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The Labour and Employment Act 1999 has
now made the Department of Labour responsible primarily for the review and
issuance of work permits. The specimen application form is attached for your
information.
WORK PERMIT APPLICATION FORM
(Form Lab/WP-01)
Department of Labour
PO Box 431, Apia, SAMOA
Telephone: (685) 20 441 / Facsimile: (685) 20 443
|
Application for Work Permit
[Labour and Employment (Employment of Expatriates)
Amendment Act 1999] |
Applicant Details
|
1.1 |
Name of Applicant as on Passport |
Surname: |
First name: |
|
1.2 |
Passport No.
.
.
... |
Other names applicant is known by:
...
.
... |
|
1.3 |
Date of Birth
...../
...
/
...
...
Day/Month/Year |
1.4 |
Place of birth
.
(City, State, Country) |
1.5 |
Citizenship
..
...
.. |
|
1.6 |
Marital Status
Never married
Now married
Divorced
Widowed |
1.7 |
Name of spouse
Wife
Husband
Partner |
1.8 |
Accompanying children
..
...
..
..
.
..
..
...
..
..
.
..
..
.. |
|
1.9 |
Occupation: |
...
|
1.10 |
Qualifications: |
|
|
1.11 |
Have you visited Samoa before?
If so, please indicate dates of previous visits
.
. |
Yes
No |
|
1.12 |
Have you applied for a work permit before?
If so, please indicate when
.
. |
|
Work Details
|
2.1 |
Name and address of proposed employer in Samoa |
|
Tel:
Fax:
E-mail: |
|
2.2 |
Proposed occupation: |
|
|
|
2.3 |
If self-employed, do you have a business license? |
Yes
No |
2.4 |
Category of worker
Visiting business-person
Short-term consultant/contract
Long-term contract (more than 3 years)
Other (Please specify)
.
... |
|
2.5 |
Term of proposed contract of employment |
|
2.6 |
Postal Address in Samoa
Telephone: |
|
3. Additional Information
Please attach to this application the following:
Employment References
Copies of Training and Academic Qualifications
Two (2) most recent passport photos
Completed Employment Conditions/Guarantee Form Lab/WP-02
Work Permit Fee of ST$200.00 payable to the Department of Labour (this is
non-refundable)
Any other information you may wish to offer in support of this
application.
Please note that the issue of a Work Permit by the
Commissioner of Labour under the provisions of the Labour and Employment
(Employment of Expatriates) Amendment Act 1999, does not pre-empt or
guarantee the issue of an Entry Permit by the Immigration Authorities under
the provisions of the Immigration Act 1966.
4. Declaration
I hereby declare that I understand the questions and
contents of this form and all the information in this application is true
and correct. I also attach the required additional information and
prescribed fee.
Signature of Applicant:
..
Date:
/
.
./
..
|
For further information please contact: |
The Commissioner of Labour
Department of Labour
PO Box 431
Apia
SAMOA
|
Telephone: (685) 20 441
Facsimile (685) 20 443
E-Mail: itsimi@lesamoa.net |
(Form Lab/WP-021)
Application No.
../
../99
Department of Labour
PO Box 431, Apia, SAMOA
Telephone: (685) 20 441 / Facsimile: (685) 20 443
|
Employment Conditions/Guarantee
[Labour and Employment (Employment of Expatriates)
Amendment Act 1999] |
This form is to be filled in by the proposed employer and
guarantor of an expatriate applying for a work permit under the Labour and
Employment (Employment of Expatriates) Amendment Act 1999 not only as
confirmation of an offer of employment, but also as an undertaking to comply
with the conditions of the work permit stipulated pursuant to the provisions
of Section 36D of the Labour and Employment (Employment of Expatriates)
Amendment Act 1999.
1. Employer
|
1.1 Name and Address of Employer
|
|
|
1.2 Location
|
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1.3 Telephone
|
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1.4 Facsimile
|
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1.5 Employment offer (designation)
|
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| |
| |
| |
| |
| |
| |
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2. Worker
|
2.1 Name of worker as in passport |
Surname: (Mr/Mrs/Miss) First Name:
|
|
2.2 Citizenship |
|
|
2.3 Most recent occupation |
|
|
2.4 Qualifications |
|
|
2.5 Date of Birth |
|
3. Conditions of Employment
I hereby undertake to comply with all the provisions of
the Labour and Employment Act 1972, and Labour and Employment Regulations
1973, and abide with the laws of Samoa in connection with the employment of
the above-mentioned worker. I also agree to make available to the Officers
of the Department of Labour any contract, record or any other information
required by them in connection with this matter.
Dated at
this
...
..day
of
1999/2000
Signature of Employer
...
Address
.
.
Full name of Employer
..
4. Guarantee
(Guarantors must be Citizens of Samoa and be able to
provide proof that they have the financial means to meet their obligations
under this Guarantee as may be required by the Commissioner of Labour,
otherwise the offer of guarantee can be declined)
In consideration of the Government of Samoa at my request
granting to the above-mentioned worker a permit to work in Samoa, I do
hereby agree with the said Government that I will upon demand pay to the
said Government any cost incurred or money expended by it in maintenance,
hospitalization, or burial expenses of the said worker, or in defraying the
cost of transferring the said worker to a place outside Samoa where he/she
will be permitted to land and remain, whether on the expiry or revocation of
the said permit or otherwise.
Signature of Employer
...
Address
.
.
Full name of Guarantor
..
|
For office use only |
Date application received |
|
| |
Receipt No. |
|
| |
Name of Receiving Officer |
|
| |
Signature of Receiving Officer |
|
| |
Name of Witnessing Officer |
|
| |
Signature of Witnessing Officer |
|
|
For further information please contact: |
The Commissioner of Labour
Department of Labour
PO Box 431
Apia
SAMOA
