외국인 대상자 제출 서류 안내

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외국인 대상자 제출 서류 안내

외국인 대상자 서류 제출 안내 □ 신원조사 제출 서류 1. 보안업무규정 시행규칙 제57조(요청절차)제2항제5호 - 자기소개서(별지 제22호서식), 여권사본, 자국 공안기관이 발행한 범죄기록증명원(한글로 작성되지 않은 경우에는 공증된 한글 번역 본을 첨부한다. 이하 이 조에서 같다.) 외국인등록사실증명원(국내 등록시) 각 1부 및 최근 6개월 내에 촬영한 상반신 반명함판 사진 또는 여권용 사진 1장(자기소개서에 붙인다) * 별지 21호 서식으로도 사용 가능 2. 개인정보 제공동의서 서식은 ↓ 붙임 첨부 [별지 제22호서식] <개정 2020. 3. 17.> (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 [백상지(80/㎡) 또는 중질지(80/㎡)] (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 [백상지(80/㎡) 또는 중질지(80/㎡)] (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 Items Name, gender, photo, nationality, place of birth, alien registration number, date & place of entry to korea, residential address in korea, workplace, job/title, telephone numbers(including office, mobile), education (including school name, period, type of degree, major, location), employment history & participation in civic/ political association(including employer/verifier name, period, job title/position, location, reward&punishment), family information(including relation, name, date of birth, final academic degree, career, address), relatives & asso ciates in korea(including relation, name, career, job title/position, telephone number) Purpose of collection/use Background check and verification Retention/ use period 2 years ※ 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 Items Participation in civic/political association Purpose of collection/use Background check and verification Retention/ use period 2 years ※ 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 Items Alien registration number Purpose of collection/use Background check and verification Retention/ use period 2 years ※ 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. [ ] 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 [백상지(80/㎡) 또는 중질지(80/㎡)] 개 인 정 보 제 공 동 의 서 ■ 본인은 보안업무규정 제36조에 따른 신원조사 대상자임을 요청기관으로부터 고지받고 신원조사기관이 본인에 대한 신원조사를 실시할 필요가 있다는 것을 이해하였으며, 이를 위해 신원조사 기관에서 ｢개인정보보호법｣ 등에 의해 보호되고 있는 본인의 개인 (고유식별)정보를 동법 제15조(개인정보의 수집ㆍ이용) 및 제17조(개인정보의 제공)의 규정 등에 따라 본인의 개인정보를 처리(제공·조회)하는 것에 동의합니다. ■ 개인정보 제공·조회 안내 동의 여부 고유식별정보 제공 동의함[ ] 동의하지 않음[ ] 개인(신용)정보 조회 동의함[ ] 동의하지 않음[ ] ※ 본인이 서명한 동의서 복사본은 원본과 동일하게 유효하다는 것을 인정합니다. ■ 귀하는 본인의 개인정보를 제3자에게 제공하는 것에 대한 동의를 거부할 권리가 있습니다. 그 러나, 동의를 거부하는 경우 신원조사를 진행할 수 없어 신원조사를 요청하는 기관으로부터 임용 ·출입·비밀취급인가 등에 제한을 받을 수 있음을 알려드립니다. 년 월 일 성명 (자필서명) 제공·조회목적 신원조사 사실관계 확인을 위한 자료 조회 제공받는 기관 교육부, 법무부, 행정안전부, 국토교통부, 경찰청, 병무청, 국민건강보 험공단, 한국신용정보원 보유·이용기간 신원조사 종료 시까지 제공·조회 항목 (해당기관) 제공 ▪주민등록번호·외국인등록번호(고유식별정보) 조회 ▪검정고시합격증명서, 고등학교졸업증명서(교육부) ▪출입국기록, 국적, 국내거소신고사실증명(법무부) ▪주민등록등·초본(행정안전부) ▪자동차등록원부(국토교통부) ▪범죄경력·수사경력자료,국내·외 수배자료, 운전면허(경찰청) ▪병적자료(병무청) ▪건강보험자격득실내역(국민건강보험공단) ▪개인신용정보(한국신용정보원)

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