Can cu Thoa thuan giua Chinh phu nude Cgng hod xa hoi chu nghia VietNam va Chinh phu Niu Di-lan ky ngdy 29 thdng 12 nam 2011 ve vigc thyce hignChuang trinh lam vi?c trong ky nghi (sau day goi Id Thoa thuqin);

Can cut Nghi dinh sd 186/200/'/ND-CP ngdy 25 thdng 12 nam 2007 cuaChinh phu qtty dinh chuc ndng, nhi?m vy, quyin han vd ca cdu td chitc cua Bo

lao ddng - Thuang binh vd Xa hoi;

Can cuNghj dinh sd 77/2009/ND-CP ngdy 15/9/2009 cua Chinh phu quydmh chuc ndng, nhi^m vy, quyen hgn vd co cdu to chuc cua Bq Cong an;

Can cu Nghi dinh sd 15/2008/ND-CP ngdy 04/02/2008 cua Chinh phu quydmh chuc ndng, nhiem vy, quyen hyn vd co cdu td chuc cua Bo Ngogi giao;

Can cu Nghi dinh sd 21/2001/ND-CP ngdy 28/5/2001 cua Chinh phu quydinh chi tiet thi hanh Phdp l$nh nhyp cdnh, xudt cdnh, cu tru cua ngudi nude

ngodi tgi Vi^t Nam.

Bg trudng Bg Lao dgng - Thuong binh vd Xa hgi, Bo trudng Bg Cong anvd Bg trudng Bg Ngogi giao hudng dan thyce hign mgt sd dieu cua Thoa thuan

giua Chinh phu nude Cong hod xd hgi chit nghia Vigt Nam vd Chinh phu l^iuDi-ldn ve Chuong trinh 1dm vigc trong ky nghi nhusau:

Dieu 1. Pham vi v& doi tuyng p dung

1.Th6ng tu nay quy dinh \b trinh ty dip gidy phdp lam vi?c trong ky nghi(gmy phep lam vi?c trong ky nghi sau day vi^t tat la giay phep), cap thi thyc vacu trd cho cong dSn Niu Di-lfin lam vi?c trong ky nghi tai Vi^t Nam.

2.D6i tuyng dp dyng id cong dan Niu Di-lan sang Viet Nam ldm vi?c trongky nghi (sau ddy vidt tat Id cong dan Niu Di-ldn); ca quan, t6 chiic, doanhnghi?p (ca quan, t6 chiic, doanh nghi?p sau day vi^t tat Id ngudi sir dyng lao

dgng) t^i Vigt Nam c6 sur dyng cong dan Niu Di-lan.

THONG TIT LIEN TICH

Hirdrng dan thyc hin mot so dieu cua Thoa thuan gifra Chfnh phu nirocCyng hod xS hyi chu nghta Vif t Nam va Chinh phu Niu Di-lan ve

Chuong trinh l&m vifc trong ky nghi

S6^5"/2012ATTLT-BLDTBXH-BCA-BNGHa Ngi, ngdy ^6 thdng 6ndm 2012

CONG HOA XA HOI CHti NGHlA VIET NAMDye lap - Ty do - Hanh phuc

BO LAO DONG - THtfONG BINHVA XA HOI - BO CONG AN -

BO NGOAIGIAO

Dilu 2. Dilu kif n cap gily phdpDilu kin clp gily phdp thyc hi^^i theo quy djnh tyi Dilu 5 ciia Thoa thuan

va c^c dilm g v^ k cua Dilu 5 dupe hudng din nhu sau:

1.Cong dan Niu Di-Lan c6 vSn b^n churng minh da md tai khoan ngan

hang tyi Niu Di-lan v^ giao djch du(jrc vdi c^c ngan hang tyi Vi?t Nam vdi tdikhoan khong dugc thlp hon 4.200 DO la Niu Di-lan.

2.D3 dugrc clp gily chumg nh^n sure kho dii dieu ki^n ldm vic theo quy

djnh cua phap lu|t Niu Di-lan. Gily chung nhan siic khod da dugrc clp khongqud 180 (mpt tr^m tdm muoi) ngdy tinh din ngdy cong dan Niu Di-lan npp hi sodl nghj clp gily phep.

Dieu 3. Ho so dl nghj clp gily phep

C6ng din Niu Di-lan c6 nhu clu dl nghj clp gily phdp n0p trvtc tilp ho^cgui qua dudng buu di^n 01 (mpt) bp hi so cho Dai sii quan Vipt Nam t^i NiuDi-lto. Hi so bao glm:

1.TO khai dl nghj clp gily phdp cua cong dan Niu Di-lan theo mlu so 1ban hdnh kdm theo Thong tu nay;

2.Ban chpp hp chilu cOa c6ng dSn Niu Di-lSn cdn thdi h^n nhilu hon ftnhlt 01 (mpt) thang so vdi thdi h^n dl nghj clp gily phdp;I

3.Gily chung nh|n sure kh6e theo quy djnh t^i khoan 2 Dilu 2 ciia Thong

tunay;4.Chung chi qulc gia phi thong trung hpc cua Niu Di-lan clp dp 02 (hai)

hodc trinh dp cao hon;

5.Van ban chung minh du dieu kipn tdi chinh theo quy djnh t^i khodn 1Dilu 2 cua Th6ng tu ndy;

6.. 03 (ba) dnh mlu cO 3cm x 4cm, dlu dl trln, chup chinh dien, r6 m^t, r3

hai tai, khong deo kinh, phong anh mau trlng va ban mem dnh mau neu tren.

Cac gily td quy djnh tai khoan 3, 4 va 5 Dilu nay Id bdn gle, trudng hpp Idban sao thi phdi cong chOng ho^ic chung thyc.

Cdc gily tfr neu tren sit dyng bdng tilng Anh vd mien hpp phap h6a ldnhsy.

Dilu 4. Thdi han ciia gily phdp vd thj thyc

1.Thin h^n cua gily phdp dupe clp theo dl nghj cua c6ng ddn Niu Di-lSnnhung khong qud 12 (muiri hai) thdng.

2.Thiri hpn ciia thj thyc clp cho cong ddn Niu Di-lan blng thiti han cuagily phdp.

Dieu 5. Trinh ty cap gidy phtip, thj thyc vti chung nhan tarn tru

1.Trinh ty cap giay phtip:a)Trade thiri han it nhdt 30 (ba muai) ngtiy kd tit ngiy dy kidn nh^p ctinh

vtio Vipt Nam, cdng dtin Niu Di-ltin npp hd so tryc tidp hotic gui qua duimg buudipn dd nghj cSp giay phtip cho Dyi sii qutin ViOt Nam tyi Niu Di-ltin;

b)Trong v6ng 05 (n3m) ngtiy (tinh theo ngtiy 1^m viOc) kd tr ngtiy nhan duhti so dd nghj cdp gidy phtip ciia cong dan Niu Di-lan, Dai stir qutin Vipt Nam tyiNiu Di-ltin chuydn hti so dd nghj cdp gidy ph^p cho Cyc Vide 14m (B^ Lao ddng- Thuong binh v4 X4 hpi) bang hinh thtic f^^ ho^c thu di^n tut;

c)Trong thiri hyn 10 (muiri) ng4y (tinh theo ng4y 14m vi^c) ke tir ng4ynhan dti h6 so dd nghj cdp gidy phep hpp 1^, Cyc Vide 14m (BO Lao dpng -Thuong binh v4 X3 h^i) thdng b4o kdt qu4 cdp gidy phdp cho Dyi stir qutinNam tyi Niu Di-lan v4 Dyi stir qutin Niu Di-lan tyi Vipt Nam bang v^^n b4n.

2.Trinh ty cdp thj thyc, chung nhan tym trti:

a)Trong thiri han 02 (hai) ngtiy (tinh theo ng4y 14m vi^c) kd t^ ng4y cdpgidy phdp, Cyc Vide 14m (B$ Lao d^ng - Thuong binh v4 Xa h^i) c6 van b4n ddnghj Cyc Qu4n ly Xudt nh^p c4nh (B6 Cdng an) xem xdt, duypt cdp thj thyc chocdng dan Niu Di-lan theo mlu so N2 ban h4nh kdm theo Thong tu lien tjch s6

01/2012/TTLT/BCA-BNG ng4y 03/01/2012 stira ddi, bd sung Thdng tu lien tjchsd 04/2002/TTLT/BCA-BNG ng4y 29/01/2002 v4 Thdng tu lidn tjch sd05/2009/TTLT/BCA-BNG ng4y 12/5/2009 cua Bp Cdng an - BO Ngoyi giaotrong linh vyc xuat nhap canh vti kdm theo ban chyp giay phdp da dupe cap cuacdng dan Niu Di-lan.

b)Trong thiri han 05 (n5m) ng4y (tinh theo ng4y 14m vide) kd tit ng4y nhtindupe v5n b4n dd nghj cua Cyc Vi?c 14m (BO Lao dOng - Thuomg binh v4 X4hOi), Cyc Qu4n 1^ xudt nh$p c4nh (BO Cdng an) tr4 liri kdt qu4 xdt duypt cdp thjthyc cho cdng dan Niu Di-lan v4 thdng btio cho Dyi stir qutin Vi^t Nam tyi NiuDi-14n dd cdp thj thyc. Truimg hpp khdng cdp thj thyc cho cdng din Niu Di-14n,Cue Qutin ly Xudt nhyp ctinh (BO Cdng an) trti liri Cyc Vide 14m (BO Lao dOng -Thuong binh vti X3 hOi) bang v3n bin vti ntiu rd ly do; Cyc Vipc ltim thdng btiocho Dyi stir qutin Vi^t Nam tyi Niu Di-ltin dd trti liri cho cdng dan Niu Di-lan. ,

c)Cdng dtin Niu Di-ltin nhOp ctinh vtio Vipt Nam dupe co quan kidm sotitxudt nhap ctinh cap chung nhtin tym tru ngay tyi cua khdu khi nhap ctinh. Thirihyn cua chung nhan tym trti dupe ctip phu hpp vtii thiri han thj thyc.

Dieu 6. Nhtin gidy phdpTrong thiri hyn 05 (ntim) ngtiy kd tir ngtiy nhip ctinh vtio ViOt Nam, cdng

dtin Niu Di-ltin nhtin gidy phdp tyi try sd Cyc ViOc ltim (BO Lao dOng - Thuong

binh va X3 hpi) hodc tpi try sd Trung tfim Gidi thi$u vi^c lam thanh pho HO ChfMinh thu$c Sd Lao dOng - Thuong binh vd X3 hpi thanh phO HO Chi Minh.

Dieu 7. So lirpng giay phdp

Moi nam, Cpc Vic lam (BO Lao dOng - Thuong binh vd Xa hpi) dp t6i da100 (mOt tram) gi^y phdp cho cOng dan Niu Di-Lan dip ling dupe ede didu kipntheo quy djnh cua Thda thupn.

Dieu 8. Mau giay phdp

1.Mau gray phdp dupe quy djnh nhu sau:

a)Hinh thdc cua gi^y phdp:

Giay phdp co kich thudc (17,8 cm x 12,5 cm), g6m 10 trang, trang 1 vdtrang 10 c6 mau h6ng dam, trdng nhua; tu trang 2 den trang 9, c6 nen mdu tr^ng,hoa van mau hong nhat, a gitta c6 hinh ngoi sao.

b)Npi dung cua giiy ph^p theo mau s6 2 ban hanh kem theo Thong tu nay.

2.Giiy ph^p do Cpc Vi^c ldm (BO Lao dOng - Thuong binh vd X3 hOO t6churc in dn va phat hanh thdng nhdt.

Dieu 9. S^ dung giay phdp

1.Trong thdi h^n 05 (nam) ngdy (tinh theo ngdy ldm viOc) k^ tOr ngdy congdan Niu Di-ldn ldm viec cho ngudi sd dung lao dpng thl ngudi sd dpng lao dpng

phdi xdc nhan trong gidy ph^p vdi npi dung: hp vd ten ngudi sd d^ng lao dOng;dia di^m ldm vipc vd sd di^n thoai; vj tri cong vi^c; ngdy bat ddu vd ngdy k^tthuc ldm vi$c.

2.C6ng dan Niu Di-ldn cd trdch nhiOm gitt gi^y phdp da dupe cdp khi gidyphep dang con hipu lpc.

3.Cong dan Niu Di-ldn phdi xudt trinh giay ph^p khi ldm ede thu tpc lienquan ddn cu tru, xudt nhap cdnh vd xuat trinh theo yeu cdu cua co quan nhdnude cd thdm quyen.

4.Trong thdi h^n 03 (ba) ngdy (tinh theo ngdy ldm vide) kk ttr ngdy ngudisu dpng lao dpng xdc nhan trong gidy phdp thl cong dan Niu Di-ldn phdi gui banchup gidy phdp cd xdc nhan cua ngudi sd dpng lao dpng ndu tai khodn 1 Didu

nay vd Cpc Vipc ldm (Bp Lao dpng - Thuong binh vd X3 hOi) bang dudng buudipn, fax ho$c thu dipn tu.

Dieu 10. Cap lai giay phdp

1. Cdc trudng hpp cdp lpi gidy phdp:

a)Gi4y phdp bi mdt;b)Giiy phdp bi hong.

2.H6 so dd nghj cap lyi gidy phdp:

a)Td khai dd nghj cdp lyi gidy phdp ciia c6ng dfln Niu Di-lfin theo mau s6 3ban hanh kem theo Thong tir ^y, trong do giai thich rfi ly do bj mit hodc bjh6ng;I

b)Giay phdp da duyc cdp trong trudng hop quy djnh tyi diem b kho^n 1Didu n^y.

c)03 (ba) &nh mdu c 3cm x 4cm, ddu de trdn, chyp chinh di?n, r6 m^t, MS

hai tai, khong deo kinh, phong anh nuku thing.

3.Thdi h^n ciia giSy phep dugc cip l^i bang th^i han cua gidy ph6p dadu<?c cdp.

4.Trinh tvr cip l^i gidy ph^p:

a)Trong th^i han 03 (ba) ngy kd tit ngy phdt hi?n giay ph^p bj mdt hoacbj hdng thi cong dan Niu Di-lan c6 trach nhi?m dd nghj Cyc Vi?c lam (BO LaodOng - Thuong binh va Xa hOi) cdp l^i giay phep bdng cdch n^p hd so dd nghjcdp l^i gidy ph^p tryc tidp hodc qua ducmg buu di^n.|

b)Trong thdi gian 03 (ba) ngay (tinh theo ngay lam vi^c) kd tur ngay nMndu hd so dd nghj cdp l^i gidy ph^p ciia cong dSn Niu Di-lto, Cyc Vi?c lam (BOLao dOng - Thuong binh va Xa hOi) cdp lyi gidy ph^p va thong bao cho cOng d^nNiu Di-lan. Trudng hyp khong cdp lyi gidy phdp phai tra ldi bdng v3n ban vanOu r6 ly do.

5.Nh|in gidy ph^p duyc cdp lyi:Cong dSn Niu Di-lan nhan gidy ph^p duyc cdp lyi tyi try sd Cyc Vi$c lam

(BO Lao dOng - Thuong binh va Xa Mi) ho(ic tyi try sd Trung t&n Gidi thi^uvi?c lam thanh phd HO Chi Minh thuOc Sd Lao dOng - Thuong binh va X3 hOithanh phd Hd Chi Minh.

Dieu 11. Ly phi cdp, cap lai gidy ph^p

Cong dan Niu Di-lan phai nOp ly phi cdp, cdp lyi gidy phOp tyi noi nhangidy phep duyc cdp, cdp lyi theo quy djnh ciia BO Tai chinh.

Dieu 12. Cac trtrdng hyp giay phep het hiyu lye ho^c vo hif u1.Gidy ph^p hdt thdi hyn.

2.Gidy ph^p bj Cyc Viyc lam (BO Lao dOng - Thuong binh va Xa h$i) thuhdi do khong thyc hiyn quy djnh tyi khodn 4 Didu 9 cua Thong tu nay.

3.COng dfin Niu Di-lan thOng bdo vdi Cyc ViOc lam (BO LaoThuong binh va Xa hOi) vd nude trudc thdi hyn.

4. C6ng dto Niu Di-13n bj phpt tu giam, chit hoc mit ti'ch theo tuyen hi

cua toa tin.

Dieu 13. Trtich nhipm thi htinh

1.Trach nhiOm ciia Dpi stir quan ViOt Nam tp< Niu Di-lan:

a)Tuyen truyen, phO bien quy djnh cua Th6ng tu nky dOi vtii cong dan Niu

Di-lto quan tint Chuong trinh ltim viOc trong k^^ nghi tpi ViOt Nam;b)TiOp nhtin vti chuyin hi so di nghj dp giiy phOp ciia cOng din Niu Di-

lSn \h C\ic Vi^c lta (Bq Lao dng - Thuong binh v^ X3 hoi);i

c)Cap thj thuc cho cong din Niu Di-lan theo quy dinh, tren co sd thong

bao ket qua duy^t ckp thj th\rc cua C\ic Quan ly xuat nhap canh (Bp Cong an).

2.Trach nhipm cua Cpc Quan V/ xuit nhap canh (Bp C6ng an):

a)Xdt duyet nhan sp cdp thj thpc cho cong dan Niu Di-lan da dupe c^pgiiy phdp;j

b)Th6ng bdo cho Cpc Vipc lam (Bp Lao dpng - Thucmg binh va X3 h^i),Dpi stir qu^^n Vit Nam t^i Niu Di-ln ve vi^c xtit duy^t cip thi thpc cho cong danNiu Di-lan;

c)Chu tri, ph6i hpp vdi Cpc Vi^c lam (B$ Lao dpng - Thuong binh va Xahpi), Cpc L3nh sp (BO Ngopi giao) giai quyOt c^c tru^ng hpp cOng ddn Niu Di-lan 1^ dOi tupng cua Thong tu nay vi pham quy dinh ciia phap luat Vipt Nam vtixuat nhap c^nh va cu tni cua ngubi nuoc ngoai tpi ViOt Nam.

3.Trach nhiOm cua Cpc Vi?c lam (Bp Lao dOng - Thuong binh va X3 hOi):

a)Ti6p nh^n va thlm djnh ho so dh nghj cdp, cdp lpi gi^y phtip cda cOngdan Niu Di-lan;j

b)C^p, dp hi gi^y phtip cho cong d^n Niu Di-ln theo sp uy quyOn cda BOtrutimg BO Lao dOng - Thuong binh va X3 hOi;

c)DO nghj Cpc Qu^n ^^ Xuit nhap canh (BO COng an) xtit duyOt nhan spcip thj thpc cho cOng dan Niu Di-lan da dupe cip giiy phep;

d)Thong bdo cho Dpi stir qutin Vipt Nam tpi Niu Di-ln kit qua cip giiyphtip;i

d)Thong bao cho Dpi stir qutin Vipt Nam tpi Niu Di-lan, Dpi stir qutin NiuDi-lan tpi ViOt Nam, Cpc Quan ^^ Xuit nhdp canh (BO Cong an) \k Cpc L3nh sp(BO Ngopi giao) sau khi hoan thanh viOc cip 100 (mOt P3m) giiy phtip moi n8mva dtimg vipc cip giiy phtip cho cOng d^n Niu Di-lan;

e)Phii hpp voi Cpc Quan ^^ Xuit nhpp canh (BO COng an), Cpc L3nh sp(BO Ngopi giao) giai quyet ctic trutimg hpp cOng dan Niu Di-lan la dOi tupng cua

6

Thong tu ndy vi pham quy djnh cua phdp lu|t Vi?t Nam ve xudt nhyp cdnh vdtru cua ngudi nude ngodi tyi Viyt Nam;

g) Thong bdo vl trinh t\r; miic 10 phi dip, cdp lyi giay phOp; s6 luyng gidyphdp da duyc cdp; cdc trufrng hyp gidy phdp hit hiOu lye hoc v6 hi?u vd cdcthong tin c6 lien quan khdc tren trang thong tin diOn turhttp://www.vieclamvietnam.gov.vn dd cong dn Niu Di-ln bidt vd th\rc hi?n.

D6i vdi cdc tnrfmg h?p gidy ph^p h^t hi^u lye ho^c v6 hiu theo quy dinhtai khodn 2, 3 vd 4 Dilu 12 cua Th6ng tu ndy thi thong bdo cho Dyi sur qudn Vi?tNam tyi Niu Di-lan, Dyi sur qudn Niu Di-lan tyi Vi?t Nam, Cyc Qudn 1^ Xudt

nhyp cdnh (By Cong an), Cyc L3nh sy (B$ Ngoyi giao) vd cong ddn Niu Di-ldif.

4. Trach nhiym cua Cyc Ldnh sy (By Ngoyi giao):

a)Hudng dan Byi sir qudn Vi^t Nam tyi Niu Di-ldn thyc hi^n cdc quy dinhtyi Th6ng tu ndy;|

b)Ph6i hyp vdi Cyc Qudn lj^ Xudt nhdp cdnh (BO Cong an), Cue Viyc lam(By Lao dyng - Thucmg binh vd Xd hOi) gidi quylt cdc truimg hyp c6ng ddn NiuDi-ldn la d6i tuyng cua Thong tu ndy vi phym quy djnh cua phdp ludt Viyt Namvd xudt nhdp cdnh vd cu tru cua nguiri nude ngodi tyi Viet Nam vd quy djnh vdcong dan Niu Di-ldn ldm vi?c trong ky nghi phu hyp vdi chiic ndng, nhiym yycua minh.

3. Trach nhiym ciia ngudi sur dyng lao dyng:

a)Thyc hiOn quy dinh cua phdp luyt Vi?t Nam lidn quan din cdng ddn NiuDi-ldn;

b)Xdc nh(in trong gidy phdp vdi nOi dung ndu tyi khodn 1 Didu 9 CdaThong tu ndy vd thyc hi?n quy djnh lidn quan din xudt nhdp cdnh vd cu tru cua

ngudi nude ngodi tyi Vi^t Nam.

6. Trdch nhiym cua cong ddn Niu Di-ldn:

a)Nghidn cdu vd thyc hidn dly du quy dinh ciia Thong tu ndy vd quy dinhcua phdp luyt Viyt Nam;

b)Nyp ho so dd nghj dp, dp lyi gidy phdp theo quy dinh;c)Nyp 10 phi cdp, cdp lyi gidy phdp; dp thi thyc; tidn fax thdng bdo kit qud

xdt duyyt nhyn sy, cdp thj thyc tur Cyc Qudn ly Xudt nhyp cdnh (By C6ng an)sang Dyi sur qudn Viyt Nam tyi Niu Di-ldn vd cdc chi phi khdc theo quy djnh cuaphdp ludt Viyt Nam.

Dieu 14. Hifu lye thi hdnh

1. Thdng tu ndy cd hiyu lye tur ngdy 15 thdng 7 ndm 2012.

oi nhin:-Ban Bi thu Trung uong Ding;-Thu drdng, cic Ph6 Thu tudng Chinh phu;-Vin phong Trung uong Ding vi cic Bancua Ding;-Vin phdng Quic hpi;-Vin phdng Chu tich nude;-Vipn kiim sit nhin din tii cao;-Toi in nhin din tii cao;-Kiim toin nhi nude;

-Cic Bp, co quan ngang Bp;-Co quan Trung uong cua cic doin thi;-UBND tinh, TP dye thupc TU;-Cong bio; Cong TTDT Chfnh phu;-Cue kiim da vin bin QPPL (Bp Tu phip);-Luu: VT Bp LDTBXH, Bp Cong an, BpNgo^i giao, CVL, CQLXNC, CLS.

KT. BO TRlTONGBO LAO DONG - THlTONG BINH

KT. BQ TRl/dNGBO CONG AN

KT.BOTRlTdNGBNGOAIGIAO

2. Trong qud trinh th\rc hipn neu c6 vudng mic, d^ nghj ph&n ^nh vi Bp

Lao dpng - Thuomg binh vi X3 hpi, Bp Cong an va Bp Ngopi giao di kjp thoihuong din, bo sung./.

ngiyth^ngnitonday.month..year....

Td KHAI B$ NGHJ CAP GlAY PHp LAM Vl^C TRONG KY NGHiApplication for issuance of a working holiday permit

Kinh gui: - Dyi sit quin Vi^t Nam tyi Niu Di-lan;

To: Embassy of Vietnam in New Zealand

- Cyc V^c lam (BO Lao dOng - Thuong binh vi X3 hpi).

Bureau of Employment (Ministry of Labour-Invalids and Social Affairs)

I.T^n t8i 14:2. Nam; Ntt:

Full nameMale/Female

3.Ngiy, thing, nim sinh:

Date of birth (DD-MM-YY)4.Qu6c tich:

Nationality5.HO chi^u s6:6. Ngiy dp:Passport numberDate of issue7. Co quan dp:8. Thin h^n hO chi^u:Issued byDate of expiry

9.Trinh dO chuy^n m6n:

Level of education

10.Bja chi H6n lye t^i Niu Di-lin:Contact address in New Zealand

II.Di^n tho^i:Di dOng:Thu din tii:TelMobile phoneEmailToi di nghien ciiu vi sS thyc hin diy di quy djnh cia phip luit Vi?t Nam li^n quan d^ncong din Niu Di-lin lam vi?c trong ^y nghi tai Vi?t Nam, toi de nghi duqc dp giiy phip, cythi nhu sau:

Having studied and will perform fully the provisions of the Vietnamese law relating to NewZealand working holiday makers, I would like to apply for issuance of a working holidaypermit as follows:-Thin han cia giiy phip tu ngiy... thingnimdin ngiythingnim .

Validity period of the working holiday permit: fromto

-Ly do di nghj dp giiy phip:The reasons for applying for a working holiday permit

12. Ncri ding ky nh^n giiy phip:Agency to deliver the working holiday permit

(Ding ky nhan it diu thi dinh diu vio 6 bin canh)(Tick the relevant box)

MAU S6 1: Ban hanh kirn theo Thong to lien tich so 15/2012/TTLT-BLDTBXH-BCA-BNGngdy 06/6/2012 cua Bo Lao ^ong - Thucmg binh va XB hoi, Bo Cong an va Bo Ngogi giaohu&ng din thyrc hien mot so dieu cua Thoa thuqn giua Qhinh phu nude Cong hod xd hoi chitnghla Vi$t Nam va Chinh phit Niu Di-ldn vi Chucmg trinh lam vifc trong ky nghi.

10

be/ certify that these statements are true to the best of my knowledge and willresponsible for any incorrectness.

Ngirfri 1dm donApplicant

(Signature)

-Try s* Cyc Vi^c ldm (BQ Lao d^ng - Throng binh yd Xa hi)TTie q^rce of the Bureau of Employment (Ministry of Labour-Invalids and

Social Affairs)

-Trung tarn Gidi thiu vi^c l^m thdnh pho Ho Chf MinhJob placement center in Ho Chi Minh City

13. Ho so d nghj dp giiy phdp gom c6:Application include:(Neu cd giiy tit ndo thl ddnh dau v&o 6 ben cynh)

(Tick the box, if any)

-B^n chyp Hp chieuA copy of passport

-Giiy chung nhan siic kho^

Heath Certificate

-Chung chi quoc gia pho thong trung hpc (NCEA) cap d$ 2 ho^ctrinh dp cao honNational Certificate of Educational Achievement (NCEA) level 2

or higher levels

-VSn bn chung minh tdi chfnh (dS md tdi khoin tdi ngdn hdng)CEvidence of financial capacity (Having opened bank accounts)

-03 dnh miu (kfch thudc 3cm x 4 cm) vd bin mem 4nh mdu03 colour photos (size 3cm x 4cm) and soft of colour photos

Toi xin cam doan ede n$i dung nu tren Id dung. Neu sai tdi xin hodn todn chju trdchnhipm trudc phdp lu^t Vi^t Nam.

11

SO:

No:

Trangl

GIAY PHEP LAM VI^C

TRONG KY NGHI

WORKING HOLIDAY PERMIT

^ QU6c HUY J

CONG HOA XA HOI CHU NGHlA VlT NAMDpc lap - T> do - H^nh phiic

NHttNG DIEU CAN LU"U Y

1-Xuat trinh giay phi p nhy khi co quan nM nude yeuciu.

2-Khong du^c t4y xda, sura chtta, tu ghi v4o giay ph^p

nay.

3-Khong dupe cho ngudi khic mupn

4-Khi that lc phii brio ngay cho B$ Lao dpng -

Thuorng binh v4 XS hpi (Cpc Vi^c 14m).

NOTICE

1-Present this working holiday permit to authoritieswhen requested.

2-Any modification, addition or amendment to theworking holiday permit is prohibited.

3-The utilization of this permit is restricted to thebearer.

4-Any case of loss should be immediately reported toMinistry of Labour, Invalids and Social Affairs

(Bureau of Employment).

TranglO

MAU S6 2: Ban hanh kirn theo ThOng tu lien tich s6 15/2012/TTLT-BLDTBXH-BCA-BNGngay 06/6/2012 cua BO Lao ^ong - Thuong binh vd Xa hoi, BO Cong an va BO Ngogi giaohu&ng ddn thuc hi$n mOt so diiu cua Thoa thuan giSa Chinh phu nude QOng hoa xa hpi chunghia ViQt Nam va Chinh phu Niu Di-lan vi Chuang trinh lam vipc trong ky nghi.

, ngiy ....thingnim

Xic nhin cua ngudi sur dung lao dpngTo be confirmed by employer

(Ky vi ghi rS ho ten, ddng diu)(Signature and stamp)

Trang5

12

NOI LAM VI$C LAN 3

Third workingplace

Hq vi tin ngtrdi sir dpng lao dpng:

Employer's name:

Dja di6m lim vipc:Dipnthoai:.

Workingplace:Tel:

Vj tri cong vipc:

Job assignment:

Thdi gian lim vipc tir ngiythingnim .

dn ngiythingnim\

Working period fromto

Trang3

NOI LAM Vl^C LAN 1

First working place

Hq vitenngirhri sirdvmg lao d^ng:

Employer's name:

Dja diem lim vi^c:Dienthoai•

Workingplace:Tel:1

Vj tri cdng vi^c:I

Job assignment:i

Thdi gian lim vi^c tir ngiythingnim ..

den ngiythingnim1

Working period from .... to

,ngiy ....thingnim

Xac nhin cua nguiri sur dung lao dpng

To be confirmed by employer

(K vi ghi ro ho ten, ddng diu)(Signature and stamp)

NOI LAM VI$C LAN 2

Second working place

Hq vi ten ngudi sir dung lao dpng:

Employer's name:

Dja diem lim vipc:Dipnthoai:

Working place:Tel:

Vj trf cing vi$c:

Job assignment:

Thdi gian lim vi$c tit ngiythingnim .

dn ngiythingnSm

Working period from .... to

ngiy ....thingnim

Xic nhin cua ngutri sir dung lao dongTo be confirmed by employer

(Ky vi ghi ro ho tin, ding diu)(Signature and stamp)

Trang4

l.HQvitin:

Full name

2.Nam(M)Ntt(F)3.Ngiy, th^ng, nim sinh:

Date of birth (DD-MM-YY)

4.Quoc tjch hipn nay:So hp chieu

Current nationalityPassport number

5.Thdi gian lim vipc tir ngiythingnSm

den ngiyth^ngnimWorking period from .... to.

NgiythingnSmcvc TRt/dNG eye vi^c lAm

BO LAO DONG - THl/ONG BINH VA XA HOICHIEF OF BUREAU EMPLOYMENT, MINISTRY OF

LABOUR, INVALIDS AND SOCIAL AFFAIRSKy vi ghi rd hp tn, d6ng diu

(Signature and stamp)

Traog2

giAy phep lam viectrong ky nghi

working holidayPERMIT

Anh m&u

3cm x 4cm

Colour photo

13

ngiy .... thingnim ..L

Xac nhan cua ngudi su dung lao dong

To be confirmed by employer

(Kf vi ghi ro ho ten, ddng dSu)(Signature and stamp)

Trang9

NOT LAM Vl^C LAN 7

Forth workingplace

Hp vi ten ngiriri sir dyng lao dpng:

Employer's name:

Dja diem lim vi^c:Dipnthoai:.

Workingplace:Tel:

Vj tri c6ng vi^c:

Job assignment:

Thiri gian lim vipc tir ngiythinghim .

din ngiythingnimJ

Workinh period from ....to

NOT LAM VI^C LAN 5

Second workingplace

Hp vi ten ngudi sir dyng lao dpng:

Employer's name:

Bja diem lim vi$c:Dipnthoai:.

Workingplace:Tel:

Vj tri cing vi^c:

Job assignment:

Thiri gian lint vi^c til ngiythingnSm .

d^n ngiythingnim

Working period from .... to

ngiy ....thingnim

Xdc ntiin cua ngudi su dung lao dong

To be confirmed by employer

(Kf vi ghi ro ho ten, ddng da'u)(Signature and stamp)

Trang7

, ngiy ....thingnim

Xac nhan cua ngudi sir dung lao dongTo be confirmed by employer

(Ky vi ghi ro ho tin, dong di'u)(Signature and stamp)

Trang8

NOT LAM VlfC LAN 6

Third working place

Hp vi tin ngudi sit dyng lao dpng:

Employer's name:

Djadilmlimvi^c:Bipnthoai:

Workingplace:Tel:

Vj tri cdng vi^c:

Job assignment:

Thdi gian lim vi$c tir ngiythingnim .

d^n ngiythingnim

Working period fromto

NOT LAM Vl^C LAN 4

First working place

Hp vi ten nguiri sir dyng laodpng:

Employer's name:

Dja diem lim vi$c:Dipnthoai:

Working place:Tel:

Vj tri c6ng vi^c:

Job assignment:

Thdi gian lim vi^c tir ngiyth^ngnSm .

din ngiythingnim

Working period from .... to

ngiy ....thingnim

Xac nhan cua ngudi su dung lao dong

To be confirmed by employer

(Ky vi ghi ro ho tin, ddng diu)(Signature and stamp)

Trang6

14

Thudi^nti:.Email

12.Bja chi Ii6n h#:Contact address

13.Bi^n tho?rt:Bi dng:TelMobile phone14.Noi ding ky nhan giay phep du^c cap l^i:Expected place of receipt of the re-issued working holiday permit(Bang ^^ nhan d dau thi dinh d^u vio 6 ben c^nh)

(Tick the relevant box)

- Tr^ sd C\ic Vi^c lim (Bq Lao dong - Thuong binh vi X8 h^i)

I.Hq vit^n:2.Nam/Nii:Full nameMale/Female3.Ngiy, thang, n3m sinh:

Date of birth (DD-MM-YY)4.Qu6c tjch:

Nationality5.HQchi^us6:6.Ng3y cap:Passport numberDate of issue

7. Ca quan cap:8. Thdi h^n h$ chieuIssued byDate of expiry

9.Trinh d$ chuy^n mon:Level of education10.T6i da duQ^ cip giiy phep s6:ng3yI was issued a working holiday permit numbered:on

v6i th^i h^n tu ng3y... th^ngn3md6n ng^ythingnSm

For the period fromtoI1.Ly do de nghi cap l^i giay ph^p (bao gom ci ly do mat, hdng giay ph^p)Reasons for applying for r e-issuance (including reason for losing, damaging the

working holiday permit)

, ngiythingnSmdatemonthyear

Td KHAI Bt NGHJ CAP LI GlAY PH^^P lAm VI^C TRONG KY NGHOJApplication for re-issuance of a working holiday permit

Kinh gtJti: Cue Vi^c lto (Bq Lao d^ng - Thuang binh v^ X3 hoi)To: Bureau of Employment (Ministry of Labour-Invalids and Social Affairs)

MAU SO 3: Ban hanh kirn theo Thong to lien tjch so 15/2012/TTLT-BWTBXH-BCA-BNGngay 06/6/2012 cua Bo Lao dgng - Thmmg binh va Xa hgi, B6 Cong an va Bo Ngogi giaohudng ddn thuc hien mot so dieu cua Thoa thugn giua Chinhphu nude Cong hoa xa hoi chunghia Vi^t Nam va Chinh phu Niu Di-ldn ve Chuong trinh lam vi^c trong ky nghi.

i

15 !

The office of the Bureau of Employment (Ministry of Labour-Invalids anh SocialAffairs)- Trung ttai Gi^^ thi^u vi?c l&m th^nh pho Ho Chi Minh0Job placement center in Ho Chi Mihh City

Toi xin cam doan cdc n$i dung nSu trSn 1& dung. Neu sai t6i xin ho^n toita chju tr^oh

nhi^m tnrdc phip lu$t Vi^t Nam./ certify that these statements are true to the best of my knowledge and willresponsible for any incorrectness./.

Ngirfri lim dffnApplicant(Kyten)

(Signature)

Ho Anh VuLuu Luyen Quynh Dung

Nguoi giaoNgudi nhyn

BIEN BAN GIAO C6NG VAN

Horn nay, ngay 01/06/2012, toi (H6 Anh Vu, chuyen vien Cyc Lanh

sy) da chuyen 01 cyp ho so gom 03 ban Thong tu lien tich giOa By Ngoyi

giao, Bo Cong an va By Lao dng Thuong binh va Xa hyi vdi chu k^ my

cua cac Th^ truong By Ngoyi giao va By Lao dng, Thucrng binh va Xa hcli

cho chi Lini Luyen Quynh Dung, chuyen vien Cyc Quan ly lao dyng ngoa i

nuoc, By LD, TB & XH.