T aiwan Semiconductor Manufacturing Company, Ltd.

Personnel Information Form

人事資料表

近3個月是否曾到台積電面談

□否

□是，面談廠區：□南科□中科□竹科□桃園龍潭

面談日期：/ ，面談單位:

是否即將至台積電任何單位進行面談

□否

□是，面談廠區：□南科□中科□竹科□桃園龍潭

面談日期：/ ，面談單位:

* Please fill out the form in English or Chinese 請使用英文或中文填寫此資料表

* TSMC will collect, process and use the personal information you provided in this form in accordance with Personal Information Protection Act (Taiwan). For more detailed information, please refer to the last page of this form. 本公司將依照個人資料保護法蒐集、處理與利用您以下所提供的個人資料。詳細資訊請參照本人事資料表最末頁之說明。

Job Applied For

申請職務

A. General Information 個人基本資料

Name

姓名

Chinese

中文

Nationality

國籍

 R.O.C. 中華民國

English

英文



Have you ever changed your name?您是否曾更改過姓名？

 No否 Yes是Name before changed原名：

Phones

電話

(Tel)

(Cell)

E-mail Address

電子郵件

B. Education, Specialty & Language Ability教育、專長與語文能力

Grade

階段

Name of School

學校名稱

Major

科系

From起

To迄

Graduated

是否畢業

Type

日/夜間部

Highest Degree

最高學歷

M月

Yr年

M月

Yr年

Yes

High School

高中(職)

Day 日間部

Night夜間部

Jr. College

專科

Day 日間部

Night夜間部

University

大學

Day 日間部

Night夜間部

Post Graduate

(Master)

研究所(碩士)

Post Graduate

(PhD)

研究所(博士)

Other

其他

Describe any special vocational or technical training and specialized knowledge/skill 請說明您的專業知識與技能

In summary, key words of your expertise are:您專業技能的關鍵字詞為何(註：關鍵字有助加速將您的履歷派送至適合職缺)

Academic Ranking: select the class academic ranking

個人在學成績排名

大學Bachelor : □ Top 10% □11~20% □21~50% □51%~100%
研究所Master : □ Top 10% □11~20% □21~50% □51%~100%

Language Ability: indicate the language and your proficiency, i.e. Excellent, Good, Useful, A little, Not at all.

語文能力：請以極佳、佳、普通、略通或不通說明您對該語文的熟練程度

Second Language and so on

第2、3...外國語

Listening

聽

Speaking

說

Reading

讀

Writing

寫

Remarks

備註

1. English

C. Academic Achievement & Honor 學術成就及獲獎紀錄
Honor/Award: indicate international or national contest awards, e.g. Presidential Award, Phi Tau Phi Scholastic Honor. 獲獎榮譽:個人書卷獎、斐陶斐榮譽學員會員、或其他國際性/全國性競賽獲獎紀錄
Name of Honor/Award 獎項名稱	Qualification for the Honor/Award 獎項競賽資格	Prize 得獎名次/獎項			Category 性質		Year 發表年
					Domestic International
					Domestic International
Publication on A Class Journal (e.g. Nature, IEEE, SPIE, JACS…etc.) A級期刊論文(例如: Nature, IEEE, SPIE, JACS等)
Journal 期刊名稱	Title of the Publication 論文題目			1^st author or 1^st author second to Professor 第一作者或次於教授後之第一作者		Year 發表年
				YesNo
				YesNo
Oral Publication on A Class Conference (e.g. Nature, IEEE, SPIE, JACS…etc.) 口頭發表之A級研討會論文(例如: Nature, IEEE, SPIE, JACS等)
Conference 研討會名稱	Title of the Oral Publication 口頭發表之論文題目		1^st author or 1^st author second to Professor 第一作者或次於教授後之第一作者			Location地點	Year 發表年
			YesNo
			YesNo

Invention /Patent 發明及專利
Patent Name 發明/專利名稱	Date of Issue 核准日	Patent Certificate No. 證號		Country of Issue 核發國
(1)
(2)
5. License or Certificate 專業證照
License or Certificate 專業證照或檢定證書	Date of Issue 發照日	Certificate No. 證照字號			Remarks 備註
(1)
(2)
6. Experience in Participating in Associations 社團經驗
Name of Association 社團名稱	Title 職稱		Year 年
(1)
(2)

D. Working Experience: It is at your discretion to provide the information of supervisor and compensation.

工作經驗:直屬主管及薪資資料請自行斟酌是否填寫

From 起

To 迄

Title /

On Grade Year

職稱/在職年資

Co. Name

公司名稱

(請填入公司全名)

Co. Location

(Country)

公司所在地點

Supervisor

直屬主管

Compensation

薪資

Reason

for Leaving

離職原因

M月

Yr年

M月

Yr年

Name

姓名

Title

職稱

Monthly Base Salary 月薪

Allowance

/Bonus

津貼/獎金

Others

其他

May we contact your present employer?台積公司是否可與您的現任雇主聯絡查證No否Yes是

We shall not do so without your consent. 未經您同意台積公司絕不會聯絡您的現任雇主

Describe your experience, major achievement during each of the period mentioned above.

請摘要您於上述各職務的主要成就

E. Others 其他

Do you have any relatives or friends working in tsmc? 目前是否有任何親屬、朋友任職於台積公司？

No否Yes是If yes, please specify the name, relation and dept. 如有，請列出姓名、關係及任職部門

Name

姓名

Relation

關係

Department

部門

Name

姓名

Relation

關係

Department

部門

Reference Check : Please provide minimum of three names. Your supervisor(s), research advisor(s) or teacher(s) must be included in.

資歷查核: 請至少提供三位查核對象，其中至少含直屬主管、論文指導教授或授課教師

Name

姓名

Relation

關係

Company / Dept.

公司/部門

Title

職稱

Contact

聯絡方式

(Tel)

(Cell)

E-mail:

(Tel)

(Cell)

E-mail:

(Tel)

(Cell)

E-mail:

What do you expect most of the job that you are applying for? Please tick and explain briefly.

您對下一份工作最重視的項目為何，請勾選並簡要說明

Aspect 項目

Why 原因

Aspect項目

Why原因

 Greater responsibility

擔負更大的責任

 New field of work新領域

 Salary薪資

Opportunities of learning & development訓練與發展的機會

 Job security工作保障

 Different location

工作地點

 Others其他

When will you be available for the new job if you are recruited?

如獲任用何時可以報到？Yr年M月Date日

Expected Salary

期望薪資

NT$

Which channel did you learn the job opening? 您自何處得知此職缺

 Campus 學校 Job bank人力銀行 Newspaper ad.報紙廣告

 Magazines 雜誌Friends / Relatives親友 Teachers/Advisors 授課教師/指導教授

 Employment Service Office 就業服務站 Others 其他，請說明___________________

Additional information you wish to add其他補充資訊

I hereby authorize TSMC to verify the accuracy of all the statements made and the personal information provided in this Form (“Information”), and I fully understand that any falsification in this Form constitutes a sufficient and just cause for dismissal of my employment if hired.

I hereby consent and authorize TSMC and its affiliated entities, employee welfare committees of TSMC and its affiliated entities, TSMC Education and Culture Foundation and any other third parties authorized by the above entity or entities to collect, process and use, domestically and internationally, the personal information that I provided or will provide for the purposes of TSMC's recruitment process, personnel management and business operation in accordance with relevant laws governing the protection of personal information, and to retain the information for at least 15 years after all the aforementioned purposes no longer exist.

In addition, I have read the above statement and acknowledged that I understood and have been informed the purposes of collecting the Information, the classification of the Information, the time period, areas, targets and ways of using the Information, my rights under Article 3 of Personal Information Protection Act and the ways to exercise them, and the consequences if I choose not to provide the Information.

本人謹此授權台積公司得就本人於此人事資料表中所提供之陳述與個人資料內容之正確性進行確認。本人充分瞭解在此人事資料表中所為之一切陳述如有虛偽不實，將足以構成終止聘僱合約之事由。

本人並特此同意及授權台積公司及其關係企業、台積公司及其關係企業之職工福利委員會、台積電文教基金會及以上公司及組織所委託之第三人為招募聘用、人事管理及業務執行之目的，在符合個人資料保護相關法令之範圍內，蒐集、於國內與國際間處理、利用本人已經提供及未來將提供的個人資料，並得於特定目的消失後保存至少十五年。

本人已詳閱上開內容，並確認本人已瞭解且已依個人資料保護法及相關法令之規定受告知本人事資料表內個人資料之蒐集目的、個人資料類別、利用之期間、地區、對象及方式、依個人資料保護法第三條規定得行使之權利及權利行使方式、及不提供本人本履歷表、人事資料表內個人資料時將對本人權益之影響。

Signature 簽名Date 日期

I hereby declare that I will comply with all TSMC regulations during my employment. In case of any violation, I agree to accept and be bound by applicable penalties as specified in the TSMC Work Rules and relevant rules.

本人同意並保證：本人於在職期間將遵守台積公司所有相關規定。如有違反，本人同意接受工作規則及其他相關規定之懲處。

Signature簽名Date日期

7/5 RS-3-01.02_1, Version 11, 03/31/2015

臺積電人事資料表

Personnel Information Form

A. General Information 個人基本資料

Nationality

Phones

(Tel)

(Cell)

E-mail Address

B. Education, Specialty & Language Ability教育、專長與語文能力

Type

Highest Degree

High School

Describe any special vocational or technical training and specialized knowledge/skill 請說明您的專業知識與技能

Patent Name

(1)

(2)

License or Certificate

(1)

(2)

Name of Association

(1)

(2)

D. Working Experience: It is at your discretion to provide the information of supervisor and compensation.

工作經驗:直屬主管及薪資資料請自行斟酌是否填寫

From 起

To 迄

E. Others 其他

Name

姓名

Name

姓名

Name

姓名

(Tel)

(Cell)

E-mail:

(Tel)

(Cell)

E-mail:

(Tel)

(Cell)

E-mail:

What do you expect most of the job that you are applying for? Please tick and explain briefly.

Aspect 項目

 Different location

When will you be available for the new job if you are recruited?

如獲任用何時可以報到？Yr年M月Date日

Expected Salary

NT$

Which channel did you learn the job opening? 您自何處得知此職缺