Fillable Notification of Termination of Employment Contract with Foreign (Workplace English Campaign)

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Notification of Termination of Employment Contract with Foreign (Workplace English Campaign)

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Country of origin: HONG-KONG
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ID 407E (08/2010)
香港特別行政區政府入境事務處
Immigration Department, the Government of
the Hong Kong Special Administrative Region
終止外籍家庭傭工僱傭合約通知書
Notification of Termination of Employment Contract
with Foreign Domestic Helper
*本人／我們 現通知貴處，下述僱傭合約 *已經／將會 終止。詳情如下：
I/ We hereby inform you that the Employment Contract with details below *was/will be terminated:
簽
證檔號
Visa Ref. :
(請參照背頁式樣。 Please see sample overleaf.)
僱主資料 Employer’s Information
僱主姓名
Name of Employer
香港身份證號碼
HK Identity Card No.
( )
地址 Address
日間聯絡電話號碼 Day time contact telephone number
僱員資料 Employee’s Information
僱員姓名
Name of Employee
香港身份證號碼
HK Identity Card No.
( )
日間聯絡電話號碼 Day time contact telephone number
合約終止日(一般為最後工作日)
Contract termination date (normally the last working day)
:
終止合約原因 (如有需要，請另頁繼續填寫)
Reason for termination of contract (Please continue on a separate sheet if necessary)
僱主 Employer 僱員 Employee
僱主及／或僱員簽署 (簽名式樣必須與僱傭合約上的簽署相符。)
Signature by employer and/or employee (Signature should agree with that on the employment contract.)
僱主簽署 Signature of Employer 僱員簽署 Signature of Employee
/ /
( )
注意 Note: (i) 僱主與僱員雙方於終止合約時應遵守外籍家庭傭工僱傭合約第 10、11 及 12 條條款。
Both the employer and employee should observe Clauses 10, 11 and 12 of the Employment Contract upon termination of contract.
(ii) 僱傭合約一旦終止，僱員須於合約終止日起計的 14 天內或其逗留期限屆滿前(兩者以較早的日期為準)離港。
The employee has to leave Hong Kong within 14 days from
the date of termination of contract or before the expiry of his/ her
limit of stay, whichever is earlier.
(iii) 僱主及僱員可遞交同一份通知書或各自填寫通知書
。Em
ployer and Employee may use the same notification form or complete a
separate notification.
(iv) 本通知書可傳真到 2157 9181 或郵遞至入境事務處。如以傳真發送，請勿再郵寄正本。本處在接獲通知書後會寄出
書面確認。 This notification may be sent by fax to 2157 9
181 or by post to the Immigration Department. Please do not send
in the original if it has been sent by fax. Written
(v) 領取本通知書無須繳費。This notification form is issued fre
acknowledgment will be sent on receipt of this notification.
e of charge.
(vi) 請用黑色或藍色筆以正楷填寫本通知書。Please complete this notification form in BLOCK letters using black or blue pen.
(vii) * 請將不適用者刪去。 Please delete where inappropriate.
致：入境事務處處長 日期
To: Director of Immigration
(傳真
號碼
Fax No
. 21
57 9181)
Date :
Form Computer Code
/ /
(日 dd) (月 mm) (年 yyyy)
僱傭合約號碼
Employment Contract No. :
*ID407E0801*
ID 407E (07/2021)
通知書亦可經香港政府一站通網頁
www.gov.hk/
fdhtermination
遞交。
The notification may also be made online via
GovHK at www.gov.hk/fdhtermination.
此欄由辦理機關處理
FOR OFFICIAL
USE ONLY
檔案條碼
Reference Barcode
外籍家庭傭工工作簽證式樣
Sample of Working Visa for
Foreign Domestic Helper
有關收集個人資 料 的 目的 Statement of Purpose
收 集 資 料 的 目的 Purpose of Collection
對於表格內所提供的個人資料，入境事務處會用作下列一項或多項的用途﹕
The personal data provided in the form will be used by the Immigration Department for one or more of the following purposes:
1. 辦理你的申請；
to process your application;
2. 實施／執行《入境條例》（第 115 章）及《入境事務隊條例》（第 331 章）的有關條文規定，以及履行入境管制職務，藉此協助
其他政府決策局和部門執行其他法例和規例;
to administer/enforce relevant provisions of the Immigration Ordinance (Chapter 115) and Immigration Service Ordinance (Chapter 331), and to assist in
the enforcement of any other Ordinances and Regulations by other government bureaux and departments through carrying out immigration control duties;
3. 在有關人士向入境事務處提出申請並提名你為保證人或諮詢人時，把你的資料供作核對用途；
to process other person’s application for immigration facilities in which you are named as a sponsor or referee;
4. 供作統計及硏究用途，但所得的統計數字或研究成果不會以識辨各有關的資料當事人或其中任何人的身份的形式提供；以及
for statistics and research purposes on the condition that the resulting statistics or results of the research will not be made available in a form which will
identify the data subjects or any of them; and
5. 供作法例規定、授權或准許的其他合法用途。
any other legitimate purposes as may be required, authorised or permitted by law.
在本表格的個人資料是自願提供的。如果你未能提供充分的資料，本處或許不能辦理你的個案，或無從翻查或不能正確地辨別有關紀錄。
The provision of personal data by means of this application form is voluntary. If you do not provide sufficient information, we may not be able to process
your case or to conduct the record search or positively identify the record.
資 料 轉 交 的 類別 Classes of Transferees
為了執行上述的目的，你在表格內所提供的個人資料或許會轉交其他政府決策局和部門及其他機構。
The personal data you provide may be disclosed to government bureaux, departments and other organisations for the purposes mentioned above.
查 閱 個 人 資 料 Access to Personal Data
根據《個人資料 (私隱) 條例》（第 486 章）第 18 及 22 條 以及附表 1 第 6 原則，你有權查閱及改正其個人資料。你的查閱權利包
括在繳交有關費用後，索取你在表格內所提供的個人資料的副本。
You have a right to request access to and correction of your personal data as provided for in sections 18 and 22 and Principle 6 of Schedule 1 of the Personal
Data (Privacy) Ordinance (Chapter 486). Your right of access includes the right to obtain a copy of your personal data provided in this form subject to payment
of a fee.
有關查詢表格內的個人資料，包括查閱或改正，可向下列人員提出﹕
Enquiries concerning the personal data collected by means of this form, including making of access and corrections, should be addressed to:
香港灣仔
Chief Immigration Officer (Foreign Domestic Helpers)
告士打道七號
Immigration Tower,
入境事務大樓
7 Gloucester Road, Wan Chai, Hong Kong
總入境事務主任 (外籍家庭傭工)
Tel.: (852) 2829 3176
電話﹕(852) 2829 3176
一 般 查 詢 General Enquiries
有關申請的一般查詢，請透過以下方式與本處聯絡﹕
For general enquiries, please contact us at:
電話 Tel.: (852) 2824 6111
傳真 Fax: (852) 2877 7711
電郵 E-mail: enquiry@immd.gov.hk
網址 Website: www.immd.gov.hk
ID 407E (07/2021)
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Notification of Termination of Employment Contract with Foreign (Workplace English Campaign)

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Completed 14 September 2021

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