[Form No. 27]

Report of Name Change (..... Day ..... Month ........ Year)						※ Please write after reading the guidelines below and, when required to select one option, please circle the number as follows "○".
① Person changing name	Name	Present name							② New name
		Korean name			Chinese characters				Korean name						Chinese characters
	Place of family origin (Chinese characters)								Resident Registration No.						-
	Permanent domicile address
	Address
	Parents' names	Father							Mother
③ Date of permission		..... Day ..... Month ........ Year							Court's name
④ Other relevant facts
⑤ Reporter	Name	Seal or signature				Resident Registration No.							-
	Relationship	ꊱ Self ꊲ Legal representative ꊳ Other (Please state : )
	Address					Tel. No.				E-mail
⑥ Submitter	Name					Resident Registration No.								-

How to fill out
※ This should be reported within one month from the date to receive the copy of permitted decision for changed name. ① : Please write to separate present name and new name. ② : Please write the name(Permitted name on copy of permitted decision for changed name) which want to change and write only on section of Korean name if the name haven't Chinese characters. ③ : Please write the permitted date(D/M/Y) of changed name on copy of permitted decision for changed name. ④ : Please write especially necessary informations for clarifying the family relation register. ⑤ : Please write the present(not new) name of reporter. ⑥ : Please write the name and resident registration number of submitter. (Regardless of declarer is true or not) [An acceptable official in charge identify the submitter]
Required Document(s)
1. Copy of permitted decision for change of a name 1 copy. 2. Identification. [In accordance with Article 23 in a certificate of family relations register] - In case of reporter's attendance : Identification card - In case of submitter's attendance : Identification card of submitter. - In case of postal submission : Copy of identification card for reporter

Report of Name change

(개명신고서)

□ This should be reported within one month from the date to receive the copy of permitted decision for name change.

(이 신고는 개명허가결정등본을 받은 날로부터 1개월 이내에 신고하여야 합니다.)

① Person changing name  (개명자)

□ Present name  (현재의 이름)

￭ Please write the present name in Korean or English and in Chinese characters.

(현재의 이름을 한글과 한자로 기재하세요.)

※ Please write present and new name in each.

(개명전의 현재의 이름과 개명하고자 하는 이름을 각각 기재하세요.)

② New name  개명하고자 하는 이름

￭ Please write the new name in Korean or English and in Chinese characters.

(개명하고자 하는 이름을 한글과 한자로 기재해 주세요.)

※ Please write the new name (Permitted Name as copy of permitted decision for         changed name). and write only Korean name if there isn't in Chinese characters.

(변경하고자 하는 이름 (개명허가결정등본에 기재된 개명허가를 받은 이름)을

기재 하며, 한자가 없는 경우는 한글 란에만 기재합니다.)

□ Place of family origin [Chinese characters]  본[한자]

￭ Please write the place of family origin in Chinese characters.

(본을 한자로 기재하세요.)

￭ Please write the resident register number.

(주민등록번호를 기재해 주세요.)

□ Permanent domicile address (등록 기준지)

￭ Please write the permanent domicile address.

(등록 기준지를 기재하세요.)

※ In event of a foreigner, please write in nationality on permanent domicile address.

(외국인의 경우 등록기준지에 국적을 기재해 주세요.)

□ Address  (주소)

￭ Please write the current address.  (현재의 주소를 기재해 주세요.)

□ Parent's names.  (부모의 이름)

￭ Please write each name of father and mother.

(부와 모의 이름을 각각 기재해 주세요.)

③ Date of permission.  (허가 일자)

￭ Please write the date of permission as copy of permitted decision for name change.

(개명허가일자는 개명허가결정등본에 기재된 연월일을 기재합니다.)

￭ Please write the court's name.  (법원명을 기재해 주세요.)

④ Other relevant facts  (기타 사항)

￭ Please write other relevant facts. (기타 사항을 기재해 주세요.)

※ Please write especially necessary informations for clarifying the family relation

register.

(가족관계등록부에 기록을 분명하게 하는데 특히 필요한 사항을 기재합니다.)

⑤ Reporter  (신고인)

□ Name / Resident registration number  이름 / 주민등록번호

￭ Please write reporter's previous name and resident registration number.

(신고인의 개명전 이름과 주민등록번호를 기재해 주세요.)

□ Relationship (자격)

￭ Please check on relationship out of following number.

(아래의 번호 중 자격을 선택해 주세요.)

ꊱ Self 본인  ꊲ Legal representative 법정 대리인  ꊳ Other 기타

□ Address & Phone Number & E-mail  주소 / 전화번호 / 이메일

￭ Please write the address, phone number and E-mail of reporter.

(신고인의 주소, 전화번호와 이메일 주소를 기재해 주세요.)

⑥ Submitter  제출인

￭ Please write the name and resident register number of submitter.

(제출인의 이름과 주민등록번호를 기재해 주세요.)

□ Required Document(s)  첨부서류

1. Copy of permitted decision for changed name 1 copy

(개명허가결정등본  1부)

2.  Identification  (신분 확인)

[In accordance with Article 23 in a certificate of family relations register]

([가족관계등록예규 제23호에 의함])

￭ If an applicant visits : then Certificate of identification.

(신고인이 출석한 경우 : 신분증명서)

￭ If a submitter visits : then identification certificate of submitter.

(제출인이 출석한 경우 : 제출인의 신분증명서)

￭ Application by mail: copy of applicant's Identification certificate.

(우편제출의 경우 : 신고인의 신분증명서 사본)