Employment Permit Renewal Form

EMPLOYMENT PERMIT RENEWAL FORM

PERSONAL INFORMATION

Phone:    Email:

CURRENT EMPLOYMENT & PERMIT DETAILS

Job Title:    Department:

Date Employment Commenced:    Current Annual Salary: $

Permit Type:    Current Expiration Date:

RENEWAL JUSTIFICATION & SUPPORTING DOCUMENTS

Please indicate attached supporting documents (check all that apply):

Passport copy

Current permit copy

Employer support letter confirming continued employment

Passport photos

Proof of residency

EMPLOYMENT HISTORY (LAST 10 YEARS)

Title:    Dates Employed:

Title:    Dates Employed:

EDUCATION

Graduation Date:

REFERENCES (PROFESSIONAL)

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

Phone:    Email:    Relationship:

LEGAL DISCLOSURES & AUTHORIZATIONS

At-Will Employment Statement: I acknowledge that submission of this renewal application does not alter any at-will employment relationship unless otherwise set forth in a written agreement signed by an authorized representative of the employer. Nothing in this form creates a contract guaranteeing continued employment for any guaranteed period.

Equal Opportunity: The employer affirms it will consider this renewal application in accordance with applicable equal opportunity laws and internal policy. The employer does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or other protected characteristic.

Applicant Certification and Acknowledgment: I certify under penalty of perjury that the information supplied in this form and any attachments is true, complete, and correct to the best of my knowledge. I understand that knowingly providing false information or material omission may result in denial of this renewal and disciplinary action up to and including termination.

Authorization to Verify and Disclose: I authorize the employer and authorized governmental agencies to verify any information contained herein, including immigration and employment authorization records, and to obtain records from prior employers, educational institutions, and other relevant sources. I consent to release of such information as reasonably required to process this renewal application and to comply with applicable legal requirements.

Background Checks and Immigration Compliance: I consent to any background, criminal, and immigration-history checks required by the employer or by applicable law for permit renewal. I acknowledge that the renewal decision is subject to the results of such checks and to compliance with immigration and employment regulations.

I authorize verification of the information provided and consent to background and immigration-related checks as described above.

APPLICANT CERTIFICATION

By signing below, I certify that I have read and understand the statements contained in this form, that all information is complete and accurate, and that I agree to cooperate in any reasonable requests for additional documentation needed to process this renewal. I understand that processing may be delayed or denied if required documents are not provided.

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