■ 인감증명법 시행령 [별지 제15호의4서식] <개정 2020. 2. 18.>
■ Enforcement Decree of The Personal Seal Act [Form an enclosure No. 15 4]
[ ] Application for the Protection of Personal Seal [ ] Application for Cancelling the Protection of Personal Seal
※ Fill out this form and check where appropriate according to the instructions on the back of the form.									(Front)
Application No.			Date			Processing Time		Immediate
Applicant		Name			Resident Registration No. -			Nationality
		Address						Right Thumb print
		Description for Application
Consent of a Legal Representative, Limited guardian or Adult guardian		Name			Relationship to Applicant			Personal seal or Signature ※ Attach the certificate of personal signature at the time of signing
		Date of Birth
		Address
Confirmation of Diplomatic Mission (Consul), Prison (Prison Officer), Town Government(Civil Servant)
I certify	[ ] the application for the protection of the personal seal. [ ] the application for cancelling the protection of the personal seal of the applicant. [ ] the consent of a legal representativeㆍlimited guardianㆍadult guardian.
Date (YYYY/MM/DD) [ ] Diplomatic Mission (Consul) (Signature or Seal) [ ] Prison (Prison Officer) (Official Seal) (Signature or Seal) [ ] Town Government(Civil Servant) (Signature or Seal) ※ Civil Servant only writes when declarant cannot visit the Town Government because of serious case
I apply for the protection of personal seal or for cancelling the protection of personal seal according to Article 17-2 of the Enforcement Decree of the Seal Imprint Certification Act.
Date (YYYY/MM/DD)
Applicant:				(Signature or Seal)
Representative:				(Signature or Seal)
Resident Registration No.:
Address:
For the Head of the City/County/District/Town/Local Government of
210mm×297mm[white paper (80g/㎡) or middle quality paper(80g/㎡)]

(Back)
Notes and Instructions
1. All representatives visiting a government office and applying for the protection (or cancelling the protection) of a personal seal on behalf of an applicant who is an overseas Korean national, a person residing (visiting) abroad, or a prisoner must bring a form of identification such as a resident registration card. 2. For resident registration number: If you are an overseas Korean national and do not have a resident registration number, enter your passport number; if you are a foreigner, enter your alien registration number; and if you are a registered domestic resident, enter your domestic residence report number. 3. Applying for the protection (or cancelling the protection) of a personal seal allows you to protect (or cancel the protection of) your personal seal by ensuring that only you or a person authorized by you can be issued the certificate of your personal seal. Describe what you are applying for in the "Description for Application" section, referring to the following examples. [Examples] □ Do not issue the certificate of personal seal to anyone but myself. □ Do not issue the certificate of personal seal to anyone except myself and my spouse (name, resident registration number). □ Do not issue the certificate of personal seal to anyone except myself, my spouse (name, resident registration number), and my mother (name, resident registration number). □ The certificate of my personal seal shall only be issued at (the city/county/district/town/local government relevant to the address); do not issue at other locations of government office. □ Other description that is necessary for the protection or cancelling the protection of personal seal. 4. If you are not able to affix your thumbprint, affix any other fingerprint instead; the print must be neatly and clearly affixed. 5. If an overseas Korean national, a person residing (visiting) abroad, or a prisoner designates a representative to apply on his/her behalf, the applicant must receive a confirmation from one of the following organizations as applicable. a. Overseas Korean national, person residing (visiting) abroad: Diplomatic mission (Consul); or b. Prisoner: Prison (Prison Officer). 6. Check where appropriate to indicate whether you are applying for the protection or cancelling the protection of a personal seal. If the applicant is a minor, limited wards or adult wards, also check the legal representativeㆍlimited guardianㆍadult guardian section. 7. Check where appropriate to indicate whether the organization is a diplomatic mission or a prison.
Procedure
This application form will be processed as follows.
	Applicant						1. A minor, limited wards or adult wards must get the consent of their legal representativeㆍlimited guardianㆍadult guardian. 2. An overseas Korean national (person visiting abroad) or a prisoner must receive confirmation from a diplomatic mission or a prison.
	Submitting Application		▲		Accepting Application
		▼
	Government office receiving personal seal registration (if this is government office in charge, it manages the register of personal seals)				Reporting Application				▶		Government office in charge (manages the register of personal seals)