diff --git a/src/main/webapp/WEB-INF/jsp/web/kccadr/accdnt/ai/adjstIncidentRequest.jsp b/src/main/webapp/WEB-INF/jsp/web/kccadr/accdnt/ai/adjstIncidentRequest.jsp
new file mode 100644
index 00000000..0957b615
--- /dev/null
+++ b/src/main/webapp/WEB-INF/jsp/web/kccadr/accdnt/ai/adjstIncidentRequest.jsp
@@ -0,0 +1,134 @@
+<%@ page contentType="text/html; charset=utf-8"%>
+<%@ taglib prefix="c" uri="http://java.sun.com/jsp/jstl/core" %>
+<%@ taglib prefix="ui" uri="http://egovframework.gov/ctl/ui"%>
+<%@ taglib prefix="fn" uri="http://java.sun.com/jsp/jstl/functions"%>
+<%@ taglib prefix="spring" uri="http://www.springframework.org/tags"%>
+<%@ taglib prefix="form" uri="http://www.springframework.org/tags/form" %>
+<%@ taglib prefix="fmt" uri="http://java.sun.com/jsp/jstl/fmt"%>
+<%@ taglib prefix="un" uri="http://jakarta.apache.org/taglibs/unstandard-1.0" %>
+<%@ taglib prefix="kc" uri="/WEB-INF/tlds/kcc_tld.tld"%>
+
열람수수료는 700원, 발급수수료는 1,000원입니다.
+ +|
+ 필수입력 항목* +조정번호 + |
+ + + + + | +
|---|---|
|
+ 필수입력 항목* +신청인 구분 + |
+
+
+
+
+
+ |
+
|
+ 필수입력 항목* +조정당사자 여부 + |
+
+
+
+
+
+ |
+
|
+ 필수입력 항목* +서류종류 + |
+
+
+
+
+
+ |
+
|
+ 필수입력 항목* +발급부수 + |
+ + + 통 + | +