FORM 4

APPLICATION FOR PERMANENT RESIDENCE IN SINGAPORE

This application is for an Entry Permit under Regulation 4 of the Immigration Regulations You may apply for permanent residence while in Singapore or abroad

Affix a recent passportsized colour photograph of Applicant here

This form may take you 20 minutes to fill in

PART A TYPE OF APPLICATION

I am applying for the grant of an Entry Permit to enter and reside in Singapore as (select one only) I am the spouse/child of a Singapore Citizen I am the spouse/child of a Singapore Permanent Resident I am the parent of a Singapore Citizen Other reasons (please specify)_________________________________________________________________

PART B APPLICANTS PARTICULARS

FIN No (if any) : I__I__I__I__I__I__I__I__I__I

FOR OFFICIAL USE

EP CATEGORY
Identification Type and No. (for Malaysians only) New ID No. : I__I__I__I__I__I__I - I__I__I - I__I__I__I__I Old ID No. : I__I__I__I__I__I__I__I__I Name in Travel Document. Please use BLOCK LETTERS (Underline Surname) Gender

l__l__l__l

Male Female

ENT/ I__I__I__I__I__I__I/ I___I__I

Chinese Characters (if applicable)

Alias (if any) 1. I__I__I__I__I__I Nationality Race Religion (Denomination) 2. I__I__I Province / State & Place of Birth Date of Birth l__l__I / I__I__I / I__I__I__I__I Day Month Year Present Residential Address in Singapore Are you currently residing with the sponsor at the above address? Yes No I acknowledge receipt of original documents presented for sighting Signature: ____________________ Date: _______________________ 3. I__I__I PASS TYPE : ______

How long have you been residing with the sponsor at the above address? __ years __ months (If the sponsor is your spouse and both of you are not living together, please provide reasons on a separate sheet of paper.) Marital Status 1. Occupation Salary per Month a) Basic : S$__________ b) Gross : S$__________ 2. Highest Academic Qualifications Attained (if different from item 3) Part-time study Full-time study 3. 1 Degree, Type and Class nd (e.g., B.A.(Hons) 2 Upper / Diploma)
st

Applicants Children (if applicable)

No. of children who are Spore Citizens

l__l__l l__l__l l__l__l

Part-time study

Full-time study

No. of children who are Spore Permanent Residents No of children who have other nationalities

Name of School / College / University (State Province / State & Country)

Name of School / College / University (State Province / State & Country)

Type & Serial No. of Travel Document Held

Date and Place of Issue

Date of Expiry

l__l__I / I__I__I / I__I__I__I__I

Day Address in Country of Nationality Month Year

Signature of Applicant / Sponsor: ________________________________ Page 1 of 7

PART B APPLICANTS PARTICULARS (CONTINUED FROM PAGE 1)

LIST COUNTRIES AND ADDRESSES IN WHICH APPLICANT HAS RESIDED DURING THE PAST 5 YEARS (TILL PRESENT DATE) Period of Stay DD/MM/YYYY From To

Address

Country

IF RESIDENT* IN SINGAPORE (LIST IN CHRONOLOGICAL ORDER) * any person who resides or had previously resided in Singapore by virtue of any immigration pass or permit or work permit. Dates of Arrival Dates of Departure

Have you or has any one of the persons included in this application ever: (a) (b) (c) (d) Been prohibited from entering Singapore or any other country? Been asked/required to leave Singapore or any other country? Been refused entry into or deported from Singapore or any other country? Been convicted of or currently charged with a crime or offence in i) Singapore? Yes Yes No No Yes Yes Yes No No No

ii) Any other country? If your answer is Yes to any of the above, please provide a detailed explanation on a separate sheet of paper. Have you or has any one of the persons included in this application ever entered Singapore using other Passports and different Particulars? If Yes, please state Name and Date of Birth: ____________________________________________________________ Type and Passport No: ____________________________________ Date of Issue: ______________ Please provide detailed particulars of all passports used.

Yes

No

IF THE APPLICANT IS THE SPOUSE OF A SINGAPORE CITIZEN OR SINGAPORE PERMANENT RESIDENT, PLEASE FILL UP THIS PART Did you provide money or any form of benefit, directly or indirectly to: (i) (ii) your spouse, your spouses family or a third party in relation to the sponsoring of this application? your spouse, your spouses family or a third party for agreeing to enter into this marriage? Yes Yes Yes No No No

Did you enter into this marriage with your spouse to enable you to obtain long-term stay in Singapore? If your answer is Yes to any of the above, please provide a detailed explanation in a separate sheet of paper.

Signature of Applicant / Sponsor: ________________________________ Page 2 of 7

PART C PARTICULARS OF APPLICANTS SPOUSE

(To be filled in only if applicants spouse is not the local sponsor)

FOR OFFICIAL USE

FIN No (if any) : I__I__I__I__I__I__I__I__I__I

EP CATEGORY Identification No. (for Malaysians only) New ID No. : l__l__l__l__l__I__I I__I__I I__I__I__I__I Old ID No. : l__l__l__l__l__l__l__l__l Name in Travel Document in BLOCK LETTERS (Underline Surname) Chinese Characters (if applicable) Applying for PR with you? l__l Yes l__l No l__l__l__l

ENT/ I__I__I__I__I__I__I/ I___I__I

Alias (if any)

1. I__I__I__I__I__I

Nationality

Race

Religion (Denomination)

Gender

2. I__I__I

3. I__I__I

PASS TYPE : _____

Male Female

Province / State & Place of Birth

Date of Birth

l__l__I / I__I__I / I__I__I__I__I

Day Marriage Certificate No. Date of Marriage Month Year

Country of Marriage Year 1. Occupation

l__l__I / I__I__I / I__I__I__I__I

Day Present Residential Address in Singapore Month

2. Highest Academic Qualifications Attained (if different from item 3)

3. 1 Degree, Type and Class nd (e.g., B.A.(Hons) 2 Upper)/Diploma Salary per Month

st

Part-time study

Full-time study

Part-time study

Full-time study

a) Basic: S$____________________ b) Gross: S$____________________

Name of School / College/ University (State Province / State & Country)

Name of School / College / University (State Province / State & Country)

Type & Serial No. of Travel Document Held

Date and Place of Issue

Date of Expiry

l__l__I / I__I__I / I__I__I__I__I

Day Present Whereabouts Month Year

Note: if deceased, give date of death.

Signature of Applicant / Sponsor: ________________________________ Page 3 of 7

PART D PARTICULARS OF APPLICANTS PARENTS AND APPLICANTS CHILDREN BY THE PRESENT MARRIAGE
Date of Birth
(DD/MM/YYYY)

(1) Race

(2) Nationality

Name in Travel Document in BLOCK LETTERS and FIN / ID Card No. 1 2 3 4 5 6

Relationship

(3) Country of Birth

Travel Document Occupation Type Number

Academic Qualification (e.g. B.A. nd (Hons) 2 Upper)

Monthly Income

Marital Status

Country of Residence

Applying For PR with you? (Yes/No)

Father Mother Son/Daughter Son/Daughter Son/Daughter

Son/Daughter

PART E PARTICULARS OF APPLICANT'S ALL OTHER MARRIAGES (including customary marriages) AND CHILDREN (if not applicable please enter NA)
(1) Particulars of other marriages: Name of Spouse Place of Birth Date of Birth
(DD/MM/YYYY)

Date of Marriage
(DD/MM/YYYY)

Present Whereabouts

*Date of Divorce/Decease
(DD/MM/YYYY)

(2) Particulars of all children (by all other marriages/illegitimate children/adopted children) : Date of Birth
(DD/MM/YYYY)

Name of Children

Place of Birth

*Name of Father/Mother

Present Whereabouts

Travel Document Type Number

Applying for PR with you? (Yes / No)

*Delete where applicable Signature of Applicant / Sponsor: ________________________________ Page 4 of 7

PART F SPONSOR'S PARTICULARS

Singapore Identity Card : Gender

FOR OFFICIAL USE

*Pink / Blue I__I__I__I__I__I__I__I__I__I * Delete where applicable Name in Travel Document in BLOCK LETTERS (Underline Surname)

Male Female

Chinese Characters (if applicable)

Alias (if any)

Nationality Date of Birth

Race Place of Birth Year Date of Marriage

Relationship to Applicant Religion (Denomination)

l__l__I / I__I__I / I__I__I__I__I

Day Month Marriage Certificate No. Country of Marriage Year Salary per Month (a) Basic: S$__________________ (b) Gross: S$__________________ 2. Highest Academic Qualifications Attained (if different from item 3) 3. 1 Degree, Type and Class nd (e.g. B.A. (Hons) 2 Upper / Diploma)
st

l__l__I / I__I__I / I__I__I__I__I

Day 1. Occupation Month

1. I__I__I__I__I__I

2. I__I__I

3. I__I__I

PASS TYPE : _____

Part-time study

Full-time study

Part-time study

Full-time study 4. l__l__l 5. l__l__l

Name of School / College / University (State Province / State & Country)

Name of School / College / University (State Province / State & Country)

Present Residential Address In Singapore

Telephone No.: Residential : Office :

Hand phone No :

IF THE SPONSOR IS THE SPOUSE OF THE APPLICANT, PLEASE FILL UP THIS PART Did you or your family receive money or any other form of benefit, directly or indirectly from any person in relation to the sponsoring of this application? If your answer is Yes, please provide a detailed explanation on a separate sheet of paper. If the applicant is not the spouse of sponsor, please fill in this Part Name of Sponsor's Spouse Gender Date of Birth

Yes

No

Male Female
4. Highest Academic Qualifications Attained (if different from item 5)
st

l__l__I / I__I__I / I__I__I__I__I

Day Month
nd

Year

5. 1 Degree, Type and Class (e.g. B.A. (Hons) 2 Upper / Diploma)

Name of School / College / University (State Province / State & Country)

Name of School / College / University (State Province / State & Country)

6. Occupation

Salary per Month (a) Basic: S$__________________ (b) Gross: S$__________________ Signature of Applicant / Sponsor: ________________________________ Page 5 of 7

PART F SPONSORS PARTICULARS (CONTINUED FROM PAGE 5)

Particulars of Sponsors All Other Marriages ( Including Customary Marriages) : Name of Spouse Nationality Place of Birth Date of Birth
(DD/MM/YYYY)

Date of Marriage
(DD/MM/YYYY)

Present Whereabouts

*Date of Divorce/ Decease, where applicable

Name of Children to be included in this application:(1)______________________________________ (2)______________________________________ (3)______________________________________ (4)______________________________________ (5)______________________________________ (6)______________________________________ Birth Cert. No : _______________________ Birth Cert. No : _______________________ Birth Cert. No : _______________________ Birth Cert. No : _______________________ Birth Cert. No : _______________________ Birth Cert. No : _______________________

Affix recent photo(s) of children applying for Permanent Residence.

(1)

(2)

(3)

(4)

(5)

(6)

Signature of Applicant / Sponsor: ________________________________ Page 6 of 7

PART G DECLARATION OF APPLICANT

I hereby make an application for the grant of an Entry Permit under Regulation 4 of the Immigration Regulations. I declare that the particulars stated from Parts A to E and the documents submitted with it are true and correct to the best of my knowledge and belief, and that I have not wilfully suppressed any material fact. I hereby give my consent to the use of the same set of thumbprints and photograph, submitted in respect of my application for immigration facilities, for the purpose of Identify Card registration, if applicable. I also hereby give my consent for your department to obtain and verify the information provided by me in respect of this application, from or with any source, as you deem appropriate for the purpose of assessment of my application for immigration facilities.

______________________________ Date

_____________________________________ Signature or Right Thumb Impression of Applicant

PART H DECLARATION OF SPONSOR I declare that (a) the statements made by the applicant and myself in this application are true; and (b) the applicant is not, to the best of my knowledge and belief, a member of any political party which has been declared unlawful in Singapore. I also hereby give my consent for your department to obtain and verify the information provided by me in respect of this application, from or with any source, as you deem appropriate for the purpose of assessment of my dependant's application for immigration facilities. I understand that male children who are granted PR status under their parents sponsorship are liable for National Service (NS) under the Enlistment Act. All NS-liable males aged 13 years old and above, are required to obtain an Exit Permit (EP) when travelling overseas for 3 months or more. Renouncing or losing one's PR status without serving or completing full-time NS would have an adverse impact on any immediate or future applications to work or study in Singapore, or for Singapore citizenship or PR status.

_________________________________ Date

_____________________________________ Signature or Right Thumb Impression of Sponsor

WARNING IT IS AN OFFENCE UNDER THE IMMIGRATION ACT TO MAKE ANY FALSE STATEMENT, REPRESENTATION OR DECLARATION IN CONNECTION WITH THIS APPLICATION
Page 7 of 7

Appendix - 2 (PR-FTS)

AUTHORISATION TO OBTAIN AND VERIFY FINANCIAL INFORMATION PROVIDED FOR APPLICATION OF PERMANENT RESIDENCE IN SINGAPORE (This option is not available for persons below 21 years old1)

Please complete this form to give your consent for the Immigration & Checkpoints Authority to obtain and verify financial information, including any information relating to the income or items of income, provided in respect of this application for the grant of an Entry Permit under Regulation 4 of the Immigration Regulations with the Inland Revenue Authority of Singapore and/or the Central Provident Fund Board of Singapore. ---------------------------------------------------------------------------------------------------------------We consent and authorise the Immigration & Checkpoints Authority to obtain information and verify the financial information provided by us in respect of this application from or with the Inland Revenue Authority of Singapore and/or the Central Provident Fund Board of Singapore, and for them to disclose the information for the purpose of assessment of this application for the grant of an Entry Permit.

Name

FIN/NRIC No.*

Signature of Applicant

Date

Name

FIN/NRIC No.*

Signature of Sponsor

Date

Hard copies of the Income Tax Notices of Assessment for the last 3 years and a statement from the CPF Board showing the monthly CPF contribution history for the last 12 months will be required from persons below 21 years old.
*

Delete where appropriate

Sept 2012