Employers

NONRESIDENT WORKER APPLICATION

Employment

Employment Services Official

Job title

Requirements

None

Job Description

Store assistant

Salary

Contact information

28182

[email protected]

1. Name of worker

2. Physical Description:

3. Date of Birth

4. Passport

5. Passport information of all accompanying family members

6. Permanent Address*:

7. Present Address:

8. If already in Palau, state the arrival

9. Citizenship

10. List previous jobs and work performed

X

11. List all countries from which you have been denied entry, removed or deported, if any

X

12. List all crime, if any, of which you have been charged or convicted

X

13. Have you previously worked in the Republic of Palau?

14. Intended address while in Palau (if known)

15. Name, phone and address of person (s) or recruiting agency who referred you to the employer

X

ATTACHMENTS TO APPLICATION:

  • Two (2) recent photographs of the nonresident worker and each accompanying family member.
  • Certificate of freedom from communicable diseases issued by a physician licensed to practice in the country of the nonresident worker's origin stating that the nonresident worker, and all accompanying family members, is/are free from communicable and contagious diseases. The certificate shall be issued not more than 30 days before the date of entry and authenticated by the Ministry of Health or equivalent entity responsible for national health services. 13 PNC § 1072.
  • Police clearance certified by a state or national government police agency, at the nonresident worker's point of hire, stating that the nonresident worker has not been convicted of a felony or other crime of moral turpitude. 13 PNC § 1048 (a)(3).
  • Affidavits of qualifications by at least two former employers indicating a minimum of two years work experience in the line of work for which the worker is being hired. Statements from travel agent or employment and placement agency staff shall not be accepted. 13 PNC § 1048 (a)(1). Provide name of company representative & contact information (phone/email address).
  • Affidavit Form provided by the Division of Labor completed by the nonresident worker and signed before a notary public under penalty of perjury. 13 PNC § 1048 (a)(1).

ATTACHMENTS FOR REEMPLOYMENT (TRANSFER) EMPLOYEES ONLY!

  1. Police Clearance (Original)
  2. Medical Certificate or Physical Examination
  3. Recent Photo – 2 each (1” X 1”)
  4. Old Work Permit & Entry Permit
  5. Passport Copy (must be valid for duration of employment)
  1. National/State License (If Applicable)
  2. Job Certification for minimum of two years related work experience.
  3. Transfer Agreement
  4. Social Security Number
  5. Vacancy Announcement Copy
  6. Reason for Transfer (If Applicable)
X

AFFIDAVIT for NONRESIDENT EMPLOYMENT

(13 PNC § 1048 (a) / Div. of Labor Rules & Regulations Part V)

I,  , being duly sworn depose and say under penalty of perjury:

  1. I am making this affidavit in conjunction with my application for a Labor Work Permit.
  2. The information contained in my application, and all attachments, are true and correct to the best of my knowledge and belief.
  3. I have a minimum of two years’ experience in the line of work for which I am being hired, namely:
    X
    1
  1. I can ___write, ___speak or ___ converse in simple English.
  2. I am ____married ____ not married (check one)
    No. Name Age Address
    1 X
  3. I have not been convicted of a felony or other crime involving moral turpitude.
  4. I am aware and do accept employment wages and other benefits for the work I’m hired to perform.
  5. I shall abide by employment rules and chain of command.
  6. I commit to ____ one year or ____ two years (chose one) term of employment.
  7. I shall not engage in unauthorized employment.
  8. My purpose in Palau is to work for my employer and if circumstances change I must abide by Labor laws, including surrendering my work permit and return to point of hire.
  9. I understand that I must attempt to work out grievances with my employer before I present them to Division of Labor.
  10. I understand that falsifying the information in my application will result in work permit not granted.

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