[별지 제41호서식]

체 류 자 격 변 경 허 가 인

체 류 자 격 변 경 허 가

PERMISSION FOR CHANGE OF

STATUS OF SOJOURN

NO. :

Status of sojourn of the bearer of this passport is amended as ____________________________________________

Date of Issue :

Chief, ○○Immigration Office

Period of Sojourn :

50㎜×50㎜