FORM 14

IMMIGRATION ACT

IMMIGRATION REGULATIONS

(Regulations 12(2) and 12 (5))

APPLICATION FOR A* VISA VISIT PASS

PART I-BASIC PARTICULARS OF APPLICANT

Foreign Identification No. (FIN) : Sex:*

(leave blank if not applicable) Male Female

Date of Birth: For Malaysian Only

Marital Status:* Single Married Identity Card No.

Separated Divorced Widowed Colour:* Red Blue

Name:

Family name/Surname

Given name

Alias:

Family name/Surname

Given Name

(leave blank

if not applicable)

Name in Chinese Characters

(If applicable)

Country of Birth

State/Province of Birth:

Race: (e.g. Malay, Indian,

Chinese, Coucasian, etc.)

Nationality :

Religion : Denomination: _____________

Address in Singapore Postal Code: Block/House No: Floor No: Unit No.

Street Name: Tel No. ____________

Building Name: ___________________________________________________________________

Address in Country of Origin

Country of origin

State/Province of Origin :

Building Name: ___________________________________________________________________

Address in Country of Origin

Country of origin

State/Province of Origin :

Address: _________________________________________________________________________

PART I (continued)

Type of Travel Document Held :

(e.g. Passport, Certificate of Identity,

Document of Identity, etc.)

Travel Document No:

Travel Document -- -- Expiry Date: -- --

Issue Date:

Country of Issue:

Place of Issue:

DISEMBARKATION/EMBARKATION FORM NO.:

(This form is the immigration white card issued to arriving foreigners)

PART II - APPLICATIONS DETAILS

Occupation:

Highest Academic/Professional Qualification Attained: _____________________________________

Purpose of visit: ___________________________________________________________________

Period of Visa/Visit Pass Applied For:_______________

Nationality of Spouse:* Signature Citizen Singapore Permanent Resident

Others (Please specify)________________________________

PART III - ANY ANTECEDENT OF APPLICANT

Please tick (/) in the box where appropriate against the following:

(a) Have you ever been refused entry into or deported from any country? Yes No

(b) Have you been convicted in a court of law in any country? Yes No

(c) Have you ever been prohibited from entering Singapore? Yes No

(d) Have you ever entered Singapore using a different passport or name? Yes No

If any of the answer is 'YES', please furnish details on a separate sheet of paper

PART IV-TO BE COMPLETED IF THE APPLICANT IS APPLYING FOR PROFESSIONAL VISIT PASS

Applicant's working experience (in chronological order)

Duties to be performed in Singapore

_________________________________________________________________________________

Job Title:

Basic Monthly Salary: S$

Duties

Name & Address of Company/Society/Orgnization

Public Entertainment License No. (if any): __________________________________

Date of Approval: __________________________

_________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

TO BE COMPLETED IF THE APPLICANT IS APPLYING AS A FULL-TIME PERFORMING ARTISTE

Name and Address of the Place of Performance:

______________________________________________________________________________

______________________________________________________________________________

__________________________________________________________________________________Number of artistes/musical band groups performing in the above premises:

Local Foreign

Performing artists

Musical band groups

PART V - DECLARATION BY APPLICANT

I hereby declare that all the particulars furnished by me in this application are true.

I undertake not to misuse controlled drugs or to take part in any political or other activities during my stay in Singapore, which would make me an undesirable or prohibited immigrant under the Immigration Act.

I further undertake not to be engaged in any form of employment or business whilst in Singapore without the written consent of the Controller of Immigration.

I am aware that overstaying or working illegally in Singapore is a serious offence and on conviction, the penalties may include mandatory imprisonment and caning.

I understand that if the Controller of Immigration is satisfied that I or any member of my family breaches this undertaking or becomes an undesirable or prohibited Immigrant, he will cancel my immigration pass and the passes of the members of my family, and we may be required to leave Singapore within 24 hours of such cancellation.

I understand that this applicant for and possession of a visa does not guarantee entry into Singapore and permission to enter is entirely discretionary at the point of entry.

___________ ___________________________

Date Signature of Applicant

PART VI - DECLARAITON BY LOCAL SPONSOR

A local sponsor is required to complete either Section I or Section II below:

Section I - For application sponsored by a company only.

Name and Address of Company :

We hereby sponsor this application and certify that it is made for the purpose as stated by the applicant.

The statements made by the applicant in the application are to the best of our knowledge true.

We undertake to be responsible for the stay, maintenance and repatriation of the applicant.

Name, NRIC and Designation/Capacity Official Stamp of Company/Firm

Signature of person acting

on behalf of the Company/Firm

and Date

Section II - For applicant sponsored by an individual only.

I, __________________________________________, holder of NRIC (Pink/Blue) / Passport / Travel Document **

No. :______________________ and residing at _________________________ is my

declare that :

The applicant, _______________________________________ is my

Parent

Husband / wife / son / daughter**

Other (Please specify) ____________________________________

I hereby sponsor this application and certify that it is made for the purpose as stated by the applicant.

The statements made by the applicant in this application are to the best of my knowledge true.

I undertake to be responsible for the stay, maintenance and repatriation of the applicant.

____________ _________________

Date Signature of Sponsor

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