거나 양자가 되고자 할 때에는 후견인의 동의를 받아야 합니다.

￭ Please write name with seal and signature of guardian.

(후견인의 성명을 쓰고 기명날인 하세요.)

￭ Please write resident registration No. of guardian.

(후견인의 주민등록번호를 쓰세요.)

￭ Please write name of permission court. (허가법원의 이름을 쓰세요.)

￭ Please write date of permission. (허가일자를 쓰세요.)

⑦ Declarer (신고인)

￭ Please write name with seal and signature of adoptive father and mother.

(양부와 양모의 성명을 쓰고 기명날인 하세요.)

￭ Please write tel No. and e-mail address of adoptive father and mother.

(양부와 양모의 전화번호와 이메일주소를 쓰세요.)

* Writing method (작성방법) :

- Person to be adopted seal and signature(or sign) on section of adopted child, but

if he is under 15 years old, don't write on section of adopted child and legal

representative(the guardian who is permitted by family court, write name of

permission court and permission date) seal and signature(or sign) after marking as

“○” on relevant item number .

- 양자란에는 양자가 될 자가 기명날인(또는 서명)하며, 다만 양자가 될 자가 15세 미만인때에는 양자란에는 기재하지 않고 법정대리인(가정법원의 허가를 받은 후견인은 허가법원과 허가일자를 기재)이 법정대리인란의 해당 항목번호에 “○” 으로 표시한 후 기명날인(또는 서명)합니다.

- If you repot the adoption in accordance with 「Exemption law for promotion and

procedure of adoption」, person to be adoptive parents and guardian of person to

be adoptive child write together on section of declarer.

- 입양촉진 및 절차에 관한 특례법에 의한 입양신고의 경우에는 양친될 자와 양자 될 자의

후견인이 함께 신고인란에 기재합니다.

￭ Please write name with seal and signature of adopted child.

(양자의 성명을 쓰고 기명날인 하세요.)

￭ Please write tel No. and e-mail address of adopted child.

(양자의 전화번호와 이메일주소를 쓰세요.)

Legal representative(법정대리인)

￭ Please write name with seal and signature of parents(father/mother).

(부모의 성명을 쓰고 기명날인 하세요.)

￭ Please write tel No. and e-mail address of parents(father/mother).

(부모의 전화번호와 이메일주소를 쓰세요.)

￭ Please write name with seal and signature of guardian.

(후견인의 성명을 쓰고 기명날인 하세요.)

￭ Please write tel No. and e-mail address of guardian.

(부모의 전화번호와 이메일주소를 쓰세요.)

In case of permission for adoption under 15 years old

(15세미만자의 입양승락의 경우)

￭ Please write name of permission court. (허가법원의 이름을 쓰세요.)

￭ Please write date of permission. (허가날짜를 쓰세요.)

⑧ Submitter(제출자)

* Writing method (작성방법) :

- Please write name and resident registration No. of submitter

(Regardless of declarer)

- 제출자(신고인 여부 불문)의 성명 및 주민등록번호 기재

￭ Please write name and resident registration No. of submitter.

(제출자의 성명과 주민등록번호를 쓰세요.)

Attached documents 첨부서류

※ Please can omit to attach below No.1 if the data is checked by computer processing.

아래 1항은 전산정보처리조직에  의하여 그 내용을 확인할 수 있는 경우에는 첨부를

생략할 수 있습니다

1. Each one set of basic certificate, family relation certificate and adoption relative certificate of family relation register for adoptive person

입양당사자의 가족관계등록부의 기본증명서, 가족관계증명서 및 입양관계증명서각 1통

2. One set of agreement of adoption(In case of requirement of agreement of adoption, but except to agreement person wrote name and resident register No. on section of "assentient" and sealed and signatured)

입양동의서1부(입양에 대한 동의가 필요한 경우, 다만 동의한 사람이 입양신고서의 “동의자”란에 성명과 주민등록번호를 기재하고 기명날인 한 때에는 제외)

3. One set permission copy of family court about agreement of adoption or permission of adoption (In case person to be adoptive child is minor and he hasn't parents or the other lineal ascendant so in case he must receive the agreement of guardian, in case the guardian adopt a ward as adoptive chid and if the guardian approve the adoption)

입양동의 또는 입양승낙에 대한 가정법원의 허가서 등본 1부(양자가 될 자가 미성년자로서 부모 또는 다른 직계존속이 없어 후견인의 동의를 받아야 하는 경우, 후견인이 피후견인을 양자로 하는 경우 및 후견인이 입양승낙을 하는 경우)

4. If adoptive parents are foreigner, attach the certificate for nationality (Ex.: Copy of family register, certificate of birth, copy of pass port, copy of identification register and etc)

양친이 외국인인 경우 그 국적을 증명하는 서면(예: 호적등본, 출생증명서, 여권사본, 신분등록부등본 등)

5. If adoptive child is foreigner, if the law of the domicile for the child require permission or agreement of child or the third party for establishing the relevant identification act, attach the written for certificating that requirement is satisfy

양자가 외국인인 경우, 그 자녀의 본국법이 해당 신분행위의 성립에 자녀 또는 제3자의 승낙이나 동의 등을 요건으로 하는 경우에는 그 요건을 갖추었음을 증명하는 서면

6. Identification

[In accordance with Article 23 of the family relation register established rule]

신분확인[가족관계등록예규 제23호에 의함]

- In case of declarer's attendance : Certificate of identification for all declarer

- 신고인이 출석한 경우 : 신고인 모두의 신분증명서

- In case of declarer's nonappearance, submitter's attendance : Submitter's

identification and certificate of identification for all declarer or the written

notarization or certificate of seal impression.(If declarer signed on report without

certificate of identification, attach signature notarization and if declarer sealed on

report without certificate of identification, attach the certificate of seal impression)

- 신고인 불출석, 제출인 출석의 경우 : 제출인의 신분증명서 및 신고인 모두의 신분증명

서 또는 서면공증 또는 인감증명서(신고인의 신분증명서 없이 신고서에 신고인이 서명

한 경우 서명공증, 신고서에 인감 날인한 경우는 인감증명)

- In case of postal submission : Signature notarization or seal impression certificate for

all declarer (If signed on report, attach signature notarization and if sealed on

report, attach certificate of seal impression)

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

※ If adoptive child is under 15 years old, in case of attendance of legal

representative or submission of identification or attachment of seal impression

certificate are same case of submission of identification certificate of declarer or

attachment of seal impression certificate.

양자가 15세 미만인 입양에 있어서 법정대리인의 출석 또는 신분증명서의 제시가 있거나 인감증명서의 첨부가 있으면 신고인의 신분증명서 제시 또는 인감증명서의 첨부가 있는 것으로 볼 수 있습니다.

[Form No.7]

Dissolution of adoption report for parental adopted child ( 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	Adoptive father	Adoptive mother
① Adoptive parents	Name	Korean or English		Place of family origin(Chinese characters)		Korean or English		Place of family origin(Chinese characters)
Chinese characters		Date of birth		Chinese characters		Date of birth
Resident Registration No.	-	Resident Registration No.	-
Permanent domicile address
Address
② Parental adopted child	Name	Korean or English		Place of family origin(Chinese characters)		Resident Registration No.
Chinese characters		Date of birth		-
Permanent domicile address
Address
Previous surname	Korean or English		Chinese characters		Previous family origin	Korean or English		Chinese characters
Retaken surname	Korean or English		Chinese characters		Retaken family origin	Korean or English		Chinese characters
③Retaken parents (Adoptive parents)	Father (Adoptive father)	Name		Permanent domicile address
Resident Registration No.	-
Permanent domicile address
Mother (Adoptive mother)	Name
Resident Registration No.	-
④Other
⑤Judgment confirmed date	Day Month Year	Name of court
⑥Declarer	Name	Seal or signature	Resident Registration No.	-
Relationship	□Propounder of trial □Opponent of trial □Other(Please state: )
Address
Tel. No.		E-mail address
⑦Submitter	Name		Resident Registration No.	-

Written method
No. ① and No. ② : If you wrote the resident registration No. on section of resident registration No. in accordance with Article 25 section 2, can omit to write the date of birth. No. ③ : In case of direct adoption of parental adopted child and adoptive parents of previous general adoption adopt as parental adopted child so if adoptive parents are same, real biological parents relation is revived at dissolution of adoption. :If adoptive parents of previous general adoption and adoptive parents of parental adopted child adoption are different, adoptive parents relation of previous general adoption is revived. No. ④ : Please write specially necessary matters for clearing the register of family relation. No. ⑥ : If the dissolution of adoption trial for parental adopted child was confirmed, propounder or opponent of trial can report alone. In this case, mark as “○” on relevant number and then seal and signature(or sign). No. ⑦ : Please write name and resident registration No. of submitter(Regardless of declarer) [접수담당공무원은 신분증과 대조]
Attached documents
※ If the data of below No.1 is checked by computer at office of family relation register, can omit to attach. 1. Each one set of basic certificate of family relation register of dissolution of adoption for parental adopted child and adoption relation certificate of parental foster child. 2. If the dissolution of adoption trial for parental adopted child was confirmed in accordance with Article 908 section 5「Civil Law」, please attach each one set copy of trial and certificate of decision. 3. Identification[In accordance with Article 23 of the established rule of family relation register] - In case of attendance of declarer : Certificate of status - In case of attendance of submitter : Certificate of identification for submitter - In case of postal submission : Copy of identification for declarer

Dissolution of adoption report for parental adopted child

(친양자파양신고서)

① Adoptive parents (adoptive father / adoptive mother) 양친 (양부/양모)

※ Writing method (No. 1and 2) ( 작성방법 1번 ~ 2번)

￭ If you wrote the resident register No. on section of resident register No. in

accordance with Article 25 Section 2, can omit to write the date of birth.

(법 제25조제2항에 따라 주민등록번호란에 주민등록번호를 기재한 때에는 출생

연월일의 기재를 생략할 수 있습니다.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s name in

Korean or English and in Chinese characters.

(양친(양부/양모)의 성명을 한글과 한자로 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s place

of family origin in Chinese characters. (양친(양부/양모)의 본을 한자로 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s date of

birth(day/month/year). (양친(양부/양모)의 출생연월일을 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s resident

registration No. (양친(양부/양모)의 주민등록번호를 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s permanent

domicile address and address.

(양친(양부/양모)의 등록기준지와 주소를 쓰세요.)

② Paternal adopted child (친양자)

￭ Please write the paternal adopted child's name in Korean or English and in Chinese

characters. (친양자의 성명을 한글과 한자로 쓰세요.)

￭ Please write the paternal adopted child's place of family origin in Chinese characters.

(친양자의 본을 한자로 쓰세요.)

￭ Please check the paternal adopted child's sex.  1)Male   2)Female

(친양자의 성별을 체크하세요 1)남 2)여 )

￭ Please write the paternal adopted child's resident registration No.

(친양자의 주민등록번호를 쓰세요.)

￭ Please write the paternal adopted child's date of birth(Day/Month/Year).

(친양자의 출생연월일을 쓰세요.)

￭ Please write the paternal adopted child's permanent domicile address and address.

(친양자의 등록기준지와 주소를 쓰세요.)

￭ Please write previous surname in Korean or English and in Chinese characters.

(친양자의 종전의 성을 한글과 한자로 쓰세요.)

￭ Please write the changed surname in Korean or English and in Chinese characters.

(친양자의 변경된 성을 한글과 한자로 쓰세요.)

￭ Please write previous place of family origin in Korean or English and in Chinese

characters. (친양자의 종전의 본을 한글과 한자로 쓰세요.)

￭ Please write the changed place of family origin in Korean or English and in Chinese

characters. (친양자의 변경된 본을 한글과 한자로 쓰세요.)

③ The retaken parents (Adoptive parents) 부활되는 부모(양부모)

※ Writing method (작성방법)

￭ In case of direct adoption of parental adopted child and adoptive parents of

previous general adoption adopt as parental foster child so if adoptive parents are

same, real biological parents relation is revived at dissolution of adoption.

(직접 친양자입양한 경우와 종전 일반입양한 양부모가 친양자 입양을 하여 양부모가

동일한 경우, 파양시에는 친생부모관계 부활)

￭ If adoptive parents of previous general adoption and adoptive parents of parental

adopted child adoption are different, adoptive parents relation of previous general

adoption is revived.

(종전 일반입양한 양부모와 친양자입양을 한 양부모가 다른 경우, 파양시에는 종전

일반입양한 양부모관계 부활)

￭ Please write name of the retaken parents(adoptive father/adoptive mother).

(부활되는 부모(양부모)의 성명을 쓰세요.)

￭ Please write permanent domicile address of the retaken parents (adoptive father

/ adoptive mother). (부활되는 부모(양부모)의 등록기준지를 쓰세요.)

￭ Please write resident registration No. of the retaken parents (adoptive father

/ adoptive mother). (부활되는 부모(양부모)의 주민등록번호를 쓰세요.)

④ Other (기타)

※ Writing method (작성방법)

￭ Please write specially necessary matters for clearing the register of family relation.

(가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재합니다.)

⑤ The confirmed date of judgement (재판확정일자)

￭ Please write the judgement confirmed date(day/month/year) and the court

name. (재판확정일자(년,월,일)와 법원명을 쓰세요.)

⑥ Declarer (신고인)

※ Writing method (작성방법)

￭ If the dissolution of adoption trial for parental adopted child was confirmed,

propounder or opponent of trial can report alone. In this case, mark as “○” on

relevant number and then seal and signature(or sign).

(친양자파양의 재판이 확정된 경우에는 소 제기자 또는 소의 상대방 단독으로

신고할 수 있습니다. 이 경우에는 해당 항목번호에 “○”으로 표시한 후 기명

날인(또는 서명)합니다.)

￭ Please write name and resident registration No.

(신고인의 성명과 주민등록번호를 쓰세요.)

￭ Please check on relationship. (신고인의 자격에 체크하세요.)

1) Propounder of trial (소 제기자)

2) Opponent of trial (소의 상대방)

3) Other (기타) : Please state(자격) :

￭ Please write address, telephone number and e-mail address.

(신고인의 주소, 전화번호, 이메일을 쓰세요.)

⑦ Submitter (제출인)

※ Writing method (작성방법) :

￭  Please write name and resident register No. of submitter(Regardless of declarer)

(제출자(신고인 여부 불문)의 성명 및 주민등록번호 기재)

￭ Please write name and resident registration number.

(제출인의 성명과 주민등록번호를 쓰세요.)

□ Attached documents 첨부서류

￭ If the data of below No.1 is checked by computer at office of family relation

register, can omit to attach.

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

생략합니다.)

1. Each one set of basic certificate of family relation register of dissolution of

adoption for parental foster child and adoption relation certificate of parental

adopted child.

(친양자파양당사자의 가족관계등록부의 기본증명서, 친양자입양관계증명서 각 1통)

2. If the dissolution of adoption trial for parental adopted child was confirmed in

accordance with Article 908 Section 5 of the 「Civil Law」, please attach each

one set copy of trial and certificate of decision.

(「민법」제908조의5에 따라 친양자파양의 재판이 확정된 경우에는 재판의 등본 및

확정증명서 각 1통)

3.  Identification[In accordance with Article 23 of the established rule of family

relation register] (신분확인[가족관계등록예규 제23호에 의함])

￭ In case of attendance of declarer : Certificate of status

(신고인이 출석한 경우 : 신분증명서)

￭ In case of attendance of submitter : Certificate of identification for submitter

(제출인이 출석한 경우 : 제출인의 신분증명서)

￭ In case of postal submission : Copy of identification for declarer

(우편제출의 경우 : 신고인의 신분증명서 사본)

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.

※ An applicant enters the number of ①,② and ⑥,⑦,⑧,⑨,⑩,⑪,⑫,⑬,⑭, the remaining number (③,④,⑤) is filled in relevant person only. ※ A report of transfer of resident registration should be declared separately with this report of registration of family relations. ① : If the contracting parties in a marriage are a foreigner, enter in nationality. ② : If the contracting parties in a marriage are an adopted child, enter personal the data of their foster parents and in event that their's parents are a foreigner, enter the date of birth and in nationality on section of resident registration number. ③ : If you've ever been a divorcement or nullify of marriage, enter the date. ④ : In the event of submission of a marriage certificate copy by wedding ceremony, enter an established date of marriage. ⑤ : In the event that the couple agreed to make their child’s surname and place of family origin following the child’s mother’s ones in accordance with the Proviso of Article 781, Paragraph 1 of the Civil Law, please enter as such fact. ⑥ : Please enter the fact[bloodline within third cousin (Include the blood relation before adoption of paternal foster child.)] that a contracting parties in a marriage aren't intermarriage(marriage between close relatives) in accordance with the Proviso of Article 809, Paragraph 1 of the Civil Law. ⑦ : Please write below facts and especially necessary informations for clarifying the family relation register. (If the space is not enough, you can write on an annexed paper) - In the event of report of marriage by confirmed judgment of marriage relation in fact, please write the court name of judgment & confirmed date. ⑧ : The witness must be a person of legal age. ⑨ : In the event of a marriage of a minor or a incompetent enter the contents of a consent. ⑩ : Enter the submitter's name and resident register number. (An applicant is unconnected) [An acceptable official in charge identify the submitter.] ⑪ : Enter the beginning date of actual marriage(cohabitation) with couple regardless of wedding day. ⑭ : 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. <Example> Drop out of junior in college → Mark a high school with "O" ⑮ : When you get married, the type of work and contents with name of company enter concretely. <Wrong Example> Employee, Public official, Business, Transportation business. <Correct Example> 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.
Required Document(s)
※ Under 1 clause can be omitted if the department in charge of family relation certification can check this information. 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. 2. Written consent of marriage 1 copy.[In case of marriage of a minor or an incompetent, if it is signed(or sealed) on consent section of report, this case is excepted] 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. [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]. 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. 5. If a foreigner and a Korean get married in Korea, a foreigner(man or woman) must submit a certificate of requirement for establishing a marriage (In case of a Chinese, it's possible an unmarried certificate and family relationship certificate also) and a certificate(Ex. a certified copy of family register, certificate of birth, copy of passport, a certified copy of status register and etc.) for nationality 1 copy. 6. If the couple agreed that their child’s surname and family origin follow mother’s ones in accordance with the Proviso of Article 781, Paragraph 1 of the Civil Law, one copy of the agreement between the married couple. 7. Identification. [In accordance with Article. 23 of the established rule for family relation register] ▪ In case of reporter's attendance : Identifications of all reporters ▪ In case of nonattendance of reporter and attendance of submitter : Identifications of submitter and all reporter or notarized signatures or certificate of personal seal impression(If applicant reported by signature without identification, a notarized signature, if reported by seal, a certificate of personal seal impression) ▪ In case of postal submission : Notarized signatures or certificates of seal impression of all reporters ※ 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.

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 협의사실을 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,30]

Revision report of register ( ..... 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 concerned		Name	Korean or English							Resident Registration No.				-
			Chinese characters
		Permanent domicile address
		Address
②Matters to be revised
③Permission or trial decision date						...... Day ..... Month .......... Year							Court name
④Other
⑤Declarer	Name			(Seal) or signature							Resident Registration No.					-
	Relationship			□ Self □ Legal representative □ Propounder of trial □ Other (Please state: )
	Address								Telephone No.						E-mail address
⑥Submitter	Name							Resident Registration No.				-

How to fill out
① : If the person concerned about the matter that No. 2, 3, 4 and 5, are all same is several person, please write as "The person concerned is same as the annexed paper" and then please write all of the person concerned on annexed paper. ② : Please write the revising items and in case of according to permission or judgment, please write the revised record items of the family relation register to follow on 'the text' of decision' but if there are many to writing items, please write as "Equal to attached the permitted decision or the text of decision". ④ : Please write especially necessary informations for clarifying the family relation register. ⑥ : Submitter(Regardless of the declarer is true or not)'s name and resident registration No. [접수담당공무원은 신분증과 대조]
Attached documents
1. One set the decision copy for permission of register revision(When the family relation register is revised as the basis of the decree absolute, each one set the judgment copy and decision certificate). 2. Identification [according to Article. 23 of the family relation register established rule] - In case of declarer's attendance : Identification card - In case of submitter's attendance : Submitter's identification card - In case of postal submission : Copy of declarer's identification card

<Annexed paper>

Person concerned	Name	Korean or English				Resident Registration No.	-
		Chinese characters
	Permanent domicile address
	Address
Person concerned	Name	Korean or English				Resident Registration No.	-
		Chinese characters
	Permanent domicile address
	Address
Person concerned	Name	Korean or English				Resident Registration No.	-
		Chinese characters
	Permanent domicile address
	Address
Person concerned	Name	Korean or English				Resident Registration No.	-
		Chinese characters
	Permanent domicile address
	Address
Person concerned	Name	Korean or English				Resident Registration No.	-
		Chinese characters
	Permanent domicile address
	Address

Revision report of register

(등록부정정신청서)

① Person concerned (사건본인)

※ Writing method (작성방법)

￭ If the person concerned about the matter that No. 2, 3, 4 and 5, are all same is

several person, please write as "The person concerned is same as the annexed

paper" and then please write all of the person concerned on annexed paper.

￭ 2, 3, 4, 5항이 모두 동일한 사안에 대하여 사건본인이 수인인 경우에는 성명란에

“사건본인 별지와 같음” 이라고 기재한 후 별지에 사건본인 전부를 기재하여야 합니다.

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

(사건본인의 성명을 한글과 한자로 쓰세요.)

￭ Please write resident registration No.

(사건본인의 주민등록번호를 쓰세요.)

￭ Please write permanent domicile address and address.

(사건본인의 등록기준지와 주소를 쓰세요.)

② Matters to be revised (정정사항)

※ Writing method (작성방법)

￭ Please write matters to be revised and in case of according to permission or

judgment, please write the revised record matters of the family relation

register to follow on 'the text' of decision but if there are many to writing

items, please write as "Equal to attached the permitted decision or the text

of decision".

￭ 정정을 하고자 하는 사항을 기재하며 허가 또는 판결에 의한 경우 ‘주문’ 에

나타난 가족관계등록 기록정정사항을 기재하되 기재할 사항이 많은 경우 “별지

첨부 허가결정 또는 판결주문과 같음” 이라고 기재합니다.

③ Permission or judgement decision date (허가 또는 재판확정일자)

￭ Please write decision date for permission or judgment and name of court.

(허가 또는 재판확정일자와 법원명을 쓰세요.)

④ Other (기타사항)

※ Writing method (작성방법) :

￭ Please write especially necessary informations for clarifying the family relation register.

(가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재합니다.)

⑤ Declarer (신고인)

￭ Please write name with signature and sign. and resident registration No.

(신고인의 성명과 서명날인 그리고 주민등록번호를 쓰세요.)

￭ Please check on relationship. (신고인의 자격에 체크하세요.)

□ Self     □ Legal representative     □ Propounder of trial

□ Other (Please state :         )

( □ 본인    □ 법정대리인    □ 소 제기자    □ 기타 (자격:       ))

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

(신고인의 주소, 전화번호, 이메일 주소를 쓰세요.)

⑥ Submitter (제출인)

※ Writing method (작성방법) :

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

(제출자(신고인 여부 불문)의 성명 및 주민등록번호 기재하세요. [접수담당공무원은

신분증과 대조])

￭ Please write name and resident registration No.

(제출자의 성명과 주민등록번호를 쓰세요.)

□ Attached documents 첨부서류

1. One set the decision copy for permission of register revision

등록부정정허가결정등본 1부

(When the family relation register is revised as the basis of the decree absolute,    each one set the judgment copy and decision certificate).

(확정판결을 근거로 가족관계등록부의 정정을 할 때는 판결등본 및 확정증명서 각 1부).

2.  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 : 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)

[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.

Writing method
① : 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(sign and seal) one party. : If the divorcing person is a foreigner, please write the nationality instead of permanent domicile address. ② : If the parents of the divorcing person haven't resident registration No., please write the permanent domicile address. If the divorcing person is foster child, please write the personal information of the adoptive parents and if the parents of the divorcing person is a foreigner, please write the date of birth and nationality instead of resident registration No. ③ : Please write below facts and especially necessary informations for clarifying the family relation register. - If there are a person who the status is changed by declared incident, please write name of the person, date of birth, permanent domicile address and the reason of the status changing. - If an incompetent has an agreement divorce, please write assentient's name, signature(or seal) and date of birth. ④ : Please write only in case of divorce by judgment(reconciliation, arbitration) and don't write in case of divorce by agreement. : In case of report for divorce according to conclude the arbitration, to decision for replacing the arbitration, to conclude the reconciliation or to decision for adjuring the reconciliation, please write on below ( ) of the confirmed date of judgement as "Conclusion of the arbitration", "Decision confirmation for replacing the arbitration" or "Conclusion of the reconciliation", "Decision confirmation for adjuring the reconciliation" and write the date of conclusion(confirmation). ⑤ : Please don't write in case of appling for intention confirmation of agreement divorce, write the decide parental authority after confirming the divorce intention of the court. The date of becoming effect for appointing is the date of reporting for the divorce in case of agreement divorce and the date of judgment confirming in case of judgment divorce. 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. If child is more than three, please attach after writing on annexed paper with connection seal stamp. In case of during pregnancy, please register the parental authority on registering of the birth. ⑥ : 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. ⑦ : Please write name and resident registration number of submitter(Regardless of declarer). [접수담당공무원은 신분증과 대조] ⑧, ⑨ : Please write the real started date of marital life(Cohabited date) and the real divorced(Separated date) date without relation of the registered date or the judgment confirmed date on the family relation register. ⑭ : 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. ⑮ : Please write occupation's kind and details with company's name at marriage time concretely. <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
Attached documents
1. Agreement divorce : One set a confirmation copy for agreement divorce intention 2. Judgement divorce : Each one set a certified copy of judgement and decision certificate(in case the arbitration and the reconciliation were established, report copy and dispatch certificate) 3. Judgement divorce by decision of foreign court - Each one set the original or copy of divorce decision and certificate of confirmed decision. - 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.(This is only in case of not clear by decision). - One set translation for above each papers. ※ If the details of below No. 4 is checked by data processing at office of family relation register, omit to attach. 4. Each one set the family relation certificate and marriage relation certificate of family relation register for each divorcing person. 5. Documents for explaining to be related the appointed of parental authority. - One set the copy of parental authority appointing agreement in case of agreement. - One set the original of judgment and decision certificate in case of court's decision. 6. Identification [In accordance with Article. 23 of the established rule for family relation register] ① Report for divorce on judgment - In case of declarer's attendance : Identification card - In case of submitter's attendance : Submitter's identification card - In case of postal submission : Copy of declarer's identification card ② Report for divorce on agreement - In case of declarer's attendance : Identification card for declarer unilateral - 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) - 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).

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).

[Form No.33]

Report of creating a new surname ( ..... Day ..... Month .......... Year)															※ Please write after reading the guidelines below and, when required to select one option, please circle the number as follows "○".
①Originator (Subject)		Name		Korean or English										Resident registration No.				-
				Chinese characters
		Permanent domicile address
		Address
②Surname & place of family origin		Previous surname				Korean or English				Chinese characters						Previous place of family origin			Korean or English				Chinese characters
		Created surname				Korean or English				Chinese characters						Created place of family origin			Korean or English				Chinese characters
③Permission date			...... Day ..... Month .......... Year													Court name
④Other
⑤Declarer	Name		(Seal) or signature									Resident Registration No.								-
	Relationship						□Self □Legal representative □Other (Please state: )
	Address												Telephone No.									E-mail address
⑥Submitter	Name												Resident registration No.					-

Writing method
※ When the person who is using foreign surname and acquired Korean nationality want to use new surname & place of family origin instead of the foreign surname, this report has to be reported within one month from getting the notification of the permission judgement for creating surname with the copy of permission judgment after obtaining the permission judgement for creating surname from the jurisdiction domestic court. ④ : Please write especially necessary informations for clarifying the family relation register. : If previous surname and place of family origin aren't in Chinese characters or in Korean, write as original characters(letters). ⑥ : Submitter(Regardless of declarer)'s name and resident registration number. [접수담당공무원은 신분증과 대조]
Attached documents
1. One set a copy of permission judgement for creating surname 2. Identification [according to Article. 23 of the family relation register established rule] - In case of declarer's attendance : Identification card - In case of submitter's attendance : Submitter's identification card - In case of postal submission : Copy of declarer's identification card

Report of creating a new surname

(창성신고서)

※ Writing method (작성방법)

￭ When the person who is using foreign surname and who acquired Korean

nationality want to use new surname & place of family origin instead of the

foreign surname, this report has to be declared within one month from getting the

notification of the permission judgement for creating surname with the copy of

permission judgment after obtaining the permission judgement for creating a new

surname from the jurisdiction domestic court.

￭ 본 신고는 외국의 성을 쓰는 국적취득자가 그 성을 쓰지 않고 새로이 성과 본을            정하고자 하는 경우, 관할 가정법원에서 창성허가심판을 받아 그 허가심판서 등본을

첨부하여 창성하가심판의 고지를 받은 날로부터 1개월 이내에 하는 신고입니다.

① Originator(Subject) (창성자)

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

(창성자의 성명을 한글과 한자로 쓰세요.)

￭ Please write originator's resident registration No.

(창성자의 주민등록번호를 쓰세요.)

￭ Please write originator's permanent domicile address and address.

(창성자의 등록기준지와 주소를 쓰세요.)

② Surname & place of family origin (성.본)

￭ Please write previous surname in Korean or English and in Chinese characters.

(종전의 성을 한글과 한자로 쓰세요.)

￭ Please write previous place of family origin in Korean or English and Chinese

characters. (종전의 본을 한글과 한자로 쓰세요.)

￭ Please write the created surname in Korean or English and in Chinese characters.

(변경된 성을 한글과 한자로 쓰세요.)

￭ Please write the created place of family origin in Korean or English and Chinese

characters. (변경된 본을 한글과 한자로 쓰세요.)

③ Permitted date (허가일자)

￭ Please write the permitted date and name of court.

(허가일자와 법원명을 쓰세요.)

④ Other (기타사항)

※ Writing method (작성방법)

￭ Please write especially necessary informations for clarifying the family relation

register. (가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재합니다.)

￭ If previous surname and place of family origin aren't Chinese characters or

Korean, write as original characters(letters).

(창성전의 성과 본이 한자나 한글이 아닌 경우에 원래의 문자표기)

⑤ Declarer (신고인)

￭ Please write name with signature and sign and resident registration No.

(신고인의 성명과 함께 서명날인하고 주민등록번호를 쓰세요.)

￭ Please check on relationship. (신고인의 자격에 체크하세요)

□ Self   □ Legal representative   □ Other (Please state :          )

(□ 본인   □ 법정대리인   □ 기타 (자격:        ))

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

(신고인의 주소, 전화번호, 이메일 주소를 쓰세요.)

⑥ Submitter (제출인)

※ Writing method (작성방법)

￭ Submitter(Regardless of declarer)'s name and resident registration No.

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

￭ Please write name and resident registration number.

(성명과 주민등록번호를 쓰세요.)

※ Attached documents 첨부서류

1. One set a copy of permission judgement for creating surname

(창성허가 심판 등본 1부)

2.  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 : 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)

[Form No.5]

Adoption report for paternal adopted child ( ..... 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	Adoptive father	Adoptive mother
① Adoptive parents	Name	Korean or English		Place of family origin		Korean or English		Place of family origin
Chinese characters		Date of birth		Chinese characters		Date of birth
Resident Registration No.	-	Resident Registration No.	-
Permanent domicile address
Address
② Paternal adopted child	Name	Korean or English		Place of family origin		Resident Registration No.	-
Chinese characters		Sex	□ Male □ Female	Date of birth
Permanent domicile address
Address
Previous surname	Korean		Chinese characters		Previous place of family origin	Korean		Chinese characters
Changed surname	Korean		Chinese characters		Changed place of family origin	Korean		Chinese characters
③Real biological parents of paternal adopted child	Father	Name		Permanent domicile address
Place of family origin	-
Mother	Name		Permanent domicile address
Place of family origin	-
④Other
⑤Judgement confirmed date	..... Day ..... Month ........ Year	Court name
⑥Declarer	Name	(Seal) or signature	Resident Registration No.	-
Relationship	□Propounder of trial □Opponent of trial □Other(Please state : )
Address
Telephone No.		E-mail address
⑦Submitter	Name		Resident Registration No.	-

Written method
① and ② : If you wrote the resident registration number, you can omit the date of birth according to the Article 25 section 2 of the law. ④ : Please write especially necessary informations for clarifying the family relation register and check the submission true or not the agreement which child's surname and place of family origin follow as child's mother's ones. ⑥ : If the adoption of paternal adopted child was confirmed, the propounder of trial or the opponent of trial can report unilaterally. In this case, please mark as “○” on the relevant number and then seal and signature(or sign). ⑦ : Submitter(Regardless of declarer)'s name and resident registration No. [접수담당공무원은 신분증과 대조]
Attached documents
※ If the details of below No. 1 is checked by data processing at office of family relation register, omit the attached. 1. Each one set basic certificate and family relation certificate of family relation register for adopting person the paternal adopted child. 2. Copy of adoption trial for paternal adopted child and decision certificate. 3. Identification [according to Article. 23 of the family relation register established rule] - In case of declarer's attendance : Identification card - In case of submitter's attendance : Submitter's identification card - In case of postal submission : Copy of declarer's identification card

Adoption report of paternal adopted child

(친양자입양신고서)

1. Adoptive parents (adoptive father / adoptive mother) 양친 (양부/양모)

※ Writing method (No. 1and 2) ( 작성방법 1번 ~ 2번) :

￭ If you wrote the resident registration number, you can omit the date of birth

according to the Article 25 Section 2 of the Law.

(법 제25조제2항에 따라 주민등록번호란에 주민등록번호를 기재한 때에는 출생 연월일의

기재를 생략할 수 있습니다.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s name in

Korean or English and in Chinese characters.

(양친(양부/양모)의 성명을 한글과 한자로 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s place of

family origin in Chinese characters. (양친(양부/양모)의 본을 한자로 쓰세요.)

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s date of

birth(day/month/year). 양친(양부/양모)의 출생연월일을 쓰세요.

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s resident

registration No. 양친(양부/양모)의 주민등록번호를 쓰세요.

￭ Please write the adoptive parents(adoptive father/adoptive mother)'s permanent

domicile address and address. (양친(양부/양모)의 등록기준지와 주소를 쓰세요.)

2. Paternal adopted child (친양자)

￭ Please write the paternal foster child's name in Korean or English and in Chinese

characters. (친양자의 성명을 한글과 한자로 쓰세요.)

￭ Please write the paternal adopted child's place of family origin in Chinese characters.

(친양자의 본을 한자로 쓰세요.)

￭ Please check the paternal adopted child's sex. 1)Male  2)Female

(친양자의 성별을 체크하세요 1)남 2)여 )

￭ Please check the paternal adopted child's resident registration No.

(친양자의 주민등록번호를 쓰세요.)

￭ Please write the paternal adopted child's date of birth(Day/Month/Year).

(친양자의 출생연월일을 쓰세요.)

￭ Please write the paternal adopted child's permanent domicile address and address.

(친양자의 등록기준지와 주소를 쓰세요.)

￭ Please write previous surname in Korean or English and in Chinese characters.

(친양자의 종전의 성을 한글과 한자로 쓰세요.)

￭ Please write the retaken surname in Korean or English and in Chinese characters.

(친양자의 부활된 성을 한글과 한자로 쓰세요.)

￭ Please write previous place of family origin in Korean or English and in Chinese

characters. (친양자의 종전의 본을 한글과 한자로 쓰세요.)

￭ Please write the retaken place of family origin in Korean or English and in Chinese

characters. (친양자의 부활된 본을 한글과 한자로 쓰세요.)

3. Real biological parents of parental adopted child(father/mother)

친양자의 친생부모(부/모)

￭ Please write real biological parents(father/mother)'s name.

(친생부모(부/모)의 성명을 쓰세요.)

￭ Please write real biological parents(father/mother)'s permanent domicile address.

(친생부모(부/모)의 등록기준지를 쓰세요.)

￭ Please write real biological parents(father/mother)'s resident registration No.

(친생부모(부/모)의 주민등록번호를 쓰세요.)

4. Other (기타)

※ Writing method (작성방법)

￭ Please write especially necessary informations for clarifying the family relation

register and check the submission true or not the agreement that child's surname

and place of family origin follow as child's mother's ones.

(가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재하며 혼인 신고시

자녀가 모의 성,본을 따르기로 협의하였는지 여부도 기재합니다.)

5. The confirmed date of judgement (재판확정일자)

￭ Please write the judgement confirmed date(day/month/year) and the court name.

(재판확정일자(년,월,일)와 법원명을 쓰세요.)

6. Declarer (신고인)

※ Writing method (작성방법)

￭ If the judgment for adoption of paternal adopted child was confirmed, the

propounder of trial or the opponent of trial can report unilaterally. In this             case, please circle the relevant number and then seal and signature(or sign).

(친양자입양의 재판이 확정된 경우에는 소 제기자 또는 소의 상대방 단독으로 신고할

수 있습니다. 이 경우에는 해당 항목번호에 “o"으로 표시한 후 기명날인 (또는 서명)합니다.

￭ Please write name and resident registration No.

(신고인의 성명과 주민등록번호를 쓰세요.)

￭ Please check qualification. (신고인의 자격에 체크하세요.)

1) Propounder of trial (소 제기자)

2) Opponent of trial (소의 상대방)

3) Other (기타) : Please state(자격) :

￭ Please write address, telephone number and e-mail address.

(신고인의 주소, 전화번호, 이메일을 쓰세요.)

7. Submitter (제출인)

※ 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])

￭ Please write name and resident registration number.

(제출인의 성명과 주민등록번호를 쓰세요.)

□ Attached documents 첨부서류

※ If the details of below No. 1 is checked by data processing at office of family

relation register, omit the attached.

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

첨부를 생략합니다.)

1.  Each one set basic certificate and family relation certificate of family relation register

for adopting person the paternal adopted child

( 친양자입양당사자의 가족관계등록부의 기본증명서, 가족관계증명서 각 1통)

2. Copy of adoption trial for paternal adopted child and decision certificate

(친양자 입양재판의 등본 및 확정증명서)

3.  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 : 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)

[Annexed paper 1]

Written Agreement

Father's name :

Permanent domicile address :

Address :

Resident registration Number :

Mother's name :

Permanent domicile address

Address :

Resident registration Number :

We agree that the surname and place of family origin of all children born to the above parents will follow the mother's one.

20        .      .      .

Father                      Seal (Signature)

Mother                     Seal (Signature)

Required Documents

1. One copy of an identification card(driver's license, passport, public official card or other similar identification) of the submitter in order to certify their identity.

2. If one side or both sides of the contracting parties of a marriage can not visit, please submit a copy of the certificate of seal impression or notarized signature.

Instructions

1. If one or both of the contracting parties of a marriage can not visit, the certificate of seal impression or notarized signatures of the party not present must be attached.

2. Any submitter of a false agreement by the illegal use of signature or seal impression of a third party shall be sentenced to up to 5 years imprisonment or a fine of up to ten million won in accordance with regulations stated in Article 231, to Paragraph 2 Article 240 of the Criminal Law.

[Annexed paper 1]

Written Agreement (협의서)

※ Father's name  (부의 이름)

￭ Please write the name of father. (부의 이름을 기재해 주세요.)

※ Permanent domicile address (등록 기준지 )

￭ Please write the permanent domicile address of father.

(부의 등록 기준지를 기재해 주세요.)

※ Address (주소)

￭ Please write the address of father. (부의 주소를 기재해 주세요.)

※ Resident registration Number (주민등록번호)

￭ Please write the resident registration Number of father.

(부의 주민등록번호를 기재해 주세요.)

※ Mother's name (모의 이름)

￭ Please write the name of mother. (모의 이름을 기재해 주세요.)

※ Permanent domicile address (등록 기준지)

￭ Please write the permanent domicile address of mother.

(모 등록 기준지를 기재해 주세요.)

※ Address (주소)

￭ Please write the address of mother.  (모 주소를 기재해 주세요.)

※ Resident registration Number (주민등록번호)

￭ Please write the resident registration Number of mother.

(모 주민등록번호를 기재해 주세요.)

□ We agree that the surname and place of family origin of all children born

to the above parents follow as mother's one.

(위의 부모 사이에서 태어날 모든 자식의 이름과 본적을 어머니의 이름과 본적으로

하기로 협의합니다.)

￭ Please write the writing date.

(작성 일자를 기재해 주세요.)

￭ Please write name of father and put the his seal.

(부의 이름을 기재하고 날인하세요.)

￭ Please write name of mother and put the his seal.

(모의 이름을 기재하고 날인하세요.)

□ Required Documents (첨부 서류)

1. One copy of an identification card(driver's license, passport, public

official card or other similar identification) of the submitter in order to

certify their identity.

제출인의 신분을 확인할 수 있는 주민등록증(운전면허증, 여권, 공무원증 등) 사본 1부)

2. If one side or both side of the contracting parties of a marriage can

not visit, submit a certificate of seal impression or notarized signature

1 copy.

출석하지 않은 혼인당사자 일방 또는 쌍방의 인감증명서, 서명에 대한

공증서 1부

□ Instructions (유의 사항)

1. If one or both of the contracting parties of a marriage can not visit,

the certificate of seal impression or notarized signatures of the party

not present must be attached.

혼인당사자 중 일방 또는 쌍방이 불출석한 경우, 불출석한 당사자의 인감

증명서 또는 서명에 대한 공증서를 반드시 첨부하여야 합니다.

2. Any submitter of a false agreement by the illegal use of signature or

seal impression of a third party shall be sentenced to up to 5 years

imprisonment or a fine of up to ten million won in accordance with

regulations stated in Article 231, to Paragraph 2 Article 240 of the       Criminal Law.

타인의 서명 또는 인장의 도용 등으로 허위의 협의서를 작성하여 제출하는

경우에는「형법」제231조부터 제237조의2까지의 규정에 따라 5년 이하의 징역 또는 1천만원 이하의 벌금형에 처해집니다.

Family Relation Certificate 가족관계증명서
Permanent domicile address 등록기준지
Section 구분	Full Name 성명	Date of Birth 출생년월일	Resident Registration No. 주민등록번호	Sex 성별	Origin of Family Name 본
Self 본인
Family Information 가족사항
Section 구분	Full Name 성명	Date of Birth 출생년월일	Resident Registration No. 주민등록번호	Sex 성별	Origin of Family Name 본
Father 부
Mother 모
Spouse 배우자
Child 자녀
Child 자녀
This certifies that above family relation certificate fully reflects the information in the original family relation register. 위 가족관계증명서는 가족관계등록부의 기록사항과 틀림없음을 증명합니다. Day Month Year 년 월 일 Head of Heaundae District, Busan Metropolitan City in Korea 대한민국 부산광역시 해운대 구청장

[Annex Form No.1] <Revised 2010.6.3>

Basic Certificate 기본증명서
Permanent domicile address 등록기준지
Section 구분	Details 상세내용
Registration 작성	[Registering date of family relation register] Day Month Year [가족관계등록부작성일] 년 월 일 [Reason for register]In accordance with Article 3 Section 1 addenda of the Family Relation Register Law [작성사유]가족관계의 등록 등에 관한 법률 부칙 제3조제1항
Modifications 변경	[Date of modification] Day Month Year [변경일] 년 월 일 [Previous permanent domicile address] [전 등록기준지] [Processing government office] [처리관서]
Section 구분	Full Name 성명	Date of Birth 출생년월일		Resident Register No. 주민등록번호	Sex 성별	Origin of Family Name 본
Self 본인
Informations of general register 일반등록사항
Section 구분	Details 상세내용
Birth 출생	[Place of birth] [출생장소] [Date of report] Day Month Year [신고일] 년 월 일 [Reporter] [신고인]
Reinstatement of nationality 국적회복	[Permission date for reinstatement of nationality] [국적회복허가일] [Previous nationality] [국적회복전국적] [Date of report] [신고일] [Reporter] [신고인] [Date of sent] [송부일] [Sender] [송부자]
Change of name 개명	[Permission date for change of name] [개명허가일] [Court of permission] [허가법원] [Date of report] [신고일] [Reporter] [신고인] [Previous name] [개명전이름] [New name] [개명후이름]
Correction 정정	[Date of correction by official authority] [직권정정서작성일] [Date of correction] [정정일] [Resident Registration No. of before correction] [정정전 주민등록번호] [Resident Registration No. of after correction] [정정후 주민등록번호] [Processing Government office] [처리관서]
This certifies that above basic certificate fully reflects the information in the original family relation register. 위 기본증명서는 가족관계등록부의 기록사항과 틀림없음을 증명합니다. Day Month Year 년 월 일

[Annex Form No.5]

Adoptive Relation Certificate 입양관계증명서
Permanent domicile address 등록기준지
Section 구분	Full Name 성명		Date of Birth 출생년월일	Resident Registration No. 주민등록번호	Sex 성별	Origin of Family Name 본
Self 본인
Information on adoption 입양사항
Section 구분		Full Name 성명	Date of Birth 출생년월일	Resident Registration No. 주민등록번호	Sex 성별	Origin of Family Name 본
Real biological father 친생부
Real biological mother 친생모
Adoptive father 양부
Adoptive mother 양모
Adopted child 양자
Section 구분		Details 상세내용
Adoption 입양		[Date of report] [신고일] [Adopted child] [양자]
Adoption 입양		[Date of report] [신고일] [Adoptive father] [양부] [Adoptive mother] [양모]
Adoption 입양		[Date of report] [신고일] [Adopted child] [양자] [Resident Registration No. of adopted child] [양자의 주민등록번호] [Processing Government office] [처리관서]
This certifies that above adoptive relation certificate fully reflects the information in the original family relation register. But, the adoptive relation of paternal adopted child is only written on adoptive relation certificate of paternal adopted child. 위 입양관계증명서는 가족관계등록부의 기록사항과 틀림없음을 증명합니다. 단, 친양자입양관계는 친양자입양관계증명서에만 표시합니다. Day Month Year 년 월 일 Head of Heaundae District, in Busan Metropolitan City, Korea 대한민국 부산광역시 해운대 구청장

[Annex Form No.3]<Revised 2010.6.3>

Adoptive Relation Certificate of Paternal Adopted Child 친양자입양관계증명서
Permanent domicile address 등록기준지
Section 구분	Full Name 성명		Date of Birth 출생년월일		Resident Registration No. 주민등록번호		Sex 성별		Origin of Family Name 본
Self 본인
Information on paternal adopted child adoption 친양자입양사항
Section 구분		Full Name 성명		Date of Birth 출생년월일		Resident Registration No. 주민등록번호		Sex 성별		Origin of Family Name 본
Paternal adopted child 친양자
Section 구분	Details 상세내용
Adoption 입양	[Confirmed date of paternal adopted child adoption judgement] [친양자입양재판확정일] [Court of decision] [결정법원] [Paternal adopted child] [친양자] [Resident Registration No. of paternal adopted child] [친양자의 주민등록번호] [Date of report] [신고일] [Reporter] [신고인] [Processing Government office] [처리관서]
This certifies that above adoptive relation certificate fully reflects the information in the original family relation register. 위 친양자입양관계증명서는 가족관계등록부의 기록사항과 틀림없음을 증명합니다. Day Month Year 년 월 일

[Annex Form No.2]

Marital Relation Certificate 혼인관계증명서
Permanent domicile address 등록기준지
Section 구분	Full Name 성명	Date of Birth 출생년월일	Resident Registration No. 주민등록번호	Sex 성별	Origin of Family Name 본
Self 본인
Marriage Information 혼인사항
Section 구분	Full Name 성명	Date of Birth 출생년월일	Resident Registration No. 주민등록번호	Sex 성별	Origin of Family Name 본
Spouse 배우자
Section 구분	Details 상세내용
Marriage 혼인	[Date of report] Day Month Year [신고일] 년 월 일 [Spouse]Full name [배우자]이름
Divorce 이혼	[Reported date of divorce agreement] [협의이혼신고일] [Spouse] [배우자]
Marriage 혼인	[Date of report] [신고일] [Spouse] [배우자] [Resident registration No. of spouse] [배우자의 주민등록번호] [Processing government office] [처리관서]
This certifies that above marital relation certificate fully reflects the information in the original family relation register. 위 혼인관계증명서는 가족관계등록부의 기록사항과 틀림없음을 증명합니다. Day Month Year 년 월 일

[별지 제12호서식 Annex form No. 12]

국내거소이전신고서 REPORT ON ALTERATION OF DOMESTIC RESIDENCE
성	Surname	한자 漢字 Chinese characters	성별 Sex	남 M
명	Given Names	여 F
생년월일 Date of Birth		국적 Nationality		국내거소신고번호 Report No.
전거소 Former Residence in Korea
신거소 New Residence in Korea	전화번호 Tel. No.
동반가족 Dependents
관계 Relation	성 명 Name	국내거소신고번호 Report No.	비 고 Remarks
재외동포의출입국과법적지위에관한법률 제6조의 규정에 의하여 위와 같이 국내거소이전을 신고합니다. I hereby report my domestic residence as above in accordance with Article 6 of the Act on Exit & Entry and Legal Status of Overseas Koreans 신 고 일 . . . Date of Report 신고인 서명 Reporter Signature ○○출입국관리사무소장 귀하 TO : CHIEF OF ○○ IMMIGRATION OFFICE
공 용 란 For official use only
비 고		접수일자		결 재
소장
원부기재 일 자
국장
과장
처 리 과
담당

210mm×297mm

신문용지(특급) 54g/㎡

Report on alteration of domestic residence

(국내거소이전신고서)

￭ Please write surname and given names with Chinese characters.

(성과 이름(명)을 한자와 함께 쓰세요.)

￭ Please check on sex(M / F).  (성별을 체크하세요. 남/여)

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

￭ Please write nationality.  (국적을 쓰세요.)

￭ Please report No. of domestic residence.  (국내거소신고번호를 쓰세요.)

￭ Please write former residence in Korea.  (국내의 이전거소를 쓰세요.)

￭ Please write new residence in Korea with telephone No.

(국내의 신거소를 전화번호와 함께 쓰세요.)

￭ Please write relation with dependent families.

(동반가족과의 관계를 쓰세요.)

￭ Please write name and report No. of domestic residence.

(동반가족의 성명과 국내거소신고번호를 쓰세요.)

￭ Please write on section of remarks for reference information.

(참고사항을 비고란에 쓰세요.)

※ I hereby report my domestic residence as above in accordance with Article 6

of the Act on Exit & Entry and Legal Status of Overseas Koreans.

(재외동포의 출입국과 법적지위에 관한 법률 제6조의 규정에 의하여 위와 같이

국내거소이전을 신고합니다.)

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

￭ Please write name of reporter with signature.

(신고인의 성명을 쓰고 사인하세요.)

[Annexed form No.8-2] <Revision 2007.12.31>								(Front page)
□Application for protection of the seal impression □Application for cancelation of the protection of seal impression										Handling period
										Immediately
Applicant	Name (Chinese characters)		( )	Resident Registration No.					Nationality
	Address in Korea								Right fingerprinting
	Overseas address
	Reason for applying the protection of seal impression (cancellation of protection)
Consent of legal representative		Name			Resident Registration No.				Relationship with applicant
		Seal impression	Seal
		Address in Korea
		Overseas address
Confirmation of the overseas diplomatic and consular missions (consulate)․ jurisdiction office		I hereby confirm the facts checked below about the above applicant. □Application for protection of the seal impression □Application for cancelation of the protection of seal impression □Consent of legal representative ...... Day ...... Month .......... Year □ Overseas diplomatic and consular missions(Consulates) (Signature) □ Jurisdiction office(Head of office) (Seal)
I hereby apply for a protection of 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 Law for Seal Impression's Certification」.									Handling charge				Nothing
...... Day ...... Month .......... Year Applicant (Signature or seal) Proxy (Signature or seal) Resident Registration No. : Address: TO : HEAD OF SI․GU․EUP․MYEON․DONG
210mm×297mm(신문용지 54g/㎡(재활용품))

(Back page)
1. 2. 3. 4. 5. 6. 7.	※ NOTES 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. 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. 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 by 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] □ Prohibit to issue except person. □ Prohibit to issue except person and wife(○○○: resident registration No.). □ Prohibit to issue except person, wife(○○○: resident registration No.) and, mother(○○○: resident registration No.). □ Prohibit to issue in the other eup․myeon․dong(by online). □ Additional necessary contents for protection of seal impression or cancellation to protect seal impression. If it is difficult to put right fingerprint, please put left fingerprint. Fingerprint has to be put cleanly and clearly. 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. In case of application to protect or 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. Please check☑ on section of relevant matters between diplomatic office and jurisdiction office.

□Application for protecting the seal impression (인감보호신청)

□Application for cancellation of the protection of seal impression (인감보호해제신청)

□ Applicant (신청인)

￭ Please write name with Chinese characters.

(신청인의 이름을 한자와 함께 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 receive 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 주민등록증등을 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 by 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]

□ Prohibit to issue except own.

□ Prohibit to issue except own and wife(○○○: resident registration No.).

□ Prohibit to issue except own, wife(○○○: resident registration No.) and,

mother(○○○: resident registration No.).

□ Prohibit to issue in the other eup․myeon․dong(by online).

정 정 신 고 서 Report of correction
성	Surname				한자 Chinese character	성별 Sex	남 M
명	Given names						여 F
생 년 월 일 Date of birth					국 적 Nationality
정정사항 (Correction)			정정전 (Before)
			정정후 (After)	전화번호 Tel.
외국인등록번호 Registration No.					등 록 일 자 Date of registration
동반자 Dependents in Korea		성 명 Name in full
		생 년 월 일 Date of birth
		성별 Sex
		관 계 Relation
		등 록 번 호 Registration No.
		비 고 Remarks
신 고 일 Date of report . . . 신고자 성명 Signature of applicant

Report of correction

(정정신고서)

□ Applicant (신청인)

￭ Please write surname and given names. (신청인의 성명을 쓰세요.)

￭ Please write name in Chinese characters. (신청인의 성명을 한자로 쓰세요.)

￭ Please check on sex (M/F). (신청인의 성별(남/여)을 체크하세요.)

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

￭ Please write nationality. (신청인의 국적을 쓰세요.)

￭ Please write information to correct as before and after.

(정정사항을 정정전,후로 나눠 쓰세요.)

￭ Please write foreigner registration No. and date of registration.

(신청인의 외국인등록번호와 등록일자를 쓰세요.)

□ Dependents in Korea (동반자)

￭ Please write as belows about dependent person.

(동반자에 대하여 아래에 쓰세요.)

￭ Please write name in full. (동반자의 성명을 쓰세요.)

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

￭ Please write sex. (동반자의 성별을 쓰세요.)

￭ Please write relation with applicant. (신청인과의 관계를 쓰세요.)

￭ Please write registration No. (동반자의 등록번호를 쓰세요.)

￭ Please write the other information in remarks.

(비고란에 그외 사항들을 쓰세요.)

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

￭ Please write name of applicant and sign.

(신청인의 성명을 쓰고, 서명하세요.)

[Annexed form No.9] <Revision 2005.1.15> (Front page)
Report(Alteration) of seal impression [For written report]													Handling period
													Immediately
Reporter	Name (Chinese characters)		( )			Resident Registration No.					Nationality
	Address in Korea										Seal impression for report
	Overseas address										For preservation			To affix the stamp of seal impression
	Reason for written report
	Supporting evidence (Annexed)
Guarantor	Name						Resident Registration No. (Date of birth)				Relationship with reporter
	Seal impression		Seal
	Address in Korea
	Overseas address
Consent of legal representative		Name					Resident Registration No. (Date of birth)				Relationship with reporter
		Seal impression		Seal
		Address in Korea
		Overseas address
Confirmation of overseas diplomatic and consular missions (Consulate)		I hereby confirm that this is the seal impression			[□Written report(alteration)]					of the above reporter.
					[□Consent of legal representative]
		...... Day ...... Month .......... Year Overseas diplomatic and consular missions(Consulate) (Signature)
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 of Seal Impression's Certification」.												Handling charge
												Report		Nothing
												Alteration		600won
...... Day ...... Month .......... Year Reporter (Signature or seal) Address (Resident registration No.: ) Proxy ○○○ (Signature or seal) Address (Resident registration No.: ) Relation TO : HEAD OF SI․GU․EUP․MYEON․DONG
210mm×297mm(신문용지 54g/㎡(재활용품))

(Rear page)
1. 2. 3. 4. 5. 6. 7. 8. 9.	※ NOTES 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 without own's visit to certifying office. 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 card 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. The guarantor must vouch for applicant after checking true or not of real intention. 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. 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. In case of overseas nation, write the permanent domicile address on section of applicant's nationality and via(confirm) diplomatic establishment abroad(consulate) and then submit. 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. 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 residence report No. and write in the below blank( ) the resident registration No. If it is via diplomatic establishment abroad, check☑ on relevant section. ※ This report is deal with as belows.
	Declarer									One person as guarantor(in case of minor or quasi-incompetent, add to consent of legal representative).
	Report (Alteration) of Seal impression		▲		Acceptance of report
		▼
	Seal impression registration office						Confirm to contrast				▶		Register of Seal impression
						◀
							Registration(Alteration) of seal impression

Report(Alteration) of seal impression [For written report]

인감(변경)신고서[서면신고용]

□ Reporter (신고인)

￭ Please write name with Chinese characters.

(신고인의 이름을 한자와 함께 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, 인감날인하세요.)

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

￭ Please write overseas address. (보증인의 국외주소를 쓰세요.)

￭ Please write resident registration No. and date of birth.

(보증인의 주민등록번호와 생년월일을 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.(date of birth) of legal representative.

(법정대리인의 주민등록번호(생년월일)를 쓰세요.)

￭ Please write address in Korea of legal representative.

(법정대리인의 국내주소를 쓰세요.)

￭ Please write overseas address of legal representative.

(법정 대리인의 국외주소를 쓰세요.)

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

□ Confirmation of 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)의 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 of Seal Impression's Certification」.

(인감증명법」제3조 및 제7조(제13조)의 규정에 의하여 위와 같이 보증인(법정대리인)과

연서하여 서면신고 합니다.)

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

(수수료는 신고시에는 없고, 변경시에는 600원입니다.)

□ Reporter (신고인)

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

￭ Please write name of reporter and signature and seal.

(신고인의 성명을 쓰고 서명날인하세요.)

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

(신고인의 주소와 주민등록번호를 쓰세요.)

□ Proxy (대리인)

￭ Please write name of proxy and signature and seal.

(대리인의 성명을 쓰고 서명날인하세요.)

￭ Please write address and resident registration No. of proxy.

(대리인의 주소와 주민등록번호를 쓰세요.)

￭ Please write relation 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 without own's visit to

certifying office.

(이 서식은 인감을 처음 신고하거나 이미 신고한 자가 인감신고기관에 본인이 직접방

문할 수 없는 경우에 본인이 증명청을 방문하지 아니하고 서면으로 인감신고 또는 인감

변경신고를 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 card 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 진의여부를 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 overseas nation, write the permanent domicile address on section of

applicant's nationality 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 확인일

부터 3월(재외공관의 확인은 확인일 부터 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 residence report No. and write in the below

blank(    ) the resident registration No.

(재외국민의 경우에는 여권번호, 외국인의 경우에는 외국인등록번호, 국내거소 신고자의

경우에는 국내거소신고번호를 주민등록 번호란에 기재하고, 주민등록 번호는 그 아래의

여백을 이용하여 (  )안에 표기합니다. )

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

(재외공관 경유시 해당사항란에 ☑체크표시를 합니다.)

[Annexed form No.13] <Revision 2005.1.15>
□Letter of attorney for seal impression or consent of legal representative □Confirmation of diplomatic establishment abroad(consulates) and tax office
Letter of attorney		Proxy		Korean or English (Chinese characters) ( )			Resident Registration No.
		Address					Number of issuance
		Usage			Reason to delegate				Relationship
		I hereby delegate the above person to receive a certification of seal impression on my behalf. ...... Day ...... Month .......... Year Mandator: Seal (Resident Registration No. - ) Address:
Consent of legal representative			I hereby consent to be issued with a certification on behalf of (name: ).					Number of issuance
			...... Day ...... Month .......... Year Legal representative: (Resident Registration No. - ) Relation:
			Address:					Seal impression
Confirmation of head of overseas diplomatic and consular mission			I hereby confirm the above delegation facts. ...... Day ...... Month .......... Year Overseas diplomatic and consular missions (Consulates) Signature
Confirmation of tax office's superintendent			Type of real estate
			Location of real estate
			I hereby confirm the above facts. ...... Day ...... Month .......... Year Superintendent of Tax Office Seal
	※ NOTES 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. If you want to issue more over 2sets, please write on the letter of attorney or consent's issuing number section. 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 kind 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. 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. 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)]. 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「Criminal Law」. Person who want to be issued by proxy, please apply after sealing own's.
10mm×297mm(신문용지 54g/㎡(재활용품))

□Letter of attorney for seal impression or consent of

legal representative (인감증명 위임장 또는 법정대리인 동의서)

□Confirmation of diplomatic establishment abroad (Consulate)

and 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.)

체류지변경신고서 Report on alteration of residence
성	Surname		한 자 Chinese characters		성별 Sex	남 M
명	Given names					여 F
생 년 월 일 Date of birth				국 적 Nationality
전 체 류 지 Former address
신 체 류 지 New address			전화번호 Tel
외국인등록번호 Registration NO.				등 록 일 자 Date of registration
동 반 자 Dependents in Korea		성 명 Name in full
		생 년 월 일 Date of birth
		성 별 Sex
		관 계 Relation
		등 록 번 호 Registration No.
		비 고 Remarks
신고일 Date of report . . . 신고자 성명 Signature of applicant
위와 같이 체류지 변경신고를 하였음을 증명합니다. I hereby certify that the report on alteration of residence has made as above. 년 월 일 Date 해 운 대 구 청 장 □ Head of Haeundae District

Report on alteration of residence

(체류지 변경신고서)

□ Applicant (신청인)

￭ Please write surname and given names. (신청인의 성명을 쓰세요.)

￭ Please write name in Chinese characters. (신청인의 성명을 한자로 쓰세요.)

￭ Please check on sex (M/F). (신청인의 성별을 체크하세요.)

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

￭ Please write nationality. (신청인의 국적을 쓰세요.)

￭ Please write former address. (신청인의 전주소를 쓰세요.)

￭ Please write new address and tel. No.

(신청인의 새로운 주소와 전화번호를 쓰세요.)

￭ Please write foreigner registration No. and date of registration.

(신청인의 외국인등록번호와 등록일자를 쓰세요.)

□ Dependents in Korea (동반자)

￭ Please write information of dependent person as belows.

(동반자에 대하여 아래에 쓰세요.)

￭ Please write name in full. (동반자의 성명을 쓰세요.)

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

￭ Please write sex. (동반자의 성별을 쓰세요.)

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

￭ Please write registration No. (동반자의 등록번호를 쓰세요.)

￭ Please write other information in remarks.

(비고란에 그 외의 사항들을 쓰세요.)

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

￭ Please write name of applicant and sign.

(신청인의 성명을 쓰고, 서명을 하세요.)

※ I hereby certify that the report on alteration of residence has made

as above.     (위와 같이 체류지 변경신고를 하였음을 증명합니다.)

위 임 장 Letter of Attorney
위임자 Mandator	성명 Name				외국인등록번호 Foreigner Registration No.	-
	주소 및 연락처 Address & Contact No.				☎)
대리인 Proxy	성명 Name				주민(외국인)등록번호 Resident(Foreigner) Registration No.		-
	주소 및 연락처 Address & contact No.				☎)
위임자와 대리인의 관계 Relationship between mandator and proxy
사용용도 Usage
위임할 내용 Contents to Delegate				☐ 체류지 변경신고 Report on alteration of residence ☐ 국내거소이전신고 Report on alteration of domestic residence
출입국관리법 시행규칙 75조 및 공공기관의 개인정보보호에 관한 법률 제10조의 규정에 따라 위와 같이 증명원 신청 및 발급에 관한 권리와 의무를 대리인에게 위임합니다. In accordance with Article 75 of the Enforcement Regulation of Immigration Control Act and Article 10 of the Regulation of Law about Privacy Information Protection in government office, I hereby delegate to proxy the rights and the duties regarding the application and issuance of the certificate as above. 년 월 일 Day Month Year 위임하는 사람 (인) Mandator (Seal) 해 운 대 구 청 장 귀하 To. Head of Haeundae District
유의사항 및 첨부서류 Instructions and Required Documents
1. 사문서위조 또는 기타 부정한 방법으로 공공기관으로부터 처리정보를 열람 또는 제공받은 자는 2년 이하의 징역 또는 700만원 이하의 벌금에 처해집니다. Person who is browsed or offered processing information from government office by forgery of private document or by illegal method shall be sentenced to less than 2 years' imprisonment or a fine of less than seven millions won. 2. 첨부서류 Required documents. 가. 위임하는 사람의 신분증( 외국인등록증), 혼인관계증명서(배우자가 외국인일 경우) Identification card(Alien registration card) of person to delegate, certificate of marital relation (If his/her spouse is foreigner,). 나. 미성년이어서 위임하는 부모와 자녀와의 가족증명이 필요한 경우 의료보험증 또는 출생증명서 등 가족관계 입증서류 제시 Documentary evidence (medical insurance, birth certificate etc.) that shows the family relationship (if an applicant is a minor and a proxy/representative is his/her parents). 다. 대리인의 신분증 지참하여 제시 Please submit identification card of proxy/representative.

Letter of Attorney

(위 임 장)

▷ Mandator  위임자

- Please write the name of mandator.

위임자의 이름을 기재해 주세요.

- Please write the foreigner registration number of mandator.

위임자의 외국인등록번호를 기재해 주세요.

- Please writer the address and phone number of mandator.

위임자의 주소와 전화번호를 기재해 주세요.

▷ Proxy  대리인

- Please write the name of proxy.

대리인의 이름을 기재해 주세요.

- Please write the foreigner registration number of proxy.

대리인의 외국인등록번호를 기재해 주세요.

- Please write the address and phone number of proxy.

대리인의 주소와 전화번호를 기재해 주세요.

▷ Relationship between a mandator and a proxy.

위임자의 대리인의 관계

- Please write the relationship between a mandator and a proxy.

위임자의 대리인의 관계를 기재해 주세요.

▷ Usage  사용용도

- Please write the usage of letter of attorney.

위임장의 사용용도를 기재해 주세요.

▷ Contents to delegate  위임할 내용

- Please select the contents to delegate.

위임할 내용을 선택하세요.

□ In accordance with Article 75 of the Enforcement Regulation of

Immigration Control Act and Article 10 of the Regulation of Law about

Privacy Information Protection in government office, I hereby delegate to

proxy the rights and the duties regarding the application and issuance of

the certificate as above.

출입국관리법 시행규칙4 75조 및 공공기관의 개인정보보호에 관한 법률

제10조의 규정에 따라 위와 같이 증명원 신청 및 발급에 관한 권리와 의무를

대리인에게 위임합니다.

- Please write the writing date.

작성 일자를 기재해 주세요.

- Please write the mandator's name and put the his/her seal.

위임하는 사람의 이름과 날인해 주세요.

Instructions and Required Documents

1. Person who browsed or offered processing information from government office by forgery of private document or unlawful method is sentenced fewer than 2 years or fewer than 7 million won.

사문서위조 또는 기타 부정한 방법으로 공공기관으로부터 처리정보를 열람 또는 제공 받은 자는 2년 이하의 징역 또는 700만원 이하의 벌금에 처해집니다.

2. Required documents  첨부 서류

A. Mandator's identification card (or certificate of foreigner registration),

certificate of marital relation (If his/her spouse is foreigner).

위임하는 사람의 신분증 (외국인등록증), 혼인관계증명서(배우자가 외국인일 경우)

B. Documentary evidence (medical insurance, birth certificate etc.) that shows the family relationship (if an applicant is a minor and a representative is his/her parents).

미성년이어서 위임하는 부모와 자녀와의 가족증명이 필요할 경우 의료보험증 또는    출생증명서 등 가족관계 입증서류 제시

C. If a representative/proxy visits, then a representative/proxy's identification card. 대리인의 신분증 지참하여 제시

[별지 서식 Annexed form.1]

사실증명 발급신청서 Application form for issuance of Certification of Fact
접수일자 Date of Receipt		발급번호Issuance No.		발급일자Issuance date		처리기간Handling period	즉시Immediately
증명종류 Type of certification	[ ] 출입국에 관한 사실증명 Certification of Fact for immigration [ ] 외국인등록사실증명 Certification of Fact for foreigner registration
증명발급 대상자 Person to be issued the certification	성명 Name	주민등록번호 Resident Registration No. (외국인등록번호) (Foreigner Registration No.)
주소 Address
※ 출입에 관한 사실증명의 영문성명 병기신청(한국인) Application to receive Certificate of fact for immigration with English name written on it. (In case of Korean) : [ ]병기하지 않음 Don't write with [ ]병기함 Write with (신청인이 발급대상자로부터 위임을 받은 경우 위임장을 첨부하여 주십시오.) (If the applicant is a proxy, please attach the letter of attorney.)
용도 Usage		발급통수 Number to be issued	통 set	제출처 Place of submission
신청인 Applicant	성명 Name	주민등록번호 Resident Registration No. 외국인등록번호(Foreigner Registration No.)
전화번호 Tel. No.	대상자와의 관계 Relationship
주소 Address
「출입국관리법」 제88조 및 동법시행규칙 제75조의 규정에 따라 출입국에 관한 사실증명(외국인등록사실증명)의 발급을 신청합니다. I hereby apply for a Certification of fact for immigration purposes in accordance with Article 88 of the Rule of「Immigration Control Law」 and Article 75 of the Enforcement Regulation of the same Law .
년 월 일장 ...... Day ...... Month .......... Year장
	신청인 Applicant		(서명 또는 인) (Signature or seal)
유의사항 Notes
1. 사실증명의 발급 신청은 본인이나 그 법정대리인 또는 그로부터 위임을 받은 자에 한합니다. To apply the issuance of the Certification of Fact is only own and the legal representative or the person to be delegated by him. 2. 아래의 경우 위 제1호의 규정에도 불구하고 사실증명의 발급을 신청할 수 있습니다. In case of belows, despite the rule of above No.1, can apply to issue the Certification of Fact. - 행방불명, 사망 등으로 본인이 의사표시를 할 수 없는 상태에 있거나 명백하게 본인의 이익을 위해 사용될 것으로 인정되는 경우 : 본인의 배우자 또는 그 직계 존․비속 When the person can't express own's intention according to missing, death and etc. or it is recognized clearly to be used in purpose of own's profit :Own's spouse or the lineal ascendant and descendant. - 본인인 외국인이 완전 출국한 경우 : 본인인 외국인을 고용하였던 자 또는 그 대리인 When own, that is, the foreigner left a country fully : The employer of own, that is, the foreigner or the proxy. - 그 밖에 법무부장관이 공익상 필요하다고 인정하는 자 The other person who the Minister of justice recognize to need for public interest. 3. 본인이 직접 증명발급을 신청하는 경우 신청서를 작성하지 않고 신분증만 제시하면 됩니다. When own applies to issue the certification directly, can submit only identification card without making the application form. 4. 위임을 받은 경우 신청인의 신분증, 위임장, 위임한 자의 신분증(사본)을 제출하여야 합니다. In case to be delegated, must submit the identification card of the applicant, the letter of attorney and the copy of identification card of the person to delegate.
210㎜×297㎜[일반용지(2급) 60g/㎡]

Application form for issuing the fact certification

(사실증명 발급신청서)

□ Type of certification (증명의 종류)

￭ Please check on type of certification to issue.(발급할 증명의 종류에 체크하세요.)

[  ]Certification of Fact for immigration (출입국에 관한 사실증명)

[  ]Certification of Fact for foreigner registration (외국인등록사실증명)

□ Person to be issued the certification (증명발급대상자)

￭ Please write name and address of person to be issued the certification.

(증명발급대상자의 이름과 주소를 쓰세요.)

￭ Please write resident registration No.(foreigner registration No.) of person to be  issued the certification.

(증명발급대상자의 주민등록번호(외국인등록번호)를 쓰세요.)

※ (In case of Korean) Please check to receive Certification of fact for

immigration with English name on written on it.

(  )Don't write with  (  )Write with

(출입에 관한 사실증명의 영문성명 병기신청에 체크하세요.(한국인의 경우만)

(  )병기하지 않음  (  )병기함)

(If the applicant is a proxy, please attach the letter of attorney.)

(신청인이 발급대상자로부터 위임을 받은 경우 위임장을 첨부하여 주십시오.)

￭ Please write usage of certification. (증명서의 사용용도를 쓰세요.)

￭ Please write numbers of issuance. (증명서의 발급통수를 쓰세요.)

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

□ Applicant (신청인)

￭ Please write applicant's name and resident registration No.(foreigner registration No.)      (신청인의 성명과 주민등록번호(외국인등록번호)를 쓰세요.)

￭ Please write applicant's tel No. and relationship with person to be

issued. (신청인의 전화번호와 신청인과 대상자와의 관계를 쓰세요.)

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

※ I hereby apply for a Certification of Fact for immigration purposes in accordance  with Article 88 of the Rule of「Immigration Control Law」 and Article 75 of the  Enforcement Regulation of the same Law .

(출입국관리법」제88조 및 동법시행규칙 제75조의 규정에 따라 출입국에 관한

사실증명(외국인등록사실증명)의 발급을 신청합니다.)

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

￭ Please signature and sign of applicant. (신청인의 서명날인하세요).

□ NOTES 유의사항

1. To apply the issuance of the Certification of Fact is only own and the

legal representative or the person to be delegated by him.

(사실증명의 발급 신청은 본인이나 그 법정대리인 또는 그로부터 위임을 받은 자에

한합니다.)

2. In case of belows, despite the rule of above No.1, can apply to issue the     Certification of Fact.

(아래의 경우 위 제1호의 규정에도 불구하고 사실증명의 발급을 신청할 수 있습니다.)

￭ When the person can't express own's intention according to missing, death

and etc. or it is recognized clearly to be used in purpose of own's profit :

Own's spouse or the lineal ascendant and descendant.

(행방불명, 사망 등으로 본인이 의사표시를 할 수 없는 상태에 있거나 명백하게 본인의

이익을 위해 사용될 것으로 인정되는 경우 : 본인의 배우자 또는 그 직계 존․비속)

￭ When own, that is, the foreigner left a country fully : The employer of own,

that is, the foreigner or the proxy.

(본인인 외국인이 완전 출국한 경우 : 본인인 외국인을 고용하였던 자 또는 그 대리인)

￭ The other person who the Minister of justice recognize to need for public interest.

(그 밖에 법무부장관이 공익상 필요하다고 인정하는 자)

3. When own applies to issue the certification directly, can submit only identification

card without making the application form.

(본인이 직접 증명발급을 신청하는 경우 신청서를 작성하지 않고 신분증만 제시하면

됩니다.)

4. In case to be delegated, must submit the identification card of the applicant,

the letter of attorney and the copy of identification card of the person to delegate.

(위임을 받은 경우 신청인의 신분증, 위임장, 위임한 자의 신분증(사본)을 제출 하여야  합니다.)

사실증명 발급신청에 대한 위임장 Letter of attorney for issuance of Certification of Fact
증명종류 Type of certification	[ ]출입국에 관한 사실증명 Certification of Fact for immigration [ ]외국인등록사실증명 Certification of Fact for foreigner registration
위임하는 사람 (발급대상자) Mandator (Person to be issued)	성명 Name			주민등록번호 Resident registration No. 외국인등록번호 (Foreigner registration No.)
	주소 Address
용도 Usage		발급통수 Number to be issued	통 set	제출처 Place of submission
위임받는 사람 (신청인) Proxy (Applicant)	성명 Name			주민등록번호 Resident Registration No. 외국인등록번호 (Foreigner Registration No.)
	전화번호 Tel. No.
	주소 Address
출입국관리법」 제88조 및 동법시행규칙 제75조의 규정에 따라 출입국에 관한 사실증명(외국인등록사실증명)의 발급신청 및 수령에 관하여 위와 같이 위임합니다. I hereby delegate to the proxy the right to be issued and to receive the Certification of Fact for immigration(the Certification of Fact for foreigner registration) in accordance with Article 88 of the rule 「 Immigration control Law 」 and Article 75 of the Enforcement Regulation of same Law.
년 월 일장 ...... Day ...... Month .......... Year
			위임하는 사람 Mandator		(서명 또는 인) (Signature or seal)
유의사항 Notes
1. 위임한 사람의 신분증사본을 첨부하셔야 합니다. Please attach the copy of identification card of mandator. 2. 위임장은 작성한 날로부터 30일까지만 유효합니다. The letter of attorney is valid till 30days only from making day. 3. 다른 사람의 서명 또는 인장의 도용 등으로 허위의 위임장을 작성하여 증명서를 신청 또는 수령한 경우에는 관련 법률에 따라 처벌 받을 수 있습니다. To apply or receive the certification after making false letter of attorney with forging the signature or seal of the other person, can be punished according to relevant law.
210㎜×297㎜[일반용지(2급) 60g/㎡]

[별지 서식 Annexed form.2]

Letter of attorney for issuance

the Certification of Fact

(사실증명 발급신청에 대한 위임장)

□ Type of certification (증명의 종류)

￭ Please check on type of certification to issue.

(발급할 증명의 종류에 체크하세요.)

[  ]Certification of Fact for immigration (출입국에 관한 사실증명)

[  ]Certification of Fact for foreigner registration (외국인등록사실증명)

□ Mandator (Person to be issued) (위임하는 사람(발급대상자))

￭ Please write name and address of mandator(person to be issued).

(위임하는 사람(발급대상자)의 이름과 주소를 쓰세요.)

￭ Please write resident registration No.(foreigner registration No.) of mandator

(person to be issued).

(위임하는 사람(발급대상자)의 주민등록번호(외국인등록번호)를 쓰세요.)

￭ Please write usage of certification. (증명서의 사용용도를 쓰세요.)

￭ Please write numbers of issuance. (증명서의 발급통수를 쓰세요.)

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

□ Proxy (Applicant) (위임받은 사람 (신청인))

￭ Please write name of proxy (applicant).

(위임받은 사람(신청인)의 성명을 쓰세요.)

￭ Please write resident registration No.(foreigner registration No.) of proxy

(applicant). (위임받은 사람(신청인)의 주민등록번호(외국인등록번호)를 쓰세요.)

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

(위임받은 사람(신청인)의 전화번호를 쓰세요.)

￭ Please write address of proxy (applicant).

(위임받은 사람(신청인)의 주소를 쓰세요.)

※ I hereby delegate to the proxy the right to be issued and to receive the Certification

of Fact for immigration(the Certification of Fact for foreigner registration) in accordance

with Article 88 of the Rule 「Immigration Control Law」 and Article 75 of the Enforcement Regulation of the same Law.

(「출입국관리법」 제88조 및 동법시행규칙 제75조의 규정에 따라 출입국에 관한 사실

증명(외국인등록사실증명)의 발급신청 및 수령에 관하여 위와 같이 위임합니다.)

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

￭ Please signature and sign of person to delegate(person to be issued).

(위임하는 사람(발급대상자)의 서명날인하세요.)

□ NOTES 유의사항

1. Please attach the copy of identification card of mandator.

(위임한 사람의 신분증사본을 첨부하셔야 합니다. )

2. The letter of attorney is valid till 30days only from making day.

(위임장은 작성한 날로부터 30일까지만 유효합니다.)

3. To apply or receive the certification after making false letter of attorney with        pirating the signature or seal of the other person, can be punished according to relevant law.

(다른 사람의 서명 또는 인장의 도용 등으로 허위의 위임장을 작성하여 증명서를

신청 또는 수령한 경우에는 관련 법률에 따라 처벌 받을 수 있습니다.)

[Annex No.7 form] <Revision 2010.8.9>
Application for inspection of resident registration table or for issuance of certified copyㆍabstract
※ Please write after reading the notes overleaf and check(√) the relevant spaces[ ]. (Front page)
Applicant (Individual)	Name			(Seal or signature)			Resident Registration No.
	Address
	Relationship with subject						Tel. No.
	Those exempt from any handling charge [ ]Qualified recipient of national basic living stipend [ ]National patriot or veteran [ ]Other ( )
Applicant (Corporation)	Name of institution						Business license No.
	Representative			(Seal or signature)			Main contact No.
	Location
	Name of visitor		Resident Registration No.				Position	Tel. No.
Subject of inspection or issuance of certified copyㆍabstract	Name						Resident Registration No.
	Address [Name of administrative agency : ]
Contents of application	Inspection	[ ]Records of certified copy [ ]Records of abstract
	※ In order to protect personal information, only fill out the parts you need on in records of below certified copyㆍabstract. If you don't select any, the ones marked in bold will be automatically "Included".
	Issuance of certified copy [ ] sets	1. Address fluctuated records of past [ ]Included all [ ]Included the last five year [ ]Not included
		2. Reason of household constitution [ ]Included [ ]Not included
		3. Relationship with householder and constituent [ ]Included [ ]Not included
		4. Moving house date of constituent / Date of change, Reason of change [ ]Included [ ]Not included
		5. Name of the other constituent except applicant [ ]Included [ ]Not included
		6. The last digits of resident registration No. of the other constituent except applicant [ ]Included [ ]Not included
		7. Cohabitant [ ]Included [ ]Not included
		8. Foreigner spouse [ ]Included [ ]Not included
	Issuance of abstract [ ] sets	1. Changed contents of personal information [ ]Included [ ]Not included
		2. Address fluctuation records of past [ ]Included all [ ]Included the last five year [ ]Not included
		3. Name and relationship of householder in address fluctuation records of past [ ]Included [ ]Not included
		4. Military service details [ ]Included [ ]Not included
Usage and object						Place of submission
Evidential matters
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」.
Day Month Year
TO : Head of siㆍgunㆍgu or eupㆍmyeonㆍdong and local office
210㎜×297㎜[General paper 60g/㎡(Recycled)]

.
(Back page)
Attached documents (We will give you back after confirmation)	1. Identification card 2. In case of corporate visitor, office badge or proof of employment status of visitor required 3. In case of being exempt from handling charges, please provide necessary evidential documents				Handling charge
NOTES
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 or English name on the 「Electronic Image Sign Input」. 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. When you apply for a issuance of 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). When you apply for a issuance of the abstract, the section of name of householder and relationship 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 the「Law of Resident Registration」, in case of public necessary by nation or local government. 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. Visitor of corporation must submit office badge(or proof of employment) and identification card. 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. In accordance with article 37 section 5 of the 「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. If same applicant inspects resident registration table of several person or applies for issuance of the certified copyㆍabstract in accordance with same evidential documents with same object, can apply for a usage of the 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.
Receipt No.		Receipt date	InspectionㆍIssuance date
Application receipt of inspection of resident registration table or issuance of certificated copyㆍabstract
Receipt No.		Receipt date	Name of applicant
Head of siㆍgunㆍgu or eupㆍmyeonㆍdong and local office				(Official seal)
* The filling receipt is issued only if it isn't handled immediately by online obstacle and etc.
210㎜×297㎜[General paper 60g/㎡(Recycled)]

Application for inspection of resident registration

table or for issuance of certified copyㆍabstract

(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(Corporation) 신청인(법인)

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

(신청인(법인)의 기관명을 쓰세요.)

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

(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(Corporation). (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 신청

할 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.

[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 신

고인에게 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 2010.8.4> [별지 제34호서식] <개정 2010.8.4>				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
Reporter (Withdrawer) 신고(철회)인	Name 성명						Relationship (In case of loss report) 분실자와의 관계
	Resident Registration No. 주민등록번호						Tel. No. 전화번호
	Address 주소
Loser 분실자	Name (Korean or English) 성명(한글)						Name (Chinese characters) 성명(한자)
	Resident Registration No. 주민등록번호						Tel. No. 전화번호
	Address 주소
Contents to report (withdrawal) 신고(철회) 내용	Date of loss 분실일자			Place of loss 장소
	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					(Seal or signature) (서명 또는 인)
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

□ Reporter(Withdrawer) 신고(철회)인

￭ Please write name of reporter(withdrawer).

(신고(철회)인의 성명을 쓰세요.)

￭ 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. and address of reporter(withdrawer).

(신고(철회)인의 전화번호와 주소를 쓰세요.)

□ Loser 분실자

￭ Please write name in Korean or English of loser.

(분실자의 한글 성명을 쓰세요.)

￭ Please write name in Chinese characters of loser.

(분실자의 한자 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 place of loss(withdrawal). 분실(철회)장소를 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.

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

(신고(철회)인의 성명과 함께 서명날인을 하세요.)

□ 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.9] <Revision 2010.8.9>
Letter of attorney for inspection of resident registration table or for issuance of certified copyㆍabstract
※ Please write after reading rear notes and mark on relevant [ ] as √. (Front page)
Proxy (Applicant)	Name					Resident Registration No.
	Address
	Tel. No.					Relationship with subject
Mandator (Subject inspection or issuance of certified copyㆍabstract)	Name					Resident Registration No.
	Address
	Tel. No.					Name of householder
	Being subject to the exemption of handling charge [ ]Qualified recipient for national basic living [ ]Subject of patriots and veterans affairs [ ]Subject of the other ( )
Contents of delegation (Contents of application)		Inspection		[ ]Records of certified copy [ ]Records of abstract
		※ In order to protect personal information, can apply only necessary records by selection in records of below certified copyㆍabstract. If you don't mark on selection records, can receive only "Included" records in bold.
		Issuance of certified copy [ ] set		1. Address change records of past [ ]Included all [ ]Included the last five year [ ]Not included
				2. Reason of household make-up [ ]Included [ ]Not included
				3. Relationship with householder and members [ ]Included [ ]Not included
				4. Date of moving house of members / Date of change, Reason of change [ ]Included [ ]Not included
				5. Name of the other members except subject to issue [ ]Included [ ]Not included
				6. The last digits of resident registration No. of the other members except subject to issue [ ]Included [ ]Not included
				7. Cohabitant [ ]Included [ ]Not included
				8. Foreigner spouse [ ]Included [ ]Not included
		Issuance of abstract [ ] set		1. Changed contents of personal information [ ]Included [ ]Not included
				2. Address change records of past [ ]Included all [ ]Included the last five year [ ]Not included
				3. Name and relationship with householder in address change records of past [ ]Included [ ]Not included
				4. Military service details [ ]Included [ ]Not included
Usage and purpose
I hereby delegate as above to apply for a inspection of the resident registration table or issuance of certified copyㆍabstract in accordance with Article 29 Section 2 of the 「Law of Resident Registration」.
					Day Month Year
Mandator					(Seal or signature)
TO : Head of siㆍgunㆍgu or eupㆍmyeonㆍdong and local office
Attached documents (We will give you back after confirmation)			1. Identification card of applicant(Proxy) 2. Identification card of mandator(In case of requirement the public servant in charge for confirmation the truth) 3. The necessary evidential documents in case of being subject to the exemption of handling charge				Handling charge
210㎜×297㎜[일반용지 60g/㎡(재활용품)]

(Rear page)

NOTES

If you apply for a false letter or attorney by forgery or illegal usage of signature or seal of other person, you shall be punished in accordance with「Criminal Law」.

Applicant can apply for a selection of the "Included", "Not included" of each item on section "Contents of delegation(contents of application)", if you don't select, only deal with the marked "Included" records in bold.

If you apply for inspection of the resident registration table or for a issuance of the certified copyㆍabstract in accordance with this letter of attorney, must write name, resident registration No., name of householder and address of person to delegate. If the written contents are not exact, can be required to complement.

The mandator must seal or signature on section of "Seal or signature" and can't use fingerprint. In case of signature, must write the handwriting name(Korean or English) and can't use normal sign(foreign, special letter and etc.) or Chinese characters.

If the public servant in charge requires to submit the identification card and confirmation evidential documents of subject to the exemption of handling charge of the person to delegate in order to confirm the truth of letter of attorney, you have to submit them.

210㎜×297㎜[General paper 60g/㎡(Recycled)]

Letter of attorney for inspection of resident registration table or for issuance of certified copyㆍabstract

(주민등록표 열람 또는 등ㆍ초본 교부 신청 위임장)

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

(뒤쪽의 유의사항을 읽고 작성하여 주시기 바라며, [  ]에는 해당되는 곳에 √

표를 합니다.)

□ Proxy (Applicant) 위임 받은 사람(신청인)

￭ Please write name of the proxy(applicant).

(위임 받은 사람(신청인)의 성명을 쓰세요.)

￭ Please write resident registration No. of the proxy(applicant).

(위임 받은 사람(신청인)의 주민등록번호를 쓰세요.)

￭ Please write address of the proxy (applicant).

(위임 받은 사람(신청인)의 주소를 쓰세요.)

￭ Please write telephone No. of the proxy (applicant).

(위임 받은 사람(신청인)의 전화번호를 쓰세요.)

￭ Please write relationship with subject and the proxy (applicant).

(대상자와 위임 받은 사람(신청인)과의 관계를 쓰세요.)

□ Mandator (Subject inspection or issuance of certified copyㆍabstract)

위임한 사람(열람 또는 등ㆍ초본교부 대상자)

￭ Please write name of the mandator (subject inspection or issuance of certified

copyㆍabstract).

(위임한 사람(열람 또는 등ㆍ초본교부 대상자)의 성명을 쓰세요.)

￭ Please write resident registration No. of the mandator (subject inspection or

issuance of certified copyㆍabstract).

(위임한 사람(열람 또는 등ㆍ초본교부 대상자)의 주민등록번호를 쓰세요.)

￭ Please write address of the person to delegate(Subject inspection or issuance

of certified copyㆍabstract).

(위임한 사람(열람 또는 등ㆍ초본교부 대상자)의 주소를 쓰세요.)

￭ Please write telephone No. of the mandator (subject inspection or issuance of

certified copyㆍabstract).

(위임한 사람(열람 또는 등ㆍ초본교부 대상자)의 전화번호를 쓰세요.)

￭ Please write name of householder of the mandator (subject inspection or

issuance of certified copyㆍabstract).

(위임한 사람(열람 또는 등ㆍ초본교부 대상자)의 세대주의 성명을 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

□ Contents to be delegated(Contents to be applied)위임 내용(신청 내용)

￭ 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.

※ I hereby delegate as above to apply for a inspection of the Resident Registration Table or issuance of certified copyㆍabstract in accordance with Article 29 Section 2 of the 「Law of Resident Registration」.

(「주민등록법」 제29조제2항에 따라 주민등록표 열람 또는 등ㆍ초본 교부 신청을

위와 같이 위임합니다.)

￭ Please write the date of application. 신청일을 쓰세요.

￭ Please write name with seal or signature of the mandator.

(위임한 사람의 성명을 서명 또는 인과 함께 쓰세요.)

□ Attached documents 첨부서류

(We will give you back after confirmation.)

1. Identification card of applicant(proxy)

(신청인(위임받은 사람)의 주민등록증 등 신분증명서)

2. Identification card of the mandator

(위임한 사람의 주민등록증 등 신분증명서)

(In case of requirement the public servant in charge for confirmation the truth)

(담당 공무원이 위임장의 진위 여부 확인을 위하여 요청하는 경우)

3. The necessary evidential documents in case of being exempt from any handling

charges (위임한 사람이 수수료 면제 대상자인 경우는 필요한 증명자료)

□ NOTES 유의 사항

1. If you apply to make false letter or attorney by forgery or illegal usage of

signature or seal of other person, you shall be punished in accordance with「Criminal Law」.

(다른 사람의 서명 또는 도장 등을 위조하거나 부정하게 사용하는 등의 방법으로

거짓의 위임장을 작성하여 신청하는 경우에는「형법」에 따라 처벌을 받게 됩니다.)

2. Applicant can apply by selection "Included", "Not included" of each item on

section "Contents of delegation(contents of application)", if you don't select, only

deal with the marked "Included" records in bold.

(신청인은 “위임내용(신청내용)”란의 각 항목에 대하여 “포함”, “‘미포함”을 선택하여

신청할 수 있으며, 선택하지 않은 경우에는 “포함”으로 굵게 표시된 사항만 “포함”으로

처리됩니다.)

3. If you apply to inspect of resident registration table or to issue the certified

copyㆍabstract in accordance with this letter of attorney, must write name,

resident registration No., name of householder and address of person to delegate.

If the written contents are not exact, can be required to complement.

(이 위임장에 따라 주민등록표의 열람 또는 등ㆍ초본 교부를 신청하는 경우에는

위임한 사람의 성명, 주민등록번호, 세대주 성명 및 주소를 정확히 적어야 하며,

기재사항이 정확하지 않을 경우 보완을 요청할 수 있습니다.)

4. The mandator must seal or signature on section of "Seal or signature" and can't

use fingerprint. In case of signature, must write the handwriting name(Korean)

and can't use normal sign(foreign, special letter and etc.) or Chinese characters.

(위임한 사람은 “서명 또는 인”란에 서명을 하거나 도장을 찍어야 하며 지문은   사용할 수 없습니다. 서명을 하실 경우에는 자필 성명(한글)을 써야 하고, 통상적인 사인(외국어, 특수문자 등)이나 한문 등은 사용할 수 없습니다.)

5. If the public servant in charge requires to submit the identification card and

confirmation evidential documents of those exempt from any handling charges

of the mandator in order to confirm the truth of letter of attorney, you have

to submit them.

(담당 공무원이 위임장의 진위를 확인하기 위하여 위임한 사람의 주민등록증 등        신분증명서와 수수료 면제대상 확인 증명자료를 요구할 경우에는 제시해야 합니다.)

Annex form No.30] <Revision 2010.8.4> 별지 제30호서식] <개정 2010.8.4>
Issuance Application for Resident Registration Card 주민등록증 발급 신청서
※ Please complete after reading the notes on the other side and the section on how to fill out the form, check √ in the box [ ] of each relevant section. 뒤쪽의 유의사항과 작성방법을 읽고 작성하여 주시기 바라며, [ ]에는 해당되는 곳에 √표를 합니다. (Front page) (앞 쪽)
Receipt No. 접수번호	Receipt date 접수일	Handling period 처리기간 Immediately 즉시
Photo사진 (Man남자) (3cm×4cm)	Name(Korean or English) 성명(한글)	Name(Chinese characters) 성명(한자)	Photo 사진 (Woman 여자) (3cm×4cm)
Resident Registration No.주민등록번호	Name of householder 세대주 성명
Address 주소
Permanent domicile address 등록기준지
Blood type 혈액형	Special technique 특수기술
Telephone No. 전화번호	Mobile Phone No. 휴대전화번호
Application contents 신청내용	Confirmation sheet of application for issuance of resident registration card 주민등록증 발급 신청 확인서	[ ] Issuance 교부	[ ] No issuance 미교부
Receiving method of resident registration card 주민등록증 수령 방법	[ ]By visiting the Office of Resident Registration 주민등록기관 방문	[ ]By registered mail 등기우편
Receipt address of the registered mail (Zip code - ) 등기우편 수령 주소 (우 - )
Confirmation of Identity 본인 확인	Responsible civil servant 담당 공무원	Head of the tongㆍ Head of a village 통장ㆍ이장	Family 가족	Relevant documents confirming identity 소명 관계 서류
				Day Month Year 년 월 일
			Applicant 신청인		(Seal or signature) (서명 또는 인)
Roll the fingers of your left hand 왼손 회전 지문 (Size of each space 각 칸의 크기 : Width가로 4㎝ × Length세로 3㎝)
Index finger 둘째손가락	Middle finger 셋째 손가락	Ring finger 넷째 손가락	Little finger 다섯째 손가락	Thumb 첫째손가락
Roll the fingers of your right hand 오른손 회전 지문 (Size of each 각 칸의 크기 : Width 가로 4㎝ × Length 세로 3㎝)
Index finger 둘째손가락	Middle finger 셋째 손가락	Ring finger 넷째 손가락	Little finger 다섯째 손가락	Thumb 첫째손가락
Left thumb print(Don't roll) 왼손 엄지 평면	Left hand four fingers together 왼손 4지 평면 (Width 가로 7.1㎝ × Length 세로 5.5㎝)	Right hand four fingers together 오른손 4지 평면 (Width 가로 7.1㎝ × Length 세로 5.5㎝)	Right thumb print 오른손 엄지 평면
210㎜×297㎜[file paper파일지 170g/㎡]

(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/㎡]

Issuance application for resident registration card

(주민등록증 발급 신청서)

※ Please complete after reading the notes on the other side and the section on how to fill out the form, check √ in the box [  ] of each relevant section.

(뒤쪽의 유의사항과 작성방법을 읽고 작성하여 주시기 바라며, [ ]에는 해당되는 곳에

√표를 합니다. )

□ 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 "Visitation to office for 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 발급신청 기관은 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 신청인에 보완을 요구할 수 있습니다.)

￭ Please affix man's photo on left of application form.

(신청서 왼쪽에는 남자사진을 붙이세요.)

￭ Please affix woman's photo on right of application form.

(신청서 오른쪽에는 여자사진을 붙이세요.)

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

□ How to fill out the form 작성방법

※ 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.)

￭ Please write applicant's name in Chinese characters. (신청자의 성명을 한자로 쓰세요.)

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

￭ Please write householder's name. 세대주의 성명을 쓰세요.

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

￭ Please write applicant's permanent domicile address.

(신청자의 등록기준지를 쓰세요.)

￭ Please write applicant's blood type. 신청자의 혈액형을 쓰세요.

￭ Please write applicant's special technique. 신청자의 특수기술을 쓰세요.

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

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

□ How to fill out the form 작성방법

※ In case of receiving by "Registered mail", the resident registration card is dispatched as written address on "Receipt address of the registered mail", so you have to write the address exactly. When the resident registration certificate 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 바랍니다.)

□ Application contents 신청내용

￭ Confirmation for issuing application of resident registration card

(주민등록증 발급 신청 확인서)

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

(확인서 교부 혹은 미교부에 체크하세요.)

￭ Receipt means of resident registration card (주민등록증 수령 방법)

￭ Please check on receipt means. (수령방법에 체크하세요.)

￭ To receive by visitating the office of resident registration

(주민등록기관에 방문하여 수령하기)

￭ To receive by registered mail (등기우편으로 수령하기)

￭ Please write address with zip code to receive the registered mail.

(등기우편 수령주소를 쓰세요.)

□ Confirmation of Identity 본인확인

※ How to fill out the form 작성방법

￭ The section of "Head of 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 국가ㆍ지방 자치단체 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.)

￭ Please confirm the identity by Head of tongㆍHead of a village.

(통장ㆍ이장에 의한 본인확인)

￭ Please confirm the identity by family. (가족에 의한 본인확인)

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

￭ Please name with seal or signature of applicant.

(신청인의 성명을 서명날인과 함께 쓰세요.)

□ How to fill out the form 작성방법

※ Please must submit to leave a blank the section of "The relevant civil servant" and the section of "The relevant document for evidence" in front page.

(앞쪽 중 “담당 공무원”란과 “소명 관계 서류”란은 비워둔 채로 제출해야 합니다.)

※ Roll the fingers of your left hand 왼손 회전 지문

￭ Please put left fingerprint in sequence of index finger, middle finger, ring finger,

little finger and thumb.

(둘째, 셋째, 넷째, 다섯째, 첫째손가락 순으로 왼손지문을 찍으세요.)

※ Roll the fingers of your right hand 오른손 회전 지문

￭ Please put right fingerprint in sequence of index finger, middle finger, ring finger,

little finger  and thumb.

(둘째, 셋째, 넷째, 다섯째, 첫째손가락 순으로 왼손지문을 찍으세요.)

￭ Don't roll and please put left thumb. (왼손 엄지 평면을 찍으세요.)

￭ Don't roll and please put left hand four fingers together.

(왼손 4지 평면을 찍으세요.)

￭ Don't roll and Please put right hand four fingers together.

(오른손 4지 평면을 찍으세요.)

￭ Don't roll and please put right thumb. (오른손 엄지 평면을 찍으세요.)

□ 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 certificate, 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)

￭ There are not handling charge. (수수료는 없습니다.)

[Annex form No.32] <Revision 2010.8.4> [별지 제32호서식] <개정 2010.8.4>
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)				Name(Chinese characters)성명(한자)
		Resident Registration No. 주민등록번호			Blood type 혈액형	Tel No. 전화번호
		Address 주소
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.

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 name in Chinese characters. (신청자의 성명을 한자로 쓰세요.)

￭ Please write applicant's resident registration No.

(신청자의 주민등록번호를 쓰세요.)

￭ Please write applicant's blood type. (신청자의 혈액형을 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.

Receiving method of the 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.

(“방문 수령”을 선택한 경우에는 신청 후 3년 내에 주민등록증을 받아 가시기

바랍니다. 3년이 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.)

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)

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)

[Annex form No.63]<Revision 2007.6.7> [별지 제63호서식] <개정 2007.6.7>
※ No. 제 호 Reporting the usage of a two-wheeled vehicle 이륜자동차사용신고서 Please don't write on the section marked with an asterisk(※). ※표시란은 신고인이 기재하지 않습니다.
Owner 소유자	Name 성명 (Title 명칭)					Resident(Business) Registration No. 주민(사업자)등록번호
	Address 주소		(Tel. No. 전화번호 : )
Name of vehicle 차명						Total engine displacement or rated output 총배기량 또는 정격출력
Usual place of usage 사용본거지
I hereby report as above in accordance with Article 48 Section 1 of the 「Management Law of Vehicles」 and Article 99 Section 1 of the Enforcement Regulations of the same Law. 「자동차관리법」 제48조제1항 및 동법시행규칙 제99조제1항의 규정에 의하여 위와 같이 신고합니다. Day Month Year 년 월 일 Applicant 신청인 (Seal and signature) (서명 또는 인)
Required documents 구비서류 1. Documents proving right of possession (Please don't submit if right of possession has already been proved in documents of the No.2 or No.4). 소유권을 증명하는 서류(제2호 내지 제4호의 서류로서 소유권을 증명할 수 있는 경우에는 제출하지 아니합니다) 1부 2. New product certificate of the two-wheeled vehicle(Only in case of two-wheeled vehicle being brand new). 이륜자동차 제작증(신규로 제작ㆍ조립한 이륜자동차에 한합니다) 1부 3. Import license or other documents proving it has been imported(Only in case of imported two-wheeled vehicles). 수입면장 또는 기타 수입사실을 증명하는 서류(수입한 이륜자동차에 한합니다) 4. Certificate proving terminated usage of the two-wheeled vehicle(Only in case of wishing to recommence usage of the two-wheeled vehicle). 이륜자동차사용폐지증명서(사용 폐지한 이륜자동차를 다시 신고하는 경우에 한합니다) 5. Confirmation of actual measurement(Only in applicable cases) 실측확인서(해당하는 경우에 한합니다)
※ Information of report 신고안내
Place to report 신고하는 곳		EupㆍMyeonㆍDong 읍ㆍ면ㆍ동		Handling period 처리기간			Immediately 즉시	Handling charge 수수료			Free 없음
○ Usage of the two-wheeled vehicle has to be reported and a registration number must be designated before you can use it(In accordance with Article 48 Section No.1 of the 「Management Law of Vehicles」). 이륜자동차는 사용신고를 하고 이륜자동차번호의 지정을 받아야 운행할 수 있습니다(「자동차관리법」 제48조제1항). - Any violation of the above may result in a fine of up to one million won(Article 84 Section1 No.12 of the Law). 위의 사항을 위반한 경우에는 100만원 이하의 과태료를 물게 됩니다(법제84조제1항제12호).
33331-06011민 96.10.4 Approval 승인					210㎜×297㎜ (General paper 일반용지 60g/㎡)

Reporting the usage of a two-wheeled vehicle

(이륜자동차사용신고서)

□ Writing method (작성방법)

￭ Please don't write on the section marked with an asterisk(※).

※ 표시란은 신고인이 기재하지 않습니다.

￭ Please write name(title) of the owner. (소유자의 이름(명칭)을 쓰세요.)

￭ Please write resident(business) registration number of the owner.

(소유자의 주민(사업자) 등록번호를 쓰세요.)

￭ Please write address and tel. No. of the owner.

(소유자의 주소와 전화번호를 쓰세요.)

￭ Please write name of vehicle. (차량명을 쓰세요.)

￭ Please write total engine displacement or rated output of vehicle.

(차량의 총배기량 또는 정격출력을 쓰세요.)

￭ Please write usual place of vehicle usage. (차량의 사용본거지를 쓰세요.)

※ I hereby report as above in accordance with Article 48 Section 1 of the

「Management Law of vehicle」 and Article 99 Section 1 of the Enforcement

Regulations of the same Law.

(「자동차관리법」 제48조제1항 및 동법시행규칙 제99조제1항의 규정에 의하여

위와 같이 신고합니다.)

￭ Please write date(day/ month/ year). (날짜(년월일)를 쓰세요.)

￭ Please write seal or signature of applicant. (신청인의 서명날인을 하세요.)

□ Required documents 구비서류

1. Documents proving right of possession(Please don't submit if right of

possession has already been proved in document of the No.2 or No.4).

(소유권을 증명하는 서류(제2호 내지 제4호의 서류로서 소유권을 증명할 수 있는

경우에는 제출하지 아니합니다.) 1부

2. New product certificate of the two-wheeled vehicle(Only in case of two

wheeled vehicle being brand new).

(이륜자동차 제작증(신규로 제작․조립한 이륜자동차에 한합니다.) 1부)

3. Import license or other documents proving it has been imported(Only in case

of imported two-wheeled vehicles).

(수입면장 또는 기타 수입사실을 증명하는 서류(수입한 이륜자동차에 한합니다.)

4. Certificate proving terminated usage of two-wheeled vehicle (Only in case

of wishing to recommence usage of the two-wheeled vehicle).

이륜자동차사용폐지증명서(사용 폐지한 이륜자동차를 다시 신고하는 경우에 한합니다.)

5. Confirmation of actual measurement(Only in applicable cases)

실측확인서(해당하는 경우에 한합니다.)

※ Information of report 신고안내

￭ Usage of the two-wheeled vehicle has to be reported and a registration

number must be designated before you can use it(In accordance with Article

48 Section 1 of the 「Management Law of vehicles」).

(이륜자동차는 사용신고를 하고 이륜자동차번호의 지정을 받아야 운행할 수

있습니다(「자동차관리법」 제48조제1항).)

￭ Any violation of the above may result in a fine of up to one million won

(Article 84 Section 1 No.12 of the Law).

(위의 사항을 위반한 경우에는 100만원이하의 과태료를 물게 됩니다(법 제84조

제1항제12호).)

[Annex No. 68 form][별지 제68호서식] <Revision 2007.6.7><개정 2007.6.7>
※No. 제 호 Reporting the revocation of usage of a two-wheeled vehicle 이륜자동차사용폐지신고서 Please don't write on the section marked with an asterisk(※). ※표시란은 신청인이 기재하지 않습니다.
Owner 소유자	Name 성명 (Title 명칭)				Resident(Business) Registration No. 주민(사업자)등록번호
	Address 주소		(Tel. No. 전화번호 : )
Registration number of two-wheeled vehicle 이륜자동차번호
Reason for application 신청사유			□ Revocation of usage 용도폐지 □ Loss․Destruction 분실․멸실 □ Theft(Stolen) 도난
I hereby report as above in accordance with Article 48 Section 2 of the 「Management Law of Vehicles」and Article 103 Section 1 of the Enforcement Regulations of the same Law. 「자동차관리법」 제48조제2항 및 동법시행규칙 제103조제1항의 규정에 의하여 위와 같이 신고합니다. Day Month Year 년 월 일 Applicant 신고인 (Seal or signature) (서명 또는 인)
※ Required documents 구비서류 1. Completed certificate of usage report for the two-wheeled vehicle 이륜자동차사용신고필증 2. Number plate of the two-wheeled vehicle(Except if you have lost it). 이륜자동차번호판(분실한 경우를 제외합니다) 3. Confirmation report of loss or theft issued at police office(Only in case of loss or theft). 경찰관서에서 발급하는 분실 또는 도난신고확인서(분실 또는 도난의 경우에 한합니다) 1부 4. Documents proving the reason of usage revocation(Only in case of usage being revoked for another reason). 사용폐지사유를 증명하는 서류(기타 사유로 인한 사용폐지의 경우에 한합니다) 1부
※ Information of report 신고안내
Place to report 신고하는 곳		Eup․Myeon․Dong 읍․면․동				Handling period 처리기간		Immediately 즉시
Handling charge 수수료		Free 없음
33331-06511민 96.10.4 Approval 승인				210mm×297mm (General paper 일반용지 60g/㎡)

Reporting the revocation of usage of a two-wheeled vehicle

(이륜자동차사용폐지신고서)

□ Writing method (작성방법)

￭ Please don't write on the section marked with an asterisk(※).

※ 표시란은 신청인이 기재하지 않습니다.

□ Owner  소유자

￭ Please write name(title) of the owner. (소유자의 이름(명칭)을 쓰세요.)

￭ Please write resident(business) registration number of the owner.

(소유자의 주민(사업자) 등록번호를 쓰세요.)

￭ Please write address and tel. No. of the owner. (소유자의 주소와 전화번호를 쓰세요.)

￭ Please write number of vehicle. 차량번호를 쓰세요.

￭ Please check on reason for application. 신청사유에 체크하세요.

□ Revocation of usage 용도폐지  □ Loss․Destruction 분실․멸실

□ Theft(Stolen) 도난

※ I hereby report as above in accordance with Article 48 Section 2 of the 「Management

Law of vehicles」and Article 103 Section 1 of the Enforcement regulations of the

same Law.

(「자동차관리법」 제48조제2항 및 동법시행규칙 제103조제1항의 규정에 의하여

위와 같이 신고합니다.)

￭ Please write date(day/ month/ year). 날짜(년월일)를 쓰세요.

￭ Please write seal or signature of applicant. 신청인은 서명날인을 하세요.

□ Required documents 구비서류

1. Completion certificate of usage report for two-wheeled vehicle

(이륜자동차 사용신고필증)

2. Number plate of the two-wheeled vehicle(Except if you have lost it).

(이륜자동차번호판(분실한 경우를 제외합니다))

3. Confirmation report of loss or theft, issued at police office (Only in case of loss

or theft).

(경찰관서에서 발급하는 분실 또는 도난신고확인서(분실 또는 도난의 경우에 한합니다) 1부

4. Document proving the reason of usage revocation (Only in case of usage

being revoked for another reason).

(사용폐지사유를 증명하는 서류(기타 사유로 인한 사용폐지의 경우에 한합니다) 1부

[Annex No.65 form]<Revision 2007.6.7> [별지 제65호서식] <개정 2007.6.7>
※ No. 제 호 Application form for altering the reported details a two-wheeled vehicle 이륜자동차신고사항변경신청서 Please don't write on the section marked with an asterisk(※). ※ 표시란은 신청인이 기재하지 않습니다.
Owner 소유자	Name 성명 (Title 명칭)					Resident(Business) Registration No. 주민(사업자)등록번호
	Address 주소		(Tel. No. 전화번호 : )
Registration number of two-wheeled vehicle 이륜자동차번호						Total engine displacement or rated output 배기량 또는 정격출력
Details to be altered 변경사항	Before alteration 변경전
	After alteration 변경후
I hereby report as above in accordance with Article 48 Section 2 of the 「Management Law of Vehicles」and Article 101 Section 1 of the Enforcement Regulations of the same Law. 「자동차관리법」 제48조제2항 및 동법시행규칙 제101조제1항의 규정에 의하여 위와 같이 신고합니다. Day Month Year 년 월 일 Applicant 신고인 (Seal or signature) (서명 또는 인)
※ Required documents 구비서류 1. Completed certificate of usage report for the two-wheeled vehicle(If lost, please explain instead). 이륜자동차사용신고필증(분실한 경우에는 그 사유로 대체할 수 있습니다) 2. Documents to prove need to details 변경사항을 증명하는 서류 1부 3. Number plate of the two-wheeled vehicle(Only in case the registration office marked on the number plate of the two-wheeled vehicle is different) 이륜자동차번호판(이륜자동차번호판에 표시된 관할관청이 다르게 되는 경우에 한합니다)
※ Information of report 신고안내
Place to report 신고하는 곳		Eup․Myeon․Dong 읍․면․동					Handling period 처리기간		Immediately 즉시
Handling charge 수수료		Free 없음
○ The owner of the two-wheeled vehicle must report any of the following alterations within the permitted time period.(Article 48 Section 2 of the 「Management Law of Vehicles」) 이륜자동차의 소유자는 다음 사항의 변경이 있는 때에는 그 신고기간안에 변경신고를 이행하여야 합니다(「자동차관리법」 제48조제2항). ․ Change of the usual place of usage or name(title) of the owner : Within 15days 사용본거지 또는 소유자성명(명칭)변경시 : 15일이내 ․ Buying and selling 매매 : Within 15days 15일이내, Contribution(Gift)증여 : Within 20days 20일이내, Inheritance 상속 : Within 3months 3월이내 -If not, a fine of up to five hundred thousand won may be given.(Article 84 Section 2 No. 2 of the 「Management Law of Vehicles」) 위 사항을 이행하지 않는 경우에는 50만원 이하의 과태료를 물게 됩니다. (「자동차관리법」 제84조제2항 제2호).
33331-06311민 96.10.4 Approval 승인					210mm×297mm (General paper 일반용지 60g/㎡)

Application form for altering the reported

details of two-wheeled vehicle

(이륜자동차신고사항변경신청서)

□ Writing method (작성방법)

￭ Please don't write on the section marked with an asterisk(※).

※ 표시란은 신고인이 기재하지 않습니다.

□ Owner 소유자

￭ Please write name(title) of the owner. (소유자의 이름(명칭)을 쓰세요.)

￭ Please write resident(business) registration number of the owner.

(소유자의 주민(사업자) 등록번호를 쓰세요.)

￭ Please write address and tel. No. of the owner.

(소유자의 주소와 전화번호를 쓰세요.)

￭ Please write number of vehicle. 차량번호를 쓰세요.

￭ Please write total engine displacement or rated output of vehicle.

(차량의 총배기량 또는 정격출력을 쓰세요.)

□ Details to be of altered 변경사항

￭ Please write before alteration. (변경전의 것에 대하여 쓰세요.)

￭ Please write after alteration. (변경후의 것에 대하여 쓰세요.)

※ I hereby report as above in accordance with Article 48 Section 2 of the

「Management Law of vehicles」and Article 101 Section 1 of the Enforcement

Regulations of the same Law.

(「자동차관리법」 제48조제2항 및 동법시행규칙 제101조제1항의 규정에 의하여

위와 같이 신고합니다.)

￭ Please write date(day/ month/ year). (날짜(년월일)를 쓰세요.)

￭ Please write seal or signature of applicant. (신청인은 서명날인을 하세요.)

□ Required documents 구비서류

1. Completion certificate of usage report for two-wheeled vehicle(If lost, please

explain instead.)

(이륜자동차사용신고필증(분실한 경우에는 그 사유로 대체할 수 있습니다.))

2. Documents to prove need to alter details (변경사항을 증명하는 서류 1부)

3. Number plate of the two-wheeled vehicle(Only in case the registration office

marked on the number plate of the two-wheeled vehicle is different)

(이륜자동차번호판(이륜자동차번호판에 표시된 관할관청이 다르게 되는 경우에 한합니다.))

※ Information of report 신고안내

￭ The owner of a two-wheeled vehicle must report any of the following

alterations within the permitted time period.(Article 48 Section 2 of the

「Management Law of vehicles」)

(이륜자동차의 소유자는 다음 사항의 변경이 있는 때에는 그 신고 기간 안에

변경신고를 이행하여야 합니다(「자동차관리법」 제48조제2항).)

□ Change of the usual place of usage or name(title) of the owner :

- Within 15days 사용본거지 또는 소유자성명(명칭) 변경 시 : 15일 이내

□ Buying and selling  (매매) : Withing 15days  (15일 이내 )

Contribution(Gift)  (증여) : Within 20days  (20일 이내)

Inheritance  (상속) : Within 3months  (3월 이내)

￭ If not, a fine of up to five hundred thousand won may be given.(Article

84 Section 2 No. 2 of the 「Management Law of vehicles」)

(위 사항을 이행하지 않는 경우에는 50만원이하의 과태료를 물게 됩니다.

(「자동차관리법」 제84조제2항 제2호).)

[Annex No. 15 form][별지 제15호서식] <Revision 2010.6.11><개정 2010.6.11>
No. 제 호			Transfer certificate of vehicle ownership (For direct transaction by transferorㆍtransferee) 자동차양도증명서(양도인ㆍ양수인 직접 거래용)
I hereby issue to compose the transfer certificate in accordance with Article 33 Section 2 No. 1 of the 「Rules of Automobile Registration 」to certify the fact that I transferred ownership to acquirer by direct transaction without going through a car broker. 본인은 자동차매매사업자의 중개를 통하지 않고 양수인과 직접 거래로 소유자동차를 양도하고, 그 사실을 증명하기 위하여 「자동차등록규칙」 제33조제2항제1호에 따라 이 양도증명서를 작성하여 발급합니다. Day Month Year 년 월 일
				Transferor 양도인 (Seal or signature) (서명 또는 인) Acquirer 양수인 (Seal or signature) (서명 또는 인)
Vehicle Registration No. 자동차등록번호								Mileage 주행거리	km
Model and name of vehicle 차종 및 차명
Chassis No. 차대번호
Date of transaction 매매일
Price of transfer 매매금액							Balance payment date 잔금지급일
Date of transfer 자동차 인도일							Remarks 비 고
Article 1. (Expression of the concerned person) In the following provisions, a transferor is called "A" and an acquirer is called "B". 제1조(당사자표시) 양도인을 “갑”이라 하고, 양수인을 “을”이라 한다. Article 2. (Simultaneous implementation and etc.) By receiving the balance from "B", "A" shall transfer a vehicle and the required documents for transfer registration of vehicle ownership to "B". 제2조(동시이행 등) “갑”은 잔금 수령과 상환으로 자동차와 소유권이전등록에 필요한 서류를 “을”에게 인도한다. Article 3. (Payment of public imposts) On the basis of the vehicle transaction day, all the taxes and charges imposed on this vehicle shall be paid by "A" till that day and by "B" from the next day. But if there are special regulations on relevant laws, regulations shall be followed. 제3조(공과금부담) 이 자동차에 대한 제세공과금은 자동차 인도일을 기준으로 하여, 그 기준일까지의 분은 “갑”이 부담하고, 기준일 다음 날부터의 분은 “을”이 부담한다. 다만, 관계 법령에 제세공과금의 납부에 관하여 특별한 규정이 있는 경우에는 그에 따른다. Article 4. (Accident responsibility) "B" shall take full responsibility for all accidents that occur after the date of transfer, as the person who is operating an automobile for himself/herself. 제4조(사고책임) “을”은 이 자동차를 인수한 때부터 발생하는 모든 사고에 대하여 자기를 위하여 운행하는 자로서의 책임을 진다. Article 5. (Legal defect responsibility) "A" shall take responsibility for administrative measures or flaws in the required document for transfer registration, other administrative defects before the date of transfer. 제5조(법률상의 하자책임) 자동차인도일 이전에 발생한 행정처분 또는 이전등록 요건의 불비, 그 밖에 행정상의 하자에 대해서는 “갑”이 그 책임을 진다. Article 6. (Responsibility of delay registration) "B" shall register an object of transaction by the due date after the date of transfer. If not, "B" shall take all responsibility for that. 제6조(등록 지체 책임) “을”이 매매목적물을 인수한 후 정해진 기간에 이전등록을 하지 않을 때에는 이에 대한 모든 책임을 “을”이 진다. Article 7. (Special condition for installment succession) If "A" bought the vehicle by installments and the installments were not finished and "A" then transfers the vehicle to "B", it shall be written as a special condition or not "B" succeed and pay the balance installment. 제7조(할부승계특약) “갑”이 자동차를 할부로 구입하여 할부금을 다 내지 않은 상태에서 “을”에게 양도하는 경우에는 나머지 할부금을 “을”이 승계하여 부담할 것인지의 여부를 특약사항란에 적어야 한다. Article 8. (Certificate of transfer) "A" and "B" shall compose two identical copies of this certificate and keep one each. "B" shall submit this certificate to the registration authorities when applying(within 15days from the balance payment day) for the transfer registration of ownership. 제8조(양도증명서) 이 양도증명서는 2통을 작성하여 “갑”과 “을”이 각각 1통씩 지니고 “을”은 이 증명서를 소유권의 이전등록 신청을 할 때(잔금지급일부터 15일 이내)에 등록관청에 제출해야 한다.
(Special condition 특약사항):					Revenue stamp 수입인지
					In accordance with「The stamp law」「인지세법」에 따름(Affix on back page)(뒤쪽에 붙임)
A 갑(Transferor 양도인)	Name 성명(or Title 명칭)					Resident(Corporate) registration No. 주민(법인)등록번호
	Address 주소				(Tel. No. 전화번호: )
B 을(Acquirer 양수인)	Name 성명(or Title 명칭)					Resident(Corporate) registration No.주민(법인)등록번호
	Address 주소				(Tel. No. 전화번호: )
Note 1. For the transferor : On composing the transfer certificate, the transferor must check that the acquirer's personal information is written correctly. 2. For the acquirer : The acquirer must check that all taxes and charges on this vehicle have been paid and if there are any other problems including sequestration. 3. General caution : If a person other than the transferor or acquirer uses this certificate, he will be punished. 4. Anyone who manipulates the odometer with no justification shall be sentenced to up to 3years' imprisonment or a fine of up to ten million won in accordance with the "Automobile Management Law".
(보존용지(2종) 70g/㎡) 210mm×297mm

Transfer certificate of vehicle ownership

(For direct transaction by transferorㆍtransferee)

(자동차양도증명서(양도인ㆍ양수인 직접 거래용))

※ I hereby issue to compose the transfer certificate in accordance with Article 33

Section 2 No. 1 of the 「Rules of Automobile Registration 」to certify the

fact that I transferred ownership to acquirer by direct transaction without

through a car broker.

(본인은 자동차매매사업자의 중개를 통하지 않고 양수인과 직접 거래로 소유 자동차를

양도하고, 그 사실을 증명하기 위하여 「자동차등록규칙」제33조 제2항 제1호에

따라 이 양도증명서를 작성하여 발급합니다.)

￭ Please write date(day/ month/ year).  날짜(년월일)를 쓰세요.

￭ Please write seal or signature of transferor.  양도인의 서명날인을 하세요.

￭ Please write seal or signature of acquirer.  양수인의 서명날인을 하세요.

￭ Please write vehicle registration No.  자동차등록번호를 쓰세요.

￭ Please write mileage.  주행거리를 쓰세요.

￭ Please write model and name of vehicle.  차종 및 차명을 쓰세요.

￭ Please write chassis No.  차대번호를 쓰세요.

￭ Please write date of transaction.  매매일을 쓰세요.

￭ Please write price of transfer.  매매금액을 쓰세요.

￭ Please write date of balance payment.  잔금지급일을 쓰세요.

￭ Please write date of transfer  자동차 인도일을 쓰세요.

￭ Please write on remark.  비고란에 쓰세요.

※ Article 1. (Expression of the concerned person) In the following provisions, a

transferor is called "A" and an acquirer is called "B".

제1조(당사자표시) 양도인을 “갑”이라 하고, 양수인을 “을”이라 한다.

※ Article 2. (Simultaneous implementation and etc.) By receiving the balance from "B",

"A" shall transfer a vehicle and the required documents for transfer

registration of vehicle ownership to "B".

제2조(동시이행 등) “갑”은 잔금 수령과 상환으로 자동차와 소유권 이전등록에

필요한 서류를 “을”에게 인도한다.

※ Article 3. (Payment of public imposts) On the basis of the vehicle transaction

day, all the taxes and charges imposed on this vehicle shall be paid

by "A" till that day and by "B" from the next day. But if there are

special regulations on relevant laws, regulations shall be followed.

제3조(공과금부담)

이 자동차에 대한 제세공과금은 자동차 인도일을 기준으로 하여, 그 기준일 까지의 분은

“갑”이 부담하고, 기준일 다음 날부터의 분은 “을”이 부담한다.

다만, 관계 법령에 제세공과금의 납부에 관하여 특별한 규정이 있는 경우에는 그에 따른다.

※ Article 4. (Accident responsibility) "B" shall take full responsibility for all

accidents that occur after the date of transfer, as the person who is

operating an automobile for himself/herself.

제4조(사고책임) “을”은 이 자동차를 인수한 때부터 발생하는 모든 사고에 대하여

자기를 위하여 운행하는 자로서의 책임을 진다.

※ Article 5. (Legal defect responsibility) "A" shall take responsibility for

administrative measures or flaws in the required document for transfer

registration, other administrative defects before the date of transfer.

제5조(법률상의 하자책임) 자동차인도일 이전에 발생한 행정처분 또는 이전등록

요건의 불비, 그 밖에 행정상의 하자에 대해서는 “갑”이

그 책임을 진다.

※ Article 6. (Responsibility of delay registration) "B" shall register an object of                  transaction by the due  date after the date of transfer. If not, "B"                 shall take all responsibility for that.

제6조(등록 지체 책임) “을”이 매매목적물을 인수한 후 정해진 기간에 이전등록을

하지 않을 때에는 이에 대한 모든 책임을 “을”이 진다.

※Article 7. (Special condition for installment succession) If "A" bought the vehicle

by installments and the installments were not finished and "A" then

transfers the vehicle to "B", it shall be written as a special condition or

not "B" succeed and pay the balance installment.

제7조(할부승계특약) “갑”이 자동차를 할부로 구입하여 할부금을 다 내지 않은 상태에서 “을”에게 양도하는 경우에는 나머지 할부금을 “을”이 승계하여

부담할 것인지의 여부를 특약사항란에 적어야 한다.

※ Article 8. (Certificate of transfer) "A" and "B" shall compose two identical

copies of this certificate and keep one to each. "B" shall submit this

certificate to the registration authorities when applying (within 15days

from the balance payment day) for the transfer registration of ownership.

제8조(양도증명서) 이 양도증명서는 2통을 작성하여 “갑”과 “을”이 각각 1통씩 지니고 “을”은 이 증명서를 소유권의 이전등록 신청을 할 때(잔금지급일부터 15일 이내)에 등록관청에 제출해야 한다.

[Annex No.67][별지 제67호서식] <Revision 2007.6.7> <개정 2007.6.7>
※ No. 제 호 Application form for re-issuance of a completed certificate of usage report for a two-wheeled vehicle 이륜자동차 사용신고필증 재교부신청서 Please don't write in the section marked with an asterisk(※). ※표시란은 신청인이 기재하지 않습니다.
Owner 소유자	Name 성명 (Title 명칭)			Resident(Business) Registration No. 주민(사업자)등록번호
	Address 주소		(Tel. No. 전화번호 : )
Registration number of two-wheeled vehicle 이륜자동차번호
Reason for application 신청사유			□ Damage 훼손 □ Loss 분실 □ Other 기타( )
I hereby apply as above in accordance with Article 102 Section 1 of the 「Enforcement Regulation of Management Law of Vehicles」. 「자동차관리법 시행규칙」 제102조제1항의 규정에 의하여 위와 같이 신청합니다. Day Month Year 년 월 일 Applicant 신청인 (Seal or signature) (서명 또는 인)
※ Required documents 구비서류 Completed certificate of usage report(in which the information is difficult to distinguish clearly). 사용신고필증(식별이 곤란하게 된 경우에 한합니다) 1부
※Information for application 신청안내
Place to apply 신청하는 곳		Eup․Myeon․Dong 읍․면․동			Handling period 처리기간		Immediately 즉시
Handling charge 수수료		Free 없음
33331-06411민 96.10.4 Approval 승인				210mm×297mm (General paper 일반용지 60g/㎡)

Application form for re-issuance the completion certificate of usage report of two-wheeled motorcycle

(이륜자동차 사용신고필증 재교부신청서)

□ Writing method (작성방법)

￭ Please don't write on the section marked with an asterisk(※).

※표시란은 신고인이 기재하지 않습니다.

□ Owner  소유자

￭ Please write name(title) of the owner. 소유자의 이름(명칭)을 쓰세요.

￭ Please write resident(business) registration number of the owner.

(소유자의 주민(사업자) 등록번호를 쓰세요.)

￭ Please write address and tel. No. of the owner.

(소유자의 주소와 전화번호를 쓰세요.)

￭ Please write number of vehicle. 차량번호를 쓰세요.

￭ Please check on reason for application. 신청사유에 체크하세요.

□ Damage 훼손    □ Loss 분실    □ Other 기타(      )

※ I hereby apply as above in accordance with Article 102 Section 1 of the

「Enforcement regulation of management Law of vehicles」.

(「자동차관리법 시행규칙」 제102조제1항의 규정에 의하여 위와 같이 신청합니다.)

￭ Please write date(day/ month/ year).  날짜(년월일)를 쓰세요.

￭ Please write seal or signature of applicant.  신청인은 서명날인을 하세요.

□ Required documents 구비서류

※ Completed certificate of usage report(in which the information is difficult to

distinguish clearly).

(사용신고필증(식별이 곤란하게 된 경우에 한합니다.) 1부)