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상륙허가 신청서
APPLICATION FOR | □승무원 CREW (□SINGLE, □MULTIPLE)
□긴급 EMERGENCY
□재난 DISASTER
□관광 TOUR (□GROUP, □INDIVIDUAL) |
| 성 Surname | 성 별
Sex | [ ]남 M
[ ]여 F |
| 명 Given names |
| 생년월일 DATE OF BIRTH(yyyy/mm/dd) |
| 국적 NATIONALITY |
| 여권번호 PASSPORT NO. | 직업 OCCUPATION |
| 상륙이유 REASON FOR LANDING | 운수업자 AGENT |
입항편명
FLIGHT NO./DISEMBARKATION | 출항편명
FLIGHT NO./EMBARKATION |
| 전출항지 DEPARTED PORT | 다음 출항지 NEXT PORT OF CALL |
| By signing below, I agree that I will comply with the Immigration Act of the Republic of Korea and notify all crews and passengers of the obligation to abide by the Immigration Act. I declare that I will assume full responsibility for any violation of the Act committed by them. |
| 서명 SIGNATURE OF APPLICANT (AGENT/MASTER) |
| 공용란 OFFICIAL USE ONLY |
| 행동범위 제한 AREA OF MOVEMENT | 유효기한 VALID UNTIL(yyyy/mm/dd) |
| 기타 제한/조건 RESTRICTIONS OR CONDITIONS |
| 92mm×132mm(인쇄용지(NCR) 75G/㎡) |