FORM T.1
EMPLOYMENT ORDER FORM FOR INDONESIAN WORKERS
REQUESTED BY OVERSEAS EMPLOYERS
Ⅰ. /

NAME AND ADDRESS OF TAIWAN AGENCIES

1. / Country, and place of Employment / TAIWAN
2. / Taiwan Recruitment Company/AgencyName
License No
Address
Phone No.
Fax No.
E-mail.
3. / Represented by.
Name:
Position:
Passport No.
Home address.
Phone No.
Mobile phone No

NAME AND ADDRESS OF INDONESIAN AGENCIES

4. / Indonesian Recruitment Company/Agency
Name:
License No.
Address
Phone No.
Fax No.
E-mail. / PT.ASA JAYA
KEP.227/MEN/X/2004
SUKOSEWU RT.01/04 GANDUSARI-BLITAR
JAWA TIMUR.66187
+62-342-693648
+62-342-695269
5. / Represented by.
Name:
Position:
Passport No.
Home address.
Phone No.
Mobile phone No. / GANDUNG
DIRECTOR UTAMA
B568382
SUKOSEWU RT.01/04 GANDUSARI-BLITAR
JAWA TIMUR.66187
+62-342-693648
+62-342-695269
6. / Recruitment agreement / Caretaker / domestic helper
Number:
Date: / 2005/1/1~~2005/12/31
Ⅱ /

TYPE AND NUMBER OF WORKERS REQUESTED

1. / Job Title / Caretaker / domestic helper
2. / Duties of the job / Take care old patient or child
3. / Number needed elaborated in dispatching
Schedule from Indonesia / We need person ( caretaker / domestic helper )
From Indonesia per ( month )
4. / Proposed duration of service / for the contract is two years can extend one year
Ⅲ / PERSONNAL REQUIREMENT
1. / Age and sex / 21- 40 years old , female
2. / Education / elementary
3. / Experience / No overseas experience
4. / Marital Status / Married or single
5. / Number of dependents allowed / One or two
Ⅳ /

TERM OF EMPLOYMENT

1. / Number of working hours / As contract
2. / Wage per day/week/month
Specified according to jobs / NT$15840/month
NT$528 / overtime pay per(day)
3. / Other benefits / Continue 2 and 3year / NT$528* 7 each
4. / Insurance against accidents or industrial
(occupational) disease/life insurance
(during the term of overseas employment) / Accident insurance as contract
Ⅴ /

TRANSPORTATION AND SOCIAL PROVISION

1. / Transportation from Indonesia to the Place of employment and return / As contract
2. / Board and Lodging / Free food and house
3. / Health Care / medical treatment / Have health insurance
4. / Working Outfit / TO BE PAID BY EMPLOYER
…………………………2005…………
(Signature and position of applicant)
______
Director
SEEN BY：
Indonesia Economic & Trade Office Taipei
Kamar Dagang dan Ekonomi Indonesia (KDEI)
FOR OFFICIAL USE ONLY：
Directorate General of Overseas Employment Service of M & T Rep. Indonesia
c.q. Directorate of Promotion and Placement

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