Thank you for using the SG Arrival Card!

This SG Arrival Card is only valid for one time use for travel on the
expected date of arrival indicated below. You may choose to download or print a copy of this acknowledgement
and retain it for the duration of your stay.Please note that the SG Arrival Card is not a visa. The use of the SG
Arrival Card e-Service is free of charge.

The unauthorised consumption, possession, import, export and/or trafficking of any controlled drug is an offence
under Singapore's Misuse of Drugs Act. Under the Act, drug trafficking is punishable by death.

Providing false health and travel declarations is an offence under Section 64(b) of Singapore's Infectious Diseases
Act. The penalty for providing false or misleading information is a fine of up to S$10,000 and/or imprisonment of
up to 6 months. For subsequent offence(s), the penalty is a fine up to S$20,000 and/or imprisonment of up to 12
months.You are reminded that it is your responsibility to update and resubmit your declarations prior to your
arrival in Singapore if you had contact with a COVID-19 case, and/or if there is any change in your health status
and/or travel history.

You are required by law to give a report using Form NP 727/A/B/C if the total value of currency and/or bearer
negotiable instruments you are carrying exceeds SGD 20,000 (or equivalent in a foreign currency).

If you are bringing in any item, or carrying an item for someone else, but you do not know what it contains, you
must declare the item at the Red Channel.

You can refer to the ICA website at Entering and Departing Singapore(https://www.ica.gov.sg/enter-depart) for
more information on Singapore's entry requirements and the list of prohibited or controlled items.

Transaction Date: 03/11/2022 11:34 AM (Singapore Time)

Number of travellers: 2

Lead Traveller MUHAN WAHYUDI

DE Number Full Name (In Passport) Passport Number

Z9740M3519 MUHAN WAHYUDI E0030695

Traveller 2 HANI SAPITRI

DE Number Full Name (In Passport) Passport Number

Z9740M3617 HANI SAPITRI E0030697
DE Number: Z9740M3519 VG

Personal Information
Full Name (In Passport)
MUHAN WAHYUDI

Sex Date of Birth

MALE 25/02/1995
Place of Residence
INDONESIA, RIAU ISLANDS, BATAM

Country/Place of Birth Nationality/Citizenship

INDONESIA INDONESIAN
Passport Number Date of Passport Expiry
E0030695 18/08/2027
Mobile Number Email Address
+62 82286625864 INDAHGITA456@GMAIL.COM

Trip Information
Date of Arrival to Singapore
03/11/2022
Mode of Travel
SEA
Mode of Travel (Details) Vessel Name
FERRY MAJESTIC FERRY
Type of Accommodation in Singapore
RESIDENTIAL
Street Name Postal Code Block Number
KAKI BUKIT VIEW 415960 24
Building Name Unit Number Floor Number
NA NA
Last City / Port of Embarkation Before Singapore
INDONESIA, RIAU ISLANDS, BATAM
Next City / Port of Disembarkation After Singapore
INDONESIA, RIAU ISLANDS, BATAM
Date of Departure From Singapore
03/11/2022

Others
Have you ever used a passport under different name to enter Singapore? NO

Name different from current passport

DE Number: Z9740M3519 VG

Electronic Health Declaration (Lead Traveller)

Have you visited any of the listed countries in Africa or Latin America in the NO
past 6 days prior to your arrival in Singapore?

Did you start to have any symptoms in the last 7 days: fever, rash, cough, runny NO
nose, sore throat, loss of sense of smell, or shortness of breath?

Do you currently have fever, cough, shortness of breath, headache, or vomiting NO

AND have visited Africa or the Middle East in the past 14 days prior to your
arrival in Singapore?

Remarks NIL
DE Number: Z9740M3617 VG

Personal Information
Full Name (In Passport)
HANI SAPITRI

Sex Date of Birth

FEMALE 23/03/1988
Place of Residence
INDONESIA, RIAU ISLANDS, BATAM

Country/Place of Birth Nationality/Citizenship

INDONESIA INDONESIAN
Passport Number Date of Passport Expiry
E0030697 18/08/2027
Mobile Number Email Address
+62 82286625864 INDAHGITA456@GMAIL.COM

Trip Information
Date of Arrival to Singapore
03/11/2022
Mode of Travel
SEA
Mode of Travel (Details) Vessel Name
FERRY MAJESTIC FERRY
Type of Accommodation in Singapore
RESIDENTIAL
Street Name Postal Code Block Number
KAKI BUKIT VIEW 415960 24
Building Name Unit Number Floor Number
NA NA
Last City / Port of Embarkation Before Singapore
INDONESIA, RIAU ISLANDS, BATAM
Next City / Port of Disembarkation After Singapore
INDONESIA, RIAU ISLANDS, BATAM
Date of Departure From Singapore
03/11/2022

Others
Have you ever used a passport under different name to enter Singapore? NO

Name different from current passport

DE Number: Z9740M3617 VG

Electronic Health Declaration (Traveller 2)

Have you visited any of the listed countries in Africa or Latin America in the NO
past 6 days prior to your arrival in Singapore?

Did you start to have any symptoms in the last 7 days: fever, rash, cough, runny NO
nose, sore throat, loss of sense of smell, or shortness of breath?

Do you currently have fever, cough, shortness of breath, headache, or vomiting NO

AND have visited Africa or the Middle East in the past 14 days prior to your
arrival in Singapore?

Remarks NIL