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wp.doe.go.th
[nz.
o-2245-27 45, o-2245-2s33, 0-2245-230 6, 0-2248-7 20 2
oiruyilwru
W.P.5 (WORK PERMIT RENEWAL)
THE MIAN DOCUMENTS REQUIRED Ptease arrange documents in the fottowing order:
1. Compteted Form WP.5
2. Work Permit and a copy.
3. FORM OF THE EMPLOYMENT CERTIFICATION dul.y fitl.ed out.
4. Passport and a copy or Certificate of Permanent Residence and Certificate of Atien with a copy.
5. Medical certificate showing that the appticant is not insane or mentatly sick, suffer from Leprosy,
6.
7.
8.
Tubercutosis, Drug Addiction, Atcohotism, Etephantitus and Tertiary Syphil.is (lssued within 1 month).
Documents as stated in the conditions of work in the Work Permit. (lf any)
Power of Attorney made by appticant with
t0 Baht duty stamp affixed and a copy of grantee's l.D. card.
A copy of emptoyer's l.D. card (Thai emptoyer) or a copy of emptoyer's Work Permit (foreigner empLoyer).
Supported Documents as category of emptoyer
1. Company
1.1 A copy of Thai Company Registration and a copy of recent sharehotders'
tist. (Updated
within six months). Or foreign juristic
person needs to submit a copy of Business Operation License of such foreigner and document about money impofr.
1.2 A copy of Batance Sheet (tast yead, VAT Payment; Phor Por 30 (3 months) and a copy of Work Permit hotder's Tax
payment; Phor Ngor Dor 91 or 90 (tast year)
2. P rivate sc h oo t / P..riu.a Ip.. U'n lve r.s i ty.
2.1 A copy of letter of teacher or Instructor assignment and emptoyment contrac/
Pf!U.qte..L).ni.u.erSLy.hgS..tO..Shpw..the.
eefificate.l*te$ra m.the. prsqn! zs1 p n.of.Mlni s.try. pl.E du ca7p n.
2.2 A copy of teacher license, in case of trainer/instructor is excepted.
2.3 Acopy of the
license of the school estabtishmen7 s.qppy.Af.the.licerse.pf.the.uri.v.e$tty.estahlshment
docaments.shpw.the.nsme.af.employilhas.he.rtghtf.q.sisnnspn.the.h?hp!f
snd.s.cqpy,pf.the.
.of.the.tfiiuersu.
3. Government organization
3.1 A certificate letter from the government organization/ Ministry
of Education and schoot, which shows appticants,
name, position and work period.
3.2 ln case of teacher
of government schoot, a copy of teacher license (as Law of The Counci[ of Teacher
and
Education Personat) is need. The trainer is not inctuded.
4. Association,/ organization/ foundation
License of association/ organization/ foundation estabtishment (ptus the l.ist of managing director)
Remark
(1)
Any documents in foreign tanguage other than Engl.ish must be transtated into Thai and certified by an academic
Thai native speaker. Al.i the Forms have to be fitted in Thai.
(2) Every page of the
documents betongs to the company need
to be certified by the authorized person or the
appointee with company seat. Every page of the documents betongs to appticant need to be certified by the
appticant himsetf or the appointee.
After
fie application
is completed, the prooess will finish within 3 working days.
wp.doe.go.th
T
el.
o-2245-27 45, 0-2245-2533, 0-2245-230 6, 0-2248-7 202
ILUUF}YI.d
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tail1v[Q114u1vl
FORMWP.5
FOROFFICIAL
USEONLY
I
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Fl'111il19151
b6n
n5iln'1T09t14'l{'lu
9
e.,
qCr-4
APPLICATION
FORA RENEWAL
OF A WORKPERMIT aafl LUL:Ja
a{u'lo
UNDER
SECTION
23
OF
DEPARTMENT
a.t
EMPLOYMENT
a./
141r'r
utnt | : vqirfr'rnurir r 6'rr
nSvvt:?{t[:{{1u
OF LABOUR
MINISTRY
' 9r U
L.
toilanun'l{41?
U
Atien's lnformation
It
4Y4o
11
u'tFt/u1t/ursar':
fla tJFluFt'l'ltF)
lJ
Name of appticant
Mr./Mrs./Miss
t
aaJ4{
#nrtrfi
NalionaLity
LflO-)UVt
al Fr
il
Date of birth
Ase
Years
l
ir t , t 4
1 2 frarilur
l:vrvrolvrrrraqrfi
U
in Thailand
No.
Address
fluu
Th an on
a-t
et
'!
1,,1:-lVll611Ft'15
?16tFI
frlooZg,ilding
S oi
girr ralllqt':..]
o1Lfla/mtn
T a m b o n /K hw aeng
Amphoe/Khet
:#alr l:r+fiei
a{ u?o
Changwat
Tvr:dr,'irri
Postcode
Tu:ar:
Tel.ephone
h ,cd d a d a 6
Ll |5lqni Frfl rn fl il5altfl A
Facsimite
E-mailaddress
1.3 ranal:[[an{nr:16'irorlcyrsrtrioulu:'rrorrurd'n:odrflerodrrvfi{r1-reiolild
Document showinga permissionto stay in the Kingdom as follows:
(i)n
uu-rf,orfiuurr
[]
Passport
ronar:Wurvruvrirfiornuvrr{.................,
Documentin lieu of passport
i6
ra?rvr
aanl#fi
No.
r l::urue't
Country
ls su e da t
6l g,ru
6t s4
i
frafl tv?uvl
y4
ar
-i
L?l 1O fl .,1111V1
Date of issue
Va[id until
j
6l
Fl5 ?q ra{n511
l: v m v r
ta?ryl
Type of visa
N o.
gJaJ
q
6]
aaf^lL?1?uvl
-i
yd
6l a fl L14Vl
l s s u e da t
s,n
v4
a-r
;
L?ltOflt'lllvt
Date of issue
V a l i du n t i L
c{
rF u vr1..rrJ'rfl-t: r ?fa''lfu'r fr'n:
4J
a)
tt|Ft?lrvl
Date of arrival at the Kingdom
q
va
y
a
w
A
y
a
!
.
t9r:u0u[u1F]11ny!1Jn.i1utQ'i14u1iln:?Qnurfl'ttl.l0.t
tu ytil'tn't:rl:?anut1J1t3J0.i...........
Havingreceiveda permissionfrom an immigrationofficerat the immigrationcheckpoint
qv
6)
o
<
v
!
tlr6tFltu:l?f 41tu1{rn: fl .111_lvr
f o O u a b l e to sta y in th e Kin g d o m u n til
Ooq./acJl
Q Luarerryfluvtoq
Certificateof permanent residence
I
qv4
<J
ta?rvl
e,
lssuedat
No.
61
9.t../
a,
a{u?o
6tfln Luvl
Changwat
q*1
;
?td
at
d
aan L?l?lrvl
Lfl [Afl{']1_lvl
Date of issue
Val.iduntil
(3) turirnTcyil:v
drd'rnurixffrr
A[ien identificationcard
j
4'
flan'l#fi
tn?rvl
No.
lssuedat
qYe)
Changwat
i
q
I
*1
9.t4
c{
e,t
616tfltlr?l_lvl
[9fLnn{1l]vl
Date of issue
Vatiduntit
q *,4 , _
1 4 1,rraunrlw{l{.rrutd
q
aanLuvl (a{ilia)
e)
lssued(Changwat)
WorkpermitNo.
6I
gt q.t
A'
a{u?01
q L \v<
;
oon Lu?uvl
et
4
L?tLAn{?UVl
Date of issuedat
Vatid until
g.,
4t
1 5 ?ta il'l Ffq]1..1
Name of emptoyer
i '^ j
t
vtou
U
uufi/arnr:....
U
tn?Jvl
A d d r e s s No .
fvloo/Buitding
cluu
.sirun/LttJ?.1
fhanon
2.
.....qtou
Soi
eirmo/rqla
Amphoe/Khet
Tambon/Khwaeng
{'rrnin
:ri'atil:ufid
lvr:d'vrd.....
Changwat
Postcode
Tetephone
.......Ivr:fi'1T...
Facsimite
It
toilan'l:1,0 0un,19l
q,
qe,
AppticationInformation
qrariaatrtrr oufl |1srvirrru
ir
Appty for a renewatof a work permit for
Year(s)
ge.,
I
4
to6tll
Month(s)
,a.,, ;
Y
d .r i
Fl{ ttFt?uv1
411fl..111M
from
to
3. tonfi1:[tavuan
fr1u
d9
D o c u m e n ts a n d Evid e n ce s
nSourirrofrtrnufr'LdEuronar:uavydngru6'lria'Lr.lfr
Together with this appLication,I have attached herewith the fottowing documents and evidences.
5.7
LJ
6f
rUoUru1gl
Work Permit
3.2 n
ririuryrftf,orduyx
uia
Copyof passport,
or
n
airrurronar:Wuvrurarirfiorfiuyrr
uio
Copy of document in lieu of passport,or
n
r{rrurtuiir6'rgri:
sdrefrnueirrrirrracdrrurh ;{r6'rgfr
udoqi
Copies of Atien identificationcard and Certificateof permanent residence.
3.3 n
eiruurud'norunr:oqryrnbfrniurlu:rrorrut6'n:
Copy of evidence of permissionto enter into the Kingdom,
Q'
?u
DaY(s)
ruuu
uf.riloiu :ornr :{'rt
FORM
OFEMPLOYMENT
CERTIFICAT1ON
gdr{ EMpLoyER's
TNFoRMATToN
t. riolaur
U_
r' r - E f f q n n a tvru o rrvrvrfU u d o '.u atd.........' ....ytuom vlfuu
PERSON
REGISTERED
ON
THAIJURISTIC
f-l
I
aa
u
PAID-UP
CAPITAL
NO.
.i
a
o
a
d
o
e
|Jijfunnagi1{'|,1?anwt[Uitijo..........................,irulutiufurrc]ri1a1nsi1{d:vtf...........'......
THEAMOUNTOF MONEYIMPORTAT]ON
ON
FORIENJURISTICPERSONREGISTERED
ryn:d:vt'rsuhrf
E qnnao::ia"r
........
NO.
NATURALPERSON
ID.CARD
WORKPERMITNO.
1.2aaruspirunlTfiu lu:ouilfiniT uil'r rHEFTNANcTAL
srArusoFrHELAsrvEAR
fiuvr:?Iu
:1u16'
tiuan/rturJrnfiu1n1: riilz/tt'lptTu
tl n.fl.
aqr d
YEAR
INCOME
A55ET
:ruki flaqriu
CASH/DEPOSIT
4
a (l,
t"t119U:t9yl
PROFIT/LOSS
TAX
............rt'rvr
lutix:sucr']a1................................
r6ou
THERECENTLY
INCOME
BAHT THEDURATION
t-l
lJ ilan1nl:a{oon rHEVALUE
oF EXPORT...........
e
l-raro
I
i
qd,
e
MONTH
..............U',tyt
BAHT
LJ !9tU1nUn',t{U:utUr,lt?'tu'tvto.llylu?lu50uuYt9.l'tulJ1............................nu
THEAMOUNTOFTRAVELLER
IMPORT
FORTHELASTYEAR
l-ld
lJ
PERSON
q
v
3JV{Ufl{lUnUtylg THEAMOUNT
PERSON
OFTHAIWORKERS........................nU
I
l-la
v
e
o
I
e
e
o
d
THEAMOUNTOF WORKPERMffHOLDERS
WORKPERMIT
NO,
rHE AMOUNT
OF ROOMS..........,...140{
ROOMSlJ n1uluufl$tlu
Q1U?U1,10{L:UU
lfoe< gla
|J
z. dolanr:dr{
THEAMOUNT
OFsTUDENTS...............nU
PERSON
TNFoRMATToN
oF EMpLoyMENT
wv , a9r v A
d n ,{
do
I
do
I
v
i"
I
a
'
To sPEgFypLAcE
Suudoluylyll{"ru 6t'ltJ'lnn?'lr4u{$14{
oF woRKtFMoRETHAN
oNEPLACE.......
I
PERIOD
OF CONTRACT
YEAR
MONTH
DAY CONTRACT
VALIDUNTIL
r ir dr q a 6 o :,r a1diuay/t6ouav.......... . ' . . ' . ' U1 y |r. ra rJ : v I Ug d d u iu a v / t 6 o u a v . ' . ' . ' . . . . . ' .. . . ' . ' . . . ' . U 1
PERDAY/ MONTH
BAHTOTHERBENEFIT
WAGEOR INCOMEPERDAY/ MONTH
:sdunr:finurd{da..............
!r
THEHIGHEST
EDUCAT1ON
rh
BAHT
..............rj:vaun1:nhi1{1u................fl
ao1un1T,r
E Tan E al:a
JOBEXPERIENCE
YEARSTATUS
SINGLE
MARRIED
g
rHE REAsoN
wHy Nor ro HIRE
THAIpERsoN
a. naqruafitridrn4nnadrgtrfilvrsnhd'r,{r'ru
-
ry
nSoliild*uuud'nilud:snouruEfiad{nrirrd'rer
u
v
{'lillal?Jo:u:o{?'l
v
e
v
6'qdrer'rcr-ose
HERn,vITH
IHEolro,vrNrc
DocrlIENrs
FoRsJpporrlhc
IHEABCA/E
FEAscfs
3a,
THEABovE
ton'l1u$'l{9luu[uun?13Jat{4nu:sfl11 | HEREBY
STATEMENT
ARE
TRUE
tNEVERY
RESPECT
CERnFv
uil1r,n4E
urJ:snounr:
raiot6':'uloudrurqbh{1nr:uvru
{r{tarhdaiu:osdnvoiocr{Ju{fio"ruroaodoqnr{uaa,
REMARKTHEPERSON
DIRECTOR
REPRESENTATION
SIGNTHISFORMMUSTBETHEAUTHORIZED
ORAUTHORIZED
Duty Stamp
10 Bath
Power of Attorney
jyAO
?tuff,oilaua1u'lq
a'ln?uuRnrurJ
oo UlYl
Writienat
O
.ri
yl'lyl
Date
q/d
?uvl
Mr./Mrs./Miss.
at presentworking
hereby authorizeand appoint Mr./Mrs./Miss.
o
9v
.
v
9
in the position of
6l
o
at the office of
oI
a1ttfiu{
Tel.
u
Soi/Lane
Located on
Yt
,
,ti
lvr:.....................
n\tAUtnSYl
Rd.
Sub-District
Province
to be lawfuland legalattorneyfor the purposeconcerningwith work permit,
{rnio
firirumsl'rrfiunr:rfiurrYunrrraoqcprnvrh'nu
o.:u'rruluranor:rl:snaunr:
.. 30U
g
District
sign any documents on behalf of myself includingchangingwords on the related documents.
uuurJa.:ufilrfi
?ooqrulnrrvru{trr{rl6qnauiu:urvhuJfi
onrrx"luroncr:el-.:n6imdru
What has been done by
.,
will remain in full force
A
!s
cl
Osa
4
,
and effect as it has been done by myself.
{tr r{rlfi n: vdrm.r4nil:vn''r?
Signed
Grantor
d-
n{ro............
$ilauCI1u'te
(
Signed
Grantee
.us.,
d
o
0..f:Uu0UA1U1a
...........e
IU
fi\:t0
(
Signed
a
fl{to...
Witness
ytu'lu
(
Signed
Witness
?rilTrrlrqnrn{rauriruroil:vc':d'ov.frrYrrlsunr:uoudrurorfluadr.:6u
aiounrydrld
loslildo,ildrdanrusrud
Remark In case grantorperfer to limit the authorizationgivingto the granteeit could be done by usingthe other
forms of power of attorney.
3.4
,rarirdoiu:ornr:6'xto14'6rovr{Juu,ru6'r$oro:vrpuqzuafilii6'rqnrnraa'rytrfitvrud'xru
X
, Z'
fl :ailil{uan61uu:vfl 01Jr14E
ilan{na1x
to raror(together
reasons
fornotemptolnga personofThainationatity
Workrecommendation
of a prospective
emptoyer
describing
with supporting
evidences.
3.5
n:niursdr{rfluunaaor:ila1
t
In casethe emotoyeris a NaturalPerson
il60
iirrurr.in:rJ:vdT
6'rrj:vsrsuttavdlrulvrs[fiaurirutorei6rost{Juuru6'1t
U
n
emptoyer,or
Copiesof ldentification
cardand houseregistration
of a prospective
v€o
a{rrutarirdorduyrtrorrifi.:ovrtjuuru6'1r
tr
Copyof Passportof a prospectiveemptoyer,or
n
iiriurluiirdcufi
ufiodrorriQi{ovr{Juulu6r{
u!{
Copy of Certificateof permanent residenceof a prospective emproyer.
nrfiurs{TtflufiBr1nna
In casethe emptoyerisJuristicPerson
n
driurronar:iu:orro.rciru:1{n1rfirfiu?dorrrarx'irfionlrro{ri6{ourfluurEJ6'rrt6'nnilvLfiuu
r,r€oli'Yror1ryrsrlfr'o-onerravsirrfiu.rrulnuQn6'0{Fnilnflvil1u
lnBranrl:vmvfionr:6'ru
Copy of Certificateof a retevantGovernmentagencystatingthe businessof a prospectiveemployerhasLegattybeen
registeredor granted a ticense to estabtishand operate, and the type of businesshas been specified.
y
d
a
ao
4
d
d
n:6uu'1
uo1{ilRxla1tu1fi
:oauila uuan51go1fu10n:
!U
In casethe emptoyer has permanentresidenceoutside the Kingdom
n
iirrurd'ryrpri'xLyxrluSa
Copy of serviceand/or operation contract, or
n
u6o
ririur#ryrprd'0fllu
Copyof satecontract,or
n
drrurronar:6ufiuanvjr{6un"T
tofinrrilsl"rr{lud'orr?ilurdrvrulu:rro1ru1i'n:
(:vq).............
Copy of other documents showing that an appl.icanthas a necessityto work in the Kingdom.
(specify)
n:aitilfiursdrr
In case of without an emptoyer
n
.i
;irrurronar:fruaon'jrfr'6urirtor{Jue1'fin?'rxriravil:vaun1:rfiruillsdilniu{1ufifloiuluourX
(:vq))...........
Copyof documentshowingthat an appticanthasa properknowtedge
for engaging
and experience
the work.
(specify)
n
eirru'r#cycyr6'r.:ryal1u6o
Ll
Copyof serviceand/oroperationcontract,or
&
alru1a6u6u1{011u
uto
Copyof satecontract,or
n
drrurtonar:6ufrurarx'irfr'durirrafinrrrsirr{lu6'oldru'nr"rtru1u:rro1il1i'n:
(:vq).............
Copyof otherdocuments
showingthat an appticanthasa necessity
to workin the Kingdom.
(speci!)
tl
rirrurluorlcg'rerrJ:u
no!D':fionu
ngrau'r
u'irpirunr:rJ:vnarq:fraro.rFruei'r{eirrtun:fifirtlurru
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