선거관리위원회 보안업무규칙
별표·별지34건 · 보관 34건
| [별지 제32호서식] | ||||||||||||
| (1st page) | ||||||||||||
| PERSONAL QUESTIONNAIRE * FOR OFFICIAL USE ONLY | [PHOTO] or photo file (3㎝×4㎝)ㆍ (3.5㎝×4.5㎝) | |||||||||||
| NAME | Last/First/Middle | GENDER | ||||||||||
| DATE OF BIRTH | Month/Day/Year | |||||||||||
| NATIONALITY (Include any dual nationality) | PLACE OF BIRTH | City/Country | ||||||||||
| ALIEN REGISTRATION NUMBER | DATE & PLACE OF ENTRY TO KOREA | Month/Day/Year City/Country | ||||||||||
| RESIDENTIAL ADDRESS IN KOREA | ||||||||||||
| WORKPLACE | JOB/TITLE | |||||||||||
| TELEPHONE NUMBERS (Include Area Code) | OFFICE : MOBILE : | |||||||||||
| EDUCATION | SCHOOL NAME | PERIOD (MM/YY-MM/YY) | TYPE OF DEGREE | MAJOR | LOCATION (City/Country) | |||||||
| 210mm×297mm | ||||||||||||
| (2nd page) | |||||||||||
| EMPLOYMENT HISTORY & PARTICIPATION IN CIVIC/POLITICAL ASSOCIATION | EMPLOYER/ VERIFIER NAME | PERIOD (MM/YY-MM/YY) | JOB TITLE/ POSITION | LOCATION (City/Country) | REWARD & PUNISHMENT (MM/YY) | ||||||
| FAMILY INFORMATION | RELATION | NAME Last/First/Middle | DATE OF BIRTH | FINAL ACADEMIC DEGREE | CAREER | ADDRESS | |||||
| RELATIVES & ASSOCIATES IN KOREA | RELATION | NAME Last/First/Middle | CAREER | JOB TITLE/ POSITION | TELEPHONE NUMBER | ||||||
| I declare that statements made in this form are true and correct, and agree if false information is knowingly or willingly provided on this form, I can be penalized in accordance with the relevant statute. DATE : SIGNATURE : | |||||||||||
| 210mm×297mm | |||||||||||
| (3rd page) | ||||||
| Consent to the Collection and Use of Personal Information | ||||||
| The National Intelligence Service, Ministry of National Defense, and National Police Agency intend to collect and use personal information, sensitive information, and personally identifiable information of the applicant for the conduction of background check pursuant to Article 46 (Processing of Personally Identifiable Information) of the "Regulations on Security Work," and Article 15 (Collection and Use of Personal Information), Article 23 (Limitation to Processing of Sensitive Information), and Article 24 (Limitation to Processing of Personally Identifiable Information) of the "Personal Information Protection Act." | ||||||
| ■ Collection and use of personal information ※ The above is the minimum information required to carry out background check and the applicant has the right to refuse the collection and use of personal information. However, in case of refusal, there may be restrictions in appointment (employment) and security clearance, as background check cannot be carried out pursuant to "Regulations on Security Work." ☞ I agree to the collection and use of personal information as described above. I agree [ ] I do not agree [ ]
| ||||||
| ■ Processing of sensitive information ※ The above is the minimum information required to carry out background check and the applicant has the right to refuse the processing of sensitive information. However, in case of refusal, there may be restrictions in appointment (employment) and security clearance, as background check cannot be carried out pursuant to "Regulations on Security Work." ☞ I agree to the processing of sensitive information as described above. I agree [ ] I do not agree [ ]
| ||||||
| ■ Processing of personally identifiable information ※ A separate consent is not required under subparagraph 1 of Article 24-2 (1) of the "Personal Information Protection Act" and Article 46 of the "Regulations on Security Work." ☞ I have read and understood that personally identifiable information will be processed as described above. [ ]
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| We comply with personal information protection regulations that personal information processors are required to follow under the "Personal Information Protection Act." We will protect the rights of the information provider in accordance with relevant laws, and the collected information will not be used for purposes other than reasons agreed to by the information provider. mm dd, yyyy Applicant (representative): (seal or signature) Legal representative (if needed): (seal or signature) Contact information: | ||||||
| 210mm×297mm |
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