Your Certificate Of Personal Records(기본증명서)

Permanent Address (Permanent Domicile)

Section	Information
Writing	[date of writing] [reason of writing]

Section	Name	Data of Birth	ID-Number	Sex	Family Origin
Myself

The General Records

Section	Information
Birth	[place of birth] [date of report] [informant]
Name Change	[permission date on name change] [permission court name] [date of report] [informant] [date of record] [previous name] [after name]

This is to certify that the certificate of personal records has same contents as the korean family relations certificate.

date :

The chief of nam - gu office Busan