REPUBLIC OF CYPRUS

MINISTRY OF INTERIOR
CIVIL REGISTRY AND MIGRATION DEPARTMENT

DECLARATION

I, the undersigned ..............................................................................................................

ARC ................................................................ MP No. ................................................
Passport No. ............................... arrived in Cyprus on ................................. and working
as .................................... with .............................................................................................

I declare that I am receiving regularly my whole salary every month, I have no complaint
against my employer and I am very satisfied with the terms of my employment.

NAME ..........................................................................
SIGNATURE ..........................................................................
DATE ..........................................................................