Name Date of Birth
Nationality Ship·Flight No.
Passport No. Date of Arrival
<Note>
<Note>
<Note>
<Note>
In response to the global COVID-19 outbreak, as of 00:00 April 1st, 2020 (arrival time), the Republic of Korea requires all inbound travelers to be subject to self-quarantine or facility quarantine.
- Facility Quarantine : Foreign nationals holding B-1, B-2, C-1, C-3, C-4, or G-1 visa, and H-2, F-4 visa holders who are nationals of high infection rate countries
- Self-Quarantine : Foreign nationals holding visas other than those mentioned above, and Korean nationals
<Subjects of submission and Consequences for non-submission>
<Subjects of submission and Consequences for non-submission>
<Subjects of submission and Consequences for non-submission>
<Subjects of submission and Consequences for non-submission>
Foreign nationals subject to Foreign nationals subject to Foreign nationals subject to
Foreign nationals subject to facility quarantinefacility quarantinefacility quarantinefacility quarantine should complete and submit this should complete and submit this should complete and submit this should complete and submit this agreement to the government of the Republic of Korea. If the person fails to submit agreement to the government of the Republic of Korea. If the person fails to submit agreement to the government of the Republic of Korea. If the person fails to submit agreement to the government of the Republic of Korea. If the person fails to submit the agreement or does not agree with all categories below, the government of the the agreement or does not agree with all categories below, the government of the the agreement or does not agree with all categories below, the government of the the agreement or does not agree with all categories below, the government of the Republic of Korea may deny the entry of that foreign national in accordance with the Republic of Korea may deny the entry of that foreign national in accordance with the Republic of Korea may deny the entry of that foreign national in accordance with the Republic of Korea may deny the entry of that foreign national in accordance with the
Immigration Act , Quarantine Act , etc.
Immigration Act , Quarantine Act , etc.Immigration Act , Quarantine Act , etc.
Immigration Act , Quarantine Act , etc.
『 』 『 』
『 』 『 』
『 』 『 』
『 』 『 』
<Facility Quarantine>
<Facility Quarantine>
<Facility Quarantine>
<Facility Quarantine>
I, as a foreign national without a Self-Isolation Exemption Certificate and being subject to facility quarantine, agree to be quarantined at a facility designated by the government of the Republic of Korea for 14 days after entry, in accordance with Article 42 of the Infectious Disease Control and Prevention Act , Article 16 of the Quarantine Act ,
『 』 『 』
etc.
Agree AgreeAgree Agree
□ □
□ □ □ □ □ □ DisagreeDisagreeDisagreeDisagree
<Expenses>
<Expenses>
<Expenses>
<Expenses>
I, in compliance with the instructions of the government of the Republic of Korea, agree to pay all expenses (maximum 2,100,000 KRW per person) for accommodation, meal, transportation, etc. incurred by facility quarantine for 14 days.
Agree AgreeAgree Agree
□ □
□ □ □ □ □ □ DisagreeDisagreeDisagreeDisagree
<Measures for Departure>
<Measures for Departure>
<Measures for Departure>
<Measures for Departure>
I, in compliance with the instructions of the government of the Republic of Korea, agree to accept the responsibility to pay the expenses incurred by facility quarantine for 14 days, and agree to unconditionally abide by the government measures including departure orders, if I fail to follow through.
Agree AgreeAgree Agree
□
□
□
□ □ □ □ □ DisagreeDisagreeDisagreeDisagree
<Prohibition of Departure in Quarantine>
<Prohibition of Departure in Quarantine>
<Prohibition of Departure in Quarantine>
<Prohibition of Departure in Quarantine>
I agree that departure from Korea is not allowed before being released from 14-days quarantine.
Agree AgreeAgree Agree
□ □
□ □ □ □ □ □ DisagreeDisagreeDisagreeDisagree Date (MM/DD/YYYY)
Completed by (Signature)
Government of the Republic of Korea Government of the Republic of Korea Government of the Republic of Korea Government of the Republic of Korea
<Notice for Travelers>
<Notice for Travelers> <Notice for Travelers>
<Notice for Travelers>
1. To prevent transmission of COVID-19, travelers entering Korea after 00:00, April 1st, 2020 (Korea time) are subject to quarantine for 14 days from the day after entry in accordance with relevant laws including the Quarantine Act.
2. Short-term travelers (foreign-nationals) without a Self-Isolation Exemption Certificate issued by the Embassy of Korea are subject to quarantine at a facility designated by the Korean government.
3. The quarantine facility is allocated randomly and cannot be changed for personal reasons. Transportation from the airport to the facility will be provided.
4. The total expense for facility quarantine is KRW 2,100,000 (KRW 150,000 daily). The expense should be paid before entering the facility.
5. The expense includes costs for accommodation, meals, etc.
6. The facility is a smoking-free area. You shall not exit the facility nor make any contact with another resident during your stay.
7. If you develop fever, cough, dyspnea, or any symptoms that may indicate infection, you will be tested for COVID-19. Even if you are tested negative, you shall not be discharged before the end of the quarantine period (14 days).
8.8.
8.8. If you plan to get a boarding pass for a flight to Korea, If you plan to get a boarding pass for a flight to Korea, If you plan to get a boarding pass for a flight to Korea, If you plan to get a boarding pass for a flight to Korea, you shall you shall you shall you shall complete and submit the Agreement to Facility Quarantine.
complete and submit the Agreement to Facility Quarantine.
complete and submit the Agreement to Facility Quarantine.
complete and submit the Agreement to Facility Quarantine. If you do not If you do not If you do not If you do not agree, your entry to Korea will be denied.
agree, your entry to Korea will be denied.
agree, your entry to Korea will be denied.
agree, your entry to Korea will be denied.
9.
9.
9.
9. Failure of compliance with the guidelines above may be deemedFailure of compliance with the guidelines above may be deemedFailure of compliance with the guidelines above may be deemedFailure of compliance with the guidelines above may be deemed as as as as violation of relevant regulations including the Quarantine Act and violation of relevant regulations including the Quarantine Act and violation of relevant regulations including the Quarantine Act and violation of relevant regulations including the Quarantine Act and result in an order for departure from Korea.
result in an order for departure from Korea.
result in an order for departure from Korea.
result in an order for departure from Korea.
COVID-19 test results for foreign nationals may be issued in specific COVID-19 test results for foreign nationals may be issued in specific COVID-19 test results for foreign nationals may be issued in specific COVID-19 test results for foreign nationals may be issued in specific
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※
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cases, including when they are required to submit the result to cases, including when they are required to submit the result to cases, including when they are required to submit the result to cases, including when they are required to submit the result to shipping companies for sea crew change;
shipping companies for sea crew change; shipping companies for sea crew change;
shipping companies for sea crew change; it is prohibited for those it is prohibited for those it is prohibited for those it is prohibited for those under quarantine from departing Korea while being under the 14-days under quarantine from departing Korea while being under the 14-days under quarantine from departing Korea while being under the 14-days under quarantine from departing Korea while being under the 14-days quarantine.
quarantine.quarantine.
quarantine.