Number:                                                                                                         …../…../………

Subject:

PROVINCIAL DIRECTORATE OF LABOUR AND EMPLOYMENT AGENCY

                                                                                                          ……………………………

…………………….. established in the province of …………………….., resident at ……………………., working with the title ……………… and ……………………… production (sales) ………………… (continuous / ……………..sustained / seasonal ………………….. (private / public) sector ………………… (in our workplace / workplaces) ………………. (number of workers / total number of workers) exceeds fifty and ………………. Therefore, we request that the necessary procedures be initiated and we be informed about the employment of disabled, ex-convicts and terrorism victims with the following qualifications.

Mailing Address and Phone                                                      Authorized Signatures

                                               Disabled           Ex-convict        Terrorism Victim

Number:

Profession:

Work:

Gender:

Age:

Marital Status:

Education:

Military Service:

Other Conditions: