[별지 제30호서식]

(앞 면)

	? CREW
	? EMERGENCY
	? DISASTER

上 陸 許 可 申 請 書

APPLICATION  FOR

LANDING   PERMIT

FAMILY NAME

漢字姓名

GIVEN NAMES

남 MALE

여 FEMALE

生年月日  DATE OF BIRTH

國籍 NATIONALITY

年 YEAR

月 MONTH

日 DAY

旅券番號  PASSPORT NO.

職業 및 職場名

OCCUPATION

上陸理由  REASON  FOR LANDING

上陸申請期間

PERIOD  OF  LANDING

入港便名  FLIGHT  NO./

DISEMBARKATION

出港便名  FLIGHT  NO./

EMBARKATION

前寄港地  PORT ARRIVED FROM

次港地  NEXT  PORT  OF  CALL

I declare that I will faithfully observe the IMMIGRATION LAW OF THE REPUBLIC OF KOREA, and notify to all       crew members and passengers that they must observe the LAW, and assume whole responsibility for all the charges      which might be occured by them.

署名  SIGNATURE OF  APPLICANT(AGENT/MASTER)

行動範圍  AREA OF MOVEMENT

有效期間  VALID UNTIL

制限·條件  RESTRICTIONS OR CONDITIONS

3236-01521 민

93.3.22 승인

84㎜×124㎜

인쇄용지(NCR)  120g/㎡

(뒷면, 앞쪽)

	? CREW
	? EMERGENCY
	? DISASTER

上 陸 許 可 書

FAMILY NAME

LANDING   PERMIT

No.

漢字姓名

GIVEN NAMES

남 MALE

여 FEMALE

生年月日  DATE OF BIRTH

國籍 NATIONALITY

年 YEAR

月 MONTH

日 DAY

旅券番號 PASSPORT NO.

職業 및 職場名

OCCUPATION

上陸理由 REASON  FOR LANDING

上陸申請期間

PERIOD  OF  LANDING

入港便名  FLIGHT  NO./

DISEMBARKATION

出港便名  FLIGHT  NO./

EMBARKATION

前寄港地  PORT ARRIVED FROM

次港地  NEXT  PORT  OF  CALL

입국심사인

출국심사인

行動範圍  AREA OF MOVEMENT

有效期間  VALID UNTIL

制限·條件  RESTRICTIONS OR CONDITIONS

(뒷 쪽)

주의사항  NOTICE

1. 이 상륙허가서는 출입국관리법에 의하여 발급하였습니다.

2. 이 상륙허가서는 여권 또는 선원수첩과 함께 항시 휴대하여 출입국관리공무원이나 다른 권한있는 공무원의 요구가 있으면  제시하여야 합니다.

3. 이 상륙허가서 소지자는 상륙허가기간 만료전에 승선해야 하며 승선시는 출입국관리공무원에게 이 허가서를 반환해야 합  니다.

4. 위 또는 전면에 기재한 조건을 위반한 때는 출입국관리법에 의하여 처벌됩니다.

1. This LANDING PERMIT is issued pursuant to the IMMIGRATION LAW.

2. This LANDING PERMIT shall be carried with passport or sea man's book at all times and Presented to the         immigration officer or other authorized official upon request.

3. The bearer of this LANDING PERMIT shall go on board not later than the date  of expiration of the permit and the PERMIT shall be returned to the KOREAN IMMIGRATION OFFICER when the bearer go on board.

4. Failure to observe any of the above or front conditions shall be punished pursuant to the IMMIGRATION LAW.

연장허가   EXTENSION OF THE PERIOD

허가번호 NO.

만료일

EXPIRES   ON

허가일

PERMITTED   ON

확인인