Request For Tax Refund - Tax Refund Form For Taiwan

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Tax Refund Form for Taiwan
Department of Labor and Employment
OVERSEAS WORKERS WELFARE ADMINISTRATION
Region: ____________________________________________
WORKERS ASSISTANCE UNIT
REQUEST FOR TAX REFUND
Name of Worker: _____________________________________________________
Category: (Please Check)
Caretaker
Factory Worker
Fisherman
Domestic Helper
Construction Worker
Passport Number: _______________________________________________________
Date of Arrival in Taiwan: _________________________________________________
Date of Departure from Taiwan: ___________________________________________
Employer/Company Name: ________________________________________________
_______________________________________________
Address and Tel. No. (Jobsite): ____________________________________________
_______________________________________________
_______________________________________________
Name of Taiwan Broker: __________________________________________________
Tel. No: ______________________________________________________________
Bank Account Number: ___________________________________________________
Beneficiary: ____________________________________________________________
____________________________________________________________
Name/Address of Bank: __________________________________________________
__________________________________________________
__________________________________________________
____________________
Signature Over Printed Name
Date: __________

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