EAF-T05-3 1110630
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：5.海洋漁撈工作 Category: Ocean fishing work
□漁業人（自然人）
fishery operator (a natural person)
□漁業公司（法人）
fishery operator (a legal person)
□箱網養殖（自然人）
cage culture (a natural person)
□箱網養殖（法人）
cage culture (a legal person)
申請項目：接續聘僱許可 Applying Item:
consecutive employment permit
□63.期滿轉換
Finish contract and transfer
外國人填寫欄位 Foreigner information
國籍 Nationality
護照號碼 Passport Number (填表說明注
意事項八) (see notice 8)
外國人行動電話 mobile number
(必填，填表說明注意事項九) (required, see notice 9)
外國人電子郵件 e-mail
(請擇一勾選，填表說明注意事項九) (Tick one of the boxes, see notice 9)
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 漁船(箱網養殖)統一編號或自然人身分證字號
(cage culture) CT number of the boat or ID number of the natural person
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) 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)
入國引進許可函文號或遞補招募許可文號(有附則免填，填 表說明注意事項三)
Introduction permit number or substitution recruitment permit number (see notice 3)
請 詳 閱 背 面 填 表 說
in the back
明noti ce on the ba ck
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
原雇主聘僱或接續聘僱許可函文號(有附則免填，
期滿續聘需填寫，填表說明注意事項三) (Consecutive) employment permit number (required for renewal of employment, see notice 3)
接續聘僱期滿轉換通報證明書序號(有附則免填，
填表說明注意事項四)
Number of the certificate on notifying consecutive employment of the foreigner for conversion expiration (see notice 4)
簽署日(有附則免填，填表說明注意事項十)
Signed date (see notice 10) 年 月 日 y m d
□雇主應檢附負責人之身分證明文件
ID certificate of the responsible person of the employer
□招募許可函 Recruitment permit
□入國引進許可函或遞補招募許可函(含名冊)正本(填表說明注意事項十一)
Original copy of the Introduction permit or substitution recruitment permit (including the name list, see notice 11)
EAF-T05-3 1110630 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_____________(ID number: ) authorize the foreigner in this application______________(Passport number: ) to apply for the employment permit on my behalf.
I hereby 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 the 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 the 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
填表說明注意事項：
Notice
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(200 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 receipt of the application such as a WHITE slip and a BLUE slip (200 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、接續聘僱期滿轉換通報證明書序號(申請國外引進外國人須填寫)：範例 右上角 00000123456789 填寫 00000123456789
4. Number of the certificate on notifying consecutive employment of the foreigner for conversion expiration (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、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。
7.Documents should include the stamps of the company and 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
EAF-T05-3 1110630
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。
9.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.
十、 簽署日為雇主接續聘僱期滿轉換外國人者，與外國人簽署雙方合意接續聘僱證明文件之日 期，有附接續聘僱期滿轉換通報證明書得免填。
10.The date of the employer and the foreigner signed the agreement for consecutive employment.
You can leave this field blank if number of the certificate on notifying consecutive employment of the foreigner for conversion expiration is attached.
十一、 招募許可函未具引進效力者，應一併附入國引進許可函或遞補招募許可函及名冊正本，
線上申請案件請將文件上傳。
11. The recruitment permit not valid of introduction shall be attached together with the original copy of the introduction permit (or the substitution recruitment permit) and the name list. Please upload the documents as for online application.
