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    Applicant    

Applicant (If there are two or more applicants, please use the paper application form)

Please provide at least one of the following: 「mobile phone」 and 「landline or other contact information. 」

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Agent of the applicant


    Counterparty    

Counterparty (Company or Firm)

Please provide at least one of the following: 「mobile phone」 and 「landline or other contact information. 」

Agent of the counterparty (responsible person)


(Please describe the disputed situation and the event process to facilitate the mediator's / arbitrator's understanding and settlement, and avoid emotional or biased language.) Please edit the text first, and then post it to avoid accidental loss.

1. Relevant materials can be brought to the site on the day of the meeting. It is not mandatory to upload them at the time of application;
2. Upload a maximum of 10MB or 10 files of data. The rest of the data shall be brought to the site on the day of the meeting;
3. The file format shall be pdf, xlsx, xls, docx, doc, zip, rar, jpg, png, or gif.

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Claim the matters of the mediation (multiple selections)

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    Mediation method    

Description of the mediation method

The local competent authority has explained the following matters to me under Article 2 of the Act for Settlement of Labor-Management Disputes：

一、Mediation may be conducted through the appointment of a mediator by the local competent authority or the formation of a labor-management dispute mediation committee。
二、When a sole mediator is chosen for mediation, the local competent authority may entrust a civil organization to appoint a mediator for mediation, or the local government may, depending on the circumstances of the case, appoint a mediator to handle mediation。
三、The mediator appointed by the civil organization shall be selected and appointed by the local government, and the mediation effect shall be the same as that of the mediation committee or mediator handled by the local government。
四、The local competent authority may be requested to submit a roster of mediators and entrusted civil organizations for review. It is recommended that mediators be selected from the roster to avoid the varying qualifications of mediators in the community affecting one's interests。
五、Mediators may be required to state their identity and qualifications during the mediation process。
六、Mediation for labor-management disputes is completely free. If there are any fees involved, please report to the competent authority。
七、If the case involves complicated expenses and mediation requires the assistance of a lawyer, it can be considered to request the local competent authority to determine whether it is necessary to appoint a lawyer to coordinate。

Selection of mediation method (either the mediator or mediation committee)

一、The Taoyuan Municipal Government appoints a sole mediator (*see Notes 2 and 3)

◆Applicants may attend meetings in Taoyuan District, Zhongli District, or Pingzhen District based on their work or residential location。
◆The contents of the dispute involve wages, overtime pays, severance pay, wages for the advance notice period, and vacations. This option can be checked, and the processing time will be shorter。

◆Applicants shall agree to have the case assigned to the local office near the applicants' workplace or residence for meetings, and to be handled by a mediator appointed by a civil organization。
◆The district offices, including the offices at Dayuan, Guanyin, Xinwu, Longtan, and Daxi, shall coordinate the use of the meeting rooms (If there is an urgent need to convene a meeting, it is recommended to select the first option)。


二、Mediation Committee (*Note 4)

◆The mediation will be conducted within 49 days。
◆The contents of the dispute are related to occupational accidents, the Labor Union Act, etc. It is recommended to choose a mediation committee。


Time of the dispute
(Required)
Location
Labor provision location
Employment status
, date of departure：
To carry out mediation procedures and necessary statutory duties, a photocopy of the application letter shall be sent to the counterparty. Do you agree to have your address, phone number, and identity enclosed with the letter? (Those who fail to check the box will be considered as disagreement.)
Labor Bureau provides information on labor laws and employment services. (Those who do not check the box are deemed to consent)
Note：
  • According to Article 10 of the Act for Settlement of Labor-Management Disputes, applicants, counterparties, agents, and the subject matters of the mediation shall be clearly stated in the application. Any omissions will require supplementary documents to be provided.。
  • The selection of the mediation method shall be confirmed by the signatures of the parties, and the attached roster, explanatory content, evidence, etc. shall be bound into a book。
  • To expedite the processing of your case, please complete the application form completely, with all fields filled and no blanks。
  • When there are two or more applicants, the mediation process-related notification letter shall be sent only to the first applicant or to the designated mailing address. The recipient is responsible for informing the other applicant(s)。
  • The 3rd floor of the Labor Bureau provides free legal consultation services, and registration consultation hours are 13:30 ~16:30 every Monday, Wednesday, and Friday。