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Amkor Technology Philippines NIGHT WORK EXEMPTION Human Resources Department APPLICATION FORM Instruction: Thr applation ont be supported by ame aie and ther laboratory enim fests reflecting the ies thatthe reson for exemption these cocomers mt be Med wu by the proper meseal authors and mut be subnet Cn er evoaton ‘Altnformotion herewith are COMFIGENTOA. Dept,/Sec: TT / esr eNet Pavey Buauie _cusmrcton reson for Roped Exampton£F Hea 1 aertyteave ursing Mother eva Pesoucr ler. Wipe “ywvreRo J 073 Printed name of supervisor/Dat Ustof supporting Bocuments: ForHealth Reasch: Medial Cette SXEMPTED oratory Exam D nor exempreD: (reason for not being qualified) . Wftfea~ 1afat 12: oxnscove, ill. it bes For Nursing Mother: Medial Crttete inating that employee is pucnoss, — Aetinstmemt Diterder felyogsh Indeed breastfeeding. arian Orerder, OD eS ee evawareo ar: aPRuseian/Date License/PTR Number Z HRD/ES-Cl-FO31 For Maternity Lave: Madea! cetieate Certeate for Expected Date of Devry

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