国立成功大学国际学人短期多房间职务宿舍借住申请表.doc

國立成功大學國際學人短期多房間職務宿舍借住申請表National Cheng Kung University Application for work-related multi-room dormitory for overseas short time visitors 申請人姓名Applicant到職日期Report-for-duty Date借住期間Period自年月日From dd mm yy至年月日 To dd mm yy身分證字號ID NO.申請日期Date of Application單 位Unit總積點數Total Performance Points職 稱Job Title電話Tel配偶、未成年子女、父母或身心障礙賴以扶養之已成年子女隨居任所者Spouses, underage children, parents, or adult children with physical/mental disabilities who rely on the support of and live with the Applicant稱謂Title姓名Name出生年月日Date of Birth身份證字號ID NO.本人確認無下列不得申請借用多房間職務宿舍情形之一(本校宿舍配借及管理要點第4點)：I hereby confirm that I do not have the following situations;(Dormitory regulation Rent and Management Clause 4) 一、配偶及扶養親屬均未隨同居住。1. Spouse and dependants are not with me. 二、本人、配偶或未成年子女在距離本校2 0公里範圍內有自有房屋。2. I,my spouse or under age dependents have own resident place within 20 kilometers from university.三、本人或配偶已獲政府輔助購置(建)住宅或貸款。 3. I or my spouse gets subsidy or loan from government to buy(construct) resident place.四、配偶為軍公教人員，已借用政府機關首長宿舍或多房間職務宿舍。4. Spouse is a military or government officer, and already rents dormitory which is for government officer or work-related.若有不實，願負相關法律責任I hold my above statement as true, and I accept full legal responsibility.申請人：Applicant :年月日Date : dd mm yy證明文件Document戶籍謄本或戶口名簿、應聘資料、入境證明。Domiciliary Register, Letter of appointment, Immigration proof單位主管Unit Supervisor學院院長Dean of Faculty審查意見Received by國立成功大學國際學人短期多房間職務宿舍配借及管理細則第 點規定辦理配借。According to National Cheng Kung University , work-related multiple rooms dormitory for oversea short time visitors regulation and management Clause _, application is approved.分配宿舍地址：臺南市 路 巷 號 樓Assigned dormitory address: Floor_, No._, Lane , Road, Tainan City. 承辦人：Clerk :人事單位Personnel Department總務長Supervisor of General Affairs資產管理組主管Supervisor of Property Management Division校長President（本申請表一式兩份，一份資產管理組存查，一份申請人收執）There are two copies of this application form, one for Property Management Division, and one for applicant.備註：奉准簽約進住後，須依規扣繳併入薪資內之房租津貼數額。Remark: After moving in, the rent is deducted from the housing subsidy in salary package. 第1頁/共3頁國立成功大學國際學人短期多房間職務宿舍配借及管理細則National Cheng Kung UniversityRent and Management Regulations for work-related multi- room dormitory for oversea short time visitors103年04月09日102學年度第4次校務會議修正通Passed at the 4th Academic Affairs meeting , 04.09.2014 一、為加強自海外來校任教教師之服務，特提供短期多房間職務宿舍，依本校宿舍 配借及管理要點第十七點訂定本細則。1. To emphasize services for oversea teachers, university provides short term multi-room dormitory, and sets up related regulations according to Dormitory Rent and Management Regulations, Clause 17.二、本宿舍供有眷外籍學者或有眷旅外回國一年內延聘來校任教之教授、副教授、助理教授及具有博士學位之講師至多借住三學年（六個學期）之宿舍。但有特殊需要，且尚有空餘宿舍可供配借，經簽請校長核准者，得延長二年，並提宿舍配借及管理委員會(以下簡稱委員會)報告。前項經延長二年期滿後，為禮遇特殊領域優秀人才，經由相關系所、學院主管推薦，教務長會簽意見，經校長核准者，得延長三年，並提委員會報告，其數量不超過總戶數十分之一為限。2. This dormitory is for married overseas scholars (professors, assistant professors, associate professors and lecturers with Ph.D degree) or those who have returned to Taiwan to teach at school within 1 year.Maximum living period is 3 years (6 semesters).If there is any special case and there is space available, and applicant gets approval from the President, living period can be extended for 2 more years. Applicant should report to Dormitory Rent and Management Committee as well.After 2 more years, in order to serve outstanding persons in special fields, living period may be extended for 3 more years after getting recommendation from supervisor of department, faculty, and getting approval of Officer of Academic Affairs and the President. Application should be reported to Dormitory Rent and Management Committee as well. The total number of such teachers cannot exceed 10% of residents in dormitory.三、凡符合本細則第二點之條件者，應填具申請表，檢附戶籍、應聘資料及入境證明(或依本細則第八點簽准之核定簽)，經由系（所）主管及院長分別簽註意見後，送交總務處資產管理組登記候配，由總務處視宿舍空出之實際情形，依規定審查分配後，簽請校長核定，並提委員會報告。 3. For applicant who meets the requirement of Clause 2, he/she should fill this application form, take letter of appointment and immigration proof (or clause 8 in this regulation), and submit to Supervisor of Department (or Graduate School) for approval, then submit to the Office of General Affairs and register. Officer of General Affairs will check the status of rooms and arrange rooms according to regulations, and submit to the President for approval and report to Dormitory Rent and Management Committee.四、宿舍借用人申請案經核准，於接獲通知後，應向總務處資產管理組辦理簽訂宿舍借用契約等手續，並至財務處出納組繳交水電、瓦斯、設備、清潔維護等費用保證金新台幣壹萬伍仟元整後，領取鑰匙，除特殊原因外，應於十五日內遷入，逾期以棄權論。 宿舍借用人進住後，應逕洽該宿舍區自治管理委員會辦理自治管理費繳交事宜。4. After getting letter of approval, applicant should go to Property and Management Office to register, and go to Accounting Department to pay NTD 15,000 as guarantee fee for utilities , gas, equipment, cleaning and maintenance. Then applicant will get the keys and need to move in within 15 day of letter of approval unless applicant has special reason. If applicant fails to move in within 15 days, he/she will forfeit his/her right to the approved space. Special waiver is required if cannot move in 15 days.After moving in, applicant needs to contact dormitory management team to pay maintenance cost monthly.五、宿舍借用人離職、借住期滿者，應於兩個月內，結清宿舍水、電及瓦斯等費用後，向總務處資產管理組辦理歸還宿舍手續，保證金於手續辦妥後，無息退還，惟如有尚未繳納水電、瓦斯、設備清潔維護等費用時，則由總務處就該保證金內如數扣繳後，餘數退還。 5. When applicant leaves his/her appointment or reaches the end of living period, applicant will pay all water, electricity and gas bills within 2 months. And go to Property Management Division to do all sign-out procedures. After all procedures are clearly done, NTD 15,000 deposit will be returned without interest. If there are dues which are not paid off, General Offices will deduct such costs from the deposit and return the rest.第2頁/共3頁六、逾期而未遷離者，按月扣繳違約金，每月新台幣貳萬元整，但因特殊需要經校長核准延長借用者，每月則酌收延期使用費壹萬元整，並按月由出納組從借用人之月薪內扣除。6. If the applicant does not move out after reaching end of living period, General Office will collect NTD 20,000 monthly as rent and penalty. But if there are any special reasons and the applicant gets approval from the President, to live longer time, General Office will collect NTD 10,000 per month and deduct such amount from applicants salary.七、本宿舍至少須保留總戶數五分之一，供旅外學人申請。凡未符合本細則第二點條件之本校新聘編制內專任教師，因特殊情況，且學術研究優異，經相關系所、學院主管推薦，教務長會簽意見，奉校長核准者，得比照旅外學人，依本細則規定，申請配借前項尚有空餘之宿舍。7. At least 1/5th of all available rooms will be reserved for oversea applicants. For all new full time teachers who do not meet requirements of Clause 2 of this regulation may apply for any available rooms. Such applicants may have special reasons, have outstanding performance, and get recommendations from department, graduated school, and recommendations from Officer of Academic Affairs and the President.八、本細則經校務會議討論通過後實施，修正時亦同。8. This regulation is passed after discussion in Academic Affairs mee