Three parties must agree
The sample records the eligible employee, the existing employer E1 and the new employer E2. It compares job titles, basic pay, allowances and gross pay, and states the agreed date on which the re-employment obligations pass to E2. Both employers’ authorised representatives and the employee sign and date it.
If the new salary is lower
Where E2 offers lower salary, the form addresses the EAP basis if it becomes payable: during the first three months of re-employment, use the employee’s last-drawn salary with E1; thereafter use the last-drawn salary with E2. EAP is not automatically payable simply because the form is signed.
Gross pay is a defined measure
The form distinguishes basic pay, allowances and gross pay under the Employment Act. The stated gross-pay definition excludes overtime, bonuses/AWS, reimbursement of special work expenses, productivity incentives, and travelling, food or housing allowances. Use that defined basis rather than simply adding every payroll item.