후원금 자동이체(CMS)동의서

<img width="595" height="120" alt="" src="file:///C:/Users/김영배/AppData/Local/Temp/DRW0000c6900ddd.gif" v:shapes="_x206538472"> <a href='javascript:fileFilterViewer("http://cfile283.uf.daum.net/attach/99076C495CBFF2903058B0", "/cfile283/99/076C495CBFF2903058B0", "CMS 후원 신청서1.hwp", "grpid%3D1XcSk%26fldid%3DULYc%26dataid%3D1%26fileid%3D1%26regdt%3D20190424142319&url=http%3A%2F%2Fcfile283.uf.daum.net%2Fattach%2F99076C495CBFF2903058B0")'><img src="https://t1.daumcdn.net/daumtop_deco/icon/icon.hanmail.net/editor/p_etc_s.gif" border="0" alt="첨부파일" class="vam"/> CMS 후원 신청서1.hwp</a>후원금 자동이체(CMS) 동의서 ■ 후원 기관<table style="border-right-color: currentColor; border-bottom-color: currentColor; border-left-color: currentColor; border-right-width: medium; border-bottom-width: medium; border-left-width: medium; border-right-style: none; border-bottom-style: none; border-left-style: none; border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 1.7pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 19.04pt;">기 관 명</td><td valign="middle" style="border-width: 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 19.04pt;">(사)한국장애인가족협회</td><td valign="middle" style="background: rgb(217, 217, 217); border-width: 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 104.91pt; height: 19.04pt;">대표자</td><td valign="middle" style="border-width: 1.7pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 133.21pt; height: 19.04pt;">이 정 석</td></tr><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 19.04pt;">고유등록번호</td><td valign="middle" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 119.06pt; height: 19.04pt;"><p class="0" style="text-align: center; letter-spacing: 0pt; font-weight: bold; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">464-82-00200</td><td valign="middle" style="background: rgb(217, 217, 217); padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 104.91pt; height: 19.04pt;">수납목적</td><td valign="middle" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 133.21pt; height: 19.04pt;">후원금 수납</td></tr><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 0.28pt 0.28pt 1.7pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 19.04pt;">주 소</td><td valign="middle" style="border-width: 0.28pt 1.7pt 1.7pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 357.18pt; height: 19.04pt;" colspan="3"><p class="0" style="text-align: left; letter-spacing: -0.5pt; font-weight: bold; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;"> 07782 서울시 강서구 곰달래로182</td></tr></tbody></table><p class="0" style="text-align: left; font-size: 8pt; font-weight: bold; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;"> <p class="0" style="text-align: left; font-size: 11pt; font-weight: bold; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">■ 후원금 자동이체 <table style="border-right-color: currentColor; border-bottom-color: currentColor; border-left-color: currentColor; border-right-width: medium; border-bottom-width: medium; border-left-width: medium; border-right-style: none; border-bottom-style: none; border-left-style: none; border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 1.7pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 19.74pt;">후원자명</td><td valign="middle" style="border-width: 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 121.89pt; height: 19.74pt;"> </td><td valign="middle" style="background: rgb(217, 217, 217); border-width: 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 102.08pt; height: 19.74pt;">연락처</td><td valign="middle" style="border-width: 1.7pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 133.21pt; height: 19.74pt;"><p class="0" style="text-align: center; line-height: 120%; letter-spacing: -2pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;"> </td></tr><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 25.4pt;">후원금액</td><td valign="middle" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 121.89pt; height: 25.4pt;"><p class="0" style="text-align: center; line-height: 120%; font-weight: bold; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">□￦ 원</td><td valign="middle" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 102.08pt; height: 25.4pt;"><p class="0" style="text-align: center; line-height: 120%; letter-spacing: -0.5pt; font-weight: bold; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">납 부 일</td><td valign="middle" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 133.21pt; height: 25.4pt;"><p class="0" style="text-align: center; line-height: 120%; letter-spacing: -0.5pt; font-weight: bold; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">매월 일</td></tr><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 23.62pt;">거래은행</td><td valign="middle" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 357.18pt; height: 23.62pt;" colspan="3"> </td></tr><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 19.85pt;"> 계좌번호</td><td valign="middle" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 357.18pt; height: 19.85pt;" colspan="3"> </td></tr><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 0.28pt 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 19.85pt;">예금주명</td><td valign="middle" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 121.89pt; height: 19.85pt;"> </td><td valign="middle" style="background: rgb(217, 217, 217); padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 102.08pt; height: 19.85pt;">예금주 휴대폰번호</td><td valign="middle" style="border-width: 0.28pt 1.7pt 0.28pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 133.21pt; height: 19.85pt;"><p class="0" style="text-align: right; color: rgb(192, 192, 192); letter-spacing: -0.5pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;"> </td></tr><tr><td valign="middle" style="background: rgb(217, 217, 217); border-width: 0.28pt 0.28pt 1.7pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 119.06pt; height: 19.85pt;">생년월일</td><td valign="middle" style="border-width: 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 121.89pt; height: 19.85pt;"> </td><td valign="middle" style="background: rgb(217, 217, 217); border-width: 0.28pt 0.28pt 1.7pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 102.08pt; height: 19.85pt;">사업자등록번호</td><td valign="middle" style="border-width: 0.28pt 1.7pt 1.7pt 0.28pt; border-style: solid; border-color: rgb(0, 0, 0); padding: 1.41pt; width: 133.21pt; height: 19.85pt;"> </td></tr></tbody></table> <p class="0" style="text-align: left; letter-spacing: 0pt; font-size: 8pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">금융거래정보 제공 및 개인정보의 수집·이용, 개인정보 제 3자(결제기관) 제공을 동의하며 상기와 같이 출금이체거래를 신청합니다.<table style="border-right-color: currentColor; border-bottom-color: currentColor; border-left-color: currentColor; border-right-width: medium; border-bottom-width: medium; border-left-width: medium; border-right-style: none; border-bottom-style: none; border-left-style: none; border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="top" style="padding: 8.5pt; border: 1.7pt solid rgb(0, 0, 0); width: 476.24pt; height: 218.36pt;"><p class="0" style="text-align: center; letter-spacing: 0pt; font-size: 8pt; font-weight: bold; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">◇ 개인정보 및 고유식별정보 수집 및 이용 동의 ◇<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">▶ 수집 및 이용목적: 자동이체(CMS)를 통한 요금 수납<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">▶ 수집항목<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;"> 개인정보: 성명, 전화번호, 휴대전화번호, 신청계좌 거래은행명, 출금계좌번호<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;"> 고유식별정보: 생년월일<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">▶ 보유 및 이용기간: 수집, 이용 동의일 부터 자동이체 종료일(해지일)까지<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">▶ 신청자는 개인정보 및 고유식별정보 수집 및 이용을 거부할 수 있습니다. 단, 거부 시 자동이체 신청이 처리되지 않습니다. <table style="border-right-color: currentColor; border-bottom-color: currentColor; border-left-color: currentColor; border-right-width: medium; border-bottom-width: medium; border-left-width: medium; border-right-style: none; border-bottom-style: none; border-left-style: none; border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="middle" style="background: rgb(217, 217, 217); padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 59.63pt; height: 15.65pt;">개인정보</td><td valign="middle" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 167.17pt; height: 15.65pt;"> □ 동의함 / □ 동의하지 않음</td><td valign="middle" style="background: rgb(217, 217, 217); padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 70.95pt; height: 15.65pt;">고유식별정보</td><td valign="middle" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 158.68pt; height: 15.65pt;"><p class="0" style="background: rgb(255, 255, 204); letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;"> □ 동의함 / □ 동의하지 않음 </td></tr></tbody></table> <p class="0" style="text-align: center; letter-spacing: 0pt; font-size: 8pt; font-weight: bold; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">◇ 개인정보 제3자(결제기관) 제공 동의 ◇▶ 개인정보를 제공받는 자: 효성에프엠에스(주)<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">▶ 개인정보를 제공받는 자의 개인정보 이용 목적: 자동이체서비스 제공<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">▶ 제공하는 개인정보의 항목: 거래은행명, 계좌번호, 생년월일, 휴대전화번호<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">▶ 개인정보를 제공받는 자의 개인정보 보유 및 이용기간: 동의일부터 자동출금이체 종료일(해지일)까지. 단, 관계 법령에 의거 일정기간 동안 보관<p class="0" style="text-align: left; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">▶ 신청자는 개인정보에 대해 수납업체가 효성에프엠에스㈜에 제공하는 것을 거부할 수 있습니다. 단, 거부 시 자동이체 신청이 처리되지 않습니다. <table style="border-right-color: currentColor; border-bottom-color: currentColor; border-left-color: currentColor; border-right-width: medium; border-bottom-width: medium; border-left-width: medium; border-right-style: none; border-bottom-style: none; border-left-style: none; border-collapse: collapse; mso-table-overlap: never;"><tbody><tr><td valign="middle" style="background: rgb(217, 217, 217); padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 226.6pt; height: 15.65pt;"><p class="0" style="text-align: center; color: rgb(76, 76, 76); letter-spacing: 0pt; font-size: 7pt; font-weight: bold; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">제3자(결제기관) 개인정보 제공에 동의 합니다.</td><td valign="middle" style="padding: 1.41pt; border: 0.28pt solid rgb(0, 0, 0); width: 229.43pt; height: 15.65pt;"><p class="0" style="background: rgb(255, 255, 204); text-align: center; letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;"> □ 동의함 / □ 동의하지 않음 </td></tr></tbody></table></td></tr></tbody></table>본 신청과 관련하여 본인은 금융거래정보를 출금이체를 신규 신청하는 때로부터 해지 신청할 때까지 상기 수납기관에 제공하는 것에 대하여 「금융실명거래 및 비밀보장에 관한 법률」의 규정에 따라 동의합니다.  <p class="0" style="background: rgb(229, 229, 229); text-align: center; font-size: 11pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;">20 년 월 일<p class="0" style="background: rgb(229, 229, 229); text-align: center; font-size: 6pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; -ms-word-break: keep-all; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt;"> <p class="0" style="letter-spacing: 0pt; font-size: 8pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;"> 개인정보 및 고유식별 정보 수집 및 제3자(결제기관) 개인정보 제공에 동의합니다. 후원자 (서명) <p class="0" style="letter-spacing: -1pt; font-size: 8pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;"> 예금주 ( 서명) <p class="0" style="letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">1. 신청인과 예금주가 다른 경우 반드시 예금주의 별도 도장 또는 서명을 받아야 합니다. <p class="0" style="letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">2. 인감 또는 서명은 출금통장의 사용인감 또는 서명을 사용해야 합니다. <p class="0" style="letter-spacing: -1pt; font-size: 7pt; margin-right: 0pt; margin-left: 0pt; -ms-text-autospace:; mso-pagination: none; mso-padding-alt: 0pt 0pt 0pt 0pt; mso-font-width: 100%; mso-text-raise: 0pt;">3. 기존 신청내용을 변경하고자 하는 경우에는 자동이체신청서를 신규로 작성하셔야 합니다. 4. 신청인이 법인사업자인 경우, 개인정보 및 고유식별정보 수집의 이용동의와 개인정보 제3자 제공 동의를 표기하지 않으셔도 됩니다.