View
0
Download
0
Category
Preview:
Citation preview
lluu 9rvl. dFORM WP. 5
loll13tn1r,ru1ll
FOR OFFICIAL USE ONLY
tat:!11 .. . . . . . .
nlun150n14'r.l1uDEPARTMENT OF
EMPLOYMENT
nt! 5'l{u:{{1uMINISTRY OF LABOUR
rirro siooruluouflJrsly'rr1u
9t1lJUln:1 bm
APPLICATION FOR A RENEWAL OF A WORK PERMITUNDER SECTION 23
o0nLv
14r 1 U tAflU:J 010r? Fr1.l0r1{n',l'l
ta{anun1{n'r?Atien's lnformation
Name of appticant Mr./N.4rs./Miss
1l
Year5Nationatity
r.z doalurj:vrrnlvruDate of birth Age
Address in Thaitand No.
vrivr-/or n r:Moo,Euitding Soi
0x,Iu............ ............. ......................... ....... ...9i't!a/$r?.i m a,/ttTambon,/Khwaeng Amphoe/Khet
Changwat Postcode Tetephone
Facsimile E.mait address
1.3 ro nd'nran{ nr:!i'ir o r4 rgr m1fi'o q1u: r t o rrur o-n:sd r':lfl a dr':vdr ol siolUdDocument showing a permission to 5tay in the Kingdom as fottowsl
(1) Ll r4u{a0tnuvl1{
Passportd ovd
14111......... .... ........ ......... ........ ........ OOn LyVt
E ra nar:lt'wuufifr oro'uvrrrDocument in tieu of passport
lssued at Country
oo n'tDate of issue
n:?Qa.1n:''tu:vType of visa
Vatid untiL
ooflloate of issue Vatid untit
tol.lvrli 'ro.r:1901 1nn5Date of anivat at the Kingdom
Having received a permission from an immigratlon offlcer at the immisration checkpoint
hi'ou'lu:rtorruli"n:To be abLe to stay in the Kingdom unti(
(zl tu61nqJoull0qCertificate of permanent residence
t4111
NO, lssued at Changwat
oon t14'tuv1......... .. tDate of issue,^ , O a w
' c w(3) LUAlnqU:vArn?nUn1{01?
Atien identifi cation card
Valid unti t
onl 0.ll.it't I
lssued at Changwatq'aa o 'J l 'v4oa
oon tutuvl.. ..... ........... ... ...111Lfin,rluvrDate of issue
hor.lqrwirrruratfiWoft permlt No.
Vaiid untit
7.4 00fl11,114
lssue at (Changwat)
oate of issue
flaulFtn't.t
Vatid untiL
Name of emptoyer
vtou tatvl ltuv[/a T
Address No. Moo/Buitding Soi
cirma/rr0r............
Amphoe/Khet
ou!..1................................. ...............................0i't!a/tt
Thanon Tambon^hwaeng
oivin.. ...... ... ........... .... .............. ... :v-a!J:uniri ......... ....Ivr:6'nli Iv:ar:Chanawat Postcode Teteohone Facsrmrte
2. dolanr:toourursrApplication lnformation
lracia ar ulr rnun rrovirsrr.r ! l LOatl 1tr
Year (s) Month (s) Day (s)
from
nufl .11u11 .......................to
Afpty,for a,renewat of a work permit for
fl{ttn?uvr.........................
3. rondr:uac anoruoocuments and Evldences
X e w\v4 . - "a,3:o nltou 1l'l lIti1 lfiuu[on615[[acuan5'tuo.lgl0 tllu
Together wlth thls app(ication, I have attached herewith the foltowin! documents and evidences:
71 l l l t rnt rnr , lEl
Work Pe.mit
5.2 L_.1 Altulvu tA0touvrl.l 1rt0a^^v
^f ^i.c^^.t ^r
Ll a1LU1t0flAltL{tLvtUlrU{AALOUVI'].I 1410
Copy of document in tieu of passport, or
! rirrurluzir6'rgtl:viirn'rnrrir.rdtuavdrrurhrirdry6udodCopies of A(ien identification card and Cediicate of permanent residence.
3.3 tr eirlurra6'n unr:aururnbiuilnlu:r{o'rfu1n-n:Copy of evidence of permission to enter into the Kingdom.
3.s n:fiuru{'xrf,uunaao::uo1
3.4 fl rarirflo:-u:ornr:6'r{to{fidiocrfluur0i'r{nu:culuelriadtrii'r,:unnaairutrfrlyulir.rruviiolri'rya'nmur.J:vnoI run r.l an'l nd rrWork recommendation of a prospective employer descnbing reasons for not empLoyng a person of Thai nat onatity to work, together
wth supporting evidences.
ln case the emolover is a Naturat Person
! rirtlrrin:rl:viirsr'rl:vtrtuuasa'rrurvrvuluurirurovi6ravrtjuuru6'ri uioCopies of ldentification card and house registration of a prospective emptoyer, or
AUJLJ A1[U',r14U{60LUl.JylT. l10.tf t{ . inVtUUUlUn1.i 1, 'r50
Copy of Passport of a prospective employer, or.J
L_.1 dTlLJ'rLUdIFrUnU110U10rtJ{. in3r1JUU1LnT{
Copy of Certificate of permanent residence of a prospective emptoyer.
n: u1uo1.!tuuununnaIn case the emptoyer is a Juristic Person
! riturtanar::-l:o.l?oriiru:rtnr:dFsrdaruraowjrfionr:ror{firovrihuru6'r.r'ldnnflvrirJuvrioldiuorlryrnlrii'nfiittavo'rufiulrulqonndolrrunnrarru Iflu[Laol ryrnv]firnr:drsCopy of Cert fcate of a re(evant Government agency stat lnS the business of a prospective emptoyer has (eqatty been
registered or granted a l icense to estabtlgh and operate, and the type of buslness has been 5pecif led.d.d J ,
n5fuulgaltun al[u'tu:anu ouuontlta']fu10n:In case the emptoyer has permanent residence outside the Kingdom
! rirrura'rgrgri'rrtvrr viaCopy of setuice and/or opention contract, or
a4u a1[u1aqlru1{01j1u 1450
a^^w ^f
<)16 .^^rr , . r ^r
! rir rur ro nar:dufi uaovir riduri'r,lofi nrrriir iflud'ar lriurlirrrulu:rtorrura-n:(ru!).......................Copy of other documents showing that an appticant has a necessity to work in the Klngdom.
Gpecify)
n: ulJ u1uo1.r
nIn case of without an emptoyer
eirtrrtanar:duanvirridurirtor{Jul.ifinrlrLiuay:ca!nr:nirurrydrnirrrufitoiuluoururn\ id l / . . . . . . . . . . . . . . . . ,
Copy of document showing that an app(icant has a proper knohiedge and expeience for engaging the work
(specify)
n ririura'ryrgr{rluarr r.rioCopy of service and/or operation contract, or
J4Ll a1t!1afrni1flal1a u50
.^^,, ̂ , .] '. -^'-., -tr ;ir turtonar:dufruaovirlidurircrofinruo'rr{lu6'ar lriurrir.rrulu:rtorruro"n:
Copy ofother documents showing that an appticant has a necessity to work in the Kingdom.
(spec ry)! a'rulrholrprn :v n oro: fi oor u n 6urLr a'jrdr u nrrl:zno!o: frnro{ n u qir.i qir':h n:nifr rflulru
fi aeinra'tdl"rniun4yrLru'jrdrsnr: :gna!q:nlro.rnuriln6'r')Copy of Business operatins l icense under the law on atien business in case that the work apptied for is under such (aw.
3.6 tr luiu:o.rto.rai{:vnoritrfinntn::rnrlnnrarLru'ird'ruitrirntn::r fiir.r:avirddun'rtoLirf,uunna?nan:nr,t:ouoefiurfiou'biarnJ:vnouuavl,rittul:nsrrilvltniuunlilunnn:ou:r.rdrosn".r,n?.llltutJln:'l oo
Certificate ftom rn€dicat practitioner under the taw on medicat treatment professional stating that an applicant
is not a person of unsound mlnd or suffering from mentat infirmity, and is free from any defecti as prescribed in
Ministedat Regutation issued under section 10.
y s ; I I11 tn't10fu:0{1110n't'ttJl't{nuutljun?1tJQ:{vtnuf vn't:I hereby certiry that the information given abwe is true in ;/ery respect
' la1urat0......................... ..........,...................4tJ1]n'ltt)
FOR OFFICIAL USE ONLY
n1: n1:ru1n110e e4
o. n?'rtJluutJ0{11un{1!lQ1t4u'l1l
u4 u Iuuufi u.: a 0 :u :0 { n 1 :{ 1.r
FORM OF EMPLOYMENT CERTIFICATIOI{
1. riouaulgdrr EMpLoyER's TNFoRMAToN. . . . . . . . . . . . . . . .1l1yl
THAI ]URISTIC PERSON REGISTERED ON NO. PAID UP CAPITAL BATH
u'rvrFORIEN JURISTIC PERSON REGISTERED ON THE AIVOUNT OF MONEY IMPORTATION
NATURAL PERSON ID.CNRD NO. U/ORK PERMIT NO.
:raki flrqiu.......... ..............u'm 'lurirr:cuvrrar................................ 16ouTHE RECENTLY NCOME BAHT THE DURATION N4ONTH|J } lnn,1n'156.1000 THE VALUE oF EXPORT ... . . . . . . . . . . .U', ' ]V1 BAHTr - l v. ilJ lsirirnusrxrj:vrvrqrrrurvorrfrsrlu:0uifrairurlr....................... .. .@u
THE AMOUNT OF TRAVELLER IMPORT FOR THE LAsT YEAR PERSON
E finu"n.rrundyu rHE AMouNr oF rHAr woRKERS........................Fru pERsoN
D fi nusirseirrdlgudreradudr..............nu'houru1enillll1atfr ............THE AMOUNT OF WORK PERMIT HOLD€RS WORK PERMIT NO,
E o'rurur.ialliau rHE AMouNr oF RooMs..............ri0.r noo,r,ls E i'rururinuiuu rHe nr\4ouNr oF sruDENrs...............nu pERsoN
2. daranr:drr TNFoRMATToN oF EMpLoyMENT
11T'/[i1U5VA{nn3nl{nlJnlno']1to I DESTRE TO EMPLOY
flotrfr uroneurv. vlIafifl erooo cnoup....-..
fit.rvu luurvnnu6uv{1u .oB DEscRrP-roN.........
tvlldf 'tu?]111.i'r1.J 0Mnn1ltu.itt14.1
:vL3r'ra^1'r:0'1:..................1J..............|f '01.J.............11.J U A qJ qJ 1n ̂. i fr i11.r11PER OD OF CONTRACT YEAR MONTN DAY CONTMCT VAL1D UNTIL
eir6,r ly5o:ru1r i , iuay/t6ouac. ' ' . . ' ' . ' ' . . ' ' . . ' ' . ' . . . ' . . ' ' . . ' ' . ' ' ' . ' . .U1y]arar] :c1Ut{6! iuav/t6ouag.. . . . . ' . . ' . . ' . . . . . . . - . . ' . . ' . . ' ' . . . . ' . . . ' . . ' ' . ' ' ]uWAGE OR INCOME PER DAY / MONTH BAHT OTHER BENEFIT PER DAY / MONTH BAHT
:voiunr:6nurq.r4o .................rJ:caunt:ni1ir.rru................fl anruntr E Tao E arl:aTHE HiGHEST EDUCATION ]O8 EXPERIENCE YEAR STATUS SINGLE MARRIED
3. $rEruafilrid1{qflnaa'rytrfihunitir{ru rHE REAsoN wHy Nor ro HIRE THAI pERsoN
" &" - :t{50!U L0UU!r4Afli'l!Ulv nOU[14911{Af]nna1lo1g U.!U I E|ICLOSE HEFAMIH TNE FOLLO\{'I|G DOCUMB.ITS FOR 9JPPORnNG THE ASOVE RF}S0\1;
, e Xa{rntirtail:o.lir {ofr?t tirnt,tiliiuni'rlln3lumj:vn't: I HEREBv cERTIF/ rHE ABor'E trAlrMENr ARE rRUE rN EVERv REspEcr
1.2 a01ucailufl1itiu "Lu:otflfidruur rHE FTNANCTAL srATUs oF THE LAsr y€AR
U V{.FI.
YEAR
fluvi51,! u
ASSET
:r uld'INCOM€
tiuaor/riuahnournr:CASH/DEPOSIT
rirt:/tr erluPROFIT/1055
t'1u1r5uytTAX
rarLranaq {lillfi6oil:ord ovd'o*ilu{fidrurrar6orynn'uaflru lrnorlnl: viol6':nraldruralfi'rirnr:uvr:REMARK THE PERSON SIGN THIS FORM MUST BE THE AUTHORIZED DIRECTOR OR AUTHOR]ZEO REPRES€NTATION
Power of Attorney?luf 6[A3JAUO1U1e
Duty Stamp10 Bath
01n?r[f loo ll']Yl
Written at
1t'111
Date Month B.E.VA' tuvt ................ Io0u .......................... v'r.f[.
l. Mr./Mrs./Miss.{ryr rit uru/ur,:/ur.:dlr
hereby authorize and appoint Mr./Mrs./Miss.
rtororriruro"hi u1u/u't,t/u1{fl 'r?at present working
rlooriurir,:rulujn the position of at the office of
airuyri.r ................ rf.':orifiritin.:ru60 ................Tel. Located on Soi/Lane
Rd. Sub-District District
Province to be lawful and legal attorney for the purpose concerning with work permit,
{.:r.rio .................... r'eirurooi lfiunr: rfi lr fi'rnr:raoururndrmu oturl"lu ron or:l:;no!nr:sign any documents on behalf of myself including changing words on the related documents.
raorlryrnumu{rnrdrldqnarir :r:.lytv.ll!fiuuulo':ufi-ltflanrrrlluranor:d'.tnaimdruWhat has been done by will remain in full force
and effect as it has been done bv mvself.
{rn rirldn:yrir ro{rn!i:nrlSigned
fl{6o ....................... ti atlohure
( . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . )
Sjgned Grantee; -- "d{ra . . . . . . . . . . . . . . . . . . . . . . . $tu}J01j0 ' tu1a
(. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . )
Signed Witnessj
d. l t0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . l lU1U
(. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . )
Signed WitnessA
o$t io . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vtu ' tu
( . )
fi tarvn rnfitJa!rirurorl:vai6evsirfi'o1o)rnr:rJa!firulq rfluodrJdu eiorn::vir'ld lorieifia{tdrdan:rrJorrildRemark In case grantor perfer to limit the authorization giving to the grantee it could be done by using the other
forms of power of attorney.
Grantor
Recommended