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- 1. Page 1 of 7 FORM 4A APPLICATION FOR PERMANENT RESIDENCE IN SINGAPORE FOR PROFESSIONALS, TECHNICAL PERSONNEL AND SKILLED WORKERS This application is for an Entry Permit under Regulation 4 of the Immigration Regulations This form may take you 20 minutes to fill in PART A – APPLICANT’S PARTICULARS (To be completed by Applicant) FOR OFFICIAL USE FIN No (if any) : I__I__I__I__I__I__I__I__I__I EP Category l__l__l__l ENT/ I__I__I__I__I__I__I/ I___I__I 1. I__I__I__I__I__I 2. I__I__I 3. I__I__I PASS TYPE : ______ Identification Type and No. (for Malaysians only) New ID No. : l__l__l__l__l__l__I – I__I__I – I__I__I__I__I Old ID No. : I__I__I__I__I__I__I__I__I Gender Male Female Name as in Travel Document. Please use BLOCK LETTERS (Underline Surname) Chinese Characters (if applicable) Alias (if any) Nationality Race Religion (Denomination) Province / State & Place of Birth Date of Birth l__l__I / I__I__I / I__I__I__I__I Day Month Year Address in Country of Nationality 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 Name of School / College / University (State Country) 3. 1st Degree, Type and Class (e.g., B.A.(Hons) 2nd Upper / Diploma) Part-time study Full-time study Name of School / College / University (State Country) No. of Children Singapore Citizen l__l__l Singapore Permanent Resident l__l__l Others l__l__l 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 Month Year Present Residential Address in Singapore Postal Code: Telephone No: _______________ Hand Phone No : _____________ Signature of Applicant :________________________________ Affix a recent passport-sized colour photograph of Applicant here I acknowledge receipt of original documents presented for sighting Signature:____________________ Date: _______________________
- 2. Page 2 of 7 EDUCATIONAL AND PROFESSIONAL QUALIFICATIONS ATTAINED AND/OR VOCATIONAL/INDUSTRIAL TRAINING COMPLETED Duration of Course (DD/MM/YYYY) Academic and Professional qualifications as Detailed in Certificates and/or Vocational/Industrial Training Received Name and Address of Institutions, Vocational Training Centres/Factories (State the Country) Nature of Course/Training (To specify Full-time or Part-time) e.g. Information Technology (Full-time) From To LIST DETAILS OF ACHIEVEMENTS AND INNOVATIONS WHICH YOU HAVE MADE IN YOUR PROFESSION/OCCUPATION EMPLOYMENT HISTORY FOR LAST TEN (10) YEARS (In Chronological Order) Period of Employment Name and Address of Organisation(s) / Firm(s) / Company (State the Country) Position held and Responsibilities Salary per month (S$)From To Signature of Applicant :________________________________
- 3. Page 3 of 7 MEMBERSHIP OF PROFESSIONAL SOCIETIES, ASSOCIATIONS, CLUBS AND OTHER ORGANISATIONS Name of Society and / or Organisations Positions Held LIST COUNTRIES AND ADDRESSES IN WHICH YOU HAVE RESIDED DURING THE PAST 5 YEARS ( TILL PRESENT DATE) Period of Stay Address Province / State & Country From To FAMILY BACKGROUND Full Name in BLOCK LETTERS Gender Date of Birth (DD/MM/YYYY) Place of Birth Nationality Present Whereabouts Occupation Father Mother Brothers And Sisters Signature of Applicant :________________________________
- 4. Page 4 of 7 PART B – PARTICULARS OF APPLICANT’S SPOUSE FOR OFFICIAL USE FIN No (if any). I__I__I__I__I__I__I__I__I__I EP Category l__l__l__l 1. l__l__l__l__l__l 2. l__l__l 3. l__l__l PASS TYPE : ____ Identification Type and No. (for Malaysians only) New ID No. : I__I__I__I__I__I__I – I__I__I – I__I__I__I__I Old ID No. : l__l__l__l__l__l__l__l__l__l__l Applying for PR with you? Yes No Name in Travel Document. Please use BLOCK LETTERS (Underline Surname) Chinese Characters (if applicable) Alias (if any) Gender Male Female Nationality Religion (Denomination) Race Date of Birth l__l__I / I__I__I / I__I__I__I__I Day Month Year State & Place of Birth Marriage Certificate No: Date of Marriage l__l__I / I__I__I / I__I__I__I__I Day Month Year Country of Marriage Address in Country of Nationality 1. Occupation 2. Highest Academic Qualifications Attained (if different from item 3) Part-time study Full-time study Name of School / College / University (State Country) 3. 1st Degree, Type and Class (e.g., B.A. (Hons) 2nd Upper / Diploma) Part-time study Full-time study Name of School / College / University (State Country) Salary per Month a) Basic : S$_____________________ b) Gross : S$_____________________ 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 Month Year Present Residential Address in Singapore Postal Code: Any previous marriages? Yes No If your answer is ?Yes?, please give details on a separate sheet of paper List countries and addresses in which applicant?s spouse has resided for one year or more during the last 3 years (till present date) :- From To Address Country PARTICULARS OF SPOUSE’S PARENTS Full Name in BLOCK LETTERS Nationality Date of Birth (DD/MM/YYYY) Place of Birth Father Mother Signature of Applicant :________________________________
- 5. Page 5 of 7 PART C – PARTICULARS OF APPLICANT’S CHILDREN BY THE PRESENT MARRIAGE Name in Travel Document in BLOCK LETTERS and FIN / ID Card No. Gender Date of Birth (DD/MM/YYYY) Race Nationality State & Place of Birth Travel Document Highest Academic Qualification (e.g. B.A.(Hons) 2nd Upper) *Applying for PR with you? (Yes/No) Type Number FOR OFFICIAL USE EDUCATIONAL RECORDS OF CHILD 1 (IF APPLICABLE) EDUCATIONAL RECORDS OF CHILD 2 (IF APPLICABLE) School / Institution Attended Country of Study Year Highest Standard Passed (State number of ?O?/?A? level passes) School / Institution Attended Country of Study Year Highest Standard Passed (State number of ?O?/?A? level passes) From To From To Signature of Applicant :________________________________
- 6. Page 6 of 7 EDUCATIONAL RECORDS OF CHILD 3 (IF APPLICABLE) EDUCATIONAL RECORDS OF CHILD 4 (IF APPLICABLE) School / Institution Attended Country of Study Year Highest Standard Passed (State number of ?O?/?A? level passes) School / Institution Attended Country of Study Year Highest Standard Passed (State number of ?O?/?A? level passes) From To From To PART D – PARTICULARS OF APPLICANT’S ALL OTHER MARRIAGES (including customary marriages) AND CHILDREN (if not applicable please enter “N.A.” ) (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) : Name of Children State / Place of Birth Date of Birth (DD/MM/YYYY) Nationality *Name of Father/Mother Present Whereabouts Travel Document Applying for PR with you? (Yes/No)Type Number * Delete where applicable Signature of Applicant :________________________________
- 7. Page 7 of 7 PART E – SPOUSE AND CHILDREN APPLYING FOR PERMANENT RESIDENCE Name of spouse and children to be included in this application: Spouse: _________________________________________ (1)_____________________ Birth Cert. No : _______________________ (2)_____________________ Birth Cert. No : _______________________ (3)_____________________ Birth Cert. No : _______________________ (4)_____________________ Birth Cert. No : _______________________ (5)_____________________ Birth Cert. No : _______________________ PART F – DECLARATION OF APPLICANT AND FAMILY MEMBERS INCLUDED IN PART E WARNING: IT IS AN OFFENCE UNDER THE IMMIGRATION ACT TO MAKE ANY FALSE STATEMENT, REPRESENTATION OR DECLARATION IN CONNECTION WITH THIS APPLICATION Have you or has any one of the persons included in Part E of this application ever: (a) Been prohibited from entering Singapore or any other country? (b) Been asked/required to leave Singapore or any other country? (c) Been refused entry into or deported from Singapore or any other country? (d) Been convicted of or currently charged with a crime or offence in i) Singapore? ii) Any other Country? Yes No Yes No Yes No Yes No Yes No 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 Part E ever entered Singapore using other Passports and different Particulars? Yes No If ‘Yes’, please state Name and Date of Birth: ____________________________________________________________ Type and Passport No: ____________________________________ Date of Issue: ______________ Please provide detailed particulars of all passports used. I hereby make an application for the grant of an Entry Permit under Regulation 4 of the Immigration Regulations for : (a) myself (b) my spouse* (as indicated in Part B of the application form); and (c) my children* (as indicated in Parts C and/or D* of the application form); * delete where inapplicable I/We declare that the particulars stated in this application and the documents submitted with it are all true and correct to the best of my knowledge and belief, and that I/we have not wilfully suppressed any material fact. I/We 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 Identity Card registration, if applicable. I/ We 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/our application for immigration facilities. I/We 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 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. Renouncing or losing one’s PR status without serving or completing full-time NS may also adversely affect any immediate or future applications for renewal of Re-entry Permits made by one’s family members or sponsors. ______________________ _________________________ ___________________________ Date Signature or right thumb print Signature or right thumb print impression of Impression of applicant Applicant?s Spouse (if applying for PR with the Applicant) Photo of Child 5Photo of Child 4Photo of Child 3Photo of Child 2 Photo of Spouse Photo of Child 1
- 8. Annex A to Form 4A (Application for Permanent Residence) Information On Main Applicant’s Current Employment Note: 1. This form is to be completed by the main applicant’s employer. Employer’s sponsorship of the application is not a requirement. Completing this form does not imply employer’s sponsorship of the application. The information provided by the employer will enable the Immigration & Checkpoints Authority to better assess the application. 2. If the space provided is insufficient, please furnish the relevant details on a separate sheet of paper. Name of Applicant FIN No. I__I__I__I__I__I__I__I__I__I Name and Address of Company/Firm Telephone Number Date & Place of Incorporation Authorised Capital (S$) Paid-up Capital (S$) Authorised capital/paid-up capital are not applicable as the company/firm is a (select one only) □ Sole Proprietorship □ Partnership □ Others (please specify):_________________________ If it is a Public-Listed Company, please indicate date and place of public listing. The company/firm is : (select one only) □ Foreign-owned □ A Joint-Venture □ Locally-owned □ Public-Listed If Foreign-owned, the Singapore Office is a : □ Regional/Rep Office □ Branch If it is a Joint-Venture, please state the percentage of foreign participation. Nature of Business (select one only) □ Manufacturing □ Restaurant/Hotel □ Construction □ IT/Communication □ Trading □ Real Estate □ Shipping/Transport □ Banking/Financial Services □ Others Please specify main products and/or activities: Value of turnover of the company/firm in the past 3 years: 1) Year ______: S$__________________ 2) Year _______: S$___________________ 3) Year _______: S$____________________ Present staffing position: Singapore Citizens/Permanent Residents l__l__l Foreigners l__l__l Position held and detailed description of duties of applicant Date of Commencement of Employment with Present Employer in Singapore Period of Employment with Company/Firm ……………… Year(s) ………………. Month(s) Present Salary per month (S$) Basic Salary:_____________________ Gross Salary: ____________________ I hereby certify that the information given in this form is to the best of my knowledge, true and correct.* Full Name : __________________________________ Signature : ____________________________ Designation : ________________________________ ( Company Seal/Stamp ) Date: ________________________________ * Please note that the signing of this form does not imply Company's Sponsorship. The signature is to serve as confirmation that the information provided is accurate and valid
- 9. July 2012 Appendix - 1 (PR-PTS) AUTHORISATION TO OBTAIN AND VERIFY FINANCIAL INFORMATION PROVIDED FOR APPLICATION OF PERMANENT RESIDENCE IN SINGAPORE 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. ---------------------------------------------------------------------------------------------------------------- I consent and authorise the Immigration & Checkpoints Authority to obtain information and verify the financial information provided by me in respect of this application from or with the Inland Revenue Authority 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 Signature of Applicant FIN/NRIC No.* Date * Delete where appropriate