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PRC Form No. 104 (Revised July 2002)

This document is a Certificate of Experience form that certifies an individual's employment with a company. It provides the company name and address, the individual's name and position held, and the dates of employment. The certifying officer, who must be a personnel manager or equivalent, signs to verify the employment details. The form includes warnings about false statements and requirements for accompanying employment certificates.

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65 views7 pages

PRC Form No. 104 (Revised July 2002)

This document is a Certificate of Experience form that certifies an individual's employment with a company. It provides the company name and address, the individual's name and position held, and the dates of employment. The certifying officer, who must be a personnel manager or equivalent, signs to verify the employment details. The form includes warnings about false statements and requirements for accompanying employment certificates.

Uploaded by

gerald
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PRC Form No.

104 (Revised
July 2002)
_______________
_______________
_______________
_______________
NAME OF COMPANY
___________________
___________________
___________________
___________
ADDRESS/E-
MAIL/TELEPHONE
NO./FAX NO.
CERTIFICATE
OF EXPERIENCE
TO THE BOARD OF:

___________________
___________________
________
This is to CERTIFY that
________________________
________________________
_____________ is/has been
employed with the above-
named office/company located
at
___________ ____________
________________________
________ for the period
and performed duties
indicated below:
F R O M T O P
O S I T I O N
H E L D S P
E C I F I C
W O R K / F
U N C T I O N
S
(Use additional sheet
if necessary)
___________________
___________________
_______________
Affiant (Certifying
Officer)(Signature above
printed name)Certificate
of Registration
No._______________issued
on______________________
IMPORTANT:1.The Certifying
officer should be the
Personnel Officer/Manager or
Equivalent Position in the
office/company.2.This form is
good only for one
office/company.3.Certificates
of Employment must
accompany this Certificate of
Experience.
SUBSCRIBED AND
SWORN
to before me
this ______ dayof
_______________ 20___ at
________________________
____ Affiant exhibited to me
his Community Tax Certificate
No.
___________________
____
issued
at ______________________
___ on __________________
______. _________________
________________________
________ Notary PublicDoc..
No.________________ Pag
e No.________________ B
ook
No.________________ Seri
es of________________
WARNING: All statements
are subject to verification
and any false statement or
misrepresentation made in
this CERTIFICATE is
a ground for
disqualification andcriminal
prosecution.

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