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FORM 4 Affix

a recent passport-
APPLICATION FOR PERMANENT RESIDENCE IN SINGAPORE sized colour
This application is for an Entry Permit under Regulation 4 of the Immigration Regulations photograph
You may apply for permanent residence while in Singapore or abroad 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 FOR OFFICIAL USE

FIN No (if any) : I__I__I__I__I__I__I__I__I__I


EP CATEGORY l__l__l__l
Identification Type and No. (for Malaysians only) Gender
New ID No. : I__I__I__I__I__I__I - I__I__I - I__I__I__I__I Male ENT/ I__I__I__I__I__I__I/ I___I__I
Old ID No. : I__I__I__I__I__I__I__I__I
Female
Name in Travel Document. Please use BLOCK LETTERS
Chinese Characters
(Underline Surname)
(if applicable)

Alias (if any)

1. I__I__I__I__I__I
Nationality Race Religion (Denomination)
2. I__I__I 3. I__I__I PASS TYPE : ______

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

I acknowledge receipt of original


Are you currently residing with the sponsor at the above address? Yes No documents presented for sighting

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 Signature: ____________________
a separate sheet of paper.)
Date: _______________________
Marital Status 1. Occupation Salary per Month
a) Basic : S$__________
b) Gross : S$__________
st
2. Highest Academic Qualifications Attained 3. 1 Degree, Type and Class
(if different from item 3) (e.g., B.A.(Hons) 2nd Upper / Diploma) Applicants Children (if applicable)

No. of children who are Spore Citizens l__l__l


Part-time study Full-time study Part-time study Full-time study
No. of children who are Spore Permanent Residents l__l__l
Name of School / College / University Name of School / College / University
No of children who have other nationalities l__l__l
(State Province / State & Country) (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 Month Year
Address in Country of Nationality

Signature of Applicant / Sponsor :________________________________


Page 1 of 8
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
Address Country
DD/MM/YYYY

From To

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) Been prohibited from entering Singapore or any other country? Yes No

(b) Been asked/required to leave Singapore or any other country? Yes No

(c) Been refused entry into or deported from Singapore or any other country? Yes No

(d) Been convicted of or currently charged with a crime or offence in

i) Singapore? Yes No

ii) Any other country? 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 this application 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.

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) your spouse, your spouses family or a third party in relation to the sponsoring of this Yes No
application?

(ii) your spouse, your spouses family or a third party for agreeing to enter into this marriage? Yes No

Did you enter into this marriage with your spouse to enable you to obtain long-term stay in Singapore? Yes No

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 8
PART C PARTICULARS OF APPLICANTS SPOUSE FOR OFFICIAL USE
(To be filled in only if applicants spouse is not the local sponsor)

FIN No (if any) : I__I__I__I__I__I__I__I__I__I


EP CATEGORY l__l__l__l

Identification No. (for Malaysians only) Applying for PR with you? ENT/ I__I__I__I__I__I__I/ I___I__I

New ID No. : l__l__l__l__l__I__I I__I__I I__I__I__I__I l__l Yes l__l No

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)

1. I__I__I__I__I__I
Alias (if any)

Nationality Race Religion Gender 2. I__I__I 3. I__I__I PASS TYPE : _____


(Denomination)
Male
Female

Province / State & Place of Birth Date of Birth

l__l__I / I__I__I / I__I__I__I__I


Day Month Year

Marriage Certificate No. Date of Marriage Country of Marriage

l__l__I / I__I__I / I__I__I__I__I


Day Month Year

Present Residential Address in Singapore 1. Occupation

2. Highest Academic Qualifications Attained 3. 1st Degree, Type and Class


(if different from item 3) (e.g., B.A.(Hons) 2nd Upper)/Diploma
Salary per Month

Part-time study Full-time study a) Basic: S$____________________


Part-time study Full-time study

Name of School / College/ University Name of School / College / University b) Gross: S$____________________
(State Province / State & Country) (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 Month Year

Present Whereabouts

Note: if deceased, give date of death.

Signature of Applicant / Sponsor :________________________________


Page 3 of 8
PART D PARTICULARS OF APPLICANTS PARENTS AND APPLICANTS CHILDREN BY THE PRESENT MARRIAGE
Highest
Name in Travel Travel Document Academic Applying
Date Country
Document in BLOCK (1) (2) (3) Qualification Monthly Marital For PR
Relationship of Occupation of
LETTERS and FIN / ID Country (e.g. B.A. Income Status with you?
Birth Residence
Card No. Race Nationality of Birth Type Number (Hons) 2nd (Yes/ No)
(DD/MM/YYYY)
Upper)

Father

Mother

Son / Daughter
(Child 1)

Son / Daughter
(Child 2)

Son / Daughter
(Child 3)

Son / Daughter
(Child 4)

EDUCATIONAL RECORDS OF CHILD 1 (IF APPLICABLE) EDUCATIONAL RECORDS OF CHILD 2 (IF APPLICABLE)

Year Year
Highest Standard Highest Standard
School / Institution Country of School / Institution Country of
Passed (State number Passed (State number of
Attended Study Attended Study
of O/A level passes) O/A level passes)
From To From To

Signature of Applicant / Sponsor :________________________________


Page 4 of 8
EDUCATIONAL RECORDS OF CHILD 3 (IF APPLICABLE) EDUCATIONAL RECORDS OF CHILD 4 (IF APPLICABLE)

Year Year
Highest Standard Highest Standard
School / Institution Country of School / Institution Country of
Passed (State number Passed (State number of
Attended Study Attended Study
of O/A level passes) O/A level passes)
From To From To

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:


*Date of
Date of Birth Date of Marriage
Name of Spouse Place of Birth (DD/MM/YYYY) (DD/MM/YYYY) Present Whereabouts Divorce/Decease
(DD/MM/YYYY)

(2) Particulars of all children (by all other marriages/illegitimate children/adopted children) :

Travel Document
Name of Children Place of Birth Date of Birth *Name of Father/Mother Present Whereabouts Applying for PR
(DD/MM/YYYY) with you?
Type Number
(Yes / No)

*Delete where applicable


Signature of Applicant / Sponsor :________________________________
Page 5 of 8
PART F SPONSOR'S PARTICULARS FOR OFFICIAL USE

Singapore Identity Card : Gender

Male
*Pink / Blue I__I__I__I__I__I__I__I__I__I Female
* Delete where applicable
Name in Travel Document in BLOCK LETTERS (Underline Surname) Chinese Characters
(if applicable)

Alias (if any)

Nationality Race Relationship to Applicant

Date of Birth Place of Birth Religion (Denomination)


l__l__I / I__I__I / I__I__I__I__I
Day Month Year

Marriage Certificate No. Date of Marriage Country of Marriage

l__l__I / I__I__I / I__I__I__I__I


Day Month Year
1. Occupation Salary per Month
(a) Basic: S$__________________ 1. I__I__I__I__I__I
(b) Gross: S$__________________

2. Highest Academic Qualifications Attained 3. 1st Degree, Type and Class


2. I__I__I 3. I__I__I PASS TYPE : _____
(if different from item 3) (e.g., B.A.(Hons) 2nd Upper / Diploma)

Part-time study Full-time study Part-time study Full-time study

Name of School / College / University Name of School / College / University


4. l__l__l 5. l__l__l
(State Province / State & Country) (State Province / State & Country)

Present Residential Address In Singapore Telephone No.: Hand phone No :

Residential : Office :
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? Yes No

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

Male
l__l__I / I__I__I / I__I__I__I__I
Female Day Month Year
st nd
4. Highest Academic Qualifications Attained (if different from item 5) 5. 1 Degree, Type and Class (e.g. B.A. (Hons) 2 Upper / Diploma)

Part-time study Full-time study Part-time study Full-time study

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 6 of 8
PART F SPONSORS PARTICULARS (CONTINUED FROM PAGE 6)

Particulars of Sponsors All Other Marriages ( Including Customary Marriages) :

Date of Date of *Date of Divorce/


Name of Spouse Nationality Place of Birth Marriage Present Whereabouts Decease, where
Birth (DD/MM/YYYY) (DD/MM/YYYY) applicable

Name of Children to be included in this application:-

(1)______________________________________ Birth Cert. No : _______________________

(2)______________________________________ Birth Cert. No : _______________________

(3)______________________________________ Birth Cert. No : _______________________

(4)______________________________________ Birth Cert. No : _______________________

(5)______________________________________ Birth Cert. No : _______________________

(6)______________________________________ Birth Cert. No : _______________________

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

(1) (2) (3)

(4) (5) (6)

Signature of Applicant / Sponsor :________________________________

Page 7 of 8
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 Identity 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. Renouncing or losing
ones 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 ones family members or sponsors.

_________________________________ _____________________________________
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 8 of 8
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

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.
*
Delete where appropriate

Sept 2012