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Download REQUEST FOR RE-ISSUANCE OF CERTIFICATE/SAFETY PASS
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INDUSTRIAL TRAINING CENTRE PTE LTD NO. 16 Boon Lay Way #01-49 Tradehub 21 Singapore609965 TEL: 6863 4148 FAX: 6863 3911 EMAIL: [email protected] Website: www.itc2007.com REQUEST FOR RE-ISSUANCE OF CERTIFICATE/SAFETY PASS SECTION A : To be completed by Requestor Name/WP/FIN Course Attended : Date Attended: Reason For Request : Lost note : i. Original Police Report is required and Attached ii. $20/- for re-issuance per certificate iii. $20/-for re-issuance supervisor safety pass iiii. $20/- for re-issuance per safety pass **Prices exclude 7% GST** Please make payment of $ Replacement Original to be returned Typo Error Others, please specify ____________________ payable to Industrial Training Centre Pte Ltd Company Name: Declaration by Requestor I hereby declare that the information provided is true and correct and that ITC is not obliged to accede to my request. Any fulfillment of request is made only after verification and purely on a goodwill basis by ITC . ___________________________ Signature ______________ Contact No, ____________ Date SECTION B: For Official Use Only Safety Pass/Certificate No. Checked by : Collected By : Date :
