國立中山大學用印申請單 - 服務證明檔案

申請日期Date (yyyy/mm/dd): _ / /

用印文件名稱

Title of Document

英文服務證明

Verification of Employment

件數

Number of Copies

用印種類

Type of Seal

■ President’s Signature in English 校長英文簽名章

□ Others:

申請人簽章

Submitted by (signature or stamp)

校長President
(授權主管決行/Authorized
V.P./ Dean)

聯絡電話

Telephone

二級單位主管

Dept./Inst./Center/
Program Head

一級單位主管

V.P. / Dean

備註/Note

1. 除已決行之公文外，凡需加蓋各種印信之文件，均需填寫本單申請用印。This application form is required for all documents requiring official seals of the university, except for approved official documents.

2. 以影印本申請用印之文件，由申請人或經辦人員加蓋「核與正本相符」章戳並蓋章證明後再行申請用印。Photocopied documents must have the "True to Original" stamp and the applicant’s or department staff’s stamp.

服務證明相關資料Information for the Verification

姓名

（中文）

First Name

Last Name

所屬單位

Department/

Institute

職稱

Position

服務證明是否顯示薪資
Salary shown on verification document

□ 是Yes

□ 否No

由授權單位註明/
Filled by
authorized
office

月薪/Monthly income:

其他需註明事項/Additional Info.to be included:

以下資料由授權單位填寫與核對

Information below to be completed and verified by authorized offices

到職日期/Starting date of employment

任現職期間/Period of

current position

起From:

迄To:

人事室核對中文資料/

Verificationby Office of Personnel Services

國際事務處核對英文資料/
Verification by Office of International Affairs