출입국관리법시행규칙 [ 별지제 17 호서식 ] ( 제 1 쪽 / Page1) < 신청서작성방법 > 신청인은사실에근거하여빠짐없이정확하게신청서를작성해야합니다. 신청서상의모든질문에대한답변은한글또는영문으로기재해야합니다. 선택사항은해당칸 [ ] 안에 표시를하시기바랍니다. 기타 를선택한경우, 상세내용을기재하시기바랍니다. <How to fill out this form> The applicant must fill out this form completely and correctly. The applicant must write in block letters either in English or Korean. For multiple-choice questions, the applicant must check [ ] all that apply. If the applicant selects Other, please provide more information in the given space. 1. 인적사항 / PERSONAL DETAILS PHOTO 여권용사진 (35 mm 45 mm ) - 흰색바탕에모자를쓰지않은정면사진으로촬영일부터 6 개월이경과하지않아야함 A color photo taken within the last 6 months (full fa ce without hat, front vie w against white or off-whi te background) 1.1 여권에기재된영문성명 /Full name in English (as shown in passport) 성 Family Name 명 Given Names 1.2 한자성명漢字姓名 1.3 성별 Sex 남성 /Male[ ] 여성 /Female[ ] 1.4 1.5 국적 Nationality 1.6 출생국가 Country of Birth 1.7 국가신분증번호 National Identity No. 1.8 이전에한국에출입국하였을때다른성명을사용했는지여부 Has the applicant ever used any other names to enter or depart Korea? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please provide details ( 성 Family Name, 명 Given Name ) 1.9 복수국적여부 Is the applicant a citizen of more than one country? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please write the countries ( ) 2. 신청사증정보 / DETAILS OF VISA APPLICATION 2.1 체류기간 ( 장 단기 ) Period of Stay(Long/Short-term) 90 일이상장기체류 Long-term Stay over 90 days [ ] 90 일이하단기체류 Short-term Stay less than 90 days [ ] 공용란 FOR OFFICIAL USE ONLY 2.2 체류자격 Visa Code (i.e. F-4, C-3-1, D-4-1) 기본사항체류자격체류기간사증종류단수ㆍ복수 (2 회, 3 회이상 ) 접수사항접수일자접수번호처리과 허가사항허가일자사증번호고지사항 결재 담당자 가 [ ] 부 [ ] < 심사의견 > < 수입인지부착란 >
( 제 2 쪽 / Page2) 3. 여권정보 / PASSPORT INFORMATION 3.1 여권종류 Passport Type 외교관 Diplomatic [ ] 관용 Official [ ] 일반 Regular [ ] 기타 Other [ ] 기타 상세내용 If Other, please provide details ( ) 3.2 여권번호 Passport No. 3.3 발급국가 Country of Passport 3.4 발급지 Place of Issue 3.5 발급일자 Date of Issue 3.6 기간만료일 Date Of Expiry 3.7 다른여권소지여부 Does the applicant have any other valid passports? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please provide details a) 여권종류 Passport Type 외교관 Diplomatic [ ] 관용 Official [ ] 일반 Regular [ ] 기타 Other [ ] b) 여권번호 Passport No. c) 발급국가 Country of Passport d) 기간만료일 Date of Expiry 4. 연락처 / CONTACT INFORMATION 4.1 본국주소 Home Country Address of the applicant 4.2 현거주지 Current Residential Address * 현거주지가본국주소와다를경우기재 *Please write the current address if different from above 4.3 휴대전화 Cell Phone No. 또는일반전화 Telephone No. 4.4 전자우편 E-mail 4.5 비상시연락처 Emergency Contact Information a) 성명 Full Name in English b) 거주국가 Country of Residence c) 전화번호 Telephone No. d) 관계 Relationship to the applicant 5. 혼인사항및가족사항 / MARITAL STATUS AND FAMILY DETAILS 5.1 현재혼인사항 Current Marital Status 기혼 Married [ ] 이혼 Divorced [ ] 미혼 Single [ ] 5.2 배우자인적사항 Personal Information of the applicant s Spouse * 기혼으로표기한경우에만기재 If Married please provide details of the spouse a) 성 Family Name (in English) b) 명 Given Names (in English) c) d) 국적 Nationality e) 거주지 Residential Address f) 연락처 Contact No. 5.3 자녀유무 Does the applicant have children? 없음 No [ ] 있음 Yes [ ] 자녀수 Number of children [ ] 6. 학력 / EDUCATION 6.1 최종학력 What is the highest degree or level of education the applicant has completed? 석사 / 박사 Master s /Doctoral Degree [ ] 대졸 Bachelor s Degree [ ] 고졸 High School Diploma [ ] 기타 Other [ ] 기타 선택시상세내용기재 If Other, please provide details ( ) 6.2 학교명 Name of School 6.3 학교소재지 Location of School(city/province/country) 210mm 297mm [ 백상지 (80g/ m2 ) 또는중질지 (80g/ m2 )]
7. 직업 / EMPLOYMENT ( 제 3 쪽 / Page3) 7.1 직업 Current personal circumstances 사업가 Entrepreneur [ ] 자영업자 Self-Employed [ ] 직장인 Employed [ ] 공무원 Civil Servant [ ] 학생 Student [ ] 퇴직자 Retired [ ] 무직 Unemployed [ ] 기타 Other [ ] 기타 선택시상세내용기재 If Other, please provide details ( ) 7.2. 직업상세정보 Employment Details a) 회사 / 기관 / 학교명 Name of Company/Institute/School b) 직위 / 과정 Position/Course c) 회사 / 기관 / 학교주소 Address of Company/Institute/School d) 전화번호 Telephone No. 8. 방문정보 / DETAILS OF VISIT 8.1 입국목적 Purpose of Visit to Korea 관광 / 통과 Tourism/Transit [ ] 행사참석 /Meeting, Conference [ ] 의료관광 Medical Tourism [ ] 단기상용 Business Trip [ ] 유학 / 연수 Study/Training [ ] 취업활동 Work [ ] 무역 / 투자 / 주재 Trade/Investment/Intra- Corporate Transferee [ ] 가족또는친지방문 Visiting Family/ Relatives/Friends [ ] 외교 / 공무 Diplomatic/Official [ ] 기타 Other [ ] 결혼이민 Marriage Migrant [ ] 기타 선택시상세내용기재 If Other, please provide details ( ) 8.2 체류예정기간 Intended Period of Stay (i.e. 6 months) 8.3 한국입국예정일 Intended Date of Entry to Korea 8.4 체류예정지 ( 호텔포함 ) Address in Korea (including hotels) * 한글로필수기재 MANDATORY 8.5 한국내연락처 Contact No. in Korea * 필수기재 MANDATORY 8.6 과거 5 년간한국을방문한경력 Has the applicant travelled to Korea in the last 5 years? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please provide details of any visits to Korea ( ) 회 times, 방문목적 Purpose of Visit 방문기간 Period of Stay ~ 8.7 한국외에과거 5 년간여행한국가 Has the applicant travelled outside his/her country of residence, excluding to Korea, in the last 5 years? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please provide details of these trips 국가명 Name of Country (in English) 방문목적 Purpose of Visit 방문기간 Period of Stay ~
( 제 4 쪽 / Page4) 8.8. 국내체류가족유무 Does the applicant have any family member(s) staying in Korea? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please provide details of the family member(s) 성명 Full name in English 국적 Nationality 관계 Relationship to the appli cant * 참고 : 가족의범위 배우자, 자녀, 부모, 형제 Note: Scope of family members - Spouse, children, parents, siblings of the applicant 8.9. 동반입국가족유무 Is the applicant travelling to Korea with any family member(s)? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please provide details of the family member(s) the applicant is travelling with 성명 Full name in English 국적 Nationality 관계 Relationship to the applicant * 참고 : 가족의범위 배우자, 자녀, 부모, 형제 Note : Scope of family members - Spouse, children, parents, siblings of the applicant 9. 초청정보 / DETAILS OF INVITATION * 회사등기관에서단기출장혹은 work permit 으로초청하는경우필수기재 MANDATORY if going to Korea for work on a short or long term basis 9.1 초청인 / 초청회사 Is there anyone inviting the applicant for the visa? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please provide details a) 초청인 / 초청회사명 Name of inviting person/organization (Korean, foreign resident in Korea, company, or institute) b) 생년월일 / 사업자등록번호 Date of Birth/Business Registration No. c) 관계 Relationship to the applicant d) 주소 Address e) 전화번호 Phone No. 10. 방문경비 / FUNDING DETAILS * 회사등기관에서단기출장혹은 work permit 으로초청하는경우필수기재 10.1 방문경비 ( 미국달러기준 ) Estimated travel costs(in US dollars) MANDATORY if going to Korea for work on a short or long term basis 10.2 경비지불자 Who will pay for the applicant s travel-related expenses? (Any relevant person including the applicant and/or organization) a) 성명 / 회사 ( 단체 ) 명 Name of Person/Organization (Company) b) 관계 Relationship to the applicant c) 지원내용 Type of Support d) 연락처 Contact No. 11. 서류작성시도움여부 / ASSISTANCE WITH THIS FORM 11.1 이신청서를작성하는데다른사람의도움을받았습니까? Did the applicant receive assistance in completing this form? 아니요 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes, please provide details of the person who assisted the applicant 성명 Full Name 연락처 Telephone No. 관계 Relationship to the applicant
유의사항 Notice ( 제 5 쪽 / Page5)) 1. 위기재사항과관련하여자세한내용은별지로작성하거나관련서류를추가로제출할수있습니다. If extra space is needed to complete any item, record on a separate sheet of paper or submit relevant documents which could support the application. 2. 대한민국사증을승인받은후분실또는훼손등의사유로여권을새로발급받은경우에는, 정확한개인정보를반영할수있도록변경된여권정보를사증에통보해야합니다. If you received Korean visa approval, and have new passport issued thereafter in lieu of lost/damaged passpor t, you must notify the concerned visa office of changes in your passport information. 3. 사증을발급받았더라도대한민국입국시입국거부사유가발견될경우에는대한민국으로의입국이허가되지않을수있습니다. Possession of a visa does not entitle the bearer to enter the Republic of Korea upon arrival at the port of entry if he/she is found inadmissible. 4. 출입국관리법시행규칙 제 9 조제 1 항에따라 C 계열사증소지자는입국후에체류자격을변경할수없습니다. Please note that category C visa holders are not able to change their status of stay after their entry into the Repu blic of Korea in accordance with Article 9(1) of the Enforcement Regulations of the Immigration Act. 5. 허위사실기재또는허위서류제출이확인되는경우에는사증발급ㆍ체류허가가취소되며, 형사처벌ㆍ입국금지의대상이될수있습니다. Providing false information or documents leads to revocation of a visa and permission to stay, and may result in criminal punishments and an entry ban to the Republic of Korea. 6. 사증심사에필요한관련서류제출요구에따르지않는경우, 사증심사가지연되거나신청이불허될수있습니다. Failure to submit all required documents may cause delay or denial of a visa. 7. 사증발급신청결과는 대한민국비자포털 (www.visa.go.kr) 에서확인 * 해야하며, 사증발급거부통지서를문서로교부받고자하는경우에는직접공관을방문하여신청해야합니다. * 확인방법 : 비자포털초기화면좌측 조회 / 발급 - 진행현황조회및출력 - 재외공관 을선택하고여권번호, 성명, 생년월일입력후조회 Visa applicants must check online on the Korea Visa Portal website* (www.visa.go.kr) for visa application results. To receive the disapproval notice in written form, visa applicants must visit the diplomatic office and apply in person. * How to check results: click Check Application Status located on the left side of the Visa Portal main display - click Ch eck Application Status & Print - select Diplomatic Office and input information in the blanks. 12. 서약 / DECLARATION 본인은위의유의사항에동의하며, 이신청서에기재된내용이거짓없이정확하게작성되었음을확인합니다. 또한본인은대한민국의 출입국관리법 규정을준수할것을서약합니다. I declare that I agree with the terms of application including the contents of the notice provided above, that statements made in this application are true and correct, and that I will comply with the Immigration Act of the Republic of Korea. / / / 신청일자 ( 년. 월. 일 ) DATE OF APPLICATION 신청인성명 ( 자필서명 ) Applicant Name SIGNATURE OF APPLICANT 17 세미만자의경우부모또는법정후견인의서명을기재할것 Signature of Parent or Legal Guardian is required for a person under 17 years of age 위서명란에본인의성명과서명을기재하지않는경우사증발급이불허될수있음 Failure to provide name and signature may result in your application being denied. 첨부서류 ATTACHMENT 출입국관리법시행규칙 제 76 조제 1 항및별표 5 에따른사증발급신청등첨부서류 처리절차 / Procedure 신청서작성 Application 접수 Reception 심사 Review 결재 Approval 사증발급 Issuance 신청인 Applicant ( 재외공관 ) 210 mm 297 mm [ 백상지 (80g/ m2 ) 또는중질지 (80g/ m2 )