PART 2 – FOREIGN EMPLOYEE’S PERSONAL INFORMATION
2A: Personal Particulars
Name: (as on travel document, excluding salutations, e.g. Mr, Miss, Professor, Doctor)
Alias:
Sex:* Female Male
Marital Status:* Divorced Married Separated Single Widowed
Date of Birth: (dd/mm/yyyy)
Nationality:
For Malaysian only
Malaysian Old Identity Card Number:
Malaysian Old Identity Card Colour:*
Blue Pink
Malaysian New Identity Card Number:
Malaysian New Identity Card Colour:*
Blue Pink
For Bangladeshi and Chinese only
Foreign Identity Card Number:
Country/Region of Birth:
Country/Region of Origin: (country where the person obtained his first citizenship by birth or parentage)
State/Province of Birth:
State of Origin:
Race:*Caucasian Chinese Indian Malay Others
Religion:* Buddhist Christian Free Thinker Hindu Muslim Others Sikh Taoist
If foreign employee's marital status is 'Married', please fill in the details below:
Is accompanying spouse a Singapore Citizen or Singapore Permanent Resident, Employment/S Pass holder or Work Permit holder?*
Yes No
Spouse First Name
Spouse Last Name
Spouse’s FIN/NRIC Number:
Spouse Identification Type:*
Spouse’s Date of Birth:
2B: Travel Document Information of Foreign Employee
Travel Document Type:*
Hong Kong Special Admin Region International Cert of Identity International Passport Macau SAR Travel Permit
Travel Document Number:
Date of Issue: (dd/mm/yyyy)
Date of Expiry: (dd/mm/yyyy)
2C: Foreign Employee’s Contact Details
Personal Email Address:
Personal Mobile Number: (+65)
PART 3 – FOREIGN EMPLOYEE’S EDUCATION / MEMBERSHIP DETAILS
Please fill in up to two qualifications that were awarded to the foreign employee. Please note that qualification is a key criterion in the assessment of the foreign employee’s eligibility for a work pass and should be provided where applicable.
3A: Education Details
(1) Awarding Body /Institution/ University that awarded the qualification
Country:
State/Province:
Specialisation: (e.g. Civil engineering)
Faculty: (e.g. Engineering)
Period of Study (dd/mm/yyyy)
from:
to:
Mode of Study:* Distance Learning Full-Time Part-Time
(2) Awarding Body /Institution/ University that awarded the qualification
Country:
State/Province:
Specialisation: (e.g. Civil engineering)
Faculty: (e.g. Engineering)
Period of Study (dd/mm/yyyy)
from:
to:
Mode of Study:* Distance Learning Full-Time Part-Time
Please complete the relevant information below if the qualification is STPM or MICSS
Sijil Tinggi Persekolahan Malaysia (STPM)
No. of Passes attained: (inclusive of General Studies/Pengajian Am) Principal pass-C Subsidiary pass-R
Has the foreign employee attained a pass in General Studies/Pengajian AM?*
Yes No
Malaysia Independence Chinese Secondary School (MICSS) United Examination Certificate
No. of Passes attained: (inclusive of Bahasa Inggeris/English language) passes
Has the foreign employee attained a pass in Bahasa Inggeris/English Language?* Yes No
3B: Societies/Organisations Membership (past five years to date)
(1) Society/Organisation Membership
Position Held:*
Chairman Member President Secretary Treasurer Vice Chairman Vice President
Period (dd/mm/yyyy)
from:
to:
(2) Society/Organisation Membership
Name of Society/Organisation:
Position Held:*
Chairman Member President Secretary Treasurer Vice Chairman Vice President
Period (dd/mm/yyyy)
from:
to:
PART 7 – DECLARATION BY FOREIGN EMPLOYEE
Please check accordingly.
Have you ever:
(a) Been refused entry into or deported from any country?
Yes No
(b) Been convicted in a court of law in any country?
Yes No
(c) Been prohibited from entering Singapore?
Yes No
(d) Entered Singapore using a passport issued by a different country?
Yes No
(e) Entered Singapore using a passport showing another name?
Yes No
(f) Been a Singapore Citizen or Singapore Permanent Resident?
Yes No
(g) Studied or worked in Singapore?
Yes No
(h) Stayed long term in Singapore (not as a tourist)?
Yes No
If any of the above answers from (a) to (h) is ‘Yes’, please provide details:
I confirm that the information as set out in this application for Employment Pass is to the best of my knowledge, true and correct. All documents submitted in support of this application for Employment Pass are true copies of the originals. I understand that I may be prosecuted if I have provided any information, which is false in any material particular or is misleading by reason of the omission of any material particular.
I declare that I have not suffered and am not suffering from AIDS or infected with HIV or tuberculosis. I acknowledge that during the period of validity of my Employment Pass, if I am found to be suffering from AIDS or infected with HIV or Tuberculosis, the Employment Pass issued to me will be cancelled and I will have to leave Singapore by the date specified by the Controller of Immigration.
I have read and understood the Conditions of Employment Pass, as specified in the Employment of Foreign Manpower (Work Passes) Regulations, which are available on the MOM website. I shall ensure that these conditions will be complied with.
Further and in addition, I hereby declare that: –
1. I shall not make any false statement or submit any document which I know to be false in order to obtain an Employment Pass
and Visit Pass.
2. I understand that if I breach any condition above, my Employment Pass and Visit Pass will be revoked and I can be prosecuted
in Court, or expelled and prohibited from entering Singapore.
3. I shall not misuse controlled drugs or 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.
With reference to this application submitted for Employment Pass and residence in Singapore, I give my consent to the Government of Singapore to obtain from and verify information with any person, organisation or any other source for assessing my application.
I hereby give my consent for the Comptroller of Income Tax to verify my income stated in my current and renewal applications, based on my assessment record for the current Year of Assessment, for the Controller of Work Passes. In the event my assessment record for the current Year of Assessment is not available or finalised at the point of verification, I understand the Comptroller of Income Tax will verify my income against my assessment record for the two previous Years of Assessment. I also hereby give my consent for the Comptroller of Income Tax to thereafter communicate the results of the verification to the Controller of Work Passes.
I understand that a SingPass will help me to access Government e-services in Singapore and I give my consent to the Ministry of Manpower to share my personal details with the SingPass issuing agency. This allows me to apply for a SingPass account at a later time if I am eligible for a SingPass.
I agree to the terms and conditions
Date:
PART 8 – DECLARATION BY LOCAL SPONSOR
I hereby sponsor this application and certify that it is made for the purpose as stated by the foreign employee. I confirm that the information as set out in this application for Employment Pass is to the best of my knowledge, true and correct. I have obtained written consent from the foreign employee to apply for an Employment Pass (Sponsorship) for him/her. I will produce this consent when requested by the authority.
I have ensured that the foreign employee fully understands the contents of Part 7 of this application form. I understand that I may be prosecuted if I have provided any information, which is false in any material particular or is misleading by reason of the omission of any material particular. I further understand that any false statement made by my company or myself in relation to this application for Employment Pass may adversely affect the future work pass applications of my company/firm.
I undertake to:
be responsible for the stay, maintenance and repatriation of the foreign employee;
Tindemnify the Singapore Government for any charges or expenses which may be incurred by the Government
in respect of the repatriation of the said foreign employee or any of his dependants; and
be responsible for the compliance by the foreign employee of any quarantine and medical surveillance imposed
on the foreign employee under Regulation 8 (2A) of the Immigration Regulations.
I understand that the Employment Pass is subject to the following conditions upon approval.
The foreign employee is to work in the occupation as stated in the Employment Pass card with the local sponsor
only. He/she is not to engage in any employment other than that specified in the application. Should there be a change in his/her duties or designation, the local sponsor is required to write in to Work Pass Division, Ministry of Manpower. If there is a change in local sponsor, the foreign employee must apply for a new work pass in order to work in Singapore; and
The local sponsor must cancel the foreign employee’s Employment Pass within 7 days upon termination of employment.
I shall keep copies of the foreign employee's education certificates as declared in the application form for as long as the foreign employee is in my employment. I understand the Ministry of Manpower can at any time request for these documents for verification and revoke the pass should the documents be inconsistent with the declaration furnished in the application form or if I am unable to produce the documents.
Name:
Date:
Designation / Capacity:
I agree to the terms and conditions