Title Page

  • Company Name

  • Document No.

  • Employee ID

  • Location
  • Conducted on

Information

  • Employee no.:

  • Profile:<br>A: SC or PR who are non-PME with basic monthly salary NOT exceeding $2,500<br>B: SC/PR who are Workman with basic monthly salary not exceeding $4.500<br>C: Work Permit Holders

Profile

Employee's Profile

  • Are you the company's director / owner?

  • Are you related to the company's director/owner?

  • Please specify your relationship

Employee Details

  • Employee Name

  • NRIC / FIN

  • Nationality

  • Please Specify

  • Residential Status

  • Please Specify

  • Age

  • Employment Start Date

  • Contact No.

  • Occupation

  • Industry

  • Please Specify

  • Place of Work

  • Supervisor's Name

  • Supervisor's Contact No.

A. Salary

  • 1. How often are you paid your salary? (State the date or day of payment)

  • Enter Date

  • Enter Date OR

  • Enter Day

  • Enter Date OR

  • Enter Day

  • Enter Date OR

  • Enter Day

  • Enter Date OR

  • Enter Day

  • 2. When were you paid your latest salary?

  • Remarks/Assessment

  • 3. Did you receive a pay slip (hard or softcopy) for your salary?

  • Non-provision of pay slip

Basic Salary

  • 4. What is your monthly gross salary?

  • Monthly/Daily/Hourly

  • What is your monthly basic salary?

  • Are there component(s) in your monthly salary, excluding basic salary? A for fixed allowance and R for reimbursements

  • Overtime ($)

  • Allowance

  • Reimbursement

  • Transport ($)

  • Allowance

  • Reimbursement

  • Attendance ($)

  • Allowance

  • Reimbursement

  • Housing ($)

  • Allowance

  • Reimbursement

  • Mobile phone ($)

  • Allowance

  • Reimbursement

  • Meal ($)

  • Allowance

  • Reimbursement

  • Laundry ($)

  • Allowance

  • Reimbursement

  • Please Specify

  • Others ($)

  • Allowance

  • Reimbursement

CPF

  • 5. Does your employer pay CPF for you every month?

  • Reason?

  • Reason?

  • 6. Is CPF paid for your allowance(s)?

  • Reason?

  • Do you have to submit receipt to support these allowance(s)?

Remarks / Assessment

  • Non-payment of CPF contribution

  • Underpayment of CPF contribution due to CPF not paid for;

  • Component 1

  • Component 2

  • Component 3

  • Component 4

Salary

  • Were there instances where your current employer paid you less salary than you were supposed to receive?

  • Please state amount owed

  • Period of occurences

  • Reason(s) given by employer

  • Did your employer pay you back the amount owed?

Sign Off

  • Interviewee Signature

  • Inspector Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.