I, the undersigned, confirm the accuracy and completeness of the above information. I fully understand that
if any of the information above is found to be incorrect the Employer may cancel my Work Permit at any time.
I hereby undertake that I shall subject myself to a medical test including for HIV/AIDS within one month since
my arrival in Thailand. In case I am found positive for HIV/AIDS I will leave Thailand at my own expense and
will have no claims against the Employer.