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雇 主 聘 僱 外 國 人 申 請 書 (外國人代雇主申請,中英文版)

APPLICATION FORM FOR EMPLOYMENT OF FOREIGNERS (For foreigner to apply on behalf of the employer)

工作類別:2.營造工作 Category: Construction jobs

申請項目:

Type of application

□聘僱許可 employment permit

□期滿續聘 renewal of employment

□展延聘僱許可 extending employment permit

外國人填寫欄位 Foreigner information

國籍 Nationality

護照號碼 Passport Number

(填表說明注意事項 九)

( see notice 9)

外國人行動電話 mobile number

(必填,填表說明注意事項十)

(required, see notice 10)

外國人電子郵件 e-mail

(請擇一勾選,填表說明注意事項十) (see notice 10)

菲律賓

The Philippines

□有 Yes:

□無 No

本申請案回復方式:□親取 □郵寄外國人工作地址 (請擇一勾選)

I would like □ to pick up the official document or □ to have the official document deliver to Foreigner’s work address.(Tick one of the boxes above)

本人聲明本申請案所填寫資料及檢附文件等均屬實,如有虛偽,願負法律上之一切責任。

I hereby declare the information and documents provided to be true, and confirm with full legal responsibility for any perjuries found.

外國人簽名:

Foreigner’s signature:

雇主協助外國人填寫欄位 Application information 雇主統一編號

Employer’s tax ID number

審查費收據(有附則免

填,填表說明注意事項 二)Receipt of application fee(see notice 2)

繳費日期 date

年 月 日 y/ m/ /d

郵 局 局 號 (6 碼)

Branch code (6 digits) Branch code (6 digits) 劃撥收據號碼(8 碼)或交易序號(9

碼)

Receipt No.(8 digits) or transaction No.(9 digits)

招募許可函文號(有附則免填,填表說明注意事項三) Recruit permit number (see notice 3)

接續聘僱許可函文號(有附則免填,僅申請展延聘僱許可案件 視情形填寫)

Consecutive employment permit number (required for extending employment permit, you can leave it blank if the permit is attached) 入國引進許可函文號(有附則免填,填表說明注意事項三) Introduction permit number (see notice 3)

請 詳 閱 背 面 填 表 說 in the back 明 notice on the back

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EAF-014 1110630

前任外國人資料(填表說

明注意事項五) Previous foreigner’s information (see notice 5)

國籍 Nationality

護照號碼 Passport Number

(僅申請展延聘僱許可須填寫, only required for extending employment permit)

□切結所聘僱外國人展延後不再以該工程引進、期滿續聘外國人(填表說明注意事項七)

Affidavit: after extending the employment permit, the same construction project will not be used to apply for introduction or renewal of employment of foreigners. (see notice 7)

原聘僱或接續聘僱許可函文號(有附則免填,期滿續

聘及展延聘僱許可需填寫,填表說明注意事項三) The original or (Consecutive) employment permit number (required for renewal of employment and extending employment permit, see notice 3)

外國人入國通報證明書序號(有附則免填,填表說

明注意事項四)

Certificate number of notification of the foreigner’s entry into the ROC (see notice 4)

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同意外國人代雇主申請聘僱許可切結書 Authorization letter

雇主 (統一編號: )同意由本案外國人(護照號碼: ) 代為申請聘僱許可,並聲明本申請案所填寫資料及檢附文件等均屬實,如有虛偽,願負法律上 之一切責任。

The employer_____________(Tax ID number: ) authorizes the foreigner in this application______________(Passport number: ) to apply for the employment permit. Hereby to declare the information and documents provided to be true, and confirm with full legal responsibility for any perjuries found.

雇主: 負責人: (簽章)

Employer Responsible person (Signature)

雇主市內電話: (不得填列私立就業服務機構之聯絡資訊)

Employer’s landline phone number:

(Cannot be the contact information of a private employment services institution.)

雇主行動電話: (不得填列私立就業服務機構之聯絡資訊)

Employer’s mobile number:

(Cannot be the contact information of a private employment services institution.)

電子郵件e-mail:□有 Yes:

□無 No

※以上 3 項聯絡資訊,請確實填寫,雇主應依規定就市內電話或行動電話擇一填寫提供雇主本人 或可聯繫至雇主之親友電話,如未確實填寫雇主聯絡電話,將不予核發許可。另聯絡資訊將作為 本機關即時聯繫說明申請案件審查情形及後續聘僱管理注意事項之用,以利縮短案件審查時間,

與保障雇主聘僱外國人之權益!

Please fill in the three contact methods above. According to the regulations, the employer needs to provide either a mobile or landline phone number at which the employer (or a contact person) can be reached. If the contact information of the employer is not provided, the Ministry of Labor will not issue the permit. The contact information will be used for the authority when needed (to inform the status of the application or attentive matters). To shorten the processing time and guarantee the rights and benefits of the employers in hiring foreigners, please fill in the form properly.

中 華 民 國 年 月 日 Year month day

(以下虛線範圍為機關收文專用區)

(Document Reception Use Only)

收文章:

Receipt Stamp

收文號:

Case Number

勞雇雙方已合意期滿續聘證明:原雇主申請續聘需填寫

Employer and employee’s mutual agreement certificate for continuous hiring: to be filled up by the Employer 本人與外國人 (護照號碼: )

Employer and foreign worker passport number:

協議自原聘僱期限屆滿之翌日起由本人續聘。

agree for continuous hiring by the employer, effective on the next day after the expiration of the original employment contract.

雇主簽章: 外國人簽章:

Employer’s Signature: Foreign Worker’s Signature:

填表說明注意事項:

Notice:

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EAF-014 1110630 一、相關法規及申請程序,請依照本機關網站所載最新規定辦理。

1. Relevant regulations and application procedures, please follow the latest regulations on the website of Workforce Development Agency.

二、審查費(100 元)收據:分為電腦收據(白色)及臨櫃繳款收據(藍色)2 種,填寫如下:

2. There are two types of the application receipt such as a WHITE slip and a BLUE slip (100 NTD each case).

(1) 電腦收據(各郵局開具之白色收據):

If you pay at the post office (a WHITE slip)

範例 00002660 110/06/11 16:46:33 00002660 110/06/11 Ex. 003110 1A6 297174

003110

填寫 繳費日期:110 年 6 月 11 日,郵局局號:003110,劃撥收據號碼(8 碼):00002660

Fill in the form as follow: payment date: 110 y 06 m 11 d; branch code: 030110; receipt No. (8 digits):

00002660

(2) 臨櫃繳款收據(郵局派本機關駐點開具之藍色收據):

If you pay at our office (a BLUE slip) 範例 右上角 B-5103097,經辦局章戳

Ex. upper right corner B-5103097; with the stamp of the post office 填寫 交易序號(9 碼):B-5103097,繳費日期:110 年 6 月 11 日,郵局局號:000100

Fill in the form as follow

transaction No. (9 digits): B-5103097 ; payment date: 110 y 06 m 11 d ;branch code: 000100 三、許可函文號:範例 勞○○○字第 1100641633 號,填寫為 1100641633

3. Employment permit number: ex. 勞○○○字第 1100641633 號, please enter 1100641633. You can leave this field blank if the permit is attached in the application.

四、外國人入國通報證明書序號(申請國外引進外國人須填寫):範例 右上角 00000123456789 填寫00000123456789

4. The certificate number of notification of the foreigner’s entry into the ROC (required for recruiting foreign worker from abroad): ex. top right corner 00000123456789, please enter 00000123456789.

You can leave this field blank if the certificate is attached in the application.

五、提前申請入國引進及遞補者須填寫前任外國人資料。

5. Previous foreigner’s information is required in applying for early introduction and substitution.

六、□請依實際情況勾選,如須檢附文件,務必檢附。

6. Please tick the boxes (□) accordingly, and do submit the required documents.

七、切結所聘僱外國人展延後不再以該工程引進、期滿續聘外國人:重大工程申請展延聘僱許可 者需勾選。本項經勾選者,即為切結日後不再以該等外國人核准工作之工程名義申請入國引 進或遞補、期滿續聘外國人,惟切結日期前已取得名額者不在此限。

7. Affidavit of that after extending the employment permit, the same construction project will not be used to apply for introduction or renewal of employment of foreigners. Must check this box when applying for extending employment permit on major construction. If this box is checked, it means that after extending employment permit, the same construction will not be used to apply for introduction, substitution, and renewal of the employment of foreigners (except for those who have obtained the quota before this application being filed).

八、申請文件除政府機關、醫療機構、學校或航空公司核發或開具之證明文件外,應加蓋公司及 負責人印章。

8. Documents should include the stamp of the company and the stamp of the responsible person.

(Documents issued by the government, school, health facility and airline are exempt.) 郵局局號 branch code

劃撥收據號碼(8 碼) receipt No. (8 digits)

繳費日期 date

局號 000100-6 110.06.11

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九、新任外國人請填護照號碼,倘非首次來臺受聘且有護照號碼異動之情事,應立即向內政部移 民署辦理居留資料異動事宜。

9.The novice (newbie) foreigner’s passport number is required. If you are not employed in Taiwan for the first time and has renewed your passport number, you should immediately apply to the Immigration Agency of the Ministry of the Interior for the update of your information.

十、外國人行動電話必填,且不得與雇主或委任私立就業服務機構電話相同,未填寫者,將退請

補正確認;電子郵件須勾選「有」或「無」,未勾選者,將退請補正確認,若勾選「有」,請

確實填寫且不得與雇主或委任私立就業服務機構電子郵件相同。

10. The foreigner’s mobile number is required and cannot be the same as the phone number of the employer or the appointed private employment services institution. If the phone number is not provided, the application will be returned for revision; the email section must be checked “Yes” or

“No”, or else the application will be returned for revision. If you tick "Yes", please enter the email address and it must not be the same as the email of the employer or the appointed private employment services institution.

參考文獻

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