출입국관리법시행규칙 [ 별지제 21 호서식 ] ( 제 1 쪽 / Page1) 사증발급인정신청서 APPLICATION FOR CONFIRMATION OF VISA ISSUANCE < 신청서작성방법 > 신청인은사실에근거하여빠짐없이정확하게신청서를작성하여야합니다. 신청서상의모든질문에대한답변은한글또는영문으로기재하여야합니다. 선택사항은해당칸 [ ] 안에 표시를하시기바랍니다. 기타 를선택한경우, 상세내용을기재하시기바랍니다. <How to fill out this form> You must fill out this form completely and correctly. You must write in block letters either in English or Korean. For multiple-choice questions, you must check [ ] all that apply. If you select Other, please provide us with more information in the given space. 1. 인적사항 / PERSONAL DETAILS 1.1 여권에기재된영문성명 Full Name in English (as shown in your passport) 성 Family Name 명 Given Names 1.2 한자성명漢字姓名 1.3 성별 Sex 1.4 생년월일 Date of Birth (yyyy/mm/dd) 1.5 국적 Nationality 남성 /Male[ ] 여성 /Female[ ] 1.6 출생국가 Country of Birth 1.7 국가신분증번호 National Identity No. 1.8 이전에한국에출입국하였을때다른성명을사용했는지여부 Have you ever used any other names to enter or depart Korea? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details ( 성 Family Name, 명 Given Names ) 1.9 복수국적여부 Is the invitee a citizen of more than one country? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details ( ) 2. 여권정보 / PASSPORT INFORMATION 2.1 여권종류 Passport Type 외교관 Diplomatic [ ] 관용 Official [ ] 일반 Regular [ ] 기타 Other [ ] 기타 상세내용 If Other please provide details ( ) 2.2 여권번호 Passport No. 2.3 발급국가 Country of Passport 2.4 발급지 Place of Issue 2.5 발급일자 Date of Issue 2.6 기간만료일 Date Of Expiry 2.7 다른여권소지여부 Does the invitee have any other valid passport? 아니오 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 3. 연락처 / CONTACT INFORMATION 3.1 본국주소 Address in Your Home Country ( 제 2 쪽 / Page2) 3.1 현거주지 Current Residential Address * 현거주지가본국주소와다를경우기재 / Write if it is diferent from the above address 3.2 휴대전화 Cell Phone No. 3.3 일반전화 Telephone No. 3.4 이메일 E-mail 3.5 비상시연락처 Emergency Contact Information a) 성명 Full Name in English b) 거주국가 Country of Residence c) 전화번호 Telephone No. d) 관계 Relationship to you 4. 학력 / EDUCATION 4.1 최종학력 What is the highest degree or level of education the invitee 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 ( ) 4.2 학교명 Name of School 4.3 학교소재지 Location of School(city/province/country) 5. 직업 / EMPLOYMENT 5.1 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 ( ) 5.2. 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.
6. 방문정보 / DETAILS OF VISIT 6.1 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 [ ] 결혼이민 Marriage Migrant [ ] 외교 / 공무 Diplomatic/Official [ ] 기타 Other [ ] 기타 선택시상세내용기재 If Other please provide details ( ) 6.2 체류예정기간 Intended Period of Stay 6.3 입국예정일 Intended Date of Entry 6.4 체류예정지 ( 호텔포함 ) Address in Korea (including hotels) 6.5 한국내연락처 Contact No. in Korea 6.6 과거 5년간한국을방문한경력 Has the invitee travelled to Korea in the last 5 years? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details of any trips to Korea ( ) 회 times, 최근방문목적 Purpose of Recent Visit ( ) ( 제3쪽 / Page3) 6.7 한국이외에과거 5년간여행한국가 Has the invitee travelled outside his/her country of residence, excluding to Korea, in the last 5 years? 아니오 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 (yyyy/mm/dd)~ (yyyy/mm/dd) 6.8. 동반입국가족유무 Is the invitee travelling to Korea with any family member? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details of the family members the invitee is travelling with 성명 Full name in English 생년월일 Date of Birth (yyyy/mm/dd) 국적 Nationality 관계 Relationship to the invitee * 참고 : 가족의범위 배우자, 자녀, 부모, 형제 Note : Definition of a Family Member - your spouse, father, mother, children, brothers and sisters 7. 서류작성시도움여부 / ASSISTANCE WITH THIS FORM 7.1 이신청서를작성하는데다른사람의도움을받았습니까? Did you receive assistance in completing this form? 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용 If Yes please provide details of the person who assisted you 성명 Full Name 생년월일 Date of Birth (yyyy/mm/dd) 연락처 Phone No 관계 Relationship to you 8. 초청인정보 / DETAILS OF SPONSOR
8.1 초청인 / 초청회사 Sponsor/sponsor company 아니오 No [ ] 예 Yes [ ] 예 선택시상세내용기재 If Yes please provide details a) 초청인 / 초청회사명 Name of sponsor/sponsor company (Korean, foreign resident in Korea, company, or institute) b) 생년월일 / 사업자등록번호 Date of Birth / Business Registration No. c) 관계 Relationship to you d) 주소 Address e) 전화번호 Phone No. 출입국관리법시행규칙 제 17 조제 2 항에따라상기외국인에대한사증발급인정서를신청합니다. I hereby apply for Confirmation of Visa Issuance for the invitee 17(2) of the Enforcement Regulations of the Immigration Act., in accordance with article 신청일자 ( 년. 월. 일 ) DATE OF APPLICATION (yyyy/mm/dd) / / / 신청인 ( 초청인 ) 성명 NAME OF APPLICANT(SPONSOR) 신청인 ( 초청인 ) 서명 ( 인 ) SIGNATURE(SEAL) OF APPLICANT(SPONSOR) ( 신청인이 17 세미만자의경우부모또는법정후견인의서명 ) Signature of Parent or Legal Guardian s for a person under 17 years of age 첨부서류 담당공무원 확인사항 출입국관리법시행규칙 제 76 조제 1 항관련 [ 별표 5] 사증발급신청등첨부서류 출입국관리법시행규칙 제 76 조제 1 항관련 [ 별표 5] 사증발급신청등첨부서류에따라주민등록등본 가족관계기록사항에관한증명서 사업자등록증 납세사실 증명 어업면허증이첨부서류로되어있는경우 ( 제 4 쪽 / Page4) 행정정보공동이용동의서 / Consent for sharing of administrative information [ 초청인용 Only for sponsor] 본인은이건업무처리와관련하여담당공무원이 전자정부법 제36조에따른행정정보의공동이용을통하여위의담당공무원확인사항을확인하는것에동의합니다. * 동의하지아니하는경우에는신청인이직접관련서류를제출하여야합니다. 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 in accordance with Article 36 (sharing of administrative information) of the Electronic Government Act. *If you disagree, you have to present all related documents yourself. 신청인성명 NAME OF APPLICANT 신청인서명 ( 인 ) SIGNATURE(SEAL) OF APPLICANT 유의사항 / Notice 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 your application.
2. 대한민국사증을승인받은후분실또는훼손등의사유로여권을새로발급받은경우에는, 정확한개인정보를반영할수있도록변경된여권정보를사증에통보하여야합니다. If you received Korean visa approval, and have new passport issued thereafter in lieu of lost/damaged passport, you must notify the concerned visa office of changes in your passport information. 3. 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 Republic of Korea in accordance with Article 9(1) of the Enforcement Regulations of the Immigration Act. 공용란 / FOR OFFICIAL USE ONLY 기본사항체류자격체류기간사증종류단수ㆍ복수 (2 회, 3 회이상 ) 접수사항접수일자접수번호처리과 허가사항허가일자인정번호고지사항 담당자 < 심사의견 > 결재 가 [ ] 부 [ ] 처리절차 / Procedure 인정신청서작성 Application for Confirmation 접수 Reception 심사 Assessment 결과통지 Notification 사증신청및발급 Visa Application and Issuance 신청인또는초청인 Applicant or Sponsor ( 출입국관리사무소 ) ( 좌동 ) ( 좌동 ) ( 재외공관 ) Diplomatic Mission 210mm 297mm[ 백상지 80g/ m2 ( 재활용품 )