外國人力仲介公司認可申請表
(Application Form for Recruitment Permit by Foreign Manpower A-
gency)
┌──────────────────────────────┐
│1 機構名稱 │
│ Name of the Agency │
│ │
│ │
├──────────────────────────────┤
│2 機構負責人或代表人姓名 │
│ Name,Title and Nationality of Owner or Representative of │
│ the Agency │
│ │
│ │
├──────────────────────────────┤
│3 機構登記字號及核准之政府單位及許可效期 │
│ No.of Registration Certificate of the Agency,Issuing Gove-│
│ rnmental office and the validity of the Registration cert-│
│ ificate │
│ │
│ │
├──────────────────────────────┤
│4 機構地址、電話及傳真號碼 │
│ Address,Telephone and Fax No. of the Agency │
│ │
│ │
│ │
└──────────────────────────────┘
※本公司申請中華民國認可，辦理本國勞工赴中華民國境內工作，願遵守
以下之規定，本公司並知悉如有違反，中華民國將依私立就業服務機構
許可及管理辦法第三十一條規定撤銷認可。
※ In consideration of applying to the Republic of China for a
License to engage in the importation of workers to the ROC,
I/We hereby certify that abide these regulations. If I/We v-
iolate these regulations the ROC will under Private Employme-
nt Service Organization Licensing and Management Regulations
of Article 31 revoke our recognition .
一 遵守本國及中華民國有關法令規定。
1 Will abide by all laws and regulations of the home countr-
y and the Republic of China.
二 向勞工收取之仲介費以不超過勞工一個月薪資為原則，並遵守本國收
費相關規定。
2 In principle, the collection of placement fee from workers
shall not exceed one month salary and shall be done accor-
ding to the related regulations of the labor sending cou-
ntries.
三 不得授權任何人至中華民國境內從事就業服務工作或主動向雇主發送
傳單、招攬訂單等行為。
3 Will not assign any one as an agent to provide employment
services in the Republic of China, issue handbills direct-
ly to employers, or to solicit job orders from employers
directly.
四 未經雇主或中華民國合作仲介業者之通知，或在未會知雇主及中華民
國仲介業者情形下，不得派遣勞工來華。
4 Shall not import workers to the Republic of China without
in advance obtaining the approval of the employer or the
cooperating manpower service agency in ROC, or without the
knowledge of them.
五 不得轉介勞工為其他雇主非法工作。
5 Shall not arrange the workers for working with other empl-
oyers illegally.
六 辦理勞工來華工作已取得中華民國簽證後，若遇勞工不能來華，應向
中華民國駐當地代表處取消該等勞工之入境簽證。
6 Shall cancel the visas of workers approved for employment
in the Republic of China who are unable to come to the ROC
, and shall notify the local ROC representative office.
七 不得提供不實資料。
7 Shall not knowingly supply false or misleading statements
or data.
八 如遇雇主因業務緊縮等因素臨時通知取消或縮減引進人數，應予照辦
，不得超額引進。
8 Shall make necessary adjustments to quotas, as requested ,
if employer gives notices that due to reduced demand or o-
ther reasons a cancellation in full or reduction of the n-
umber of workers to be imported required.
九 所引進之勞工若在中華民國遇有重大事故或死亡，應來華協助處理善
後。
9 Shall make necessary arrangement in the ROC for handling
of cases in which workers meet with serious accidents or
death.
十 公司終止營業、停業或地址電話遇有異動，應於十天內通知中華民國
駐當地國代表處。
10 Shall notify the local ROC representative office with-
in 10 days of any cessation or suspension of business
or change of address or telephone number.
負責人或代表人簽名：
Signature of responsible person or agent.
日期：
Date：
附件：公司執照及許可證影本各一份。
Attachment： Company License and Permit, one copy of each.
注意事項：本表及附件均需由申請人國籍法院或公證人之公證，並經中華
民國派駐申請人國籍國之機構驗證。
Note：This application form and associated documentation must be
duly notarized by a court or Notary Public in the home co-
untry of the agency making application, and approved by t-
he local ROC representative office in that country.