REPUBLIC OF TRINIDAD AND TOBAGO P. & I.
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IMMIGRATION REGULATIONS, 1974
APPLICATION FOR A WORK PERMIT OR AN EXTENSION OF A WORK PERMIT
To: The Permanent Secretary, Ministry of National Security
Note: Applicants wishing to employ persons are requested to submit in respect of the respective employee one (1) original and seven (7)
completed copies of this form to the Permanent Secretary along with the following:
(a) the official receipt of the Comptroller of Accounts evidencing payment of the fee payable on application for a work permit;
(b) three (3) photographs of the prospective employee;
(c) a police certificate with respect to the previous five (5) years;
(d) two (2) written character references, one (1) of which must be from the last employer; and
(e) in cases of extension, proof that all income tax due, has been paid.
EMPLOYEE DETAILS (Prospective Employee)
1. Full Name
Title Mr. Mrs. Miss
First Name Last Name Middle Name
2. Date and Place of Birth
Date Town Country
- -
yyyy mm dd
3. Present Nationality
4. Previous Nationality
Date of Issue
5. Passport No. - -
yyyy mm dd
Town/State of Issue Country of Issue
6. Particulars of any change of name
Deed Poll Name Deed Poll Date
- -
yyyy mm dd
1
7. Permanent Address
Street Address (line 1)
Street Address (line 2)
Town State/Province
Postal Code Country
8. Marital Status Married Single Separated Divorced Widowed
9. Full Name of Wife/Husband Wife Husband Not Applicable
Full Name
10. Particulars of Children
Date of Birth Date of Issue
Name Place of Birth Nationality Passport No. Place of Issue
(yyyy-mm-dd) (yyyy-mm-dd)
11. Profession or occupation to be followed in Trinidad and Tobago
12. State job experience, including on-the-job training
2
13. Whether accompanied by wife/husband Wife Husband
14. Whether accompanied by children Yes No
15. Date of arrival/intended arrival in Trinidad and Tobago (in relation to present application) Date
- -
yyyy mm dd
16. Local Residential Address
Street Address (line 1)
Street Address (line 2)
Town State/Province
Postal Code Country
17. Particulars of employment during the past five (5) years:
Duration of
Employer Employer's Address Position Held Reason for
Employment
Termination
(yyyy-mm-dd)
From To
3
18. Place/places of residence during the last ten (10) years preceding the application giving dates of such residence in each country:
Duration of Residence
Country From To
(yyyy-mm-dd) (yyyy-mm-dd)
19. Particulars of income assured while employed in Trinidad and Tobago, (state salary, commission and other benefits):
Base Salary Other Allowances (Total) Total Salary
$TT $TT $TT
20. SCHOOLS/UNIVERSITIES ATTENDED
Dates
Institution Degrees/Diplomas/Certificates Obtained Dates Awarded
From To
(yyyy-mm-dd)
(yyyy-mm-dd) (yyyy-mm-dd)
Secondary/
High School
University
Other Courses
21. Will the applicant be self-employed: Yes No
If to be self-employed, give particulars of intended business on a separate sheet including financial circumstances with documentary
support and business references).
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22. Has the prospective employee ever been deported or required to leave any other country? Yes No
23. State offences (other than traffic offences) of which applicant has been convicted, if any, and give the date of conviction in each case.
Offence Date of Conviction
(yyyy-mm-dd)
I,
hereby declare that the foregoing particulars are true and correct.
Date Signature of Employee
- -
yyyy mm dd
EMPLOYER DETAILS
24. Capital formation of company including:
(a) percentage of captial owned by Nationals of Trinidad and Tobago %
(b) percentage of capital owned by Non-Nationals of Trinidad and Tobago who are residents %
(c) whether subsidiary or affiliate of foreign-based company, and if so, name of parent company. Subsidiary Affiliate
If yes, please state the name of the parent company:
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25. Brief description of company's activities
26. Number of employees:
27. Particulars of Non-Nationals employed in Professional, Managerial and Senior Technical positions (for additional entries, please fill in and
attach Form WPA 1a).
Date
Name Post Held
From To
(yyyy-mm-dd) (yyyy-mm-dd)
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28. Particulars of Trinidad and Tobago Nationals employed in Professional, Managerial and Senior Technical positions (for additional
entries, please fill in and attach Form WPA 1b).
Date
Name Post Held
From To
(yyyy-mm-dd) (yyyy-mm-dd)
29. Full description of post to be filled with special experience and skills required for the position:
30. Period for which Permit is required:
Duration
Mths Yrs
From To
- - - -
yyyy mm dd yyyy mm dd
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31. Description of Programme instituted by Company to train Nationals to fill the post for which this work permit is required:
32. Statement by employer as to what steps he has taken including advertisements in the Trinidad and Tobago daily newspapers and in the
newspapers in foreign countries where there are large concentrations of nationals of Trinidad and Tobago to secure the services of a
national of Trinidad and Tobago to perform the duties for which this application is made and with what results:
33. I hereby declare that all the particulars in paragraphs 24-33 of this application are correct and true. If a visa is required in addition to this
work permit, I hereby make application for the said visa.
Date Signature of Employer
- -
yyyy mm dd
Street Address (line 1)
Street Address (line 2)
Town State/Province
Postal Code Country
N.B.- (i) If the above space is insufficient the requested information can be attached on a separate sheet;
(ii) One copy of each newspaper containing the advertisement referred to in paragraph 32, and photostats of diplomas, certificates, etc., should be
forwarded with this application.
