切結書(草案)-meco.docxVIP

外國人入國工作費用及工資切結書Foreign Worker’s Affidavit Regarding Expenses IncurredFor Entry Into The Republic of China To Work And The Wage/Salary一、外國人(姓名) ，國籍： 菲 ，護照號碼： 確實瞭解來臺工作最長可達三年，惟是否能展延到三年，係由雇主與外國人就外國人工作表現及業務需要，協議是否展延。來臺工作應領工資、加班費等如適用勞動基準法，則依該法規定辦理；如不適用則於勞動契約中訂定。1. I (Full Name: ; Nationality: Filipino ; Passport Number: have fully understood that the period in which I am permitted to work in the territory of the Republic of China (hereinafter R.O.C.) shall not exceed three (3) years, that whether my term of employment will be extended to three (3) years depends upon whether my Employer and I will agree to make such extension taking into account my working performance and my Employer’s business needs, and that those matters including inter alia the regular and overtime wage/salary to be received by me for my work in R.O.C. shall be governed by the Labor Standards Act if applicable or by the Labor Contract if the said Labor Standards Act is inapplicable.二、外國人來臺前在勞工輸出國所發生之全部費用如下：2. All the expenses incurred by foreign worker in the Labor-sending Country prior to my arrival in R.O.C. to work are listed as follows:（一）仲介費：勞工輸出國幣值 0元(NT$：0元)。(1) Placement Fee: dollars in the currency of the Labor-sending Country (NT$ ).（二）規費及來臺工作所需費用：(2) Regulation and Other Fee(s) for workers bound for Taiwan:項目ITEMS金額(勞工輸出國幣值)AMOUNT (Labor-sending Country Currency)項目ITEMS金額(勞工輸出國幣值)AMOUNT (Labor-sending Country Currency)Paid for by ?employer?workerPaid for by ?employer?workerPaid for by ?employer ?workerPaid for by ?employer ?workerPaid for by ?employer ?workerPaid for by ?employer ?workerPaid for by ?employer ?workerPaid for by ?employer ?workerPaid for by ?employer ?workerPaid for by ?employer ?workerNOTE: ALL EXPENSES SHOULD BE COVERED WITH OFFICIAL RECEIPTS所有費用應提供發票或正式收據。合 計TOTAL勞工輸出國幣值 大約PHP 元(大約NT$ 元)Php in the currency of the Labor-sending Country (NT$ ______________)三、前項費用外國人於來臺前在勞工輸出國已繳納勞工輸出國幣值 0 元(NT$: 0 元)；不足部分經向 N/A (債權人)借貸含利息共勞工輸出國幣值 0 元(NT$: 0 元)。上開金額經外國人確