Appendix Form No. 4 — Venue Rental Approval Cancellation Application Form

Seoul Gallery Venue Rental Approval
Cancellation Application Form

1. Applicant

Applicant Organization (Group)	Organization (Group) Name
	Address
	Name of Representative
Applicant	Position
	Name
	Phone Number
	Email Address

2. Cancellation Request Details

Event Name
Rental Space
Rental Date/Time
Event Details

3. Reason for Cancellation Request

Pursuant to Article 4 of the Enforcement Rule of the Seoul Metropolitan Government Ordinance on the Operation and Management of Seoul Gallery, the Applicant hereby requests cancellation of the venue rental approval details as stated above.

MM DD, YYYY

Applicant              (Signature or Seal)

To the CEO of Insight Motion Co., Ltd.