1. Applicant's name : (write in capital letters)
2. Alien Registraion Number : * Nationality :
3. Address : .....e-mail :
4. Company : ....
5. Telephone number in Korea :
6. Date of Stay & Work : from ~ to

7. Exemption: Please check at least 1 item below.

Single Married (A copy of your marriage certificate is required)

 
Spouse's name : His/Her Date of Birth
¡Ø Does your spouse have any form of income? ( Yes / No)
Number of children below 20 years of age :
(A copy of child¡¯s birth certificate is required.)
Child's name His/Her Date of Birth
Child's name His/Her Date of Birth
Child's name His/Her Date of Birth
Child's name His/Her Date of Birth
8. The Class B income
¨ç Basic Salary per month (USD, EURO, NOK, GBP, KRW) :
¨è Overseas allowance per month (USD, EURO, NOK, GBP, KRW) :
¨é Bonus per month (USD, EURO, NOK, GBP, KRW) :
Total per month (USD, EURO, NOK, GBP, KRW) :(¨ç+¨è+¨é)
9. Did you worked for other company during the same year? ( Yes / No)

If Yes, you must submit a Receipt for wage and salary income Tax withholding of your previous employment to GTA to avoid penalty tax.

I, have read and ratified the charter of Geoje Taxpayers Association and hereby apply for membership to the Association.
Applicant's Signature :