_____年 Year _____月 Month
薪 資 明 細 表(參考樣例) Salary Slip (Sample)
外國人姓名 Name：
護照號碼 Passport：
工資給付日期 Payday： 年 Yr 月 Mo 日 Date 項目 Item 金額 Amount（幣別
currency
□新臺幣NT$
□ 其 他 （ 請 註 明 ） Other __
please describe
）
應領金 額 Due Amount
工資 Salary
加班費 Overtime Pay 其他 （請註明）
Other (please describe)
其他 （請註明）
Other (please describe)
合計 Subtotal 扣款金
額 Deducti
on
全民健康保險費 National Insurance 勞工保險費
Labor Insurance 所得稅
Income Tax 膳宿費
Board and Housing 職工福利金
Employee’s Benefit 依法院或行政執行機 關之扣押命令所扣押 之金額
Derived from the penalty of court or administrative authorities 合計
Subtotal
實領金額 Net Total
工資給付方式 Paid By □現金 Cash
□票據（匯票、支票、本票）
Note(
remittance、check 、promissory note)
□其他方式 （請註明）Other ( please describe)
外國人簽名 Signature：
雇主名稱 Employers’ Signature：
備註 Note：
1、外國人應依我國法令規定負擔全民健康保險費、勞工保險費或所得稅。
Foreign workers shall pay national insurance fee, labor insurance fee, or income tax according to the law.
2、膳宿費應由勞資雙方於外國人入國前議定，並於勞動契約內訂定之，且其數額應合 理訂定。
Board and housing fees should be settled and stipulated on the employment contract before foreign workers enter Taiwan, and the amount should be reasonable.
3、家庭類外國人之雇主不得替外國人扣繳所得稅款，事業類外國人之雇主應依所得稅 法相關規定辦理扣繳所得稅款事宜。
Employers should not deduct tax for domestic helpers; Employers of business category workers shall deduct tax according to the law.
4、外國人工資除其應負擔之項目及金額外，雇主應全額以現金直接給付；若以其他方 式給付者，務必註明以何種方式給付（如匯款、支票），並提供相關證明文件，交 予外國人收存，並自行保存 1 份。
Employer should pay in cash expect for the due amount of workers; If salary were paid by other way, please write down (remittance、check…) and give related certificate to workers and self.
5.本薪資明細表應於發放工資時，同時交由外國人保存，雇主並應自行保存 5 年。
This slip should be given to the foreign workers while paying the salary. And the employers should keep the salary slips for five years.
6.雇主如未檢附中文及外國人母國文字之薪資明細表或未全額給付工資，將廢止其招 募許可及聘僱許可之一部或全部，並處新臺幣 6 萬元以上 30 萬元以下罰鍰，且其 後續申請案將予以管制 2 年不予許可。
If the employers are not able to give salary slip in both Chinese as well as foreign workers’ mother tongue or pay full amount of salary, ones are subject to be abolished the recruitment permit or employment permit and be fined $60,000 up to $300,000 NT dollars; and the following application will be imposed restrictions for 2 years.
