Issue No.		CERTIOFICATE OF LOCAL TAX ASSESSMENT
Taxpayer		Address
		K.I.D. No. (Cop.Reg.No)							Name in full (Name of rep.)
Location
Name of firm								Item of business
Location of taxable Object
Tax Item			Year		Term		Tax No.			Tax Amount			Remarks
Please certify that the above taxation is true. Applicant＞ /S/
This is to certify that the tax assesments in this form is ture and correct.
Fee	/S/ Official seal affixed.

36134１00111일

190□×268□

1998.9.9. 심사

(신문용지 50g/□)