Leaving certificate
Name date of birth year month day
The male se-x.
Each female identity card number
Home addretelephone
Turnover turnover: year month day month wages actually
Working ground county ( city)
Reason for leaving
(this column can only select a ) a, involuntary separations:
- shut the factory - factory moved - - - closed dissolution declared bankrupt
The Labor Standards Law eleventh: - A - two - three - four - five
The Labor Standards Law Article fourteenth A: - A - two - three - four - five - six
Labor Standards Act thirteenth but the labor standard law twentieth
Each contract work: from year month date to expiration year month day
Two - three, voluntary turnover, other ( checked, be sure to text )
( ID card copy positive paste bar ) ( ID card copy back adhesive bar )
The insured units demonstrate that column ( of leaving certificate issued by the insured units please fill in this column ) ( please affix the official sealOr seal )
Insured unit name:
Insurance certificate insurance: telephone unit:
Insured unit address:
The table and recorded in the content of the information, industry by the insured units review accurate, if not willing to bear all legal responsibility.
The insured units contact: contact telephone number:
Authority of that column ( of leaving certificate by the local authorities issue please fill in this column, and please fill issued authority of reason ):
( please seal or stamp at )
The applicant 's own interpretation bar ( of the certificate leaving office to the insured units and the labor administration authority for cannot obtain please fill in this column )
, if not willing to bear all legal responsibility.
Applicant ( signature )