You are on page 1of 11

gru.

tdtlrvq
uu u uo { u ilwit?, :'l u {o tt:.l {l'l u 9t'l { 9r'l ? d n ?r1 n a 1 ?
ll *,lI: ; f'irilu; : 2565

mruufinruviouusrirdaiud t5 fiurau 2565


d9
16'r
-6lur3o.:....-. mftn
{iu rarird

doo./don. .O!U[

dur,''r,r^..1t-1--6-...lft.. it-clSl..s.. .utr.r:ciirdr :crrtun:a..{ana....2}--1.9-!9-o-P-r,1.111...


'lr*rnon.r...iiQ}fu.2$!.1$1.$.1..

aiuiqr...........11[-d.J......... *'slruurid -19]!?.9... .. In:e'vrri.91.9.- 9.1.1!?-Z-2..


'tF'

,o-rraia.......lflP]............ :u'ahl:uriti...3Q.11e............. Iu:d'nd.-Q9-q.:11h.!-11-9..........


a ' - )" -
iu:.r.:rusir{dr'rfr er'rriunr:nrurFnruv:"grusrirfi oirfi 15 iurnu :i565 o'rurrnusir.r6'rr n'.rrar0,..........1-........."u

rsnrflurflfl Et'',u........1.......o, flv{r..................nu

fia - uruana I
tuorlryrmlirrru rarirfl o r6uvrrt (Passport)
! a aa
"uJ
alnu?t ?u toou utno 01u [v{fl
R1U1A{nqU !atvr ?uuiln01u I
m{vt ?u1{ila01u I

1. 7000630003415 6 riuurElu 2565 P2032403 27 MAY 2028 06 MAY 1989 33 M

vr io u rrr u d {r vr ri'ri6'0 u L o fl a 1 : LLa y u a-fl f, 1 u ri.: si oh il


E a'rU rU r,ilr.: u:w r u ri r r 6'rr a-ryt r6ar r E raa'ngruului'1.:
E a'r rulrrirfi o rfiuvrx (Passport) E iirrurtuoururrrdl{1u
- iu

e e y e y Ea
u'tv{t01lJo5u50.1?'lton't1ul,'l{lauutuun?1ilot.iyl I
nu :sn'l:
trim:r oa ou ua riu:o.r #ryryl,ff"'0,,/lrui'.r0 ffi t1fla ra udr

cr -S \
4i
a{a1uil0t0. %n: t1rLffS:
...........1r.............r.............
aJ\.-
A{41Uil0{0. .d....u...........e..(..............
ulutelS :RlJLAUU
( utufrnr -ll-rrlft?:t I e a
\
(.................'.*................."4..-'......r'{.-..-,
rjniqr n'i5ii:.1r,iufiii'i {i rii5fi t?lti'fnr.lr Yrtlnl : LLYrU

oirurailr........ Fl'.lt114U.1..................d................y......,r.............a............
Q 9)1i 1{1U- {14X e :1"tjqr

uru i'r r/oi:-u rL o u dr ur o *"ffiU:'2565


iufi : !
*fyra
l"i' r'
fii
'f'
F

t,
It''lYl

v9
6iln'ln1'{lU:{l.l1U Emptoyment Contract
funfiUnafur
u y Jo i I
a fufu 1af {tt5{nluuYtlt utilo
r{ This aqreement is made on
fg :11,U: :uu.j1 u1uf,ni trrTn:.r at Ratchakiuri between Wf.fC
;rqu
393/1 lilJfi 5 siruapronn:?u Ad;;;-------393l1 Mo
MOUUAQUU
trt
ooauud_
Da 7qB0
01LflOFllLUUflvn?n QSUin:rtUi 70130 q (hereinafter referred to as the "Emptoyer") and
MR.INPAN PHOUTTHACHAK
( {i.r siohJtudryryrdo v u-u n'j1 " u1udrr " ) dlr Eruft fru
MR.INPAN PHOUTTHACHAK ruurltcrrftdll3e&rtq
attr&t3
yt0u 393/1. r4ilfr 5 eiruaotonn:?u MR.NIKON CHANGKHRONG
tI
ooauud_
0lLno01Luuaufl?fl 0{14?Ft:11'u: 70130
,irtauJdr-.D-.Gt,,i
(rinaLULu6ru[uuav[:un?1'anr,l{") 0nD{1u14u{
1dlrddlu
vYr a o r al r u rl n a.r rir drg ry rlisi a fi'u or'r fi {a nr ru ri olil ii MR.INPAN PH HAK

Dam Noen Saduak District, Ratchaburi Province.7Olt30


f. iruuri{qruuavdn:rdr{rq (hereinafter referred to as the "Emptoyee") Bothparties agree on the
fottowines:
YUYoYAy
lo 393/1 Moo 5, Dok Kruei Subdistrict,

rix rulfiu
ulualdn na{41{Qnn.l{y|l{1uuauQfl a1{fl na{:uQ1{
r u d'rdu e{r Ruil.: n5:tJfl:
Dz 130
fir6\ffisl&r{r'yrlq} lrrattt dt ftrcadhrfrilgtlo
utv
oflt1n1Q',l{ 315 utvt/iu oiar6o,@ifu.r rrrrntsAts foSlseu&htt:
IerumnarovqiruFir{'r{r[qniud 1 ro.:r6ou 1. Job Assignment and Wages
W
The Emptoyer hereby engages the Emptoyee and the

2. :luEl?a1fl1:d1{uavdnrudriro.u Emptoyee agrees to work for the EtlrgLpyg i4 [hg4apacity of


Labour attheratelol: uarn/upUznorr,@lnontn.
t'l
The wage shatt be paid on 2 diy of the month
:uuut?a1n1:4fi il n'luu9r
t, do
6or@
ryftf Cntt@:plrl&t!1
t:ila{ [!et?uuannrldutrlfiril:vrvrnlvru lrr ufr aorufrvrhlru Iulrt$mtltrf&rura|rrtu0edr - .jc-sJ.oJn .trsot
a.rrf t s- rt I nfe[-@W.: ilacr.r{ro*rcr3
!"

rg 393/t l4ilfi 5 siruanonn:?u


dr morir rfruavorn o-ruipr:rrui 70 1 30 f-1n!uf-,4--;a1ltan
2. Duration of contract and Worksite
n1: rio:u uu r?a1to{ f,tUryrdarur: on:cdrldln u nr:
The duration of the contract is for
flna{ta{y't"{aa{frhu rnontl.FlJlstarting from the day of anivat of the Emptoyee
inThaitand and theworkite is at
393/t Moo 5, Dok Kruei Subdistrict,
o 30
hocaoarnrrtlrl8hdo - ,z . .
=rcsr6-l
&fui&rff nlrlr0urytrhrr=moln lu8rrrQnrilo n'
39311 M". 5, D"k Kruei Subdistrict
"Srfr
T zQrso
I

The extension of the contact shatl be mutuatty agreed upon


between the Emptoyer and the Emptoyee
nau*tarrrenrr tu t,
llnlr.s3l!16$ro [orn
3. Working Hours
3. rirlurnr:r'r.rru btrrsltrlfiooga
The working hours shatl not exceed
.|s o , G .ls -u
{r}x rn r:dx rurj nfilil rfi u t?u.r{ / ?u hours a day, 6 day per week

mvtu t f,rJnrririrnu ?u htt lrrt,roa.rrem0eh, . .8 ,,-lellar$


ss!&rffioCoqn ,. 6- ..-.-[
4. Hotiday and Leave

4. iuusn
t
Str
4.1 The Emptoyer shatt arrange for theEmptoyee

dafs) off weekty with regutar pay.


4. 1 u 1 u i'1 { sior d'nlfiatrtn i'r.: fi iurl u rnj : v,iT #rJ nr ri
unu&1 nqlotQnlq8!&rreftsrGolou
Toruld'Yuriri'tdrJorrriac 1 iu Iifrl0tltfrtlloac
4.2 The Emptoyer shatl anange for theEmptoyee
4. 2 ur u i'r r fr'o.r {'nlfiq n 6'rd iurl q or m ru rJ : s rfl aitu u
13
lnuteiiuriri'rtav 13
aays off per year on Thai officiat hol.idays with regutar pay.
iu nolr:tuiIoffi grtqllOaarprlmrfikr
o.l uioqnd'rrrirnun:u r t uru{1{n nar{orhlqni'rr ladffu&ft0ar ..,.1.1.-- i
u nvTniirt In ukiiu ri rdr rfl una r
aiourj:v er 13J n8ilrner 4.3 Annual 1gayq e; The Labor Protection Law. days shatt be
u
I
attowed by the Emptoyer for the Emptoyee when compteted one-year
drn:oru:wru iu emptoyment with regutar pay.
rtqn&3rf oa$rau0Urcfrf CnAf lotrf,
inir3gilt :i€ tooUtlsHtts0trcal-4-j
5. drrirqnaruagir{'l{tuiuugnt 5. Overtime orurilourux)quooJccsJ
@
s. t filurEli'r.:hla! n{rwirnurfiunarrir.:rurJ nfi 5.1 lf the Emptoyee works more than the usual hours on the
regutar working day, the Emptoyee shal.t be paid extra for overtime by
ur u {r r do { iiT sr Fir eir q rr a {fiq n6"x1uo"n :r n1:.rnflmJlB
the Emptoyer at the rate of The Labor Protection Law.
g.
niln:o{lttnn1u .funrfq
s.z dT uru d'r{fian{roituluiuraua
vt u1u{'1{fro.t Ottttt0 uuftfiq0*eraayastfltr$rfom _+_
tt',rovO r)')Dnoou1e)€luo9JccsJ
Q1u n1e 1{ Lu?u14EI n LfiA n{r{udm:.I FtTJ nfl uxlu {tJn:s{ 5.2 lf the Emptoyee work on hotidays, the Emptoyee
tU
u:{n1u {rlur / r-u shal.t be paid extra for overtime by the Emptoyer at the rate of
The Labor Protection La!_ per hour/day
flure&ltafnlr$ls8rr&rfun rnaGtg
6. B1u1:
6rgrohtqtllcol{ryrrCUlrltocr__+_{llhl!
olDnouulQ)6luooSccsl
6. Food
u'r ui'1{ n n a r dn arrnr:hiq n{rlr1 niurir{ 1u iua u 3 ulttt
The Emptoyer shatt provide to the Emptoyee three, meats a
fo lor u ri r1d'd r utlin na q du ro{ : vx'i N u r u {x rYu a n
t,
{r.: day of working day and the food expenses depend on the agreement of
the Emptoyer and the Emptoyee.

dw t raartlnltlcr{rruLfitartryr$rlcrfn les
{. u?{n 3 at, los0rt{{roilUr0ftocf*nAqrurlr3iltrydq
7. Accommodation
v
u1 r,d1{ rt na{ a udn fr rr-naT
v Au
rTu
v J,
fi il ao nrYu ua cnt, n *&
The Emptoyer shatt provide to the Emptoyee safe and
qt dn uru vtvlu riq n i'r r ln u rirl{qir u rC o.: dfrnhft r na { f,u m {
hygienic accommodation and the accommodation expenses depend on
rlrl,
:u14?',I{u'ru a 1{l ltavanQ
t
Tl the agreement of the Emptoyer and the Emptoyee.
rnuurer!0rdnl&trtt&robc*Qnrr
&rral:lftdqnfq lao&rtlttrg6.!*sntfreEt'hnlr
.lnrni$ilftrreqn{r1
#1
8. drintnnu'rula 8. Medicat Treatment
lrlnnrsauut
I u Qltd d . I v . I ln the event of the Emptoyee's ittness or accident caused by
u1 ua 1{ n n an a n tuilu : aQ 1 u n 15 nu1?r u 1u 1a un e n a'li
work during the period of the contract, the Emptoyer shatt both provide
naon : u u u r'r a ru a r drg cg r yYllu n : rfi rJ : v au du n : 1 er rfi o m r n atl necessary medicat treatment free of charge to the Emptoyee, and in
- ,9 dc t d . r y . u the meantimepay regutar wage and compensation on terms not
n1:yl1.r1uuaun:illauu?u0u naonaualunlaN :cm1{fln less
than those stiputated by the taw.
,tu
inurdr ua v riru n uilust nfl uil 1u ulofq 6n[ etiffi fio*lInr.ruEair.Eudl
Q .{.a r/, .{ Gaa rQtr. Q u ay
3alqotreooteororrla1lun Qtdac&Iafu
tun:fuyranaNKBt?Ft
U
n1 Ltnlu lun1:ann1:ftll Lx funl;eco&$riilloagnredtac{hlt O.du ocaeoolu
A'd,YUA
u1BA1{[UU9{:Uil9tt0U
1'
{rutltr1aninifinftrnr6ffioEru
ln the event of death of the Emptoyee. att expenses of
managing the body witt be under responsibiLity of the Emptoyer.
9. dr6uvrr.r tuft*Oft * rlrmgo Artltrotmut qltuft,
tftnatrf0uQ&6ofou
9taaya.x
ulue'r{avQ1un1lftuyl1.:lJ0{QnaNfl {u:vtytfl tytB 9. Trarcl and Transportation
3 u
:?tJyr{QFtT{114UU:UA{enn1.:nU0{tytfl
v I t, a Jv
n uavalunl mual:nciu
I r s u &rert1
The emptoyer shatt pay for the cost of Emptoyee's traveling
Ao u q do u w a.ia
{ra1ru'lrj0{QnaN [un:fuyt1.i1un:uaQfu'1 untaunTn]fi rllu to Thailand as wett as pay the anangement for transportation to his
aYdeV assigned housing. The Emptoyer shatt atso pay for the cost of the return
n?1r0,lat0{anQ1{
u
u5auantan6flJflJ1
os
traveting of the Emptoyee to his country after he finish his working
contract, except that the Emptoyee is at fautt or terminates the contract.

to. torir6'u
uro*t6trtrg*rt&unf rqjnlnfl ftrlr:retr
aerilf ract roirtoulru
lftr{&&ldlrraelntltdlel0rtsf r{u&mn Ar&rta*
1 0. 1 q n i'r.: d'o+dofl I uav rJ
fr thn ru n g{oril d'rr or
*Arnotrf, o rc1$ttrtrluorxln3lar
-
au
u5 $vr u r u ir rr i
fl r
o
riru u n fi un r e[eTr.i' oult n n r,tu'l u ua vt]in ?'t il 10. Obtigation

m1:vleiol,uuo::il rfi uilil:unrdtvrEJ Iffu


10.1 The Emptoyee shatl abide by the rutes and regulations of
the Emptoyer's company stiputated inconformity with the [aw, and shatl
1 0. 2 at, n 6"x do w{r n ul#n-u u'r rJ i"l r uvi rusu bltrj lir .rru
respect the Thai traditions and customs.
oyu d'
Lunuunnaou
I jn.CrletrlaAf ser*rr0Oeocdtrtl0$u
sctfiltrrlrefr1&fmo&mulirh'utrtlornu ssst t
1 0.3 Qni'1{ d'o.r1rin:vd1n1:1n 1 tudnuuuqilqx oaur.tr€s{or0rCer$n :ru&tr
tyduoeio 10.2 The Emptoyee shatt work onty for the Emptoyee's
u : vvr?{14:o:?iln? n:uYl1n1: Lua{ Ho nauil'lu
company.

Srrtqtqrloa3nt ro[.r$lds0lh,
llnogaltrtr4p&*r
10.3 The Emptoyee shatl not engage in any untawfut activities
such as protest or demonstntion.

lIrf r16!3rMtrrlli6tuilnGrlrgryrrrr!
f ofrrlarerr*rnn tulrOdlonllo
#x-D
(\f
t' ir \Y.".Jifl8),f..//
''.,; ATi/4 \,\;
\:f'

t{rn
11. n1ruonrfin#rgrgr 11. Termination of the Contract
mttmutttf,r
t t. t n:fi u"rsl dr{il:varriuon rfindryrgruru{r dar 11.1 ln case the Emptoyer terminates the contract, the
r OY I I l, a a I a a lY Emptoyer shatt give one-month notice to the Emptoyee, or pay one-
uonnal?L14ane1{Yt51ua?{14u1
l,
1 tnau u:oQ1uNun1a}i 1
month wage in tieu of giving notice, or otherwise act in conformity with
16 ou uvu n T :u o n rf, na'rg rg r uiobiLfl ultJ n ru nnuil 1 u u:{{ 1u the Thai tabour [aw. The Emptoyer shatt thereby pay for the cost
r & v I r . - v r 99 i v
Lvtu :?ltyt{u1uaNA0{a1un1tFluyt1{nauU:ul,Ylfi LuunennN of the return tnvel of the Emptoyee to his country.

91?U
v Itar0urrltrJtllutltrlnlu gr urslq6rt
rrryri.retigrltiaofdr r r&ngrltrar$&Org I :iau
crurmnJgnlnlolA afitilOuhlaudlouucgrutr
rz. du 1 aoullrnolntr$ro&r&n rfilhn rco!fiClgl.rl6ou
11.2 ln case the Emptoyee terminates the contract, the
Emptoyee shatt give a one month notice to the Emptoyer and shatt pay
t z. t ureri'rmvfrorouunqni'xhJoqluanrud
.r, for his own expenses.
,uJaaaruq
uaonnu uJarnn?nqnn1:or ttu nuo::lJt1n n1:na1na
|tv
fladlnf ntlrlluanr&rhfir if ltit:
u a v ar,J c
n1:a:u
U
u:on1:a{n :1u Bauolanlunl:fu [1r 1000'lu? u Lr4 uorrlholfrrru|*1asr!0rl rfrct eadaStrro&rr0um$u
oru,',lt.vv,f)ta,
vn.: 1um a l,u ulue N fl a{a{QnnN nauu:ct vlr,l [9] uuluaN Luu
Uxne6utrraa
I retrr !, 12. Others
il00nn1L{a1uvr{14ila
IJ
es
A r J iarv o v iov.a.r, 12.1 ln the event of naturat disaster, riot, fighting or war the
1 2. 2 r{ 0u lrjouvrrJ L9t:uq Lufi rurulu Ll4ruu LUa 1il
Emptoyer shatt evacuate the Emptoyee to the safe area, and if the
nflulrlu situation is no longer conducive for the continuity of work, the Emptoyer
shatl repatriate the Emptoyee and shatt pay for at[ the expenses of the
t z. I tu n : d vr'u r u 61.:tri il fr
rifi rr ru d oulu ulir f,ry ry r d repatriation.
t
lJ O14U
A y e
i r A [n
d ,a.ah
r
UTAU 0U 9l trJ n
9 C r . v
:U 0?U er''rrJ r{ OU !fl U14{ A rU rUlU
J
rnatniaff@qtttuao
v a v a.t .a io g . t) ls dcdtdlosrer.rig; lsmef{llir$ nurnacfu
u1un1{ uusouSu0,rn Lun?1il !Aux'lufl Lnnru$nQnnNlnu:vn1:
fiiu|3r, u&nauhmo r*{r@rrtit
*oa8tdlu rnotrrttl$mnf rt'h*ntlototnnts,6t0r{
lanahtfcrril:do
12.2 Other conditions not mentioned in this contiact shatt be
in accordance with the stiputations of the [aw.

riafirJrtHalrrlbrrnn& tfrU$rlnrr
tlorlrs
12.3 ln case the Emptoyer faits to imptement any of the
conditions agreed in this contract, in futt or in part, the Employer shatt be
responsibte for atl the losses incurred to the emptoyee.
trae*{hnor qfi l:aom'wrtautrn*:
lufifiIIo&& rlrlgBaotcu{trlrlstrtitiltrdEtr ad
@otriet,..uf,lo**ofuAre*lrOfn
dgrrrr
v99

drp ry rariu fi lirfi uft n


T
urlvr u nrur dr nquua u nlu1 Done in dupticate, one in both Thai, Engtish and Laoeach
t- u o J 4 u du v e re A
a1? Ln uanillrur,uuaa{ auuilton'r 1il nao{el:{ nu eafury1u.r being equatty authentic, each party hotding one copy.
Q
tusartfiufitf olutf rrtntr tnrllfioearrutnala
aor dl ru sirr 6 ot{dlruavr,rfi r afu
toalarlelurturotrs0ullavuranarf SClu {furnf, 1
r ol3roSlQl6r0r oar$lr=8u
rv A rr I va I e u Jotly
na fu fulu{ao{,.11u9r1{ Lt
ll oo
1 Liton?lil LuaflJajlu
99 Q { [o a{ ln witness whereof, the undersigned, having futty understood
a i uv, v the contents of the contract stated here-in, have signed this agreement.
a'l ul.roto I? Flouu'11r u1u
glurnQral &r ofra ilrtrlserstulrlln! t$nfi
araSffirfitlco.ru

.ion" {"fl^ }. u1ge1{


v
Signature
qr^1'
+\fl: t1?ta:? Emptoyer

ulufin: txTn:r 1 MR.NIKON CHANGKHRONG I


'\ fnt
{.1oI .
X
j v
a{t0 antl{
t, 5rt --r,ht
MR.INPAN PHOUTTHACHAK ) t.Y*r'19.\S-W,
uod, [)k' Y{u1u stsnutrr" trf4 Empr.oyee
I

.( tv.nonaull:
ul{flata ) ( MR.INPAN PHOUTTHACHAK )

a{t0 1\U1U

t
AU
u''tu?giltJu u?uu'tFtv f YRlljl! PHOUIHACHAK
r
Signature tw Witness
1
MRS.KULCHALEE DOKJUN

Ert

Signature \Mtness

( MR.WUTTHICHAI NWMNAKHA )

a* -nBatu
,
tt
MR.WUTTHICHAI NWMNAKHA i
,s
Cfi
\
\io/
\h1

ehrulgnfro{
4n s {.,Jol r
-a a) ,Y
:"t8fl'l5tRE ?nuu^ru rcirufii

tnfl:fdilrvqirfru ;ili)-t*f) -t 5J i.I* i drrinmytfigU ii' l t fiiltit''l i

flsnt:dad 3it.]rr: ',nifi 5 ia'lii6lii,e]1tfr: iir


4\ i/ 'W .it
il ''l I il'cr;l'l t lllii{:? it J il { ;l ti i it '-i 'f i i"i

1,/ / ii'.

,::y
'rr
! i'11Jl"l$.lf'tnflt'f^t'iil )5 \ ilH,|iT
J
safiilu]u
.le i ,aJ
rJ, di
r.tll.l ! 'tlt t: ii{j'i
d:cmflfru
u .l o '('
iutGauilfiriruuorirutailfi:: iiiiji,ililifl
a,i
:\a
;\ti:

il'{: rfl t d{1


f
Ul.t,q "ir q 1;]la u n [at]
;., --"I{--*.:H-i#rie
tffi*Yq..i1-dt.)'t"i'

q.-

F r'6)'0n,,o'roc
anr:unnaluriruza.:raa:rlail:cli1liru ,.i)t,;; *li.llj 'i...
- i iirrfi'uii :

.: Y,V," ii'rgtr6 2i,i [ilt6t:i; i.,,


If,+#rd u,{//
i*; l',J::*,it"lrii;:.* ,;:-:- ^
dflliln.l?{ .r***+t, {ts rfiorfta ,:* i: , i ;:,;;
'"1'iirI
ri'rgm6
i
v-g]{llulrgg tra I:t, jirj
A S o. A ;

* lt1l1n, ; ." ,:j


-:. i,} liitii f! ;1 ;f"i;.ir{ itirq116

rte* tul1 -.:


1l1t ?lstutJlr

cirrutgnfio.r

,tw ...,fu,\,
,d al 1-
l1uril uurarii ..i77Q$gQ06.i L2?........ lrlJlJ ?rA.04{}3
riluad .itlq?.lfgaa,gQgz....

aJae'
n5ilytgltu1fi:nonl:Ft1
qd
oQ-rdA
fl]U R{l I U n A 1{l?l UIUgU ?\l] €UUU
aaiAt
lumytrifju?[16r{utJ
99ll

lu d'r ffo fi o o nl fi r?'roo ufi o { ? l


!,

ZA

H:tp 1ltr3
9(1
l,lriat)a/Adc
'loonyl r lilsu u r fr uu v{: v : ru:.ity uunr r u yt.?t, 24gg
sr r tJ
{fi vr v rfi tfi
Ita
ct
ruoiufi ....1.f..IBU;lqH.y.t.fl,.?564.....
lt9

#offir1u nr : il: y noun rfi rufro

eE lnlnuit:y
rfisurrlud'nu:I:rYu

I
a6A
YU9ttrfiilT.l1ottgno
9r1 ,
s4{o

ci:nflgnfrR{r
4ts t tr Lal r

j& c q., o '


Yt9l{tfl1un{lUt?iAJe
,...
r::.i.E:.:.15 i,' f;i.r{l t 1; +r+

q2,.. . r..'
f rUurlrrrarJ / Nurn in l-:gr / Nurrc.irr Lro u,ouuqn'
.'$
.'-' .-,,.-.
a"|urq:,JBrn
Sirruturt du rilulaii(..
Sign:tiulcol'h(.iil'cr'.

ff,Jr*r..'*"/Atltrr.css SAVANNAKHET

DONGPHOSI, XAYPHOUTHONG
''" 1 '' '"1 1 '. " : .'.

eftl.:q, ,cqe'fi

U'llJEunU
.l
/Ndm /Surom
PHOUTTHACHAK
Q/Pr€nonrs /Given ranrcs
INPAN

Aqa Lao Lao


ao &o
AU(OAUUGnO/Date de naissance /Date of binh iitiiol Licu oe naisre / Ptrce of birth
06 / 05, 1989 SAVANNAKH€T
ftll6) /Sexe /Sex
M
Ovv d
AAn TUAUU /Datc rle dilivmnce / Datc of ise t?'lUlfl& /Aurorid /Authcity
2810512018 MOFA. LAO PDR
mr6!91€]CUU / Dure d'expirdrion / Date of expiry
27t45t2028

You might also like