[업무문서] 사증발급신청서

[별지 제17호서식]
査證發給申請書 APPLICATION FOR VISA
公館(申請)番號：
寫 眞
PHOTO
35×45㎜

1. 姓 SURNAME 漢字姓名

2. 名 GIVEN NAMES

3.生年月日 DATE OF BIRTH

year年 month月 day日

4. 性別

SEX

5. 國籍

NATIONALITY

6. 出生地 PLACE

OF BIRTH

7. 旅券 PASSPORT 種別 CLASSIFICATION 番號 NUMBER 發給日 DATE OF ISSUE 滿了日 DATE OF EXPIRY 發給處 ISSUED BY

外交. 官用. 一般. 其他
DP OF OR

8. 配偶者 姓名 및 國籍 SPOUSE`S NAME & NATIONALITY

9. 職場 및 職位 OCCUPATION & TITLE 電話番號 PHONE No.

10. 入國 目的 PURPOSE OF ENTRY(EXPLAIN FULLY)

11. 住所 PRESENT ADDRESS 電話番號 PHONE No.

12. 國內 滯留地 ADDRESS IN KOREA 電話番號 PHONE No.

13. 國內 連絡處 REFERENCES IN KOREA 電話番號 PHONE No.

14. 滯留 豫定期間 DESIRED LENGTH OF STAY

15. 訪韓事實 PREVIOUS VISIT IF ANY

16.最近 5年間 旅行國家 COUNTRIES WHERE YOU HAVE LIVED OR TRAVELLED DURING THE PAST 5 YEARS

17. 同伴家族

ACCOMPAN…

國 籍

姓 名

性 別

生 年 月 日

DATE OF BIRTH

18. 國內 滯留家族

IN KOREA

I declare that the statements made in this application are true and correct to the best of my knowledge and belief, and that I will observe the provisions of the Immigration Law of the Republic of Korea and that I will not engage in any activities irrelebant to the purpose of entry stated herein. Besides, I admit that any false or misleading statement may result in the refusal of a visa, and that 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.

申請日 DATE OF APPLICATION 申請人 署名 SIGNATURE OF APPLICANT

공용란 FOR OFFICIAL USE ONLY

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’95.10. 5 승인