■ 사회복무요원 복무관리규정 [별지 제5호서식] <개정 '13.12.4>
Certificate of Service for Public Interest Service Personnel
Certificate No.
Personal Background	Name	Resident Registration No.
Address
Service Information	Institution Served	Service Field
Date Called	Date Discharged (Expected)
Usage	[ ] For application of returning to University and others [ ] Others ( )
It is hereby certified that the person above mentioned is in the service.
Date of issue :
	Approved by		(Sign and seal)
Head of O O Regional Office of Military Manpower Administration or Head of Institution Served (Official Seal)
Reference	The date discharged (expected to be discharged) may be changed in accordance with the regulations of the enforcement decree of the Military Service Act.
210mm×297mm[백상지 80g/㎡]