Korea-Birth Registration-English PDF
Korea-Birth Registration-English PDF
1]
Birth Registration Form ※ Please complete this form according to the instructions on
( Day Month Year) the reverse side. Circle where appropriate.
① Hour Minute Day Month Year (Please enter in 24 hour clock format based on
Time & Date of birth
Person the local time of birthplace)
of birth Birthplace address Own residence Hospital Others
(Child)
Permanent address designated by parents
Address Relationship to the head of household of
If the child has dual nationalities, please indicate this fact and enter the other nationality.
Place of family origin
Father Name (Chinese characters) Resident registration No. -
(Chinese characters: )
② Mother Name Place of family origin Resident registration No. -
Parents (Chinese characters: ) (Chinese characters)
Father’s permanent address
Mother’s permanent address
When reporting a marriage, did you submit the agreement certifying that your child will carry his/her mother’s surname
and the place of family origin? Yes⎕ No⎕
③ Indicate below if you are registering the birth again after the Family Register was closed in accordance with a court
judgement confirming the non-existence of parent-child relationship.
Particular details in the closed Name Resident registration No. -
Family Register Permanent address
④ Remarks
Name Seal or signature Resident Registration No. -
⑤ Applicant
Relationship Father Mother Cohabiting relative Others (Eligibility : )
Address
Tel. E-mail
⑥ Submitting person Name Resident registration No. -
※ A person filing a false registration form making a fraudulent use of other person’s signature or seal or causing a false entry on the Family
Register as a result of a false report is punishable by imprisonment for not more than five years or fine of up to KRW 10,000,000 under the
Criminal Act.
※ The following information is required for national population policy. You are obliged to provide accurate information in
a faithful manner according to Articles 32 and 33 of the Statistics Act. All personal information will be strictly
protected.
Details of the Person of Birth
⑦ Duration of pregnancy Pregnancy Weeks Days ⑧ Weight of the new born baby . ㎏