Fillable APPLICATION FOR A TEMPORARY WORK PERMIT

Fill Online, Printable, Fillable, Blank APPLICATION FOR A TEMPORARY WORK PERMIT Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

APPLICATION FOR A TEMPORARY WORK PERMIT

On average this form takes 55 minutes to complete

The APPLICATION FOR A TEMPORARY WORK PERMIT form is 7 pages long and contains:

  • 0 signatures
  • 125 check-boxes
  • 162 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
APPLICATION FOR A TEMPORARY WORK PERMIT
APPLICATION FORM CONTAINS 7 PAGES
The application for the grant of a Temporary Work Permit should be addressed to:
The Director, Workforce Opportunities & Residency Cayman, P.O. Box 1098, Grand Cayman KY1-1102, Cayman Islands
PLEASE DO NOT LEAVE ANY QUESTION BLANK. IF A QUESTION DOES NOT APPLY TO YOU, INSERT, “NOT APPLICABLE” OR “N/A” IN THE SPACE PROVIDED.
NOTES: (i) The Applicant must have a valid passport. (ii) This application is in two parts. The first part is to be completed by the employee and the second part by the employer or
the self-employed. (iii) Temporary Work Permits are valid for periods of up to six months at the discretion of the Director of WORC and may be granted for any category of
occupation. (iv) Refer to the checklist accompanying this form for additional documents required to process this application. (v) Use separate sheet of paper, where necessary, to
thoroughly answer each question. (vi) For support and guidelines see the Immigration website www.worc.ky, go to Forms section, and select this form. (vii) If the employer /
additional employer is a company; all communication will be sent to the contact information associated with the company's Trade & Business License as held by the Department of
Commerce and Investment.
T1
PAGE 1 of 7
WORC/TWP (2020/04) COVID-19 T1
COVID-19 Form
PART 1 - To Be Completed By Prospective Employee
Gender Male Female 2. Nationality Date of Birth
DD/MM/Y
Y
3. Passport Number Date of Issue Place of Issue Date of Expiry
5. Physical address
(iv) PO Box & KY
(i) House No (ii) Street Name
(iii) District (v) Telephone
If yes, Email Address
DD/MM/YY
4. Are you known by any other name(s)?
6. What is your marital status? (certified copy of relevant legal document should be attached, where applicable, when adding spouse to permit)
Married - Date Divorced - Date Separated - Date
DD/MM/YY
DD/MM/YY
DD/MM/YY
Single
1. Surname
(Last Name)
Maiden Name Given Names (First Names)
Name of Spouse Nationality of Spouse
8. (i) What position are you applying for?
(iii) How many years of this experience do you have?
(ii) What experience do you have which is relevant to this job?
Yes
No
If Yes, provide other Name(s)
Do you have E-Mail? No
Yes
years
DD/MM/Y
Y
9. Do you have a current appeal pending with the Immigration Appeals Tribunal? (if yes, please provide details)
No
Yes
7. Please list the particulars of any dependants (spouse, children or others) whom you wish to accompany you to the Cayman Islands or are already residing in the Cayman Islands.
Country of ResidenceRelationshipNationalityDate of Birth
Name
Add to Work Permit
No Yes
No Yes
D/MMM/YY
D/MMM/YY
No Yes
D/MMM/YY
DO NOT USE LIQUID PAPER OR CORRECTION TAPE, IF AN ERROR IS MADE CROSS OUT AND INITIAL THE CHANGE(S) OR USE A FRESH PAGE
PLEASE DO NOT LEAVE ANY QUESTION BLANK. IF A QUESTION DOES NOT APPLY TO YOU, INSERT, “NOT APPLICABLE” OR “N/A” IN THE SPACE PROVIDED.
Use separate sheet of paper if necessary.
APPLICATION FOR A TEMPORARY WORK PERMIT
PAGE 2 of 7
WORC/TWP (2020/04) COVID-19 T1
12. Since your first arrival have you at any time left the Cayman Islands for a period in excess of 1 year?
No
Yes
If you answered yes, please give dates of and reasons for the absence
11. Since your first arrival in the Cayman Islands have you ever been named as a dependant on another person's work permit/government contract/exemption?
No
Yes If you answered yes, please provide name of permit holder
NoYes
13. Have any dependants accompanying you ever been charged or convicted of a criminal offence in any country?
(iii). Have you ever been required to pay an administrative fine for an offence in the Cayman Islands or other country, other than for a traffic offence?
Nature of fine
Date
Location
Amount ($)
DD/MM/YY
No
Yes
If you answered yes, please provide details.
(iv). Have you ever been sanctioned by a professional ethics body, licensing board or any other regulating body?
Nature of sanction Date Location
Reasons
DD/MM/YY
No
Yes
If you answered yes, please provide details.
(ii) Have you ever been deported from or refused entry to:
(a) the Cayman Islands
NoYes If you answered yes, please give details
(b) any other Country NoYes If you answered yes, please give details
10. (i) Have you ever been charged or convicted of a criminal offence in any country, including the Cayman Islands?
Nature of offence Date Location
Verdict and Sentence
DD/MM/YY
No
Yes
If yes, please provide details of ALL offences
Nature of offence Date Location
Verdict and Sentence
DD/MM/YY
DD/MM/YY
DD/MM/YY
DD/MM/YY
DD/MM/YY
14. Dates and addresses of all places where you have lived for more than 6 months during the past 10 years, if other than stated in reply to question 5.
From To
Address
D/MMM/YY D/MMM/YY
D/MMM/YY D/MMM/YY
D/MMM/YY D/MMM/YY
PLEASE DO NOT LEAVE ANY QUESTION BLANK. IF A QUESTION DOES NOT APPLY TO YOU, INSERT, “NOT APPLICABLE” OR “N/A” IN THE SPACE PROVIDED.
Use separate sheet of paper if necessary.
APPLICATION FOR A TEMPORARY WORK PERMIT
PAGE 3 of 7
WORC/TWP (2020/04) COVID-19 T1
I declare that the information provided above by me is true and correct and I understand and accept that if it is proven that I have made a false statement I am liable on conviction to
a fine of CI$5,000 and imprisonment for one year. By signing below I also understand and accept that if this application is approved any and all conditions contained in the Temporary
Work Permit must be complied with.
17. (i) Are you in good physical and mental health? No
Yes
If you answered yes, please give details
(iii) Have you ever tested positive for HIV or any other sexually transmitted diseases? No
Yes
If no, please give details
Note: If approved, the Temporary Work Permit will be subject to the following and any other additional conditions contained therein: (i) the employee is not allowed to work for any
other employer or perform any other occupation other than that or those listed in this application; and (ii) the permission of the employee to remain and work in the Cayman Islands
ceases in the event that the Temporary Work Permit expires, is revoked, or if their employment is terminated.
In accordance with The Immigration (Transition) Law 2018, I hereby agree to submit to being Fingerprinted/Palm-printed for the purpose of identity verification and criminal checks
domestically and internationally.
(ii) Are all dependants accompanying you in good physical and mental health? No
Yes If no, please give details
Signature of Employee
(Original signature required, cannot be Agency Signature)
Date (DD/MM/YY)
Important note: Applicants from a non-English speaking country must have their English language skills tested. The applicant must receive a passing mark on their assessment to
take up employment in the Cayman Islands.
16. Is English your native language? No
Yes
If No, what is your native language?
Score Report No
Attach a copy of your score report
Do you speak English? No
Yes
Do you read English? NoYes
Do you write English?
No
Yes
b) TOEIC
a) IELTS
If Yes, skip to question 17.
and answer all other language related questions.
Have your English skills been previously tested by?
Score/Band Exam Date
Are you currently on Island?
No
Yes
Attach a copy of your score report
DD/MM/YY
DD/MM/YY
NoYes
NoYes
Name Relationship Address
15. Are you of Caymanian descent or have close connections with the Cayman Islands, either historically, or by marriage to a Caymanian?
If yes, please provide details and include marriage and/or birth certificates
No
Yes
PLEASE DO NOT LEAVE ANY QUESTION BLANK. IF A QUESTION DOES NOT APPLY TO YOU, INSERT, “NOT APPLICABLE” OR “N/A” IN THE SPACE PROVIDED.
Use separate sheet of paper if necessary.
APPLICATION FOR A TEMPORARY WORK PERMIT
PAGE 4 of 7
WORC/TWP (2020/04) COVID-19 T1
PART 2 - To Be Completed By Employer
Name (i) Date of Birth
2. Is the Employee a family member of the Employer?
No Yes
DD/MM/YY
NOTES: (i) The Applicant must have a valid passport. (ii) This application is in two parts. The first part is to be completed by the employee and the second part by the employer or
the self-employed. (iii) Refer to the checklist accompanying this form for additional documents required to process this application. (iv) Use separate sheet of paper, where
necessary, to thoroughly answer each question.
(v) Occupation
(iv) Personal Email Address
3. State the occupation for which prospective employee is required and provide description of duties and responsibilities.
4. What skills, qualifications and experience are required for this position?
5. How many persons do you currently employ?
Name
If Yes, Relationship?
Of those you currently employ, how many are Caymanian?
6. Has the position been referred to the Workforce Opportunities & Residency Cayman (WORC)?
No Yes
i. If Yes, provide WORC Job ID No.
(ii) PO Box & KY
(vi) Employer Name
(iii) Telephone/Cell
1.A. Complete this section ONLY if you are a Company
1.B. Complete this section ONLY if you are a Personal Employer
(ii) PO Box & KY (iii) Physical address
(v) Telephone
(i) Nature of Company Business
(iv) Email Address
(vii) Employer PO Box & KY
(viii) Employer Telephone
(vi) Under which Law is business licensed to operate?
(vii) Expiry date of current licence
(viii) Licence Number
DD/MM/YY
(ix) Is the employee a shareholder or owner of the Company?
No Yes
(a) If Yes, will this employee be remunerated only in the capacity of the occupation of this work permit?
No Yes
If No, explain
ii. Has the position been advertised?
No Yes
If Yes, provide advertising dates
How many are Permanent Residents?
7. If the job was advertised or referred to WORC, did any Caymanian apply?
No Yes
If Yes, how many applied and why were they not hired?
DO NOT USE LIQUID PAPER OR CORRECTION TAPE, IF AN ERROR IS MADE CROSS OUT AND INITIAL THE CHANGE(S) OR
USE A FRESH PAGE
8. (i) How long do you wish this Temporary Work Permit to be valid for:
3 Month
(ii). What date do you wish this Temporary Work Permit to begin?
PLEASE DO NOT LEAVE ANY QUESTION BLANK. IF A QUESTION DOES NOT APPLY TO YOU, INSERT, “NOT APPLICABLE” OR “N/A” IN THE SPACE PROVIDED.
Use separate sheet of paper if necessary.
APPLICATION FOR A TEMPORARY WORK PERMIT
PAGE 5 of 7
WORC/TWP (2020/04) COVID-19 T1
I declare that the information provided above by me is true and correct and I understand and accept that if it is proven that I have made a false statement I am liable on conviction
to a fine of CI$5,000 and imprisonment for one year. By signing below I also understand and accept that if this application is approved any and all conditions contained in the
Temporary Work Permit must be complied with.
Note: If approved, the Temporary Work Permit will be subject to the following and any other additional conditions contained therein: (i) the employee is not allowed to work for any
other employer or perform any other occupation other than that or those listed in this application; and (ii) the permission of the employee to remain and work in the Cayman Islands
ceases in the event that the Temporary Work Permit expires, is revoked, or if their employment is terminated.
Signature of Employer (Original signature required, cannot be Agency Signature)
Date (DD/MM/YY)
10. Is this prospective employee being recruited from a non-English speaking country?
(i) If “YES”, are you aware of the requirements of the English Skills Test which must be undertaken by the prospective employee.
(ii) Are you satisfied that the prospective employee has a basic understanding of the English language in both spoken and written form as required?
(iii) What steps have you taken to satisfy yourself that the prospective employee can speak and write the English language to the level required?
No Yes
No Yes
No Yes
9. (i) How much will the employee receive in salary or wages?
(ii) How many hours is the worker required to work each week?
Declaration
CI$ US$
week month
dayhour
(iii). What other benefits, (if any) will the worker receive?
(iv). If worker is a household domestic, will the worker live in the same residence as the employer?
Yes
(v). If worker will receive gratuities, does the employer have a gratuities scheme in place approved in writing by the Director of Labour?
No
Yes
(If yes, please provide copy of Approval)
No
Name of Employer
I declare that the information given above is correct and confirm that the employee for whom the work permit is
being sought is or will become a member of the above Health Insurance Plan in accordance with the Health
Insurance Law and is a member or will join the above Pensions Plan in accordance with the National Pensions Law.
I understand that I will be responsible for any medical expenses incurred by the employee and their dependants in
the absence of a standard health insurance contract.
I understand making a false statement or representation knowing the same to be false in accordance with the
Immigration Law, I am liable on conviction to a fine of up to CI $5,000.00 and imprisonment of one year.
Authorized signatory for
and on behalf of Employer
Date (DD/MMM/YY)
Supplement - To Be Completed By Employer and Attested To By The Employee
Yes No
Registration No
Telephone No
1. Do you have a valid Pension Plan for this employee in accordance with the National Pensions Law and its current revisions?
2. What is the name of the Company and Administrator of your registered Pension Plan?
PENSION PLAN
Company
E-Mail Address
3. Are your Company's Pension Plan contributions for this employee paid up to date?
Yes
No
If No, why not?
Employee Pension No
HEALTH INSURANCE
1. Do you have a valid Health Insurance Plan for this employee in accordance with the Health Insurance Law and its revisions and regulations thereunder?
Yes No3. Are your health insurance premiums for this employee paid up to date?
Name of Employee
Signature
Date (DD/MMM/YY)
EMPLOYER'S DECLARATION: EMPLOYEE'S DECLARATION:
Policy No
Telephone NoCompany
E-Mail Address
Yes No
2. What is the name of the Company and Administrator of your registered Health Insurance Plan?
I declare that the information given above is correct and confirm that the employer from which I seek
employment has or will enrol me in the Health Insurance Plan and has or will enrol me in the above Pension
Plan (unless exempted by Pensions Law).
I understand making a false statement or representation knowing the same to be false in accordance with the
Immigration Law, I am liable on conviction to a fine of up to CI $5,000.00 and imprisonment of one year.
Employee Membership No
If No, why not?
If No, why not?
WORC/H&P (2020/04) HP001
Page 6 of 7
Health Insurance and Pension - Supplement To Work Permit Application
(Temp/Grant/Renewal)
Questions relating to the Provision of Pension Benefits and Health Insurance
Original Signature of Employer Required!, cannot be Agency signature
www.worc.ky
If No, why not?
D/MMM/YY
D/MMM/YY
Original Signature of Employee Required!, cannot be Agency signature or Employer
In accordance with the Health Insurance Law every person, and their dependants, resident on Island must have health insurance coverage effected by their employer.
Print Name
In accordance with the National Pensions Law after an employee has completed 9 months of
employment in the Cayman Islands, the enrollment & payment of pension contributions are mandatory.
DO NOT USE LIQUID PAPER OR CORRECTION TAPE, IF AN ERROR
IS MADE CROSS OUT AND INITIAL THE CHANGE(S) OR USE A FRESH
PAGE
WORC/CKL (2020/04) COVID-19 CKLT1
PAGE 7 of 7
For Accompanying Dependants
TEMPORARY WORK PERMIT CHECKLIST
This list is a summary of general requirements for ALL applicants. The Director of WORC reserves the right to request additional information or documentation as he sees fit.
Application forms duly completed, signed and dated by employee and employer - original signatures required. Please do not leave any question blank. If a question
does not apply to you, insert "not applicable" or "n/a" in the space provided.
Correct work permit fee, including non-refundable CI$70 application fee, dependant fee if applicable
A release letter where the applicant is changing jobs prior to the expiry of their current work permit from employer. Where one is not forthcoming, a letter of explanation and
any supporting documentation is required.
Cuban National: Copy of Cuban Visa
Section 52 (10) application (to coincide with spouse): An affidavit (see Immigration forms for sample) AND copy of marriage certificate
Copy of applicant's Resume (where applicable).
Additional Requirements To Be Attached to Application Based on Occupation / Industry
Construction: Completed Form A AND copies of signed contracts, from employer, redacted
where appropriate. A customized version of Form A can be provided by companies who have
more than 15 contracts, however each page submitted must have declaration on it and be
signed and dated.
Janitorial or Gardening: Completed Form A
Professional/Managerial: Copies of qualifications
If regulated by CIMA: Written approval for Senior Finance/Banking professional
(e.g. Managing Director, CEO)
Nurse/ Health/Dental Practitioner: Approval from Health Practitioner's Board or Medical &
Dental Counsel *
Veterinary: Approval from Veterinary Board
Electrical: Copy of license from Electrical Board of Examiners and the ratio of Electricians to
apprentice/wiremen
Driver: Copy of of license from the Public Transport Board for the appropriate category of
vehicle
Diving-PADI/NAVI: Copy of Divers Photo ID Card & Membership Status Skilled/Supervisory: Copies of qualifications and detailed list of skills
Plumbing: Copy of license from Water Authority Employment Agency: Proof of past and future employment for the applicant
Domestic, nanny or caretaker: Copies of birth certificates of children to be cared for.
Caretaker for the elderly or infirm: A Physician's letter confirming the illness if
the Infirm is under 65 years of age. Patient proof of age is required.
Security Officer: Copy of preliminary license from the Royal Cayman Islands Police (RCIP)
Farming: Agriculture ID Card or certified copy of certification from the Department
of Agriculture, letter from Agriculture
Teachers: Approval from Educational Council Mobile Car Wash: Copy of Mobile Car Wash Vehicles' Logbook(s) and Insurance Certificate(s)
Entertainment Industry - Additional Requirements
Musical and Theatric Entertainer: Provide a demo tape/CD/DVD of show to be performed Liquor License: Approval for the event, if applicable
Theatrical/Stage Show: Written approval from the Cultural Foundation DJ/Entertainer: Written approval from the Music Association
Event Advertising: Provide reasonable size samples of advertising materials (e.g., flyers)
* See Health Practice Law Extract
A copy of the T&B License, where the Trade & Business licence has expired, a copy of the receipt of payment for the renewal from employer
Where the employer is licensed by another body other than the Trade & Business Licensing Board, proof of current license or copy of the receipt of payment for the renewal
Copies of educational certificate/diplomas/degrees.
Please note that due to the COVID-19 response, submission of the following documents is not required at this time: Medical Questionnaire inclusive of X-ray and Lab reports, Police
Clearance Certificates, Advertisements, Photographs, Cover Letter, Accommodation form. Please further note, the relaxation of these requirements extends for only as long as the
Shelter in Place restrictions are in effect
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

APPLICATION FOR A TEMPORARY WORK PERMIT

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 3 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document