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 – APPLICANT’S 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

Applicant’s Children (if applicable)
No. of children who are S’pore Citizens

l__l__l l__l__l l__l__l

 Part-time study

 Full-time study

No. of children who are S’pore 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

Signature of Applicant / Sponsor: ________________________________ Page 2 of 7 . your spouse’s 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 state Name and Date of Birth: ____________________________________________________________ Type and Passport No: ____________________________________ Date of Issue: ______________ Please provide detailed particulars of all passports used. 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. Have you or has any one of the persons included in this application ever entered Singapore using other Passports and different Particulars? If ‘Yes’.PART B – APPLICANT’S 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. please provide a detailed explanation in a separate sheet of paper. directly or indirectly to: (i) (ii) your spouse. your spouse’s family or a third party in relation to the sponsoring of this application? your spouse. □ 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. please provide a detailed explanation on a separate sheet of paper.

I__I__I 3. I__I__I__I__I__I Nationality Race Religion (Denomination) Gender 2.g. 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. (for Malaysians only) New 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..(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. Signature of Applicant / Sponsor: ________________________________ Page 3 of 7 . 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. give date of death. B. 1 Degree. Type and Class nd (e.PART C – PARTICULARS OF APPLICANT’S SPOUSE (To be filled in only if applicant’s 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. Highest Academic Qualifications Attained (if different from item 3) 3. : l__l__l__l__l__I__I – I__I__I – I__I__I__I__I Old ID No.A. 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.

B.PART D – PARTICULARS OF APPLICANT’S PARENTS AND APPLICANT’S 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. 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 .A.g.

PLEASE FILL UP THIS PART Did you or your family receive money or any other form of benefit.A. please fill in this Part Name of Sponsor's Spouse Gender Date of Birth □ Yes □ No □ Male □ Female 4. Type and Class nd (e. please provide a detailed explanation on a separate sheet of paper. (Hons) 2 Upper / Diploma) Name of School / College / University (State Province / State & Country) Name of School / College / University (State Province / State & Country) 6.g. l__l__l 5. (Hons) 2 Upper / Diploma) st l__l__I / I__I__I / I__I__I__I__I Day 1. If the applicant is not the spouse of sponsor. Country of Marriage Year Salary per Month (a) Basic: S$__________________ (b) Gross: S$__________________ 2. Highest Academic Qualifications Attained (if different from item 3) 3. 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. I__I__I PASS TYPE : _____  Part-time study  Full-time study  Part-time study  Full-time study 4. 1 Degree.A. I__I__I 3. I__I__I__I__I__I 2. B. 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. Type and Class (e.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. 1 Degree. directly or indirectly from any person in relation to the sponsoring of this application? If your answer is “Yes”.: Residential : Office : Hand phone No : IF THE SPONSOR IS THE SPOUSE OF THE APPLICANT. Occupation Month 1. B.g. Occupation Salary per Month (a) Basic: S$__________________ (b) Gross: S$__________________ Signature of Applicant / Sponsor: ________________________________ Page 5 of 7 .

where applicable Name of Children to be included in this application:(1)______________________________________ (2)______________________________________ (3)______________________________________ (4)______________________________________ (5)______________________________________ (6)______________________________________ Birth Cert. No : _______________________ Birth Cert. (1) (2) (3) (4) (5) (6) Signature of Applicant / Sponsor: ________________________________ Page 6 of 7 . No : _______________________ Birth Cert. No : _______________________ Birth Cert. No : _______________________ Affix recent photo(s) of children applying for Permanent Residence.PART F – SPONSOR’S PARTICULARS (CONTINUED FROM PAGE 5) Particulars of Sponsor’s 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. No : _______________________ Birth Cert. No : _______________________ Birth Cert.

All NS-liable males aged 13 years old and above. a member of any political party which has been declared unlawful in Singapore. to the best of my knowledge and belief. REPRESENTATION OR DECLARATION IN CONNECTION WITH THIS APPLICATION Page 7 of 7 . as you deem appropriate for the purpose of assessment of my dependant's application for immigration facilities. or for Singapore citizenship or PR status. I also hereby give my consent for your department to obtain and verify the information provided by me in respect of this application. I also hereby give my consent for your department to obtain and verify the information provided by me in respect of this application. 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. if applicable. and (b) the applicant is not. and that I have not wilfully suppressed any material fact. _________________________________ Date _____________________________________ Signature or Right Thumb Impression of Sponsor WARNING IT IS AN OFFENCE UNDER THE IMMIGRATION ACT TO MAKE ANY FALSE STATEMENT. for the purpose of Identify Card registration. I hereby give my consent to the use of the same set of thumbprints and photograph. are required to obtain an Exit Permit (EP) when travelling overseas for 3 months or more. from or with any source. as you deem appropriate for the purpose of assessment of my application for immigration facilities. from or with any source. ______________________________ 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.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 understand that male children who are granted PR status under their parents’ sponsorship are liable for National Service (NS) under the Enlistment Act. submitted in respect of my application for immigration facilities. 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.

* Delete where appropriate Sept 2012 .* Signature of Applicant Date Name FIN/NRIC No. Name FIN/NRIC No.Appendix . ---------------------------------------------------------------------------------------------------------------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.* Signature of Sponsor Date 1 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. and for them to disclose the information for the purpose of assessment of this application for the grant of an Entry Permit. 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. including any information relating to the income or items of income.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.

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