xform 4irascpf

7/28/2019 XForm 4IRASCPF

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FORM 4

APPLICATION FOR PERMANENT RESIDENCE IN SINGAPOREThis application is for an Entry Permit under Regulation 4 of the Immigration RegulationsYou may apply for permanent residence while in Singapore or abroad

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

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

Gender

Male Female

Name in Travel Document. Please use BLOCK LETTERS(Underline Surname)

Alias (if any)

Chinese Characters(if applicable)

Nationality Race Religion (Denomination)

Province / State & Place of Birth Date of Birth

l__l__I / I__I__I / I__I__I__I__IDay Month Year

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 : ______

Present Residential Address in Singapore

Are you currently residing with the sponsor at the above address? Yes No

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 ona separate sheet of paper.)

Marital Status 1. Occupation Salary per Montha) 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 Province / State & Country)

3. 1st

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



Applicants Children (if applicable)

No. of children who are Spore Citizens l__l__l

No. of children who are Spore Permanent Residents l__l__l

No of children who have other nationalities l__l__l

Type & Serial No. of Travel Document Held Date and Place of Issue Date of Expiry


Address in Country of Nationality

Affixa recent passport-

sized colourphotographof Applicant

here

I acknowledge receipt of originaldocuments presented for sighting

Signature: ____________________Date: _______________________

Signature of Applicant / Sponsor: ________________________________Page 1 of 7


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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) 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?

ii) Any other country?

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 this application ever entered Singapore using otherPassports 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 thisapplication?

(ii) your spouse, your spouses family or a third party for agreeing to enter into this marriage?

Did you enter into this marriage with your spouse to enable you to obtain long-term stay in Singapore?

Yes No

Yes No

Yes No

If your answer is Yes to any of the above, please provide a detailed explanation in a separate sheet of paper.



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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

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

Applying for PR with you?

l__l Yes l__l No

Name in Travel Document in BLOCK LETTERS (Underline Surname)

EP CATEGORY l__l__l__l

ENT/ I__I__I__I__I__I__I/ I___I__I

Alias (if any)

Chinese Characters(if applicable)

1. I__I__I__I__I__I

Nationality Race Religion

(Denomination)

Gender

MaleFemale

2. I__I__I 3. I__I__I PASS TYPE : _____

Province / State & Place of Birth Date of Birth


Marriage Certificate No. Date of Marriage


Country of Marriage

Present Residential Address in Singapore 1. Occupation



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

3. 1st

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



Salary per Month

a) Basic: S$____________________

b) Gross: S$____________________

Type & Serial No. of Travel Document Held Date and Place of Issue Date of Expiry


Present Whereabouts

Note: if deceased, give date of death.



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PART D PARTICULARS OF APPLICANTS PARENTS AND APPLICANTS CHILDREN BY THE PRESENT MARRIAGE

Travel Document

Name in Travel Document inBLOCK LETTERS and FIN / ID

Card No.

RelationshipDate

ofBirth

(DD/MM/YYYY)

(1)

Race

(2)

Nationality

(3)Countryof Birth

Type Number

Occupation

AcademicQualification(e.g. B.A.(Hons) 2ndUpper)

MonthlyIncome

1 Father

2 Mother

3Son/Daughter

4Son/Daughter

5Son/Daughter

6Son/Daughter

PART E PARTICULARS OF APPLICANT'S ALL OTHER MARRIAGES (including customary marriages) AND CHILDREN

(1) Particulars of other marriages:

Name of Spouse Place of BirthDate of Birth(DD/MM/YYYY)

Date of Marriage(DD/MM/YYYY) Present Wherea

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

Name of Children Place of Birth Date of Birth(DD/MM/YYYY)

*Name of Father/Mother Present Whereabouts

*Delete where applicableSignature of Applicant / Spo

Page 4 of 7


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PART F SPONSOR'S PARTICULARS FOR OFFICIAL USE

Singapore Identity Card :

*Pink / Blue I__I__I__I__I__I__I__I__I__I

* Delete where applicable

Gender

Male Female

Name in Travel Document in BLOCK LETTERS (Underline Surname)

Alias (if any)

Chinese Characters

(if applicable)

Nationality Race Relationship to Applicant

Date of Birth


Place of Birth Religion (Denomination)

Marriage Certificate No. Date of Marriage


Country of Marriage

1. Occupation Salary per Month

(a) Basic: S$__________________

(b) Gross: S$__________________

1. I__I__I__I__I__I




3. 1st Degree, Type and Class(e.g. B.A. (Hons) 2

ndUpper / Diploma)



2. I__I__I 3. I__I__I PASS TYPE : _____

4. l__l__l 5. l__l__l

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 inrelation 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

MaleFemale

Date of Birth


4. Highest Academic Qualifications Attained (if different from i tem 5)

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

5. 1st

Degree, Type and Class (e.g. B.A. (Hons) 2nd

Upper / Diploma)

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

6. Occupation Salary per Month

(a) Basic: S$__________________

(b) Gross: S$__________________



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PART F SPONSORS PARTICULARS (CONTINUED FROM PAGE 5)

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

Name of Spouse Nationality Place ofBirth

Date ofBirth

(DD/MM/YYYY)

Date ofMarriage

(DD/MM/YYYY)

Present Whereabouts*Date of Divorce/Decease, where

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 6 of 7


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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 tothe 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 ofmy 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 respectof this application, from or with any source, as you deem appropriate for the purpose of assessment of myapplication 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 beendeclared 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 mydependant'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 Impressionof Sponsor

WARNING

IT IS AN OFFENCE UNDER THE IMMIGRATION ACT TO MAKE ANYFALSE STATEMENT, REPRESENTATION OR DECLARATION IN

CONNECTION WITH THIS APPLICATION

Page 7 of 7


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Sept 2012

Appendix - 2 (PR-FTS)

AUTHORISATION TO OBTAIN AND VERIFY FINANCIAL INFORMATIONPROVIDED 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 & CheckpointsAuthority to obtain and verify financial information, including any information relatingto the income or items of income, provided in respect of this application for the grantof an Entry Permit under Regulation 4 of the Immigration Regulations with the InlandRevenue Authority of Singapore and/or the Central Provident Fund Board ofSingapore.

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We consent and authorise the Immigration & Checkpoints Authority to obtaininformation and verify the financial information provided by us in respect of thisapplication from or with the Inland Revenue Authority of Singapore and/or theCentral Provident Fund Board of Singapore, and for them to disclose the informationfor the purpose of assessment of this application for the grant of an Entry Permit.

Name

Signature of Applicant

FIN/NRIC No.*

Date

Name

Signature of Sponsor

FIN/NRIC No.*

Date

1Hard 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 requiredfrom persons below 21 years old.

*Delete where appropriate

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