APPLICATION FOR A WORK PERMIT UNDER SECTION 13 (2) (For Item No.3, please complete the application only on item No. 3.1)

Transcription

1 b1 ~V1 ~ Form WP 8 '" n13jm1;)"'m1"11 DEPARTMENT OF EMPLOYMENT n1::vl11"1ll1"1"11'ij MINISTRY OF LABOUR o o 0 I, f111 I I'lJW1""1"11'IJ I"IfII'IJ"1"I"11 QI Q I,QI, cal flty1"'w3j1 ~11 LL~:m3J~1 Vl1!3J'IJ"111m1 m::vi11"i3j'm1,,1vi fi'lh::mfl l\ity1"toml;;13j1 il~1'ij11il11u1'"n1lti'ijn1dl~lfl'l'!t APPLICATION CONCERNING WORK PERMIT OF MYANMAR LOAS AND CAMBODIA WHO IS PERMITTED TO ENTER THE KINGDOM AS A SPECIAL CASE SUBJECT TO THE NOllFICAllON OF THE MINISTRY OF INTERIOR If If,j Ltl'W1::L;)1'M'lJ1" FOR OFFICIAL USE ONLY '" bg'l"lj1vi '" ""'" 1Vl1,j "'''' 'tib~1 '\J I 1Bqj1~bG'l"lJVI,, "I BBn ~'VIblJB ~'1'V11~ 'VIlJ1~bG'l"ll'\J1t:lii1~1f'l~1'1~11 f'l1"ljbi'1b'4t:y1~'vh:j1"1ljlj1~11 to)btl (\!) (IiB btl mbnib~m~')'j1t:lib btlto) APPLICATION FOR A WORK PERMIT UNDER SECTION 13 (2) (For Item No3, please complete the application only on item No 31) o f'l1"ljb~bej1~1bf)11,,'vh:n"1ljlj1~11 \!)btl (IvB btl mbflibljm~')'j1t:lib btl\!) "Dt; \J APPLICATION FOR A RENEWAL OF A WORK PERMIT UNDER SECTION 23 (For Item No3, please complete the application only on item No 32) o f'l1"ljbi'lblv1lb'4qj1'''vhn''1ljlj1~11 \!)d:: (IiB btl mbflib~g'lb~')'j1t:lib btlbtl) APPLICATION FOR A SUBSllTUTE OF A WORK PERMIT UNDER SECTION 25 (For Item No3, please complete the application only on item No 33) o f'l1"l1bb'\j~~'vi~m~lj'\j1t:bflvl'vi~b"'fl'l!frut: n"1ljlj1~11 \!)b (IiB btl mbflib~g'll~')'j1~1ib btl~) APPLICATION FOR CHANGE OR ADDITION OF CATEGORY OF WORK OR NATURE OF WORK UNDER SECTION 26 (For Item No3, please complete the application only on item No 34) o f'l1"ljm'\j~~'vi~m~lj1~~1:j"1ljlj1"11 \!)b (IiB btl mbnibljg'll~')'j1~1ib btld::) '\J APPLICATION FOR CHANGE OR ADDITION OF AN EMPLOYER UNDER SECTION 26 (For Item No3, please complete the application only on item No 35) o f'l1"ljm'\j~~'vi~m~ljvfb:j~'vi~m'lm~'vi1:j1mljlj1~11 \!)b (IiB btl mbflibljm~')'j1~lib btl b) '\J APPLICAllON FOR CHANGE OR ADDITION OF LOCALITY OF WORK OR PLACE OF WORK UNDER SECTION 26 (For Item No3, please complete the application only on item No 36) o f'l1"ljm'\j~~'vi~m~lj L~B1"lJVl1lJlJ1"11 \!) b (IiB btl mbflibljg'l b~')'j1~1ib btlb'j1) " APPLICATION FOR CHANGE OR ADDITION OF CONDITIONS OF WORK UNDER SECTION 26 (For Item No3, please complete the application only on item No3 7), 1 "ljbljg'lf'lvl1:j~11 " Alien's Information 1~/1'1/1:Jt'!11 Name of applicant Mr!Mrs!Miss ~ blt:y'tl1~ - bfl~1vi - '" ""B1~ u ~I Nationality Date of birth A'Se Years 12 ~B~t~1:J'\J1~bVlPl Address in abroad '\J1t:bVlPl1Vi't'!1'\J1~~ Country Postcode I it VlB~ '\J1~bVlPl VI~ LG'l"lJVI 'VI\!V1/B1f'l11 'IIB~ Address in Thailand No Moo/Buildin'S Soi,,1111 ~1G'l/LL"lJd:Je:i1bflB/b"lJ~ Thanon Tambon/Khwaen'S Amphoe/Khet ~:J'VI1"1Vi't'!1'\J1~~1Vl1Pf')'jVl1Vl1t'!11 Chan'Swat Postcode Telephone Facsimile

2 2 2 Work Information 21 0 hlbfltjffi Utl'4qJ1VlVhnu No work permit,j "t,,,,, ) o bfltjffiutl'4qj1vl'yhnu b~"u'vl tltlf1 ~'VI'Vl (':ij:!'vi1~ Had been ~ranted a work permit No Issued at (Chan~wat) "t 0 ~ "" "t, 22 0 ~Utlfll1Vl'Vll:!1u':iJ':iJU b~"u'vl tltlf1 ~'VI1'Vl, -ill 3 Present work permit No Date of issue II~ QJ QI ~ ~ tiel v d tltlf1lvi'vl (':ij:!vl1~) ~"U I~Cl:!1'Vl Place of issue (Chan~wat) Application Information Valid until 31 0 "Utl-rUL'eJ'4'Y1Vlvh:n Apply for a work permit 'lj's:::ifi'vl:!l~"utltlrulvl Cate~ory of work bein~ applied "'n~w::::!l Nature of work in detail 0 0 ~ 00 ~ ~ ~ 0 0 o I"'~ ell! c: cd Vllbb'VI:!'VIl'Vl/tl1'l1'WI 1'l11 'l1'w Title/Occupation/Profession, 'l1tlltj':ijl'1 Name of employer d d,d 'Vltl~ b~"u'vl 'VIlJ'Vl/tllfll'S 'lftl tj Address No Moo/Building 50i Cl ~lu~/bb"u1:!ellbfltl/b"uvl Thanon Tambon/Khwaeng Amphoe/khet ~ I ~ 1 ~ 1 ':ij'i'vi1~'s'vit'i btj~~wtj 'Vl~Pl'W'Vl 'Vl~t'll~ Chan~",,:,at Postcod~, Telephone FacsimiLe t'lmyh11:!1"utl:!fl~1:!~11 b~"uvi VI~Vi/tllfll~ 'lftltj Place of work No Moo/BuiLding 50i Cl ~lu~/bb"u1'1 el1bflej/b"uvl Thanon Tambon/Khwaeng Amphoe/khet '" ~ I ~ 1 '" 1 ':ij:!'vi1~ ~'VIt'lbu~~WtJ 'Vl~Pl'W'Vl 'Vl'St'll'S Changwat Postcode Telephone Facsimile (~:::'4t'1m~'Yh:!l Ll13j:lJl nf111v1;l:!bbvi:!) (In the case where there are more than one place of work, please specify au) ~~~* ~ * ~ ~ 32 '~o 11 OJ 0 "ljtlvlejtl1~ UeJ'4'Y1Vl'Vl1:!1 b~tl1'11 Apply for a renewdl of a work permit for Year (s) Month (5) Day (s) ~ V,, IV _ V q Vl:!bbVl1'Vl ':ijcl'l1'vl from to

3 "1Jfl~tIhJLL'VILtIfl'4qjlVl'Vhnu Apply for a substitute of a work permit o 4 ~ fi':irulahvi11:j Damage o mru~qjvlll:j Lost!:J 4 QI d LG"ltlVlll:J L:lJfl1'VI Date of the damage, ~qjvlll:j L:lJfl1'VI Date of the lost occurred tj d QI d Lb~:Jf111:lJLt'l"1J'VI1'VI Police daily record No, Date of issue ru afllvll':i1~ At police station 34 0 "1JmU~I:JVI~m~:lJ'lh::L!l'VI'VI~mrn'1!tru:::Jl Apply for change or addition of category of work or nature of work o LU~tIU':i::b!l'VI:Jl / &in'1!tfl!:::jl To change category of work / nature of work L~:lJU':itL!l'VI'll / &in'1!tfl!t'll To add category of work / nature of work (1) U':itL!l'VI:JlLVI:W New category of work (2) &in'1!tfl!t:jllvi:w New nature of work ~ ~~ ~ ~ Reason(s) for change or addition of category or nature of work ~ ~ ~~~~ ~ ~ e 35 e 00 e o ~ 0_ ~ "ljmu~i:jvi~m~:ljltjijl:j Apply for change or addition of an employer o bu~i:j11:jij1'1 o To change employer To add employer (1) ;'ifl11:jij1:jlvi:w Name of the new employer did Id 'VIeJ ~ ba"ij'vi 'VIlJ'Vl/eJlf11':i"IleJ t:l Address No Moo/Building Soi fi19l1tit'l/bb"ij1:jelll!lfl/b"1jvl Thanon Tambon/Khwaeng Amphoe/khet ~ 1 OJ ~ 1 OJ OJ 11 ~'1V11\?l':i'VIa u':i~rucj 'VI':if'l'W'VI 'VI':it'll':i Changwat Postcode Telephone Facsimile

4 4 (2) Reason(s) for change or addition of an employer ~ u ~ 0 * eo ~*, eo eo "1Im'\J~t:J'W'VI~m~~yftFl~'VI~ lg'1m'w~'vh~1'w AppLy for change or addition of Locality of work or place of work o L'\J~t:J'Wyf l~~'vh:n'w / G'1m'W~'Vh~l'W To change locality of work / place of work " o LvhJ'Vl l~yj'vh~l'w / G'1m'Wyj'V11~1'W 0 0 ' 00 0 ~ 00' 0 To add locality of work / place of work *f1)rum';ib'\j~tj'w'vi~m~1l<vfm~'v11~1'w1~f1) ln~~ (1) bl~~ (2) In case of applying for change or addition of locality of work, please complete both (1) and (2) v ~ 0 l' (1) 'Vl l~'vl'vl1~1'w 'VI1I New Locality of work (2) G'1m'Wvi'V11-:Jl'W1'V1li New place of work d,d L~"1I'Vl'VI:I;!'Vl/ l11'l1';i 1\1 I tj PLace of work No Moo/BuiLding Soi f:l'w'w ~TlJ~/bI"1I1:jel1Lfl l/l"1i@l Thanon Tambon/Khwaeng Amphoe/Khet,, ""1-1 1, 1 ~~'VI1(il':i'VIG'1 u';i~rut:j 'Vl';iI"1'Y'l'Vl 'Vl';iG'11';i Changwat Postcode Telephone FacsimiLe (';i~\lg'1m'wvi'v11~1'w t11ij1l1nn11'v1~~bb'i-i:j) (In the case where there are more than one place of work, please specify all) (3) L'VItrI~~1'Wm';i"1l lb, '\J~tJ'W'VI~m~1lyf l:jvi'vi~ lg'1m'wvi'v11-:j1'w Reason(s) for change or addition of Locality of work or place of work 37 0 "1Im'\J~t:J'W'VI~ lbvillb~ I'W1"11 Apply for change or addition of conditions,j, o b'\j~tj'wb1 1'W1"11 To change conditions of work o b~1ib~ I'W1"11 To add conditions of work (1) L1 1'W 1"lJ1'VIli New conditions of work (2) b'vi@l~~1'wm';i"1l lb'\j~tj'w'vi~m~llb1 1'W1"11, Reason(s) for change or addition of working conditions

5 5 Documents and Evidences Together with this application, I have attached herewith the following documents and evidences: 41 mw~1"l1"lla-r1 a'4fy1vlvhn 1"l1"lla~a81~1 a'4fy1vl LL~:::1"l1"llmtJ~fJLLtJ~:J';i1fJrn';i1 l a'4fy11jl In case of Application for a work permit, Application for a renewal of a work permit, and Application for change of items in work permit (1) 0 ri1l1trvl';itj';i:::"il1~1f);:jhlij~fy"lf1~lvm '\tj~a Copy of Identification card of Non - Thai Nationality, or o G1 r l L ri La fl6'l1wl::: L U fjtj';i:::-wi"ij1flg111jfl'vl:::lu fje:l1ljla'\tj~ag111jfl'vl:::lu fjvfa:j~~:jaa flvl1lj fl~'\tj:w1fj D I 11 d odii 11~1fJrn';i'Vl:::LfJ';i1~~';i '\tj';ia Copy of registration record from District or LocaL Registration Office issued under the Law on Registration of inhabitants, or G11L1 La fl6'l1';i-r';ia:j';i1fj rn';i'vl::: LUfJtJ';i:::-wi"iJ1 flg111jfl'vl::: L U fje:l1 LJla'\tj~aG111Jfl'Vl::: L U fjvfa:j~ ~ I 11 d ~:Jaa flvl1lj fl~vllj1m1~1 fj rn';i'vl::: LfJ';i1~~';i Copy of certificate of registration record from District or LocaL Registration Office issued under the Law on Registration of inhabitants (2) 0 l-r';ia:j"lla:j~tj';i:::fla1"lf1"il~l1"lfm';iljvl1ljfl~vllj1fjl1~1fj1"lf1"il~l1"lfm';ilj "ij1fl6'lm~m1~~-r';ia:jl1 er~rl1"ll a l~m';if)vi'a:jv!1lj Vl1lJ~ -r~:w Vl~11 fl1';i m:::'vl';i1:j6'l151';ifll6'l"lltj ';i::: rn ~ r11'\tj ~, Certificate of a medical practitioner under the Law on medical treatment professional from medical services specifying that the applicant is free from any prohibited diseases as publicated by the Ministry of Public HeaLth (3) D '\tj1j:j~a-r';ia:j rn';i:ij1:j"lla:jer~:j"ij::: LtJ1fJ:ij1:J1~ m::: L VlVl~~~1~:ij1:Jf)f)~~fI'"lf1~1'VlfJ'Vl1:J1 cu ", g~ ~-raljr:jvi~fl~1tj';i:::fla LVlVl~~~:J, fl~11 Work recommendation ofa prospective employer describing reasons for not employing a person of Thai nationality to vork together with supporting evidences (4) D G11L1V11J:J~aa'4qj1IJllV!f)~1:J~11aaflam"llVlij:J'Vf'r~m~'Vl1'Vl:::LUfJtJ';i:::-wi Copy of Leave for an alien to depart from the Changwat of registration record (5) D LL~~LL6'I~:J6'lm~~:J"lla:J6'lm~'Vi'1:J1~"llmtJ~fJVI~m~lJ Map showing the changed or added Location of place of work as specified in the application (6) mru1fj:ij1:jltjf)f)~5';i';ilj~1, In case the employer is a NaturaL Person o G11L1trlJl';itJ';i:::"il1~1tJ';i:::"lf1"1lLL~:::ri1L1'Vl:::LUfJ,j'1"lla:Jer;:J"iJ:::LtJ1fJ:ij1:J Copies of Identification card and house registration of a prospective employer, or D G11L1V11J:J~m~'Vl1:J"lla:Jer~:J"iJ:::LiJ1fJ:ij1:J VI~a Copy of Passport of a prospective employer, or D G11L11G11~fI'~~a~"lla:Jer~:J"iJ:::LtJ1fJ:ij1:J ~ Copy of Certificate of permanent residence of a prospective employer mru1fj:ij1:j LiJij~f)f)~, In case the employer is a Juristic Person D 611L1 La fl6'l1';i-r';ia:j"lla:j611';i1"lfrn';i~ LM fj1ia:j LL6'I~:Jl1n"iJ rn';i"lla:jer~:j"ij::: LtJ1fJ:ij1:Jl~"iJ~'Vl:::LUfJ v VI~a1~-ra'4qj1(911v!ij~~:J LL~:::~1 Lij:J11~ fj~ fl~a:jvl1lj fl~vllj1fj 1~ ml6'i ~:J'th::: LJl'Vln"iJ rn';i~1fj Copy of certificate of a relevant Government agency stating the business of a prospective employer has LegaLLy been registered or granted a license to establish and operate, and the type of business has been specified (7) D ';itjci1fj "ll1~ m X ct ~lj "il11 m ';itj 3 Photos (size 3 x 4 cm) I I II I q qq,l l1:::li0 (8) D LL~'Vl LL6'I ~:J'VlIJl:J"ll a:j6'i m'vl'vl1:j1 Map showing the Location of place of work VI~a r

6 6 (9) L8'4qJ11Pl (bq~1:;mru~rl1"lj8tol8m~18'4qj11pl'vi~8rl1"ljmtl~tjbbtl"~11t:jm1118'4qj11pl) Work Permit (In case of Application for a renewal of a work permit or Application for change of items in work permit) 42 mru~rl1"lj8-r1bb'vll8'4qj11pl In case of Application for a substitute of a work permit (1) 0 18'4qj11Pl~bat:J'VI1t:J 'VI~8 Damaged Work Permit, or Q,I QJ 9J' ij QJ 0 o 'VI"n~1nl'l1bb"\l~fld1aJ"lJ8~b"\l1~n~11Pl11d"\l Police daily record (2) 0 1tlci1t:J "lj1~ btl x ~ 6IIaJ ~11 btl 4tl ~ ~ 3 Photos (size 3 x 4 cm) I hereby certify that the information given above is true in every respect -=!II d 9J'd 0 "1t:JaJ8"118tJtJfl1"lJ8 ~ OJ Signature 1'Vl Date Applicant

7 7 m":imt'illejng'l1'avl~n~1 OJ IV o LeJnG'l1'aU 'l:::vi 'ln~11'l":i~1 LeJflG'l1'a Lb 'l :::VI~fl ~1hil'l 'a'lj ~1 IV IV,J LQ'rl1::: L~1V11'V1 FOR OFFICIAL USE ONLY " 'O ~ "'O,J 'l1e:ljej"ilb () 1fi1bbVltl-:J IV ",J '" L"il1V11'V1 (:J\9l":i1~ LeJflG'l1":i v,j ~ 1'VI o L~1'l1":ieJt:U11Pl,, o LVI1'l1":i '" l' :ljej'4tjj11pl LVI~(:J 'I <II 'l1e:ljej"ilej () 1fi1UVltl-:J QJ ii vcj 'rlm1b~1v11'v1 OJ,J 1'VI o "" rn I'l1G'1-:J1E'VIt:bE o ejt:u11pl,, 1:~h)'4tjJ1\9l LVI~(:J 'I d d 'l1e:ljej"ilb c) 1fi1LLVltI-:J 1E'VI::i L'lJE "",J 1'VI 1'lJLG'I~"ilb~:IJ~ Lf1"1J~ 'l1e:ljb"ilb () 1fi1LLVltI-:J, ii VClIQJcfll b~1v11'v1 'lj'vi fl"1jej:ij 'I ~ OJ "" 1'VI