Work Permit Application Form Page 18
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18SECTION J
DECLARATIONS
J1
Declaration by Employer (Company/Firm/Individual):
I hereby declare that I am authorized to bind the Employer for the foreign worker named in Section A to the
following:
I have read and I understand the applicable regulatory conditions of the grant of a Work permit, as specified in the
Immigration Ordinance 2015.
The Employer consents, for the purpose of assessing this application, for the Government of the Turks and Caicos
Islands and any statutory authorities thereof to obtain from and verify information with any person, organization, or
any other source; and further, to the release of all information thereby obtained to the Government of Turks and
Caicos Islands, Statutory Authorities and authorized agents thereof.
The information as set out in this applicationare, to the best of my knowledge, true and correct; and that all
documents submitted in support of this application are true and authentic copies of the original document.
I understand that it is an offence to provide false or misleading information under Section 97 of the Immigration
Ordinance 2015 and that if found guilty, I am liable on summary conviction to a fine of $20,000 or a term of
imprisonment of four years, or to both.
____________________________________________
Name and Designation of Authorized Representative
Date:
DD MM YYYY
J2
Declaration by an Agency:
(Applicable if the Employer engage the services of an Agency/Agent)
I hereby declare that I am authorized to bind the Employer for the Foreign Worker named in Section A to the
following:
I, the undersigned, am the Agency personnel handling this application.
I have explained the contents of the application and the applicable regulatory conditions of the grant of a Work
permit, as specified in the Immigration Ordinance 2015 to the Foreign Employee and the Authorized Officer of the
Employer.
The information as set out in this application are, to the best of my knowledge, true and correct; and that all
documents submitted in support of this application are true and authentic copies of the original document.
I understand that it is an offence to provide false or misleading information under Section 97 of the Immigration
Ordinance 2015 and that if found guilty, I am liable on summary conviction to a fine of $20,000 or a term of
imprisonment of four years, or to both.
________________________________________________________
Name, Signature and Designation of Authorized Agency Personnel
_______________________________________________________
Date:
DD MM YYYY
tails
Authorized Agency Personnel Contact De
THIS DOCUMENT IS NOT TO BE SOLD OR PURCHASED
18
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