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PRC Form 104

This document is a certificate of experience form that verifies an individual's employment history and duties at a specific company. It requires information such as the name of the company, addresses, contact information. It also needs the applicant's name and dates of employment, positions held, and specific work and functions. The certifying officer must fill this out, sign and swear to its contents before a notary public. This form verifies an individual's work experience for qualification purposes.

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Ber Salazar Jr
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14K views

PRC Form 104

This document is a certificate of experience form that verifies an individual's employment history and duties at a specific company. It requires information such as the name of the company, addresses, contact information. It also needs the applicant's name and dates of employment, positions held, and specific work and functions. The certifying officer must fill this out, sign and swear to its contents before a notary public. This form verifies an individual's work experience for qualification purposes.

Uploaded by

Ber Salazar Jr
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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PRC Form No.

104 (Revised July 2002)

NAME OF COMPANY/OFFICE

ADDRESS / E-MAIL / TELEPHONE NO. / FAX NO.

CERTIFICATE OF EXPERIENCE
WARNING : All statements are subject to verification and any false statement or misrepresentation made in this CERTIFICATE is ground for disqualification and criminal prosecution

TO THE BOARD OF :

This is to CERTIFY that M ______________________________________________________________ is/has been employed with the above-named office/company located at ____________

______________________________________________ for the period and performed duties indicated below.

FROM TO POSITION HELD SPECIFIC WORK / FUNCTIONS

SUBSCRIBED AND SWORN to before me this ___________day of


______________,20 ____ at ______________________________________
Affiant (Certifying Officer) Affiant exhibited to me his Community Tax Certificate No. ____________
(SIGNATURE ABOVE PRINTED NAME) issued at ____________________________ on _____________________________

IMPORTANT:
1. The certifying officer should be the personnel officer / manager or equivalent position Notary Public
in the company
2. This form is good only for one office / company Doc. No. _______________
3. Certificate of Employment must accompany this Certificate of Experience. Page No. _______________
Book No. _______________
Series of _______________

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