Labour Relations Act, 1995 (Act No. 66 of 1995)

Certificate of Service in the Civil Engineering Industry

CIVIL ENGINEERING

INDUSTRY,

SOUTH AFRICA

READ THIS FIRST

WHAT IS THE PURPOSE

OF THIS FORM?

This form is proof of

employment with an employer.

WHO FILLS IN

THIS FORM?

Authorised staff member

WHERE DOES THIS FORM

GO?

To the employee.

INSTRUCTIONS

This form must be issued upon

termination of employment.

NOTE

The reason for termination of

employment must only be

given if requested by the

employee.

This is only a model and not

prescribed form. Completing

a document in another format

containing the same

information is sufficient

compliance with Clause 2 in

Chapter III of this agreement

I, ........................................................................................................................

(Full name and position of authorised staff member)

of

.............................................................................................................................

(Full name of employer)

Employer's Address: ...............................................................................................

...............................................................................................................................

................................................................................................................................

declare that

..................................................................................................................................

(Full name of employee)

....................................................................................................................................

(I.D no.)

Was in employment from .............................................................................................

Until .............................................................................................................................

as

......................................................................................................................................

(Type of work/occupation)

Any other Information ...................................................................................................

On termination of service this employee was earning: R...................................................

.............................................................................................................(Amount in words)

[per hour]          [per day]         [per week]         [per fortnight]         [per month]         [per year]

........................................................................                ..................................................................

Staff member' signature                                                Date