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[ 34]

APPLICATION FORM (REPORT FORM)

SELECT APPLICATION
[ ] [ ]
ALIEN REGISTRATION ENGAGE IN ACTIVITIES NOT COVERED BY THE
STATUS OF SOJOURN PHOTO
(3545)
[ ] [ ] /
REISSUANCE OF REGISTRATION CARD CHANGE OR ADDITION OF WORKPLACE

[ ] [ ] (, )
EXTENSION OF SOJOURN PERIOD REENTRY PERMIT (SINGLE, MULTIPLE)
[ ] [ ] Photo only for
CHANGE OF STATUS OF SOJOURN ALTERATION OF RESIDENCE Alien Registration
(Reissued)
[ ] [ ]
GRANTING STATUS OF SOJOURN CHANGE OF INFORMATION ON ALIEN REGISTRATION

Surname Given names [ ] M

Name In Full Gender [ ] F

Date of Birth or Year Month Day Registration No. Nationality
Alien Registration No. (If any) /
Others

Passport No. Passport Issue Date Passport Expiry Date

Address In Korea
Telephone No. Cell phone No.

Address In Home Country Telephone No.

Current Workplace Business Registration No. Telephone No.
Workplace
New Workplace Business Registration No. Telephone No.
Intended Period Of Reentry E-Mail
( )
Refund Bank Account No. only for Alien Registration

Date of application Signature/Seal

52( )
52( ) ,

, ,

(Consent for sharing of administrative information)

36
. * .
I, the undersigned, hereby consent to allow all documents and information required for the processing of this application to be
viewed by the public servant in charge. As specified under E-government Law, article 36. *If you disagree. you will present all
related documents yourself.

Applicant signature/seal Spouse of applicant signature/seal Father/Mother of applicant signature/seal

(For Official Use Only)

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/

(Revenue Stamp Here) / (exemption) [ ] (: )

210mm297mm[ 80g/()]
 [ 343]

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[ ] [ ]


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210mm297mm[ 80g/()]