[별지제17호서식](앞쪽)签证发给申请表APPLICATIONFORVISA※返签证号码(CONFIRMATIONOFVISAISSUANCENo:)照片PHOTO3.5㎝×4.5㎝1.姓Surname3.漢字姓名4.性别Gender[]M[]F2.名GivenNames5.出生月日DateofBirth6.国籍Nationality7.出生国家CountryofBirth8.现住所HomeAddress9.电话号码PhoneNo.10.手机号码MobilePhoneNo.11.电子邮箱E-mail12.身份证号码NationalIdentityNo.护照13.护照号码PassportNo.14.护照种类Classification外交,公務,公務普通,因私,其他DP(外交),OF(官用),OR(一般),OTHERS(其他)15.签发地PlaceofIssue16.签发日DateofIssue17.到期日DateOfExpiry职业18.职业Occupation19.单位电话号码BusinessPhoneNo.20.单位名称与住所NameandAddressofPresentEmployer结婚与否Maritalstatus21.[]已婚married[]丧偶widowed[]未婚Single[]离婚divorced22.配偶姓名Spouse'sName23.配偶出生月日Spouse'sDateofBirth24.配偶国籍Spouse'sNationality25.配偶电话号码Spouse'sPhoneNo.26.入国目的PurposeofEntry27.预定滞留期间PotentialLengthofStay28.入国预定日PotentialDateofEntry29.访韩事实PreviousVisit(IfAny)30.韩国滞留地AddressinKorea31.韩国电话号码PhoneNo.inKorea32.旅行费用支付者WhoWillPayForTheExpenseForYourStay?33.最近5年间旅行(访问)过的国家CountriesYouHaveTravelledDuringThePast5Years※PleasenotethatC-seriesvisaholdersarenotabletochangetheirresidentialstatusafterentryintoRepublicofKoreapursuanttothefirstclauseofarticle9ofImmigrationRegulation34.同伴家族AccompanyingFamily关系Relationship国籍Nationality姓名Name出生月日Dateofbitrh性别Gender35.韩国担保人GuarantororReferenceinKorea关系Relationship国籍Nationality姓名Name出生月日Dateofbitrh性别GenderIdeclarethatthestatementsmadeinthisapplicationaretrueandcorrecttothebestofmyknowledgeandbelief,thatIwillobservetheprovisionsoftheImmigrationLawoftheRepublicofKoreaandthatIwillnotengageinanyactivitiesirrelevanttothepurposeofentrystatedherein.Besides,Iamfullyawarethatanyfalseormisleadingstatementmayresultintherefusalofavisa,andthatpossessionofavisadoesnotentitlethebearertoentertheRepublicofKoreauponarrivalattheportofentryifhe/sheisfoundinadmissible.申请日DATEOFAPPLICATION申请人署名SIGNATUREOFAPPLICANT공용란FOROFFICIALUSEONLY기본사항체류자격체류기간사증종류단수ㆍ복수(2회,3회이상)접수사항접수일자접수번호처리과허가사항허가일자허가번호고지사항결재담당자가ㆍ부〈심사의견〉