FORM 4
Affix a recent
passport-sized
colour photograph
of Applicant here
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
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
FOR OFFICIAL USE
I__I__I__I__I__I__I__I__I
Identification Type and No. (for Malaysians only)
New ID No. : I
I__I
Old ID No. : I__I
I__I
I__I – I__I__I – I
I__I__I__I
I__I__I__I
I__I__I
Name in Travel Document. Please use BLOCK LETTERS
(Underline Surname)
Gender
☐ Male
EP Category
I__I__I__I
☐ 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
Nationality / Citizenship
Race
I
Religion (Denomination)
2. I__I__I
Province / State & Country / Place of Birth
3. I__I__I
PASS TYPE : ______
Date of Birth
l__I
I / I__I
Day
I / I__I
Month
I__I__I
Year
Present Residential Address in Singapore
☐ Yes
Are you currently residing with the sponsor at the above address?
☐ No
I acknowledge receipt of original
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 a separate sheet of paper.)
Signature:___________________
Marital Status
Date: ______________________
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 Province / State & Country / Place)
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 Province / State & Country / Place)
Type & Serial No. of Travel Document Held
Date and Country / Place of Issue
Applicant’s Children (if applicable)
No. of children who are S’pore Citizens
I__I
I
No. of children who are S’pore Permanent
Residents
I__I
I
No. of children who have other nationalities /
citizenships
I__I
I
Date of Expiry
l__I
Day
I / I__I
I / I__I
Month
I__I__I
Year
Address in Country / Place of Nationality / Citizenship
Signature of Applicant / Sponsor :_________________________
Page 1 of 8
PART B – APPLICANT’S PARTICULARS (CONTINUED FROM PAGE 1)
LIST COUNTRIES / PLACES AND ADDRESSES IN WHICH APPLICANT HAS RESIDED DURING THE PAST 5 YEARS (TILL PRESENT DATE)
Period of Stay
(DD/MM/YYYY)
From
Address
Country / Place
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:
☐ Yes
☐ No
(b) Been asked/required to leave Singapore or any other country / place?
☐ Yes
☐ No
(c)
☐ Yes
☐ No
☐ Yes
☐ No
☐ Yes
☐ No
☐ Yes
☐ No
(a)
Been prohibited from entering Singapore or any other country / place?
Been refused entry into or deported from Singapore or any other country / place?
(d) Been convicted of or currently charged with a crime or offence in
i)
Singapore?
ii) Any other Country / Place?
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?
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 spouse’s family or a third party in relation to the sponsoring of this
application?
☐ Yes
☐ No
(ii) your spouse, your spouse’s family or a third party for agreeing to enter into this marriage?
☐ Yes
☐ No
☐ Yes
☐ 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 provide a detailed explanation in a separate sheet of paper.
Signature of Applicant / Sponsor :________________________
Page 2 of 8
PART C – PARTICULARS OF APPLICANT’S SPOUSE
FOR OFFICIAL USE
(To be filled in only if applicant’s spouse is not the local sponsor)
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
Applying for PR with you?
EP Category
I__I__I__I
☐ Yes
Old ID No. : I__I
I__I__I__I
ENT/ I__I__I__I__I
I__I/ I__I__I
Chinese Characters
(if applicable)
Alias (if any)
☐ Male
I__I
☐ No
I__I__I
Name in Travel Document in BLOCK LETTERS (Underline Surname)
Gender
I__I
Nationality / Citizenship
Religion (Denomination)
Date of Birth
Province / State & Country /
Place of Birth
1. I__I
I__I__I__I
2. l__I
I 3. l__I
I PASS TYPE : ___
☐ Female
Race
l__I
I / I__I
Day
Marriage Certificate No:
I / I__I
Month
I__I__I
Year
Date of Marriage
l__I
I / I__I
Day
Month
Country / Place of Marriage
I / I__I
I__I__I
Year
Present Residential Address in Singapore
1. Occupation
2. Highest Academic Qualifications Attained
(if different from item 3)
3. 1st Degree, Type and Class
(e.g., B.A.(Hons) 2nd Upper / Diploma)
☐ Part-time study
☐ Part-time study
☐ Full-time study
Name of School / College / University
(State Province / State & Country / Place)
☐ Full-time study
Name of School / College / University
(State Province / State & Country / Place)
Salary per Month
a) Basic : S$_________________
b) Gross : S$_________________
Type & Serial No. of Travel Document Held
Date and Country / Place of Issue
Date of Expiry
l__I
Day
I / I__I
Month
I / I__I
I__I__I
Year
Present Whereabouts
Note: if deceased, give date of death
Signature of Applicant / Sponsor :________________________
Page 3 of 8
PART D – PARTICULARS OF APPLICANT’S PARENTS AND APPLICANT’S CHILDREN BY THE PRESENT MARRIAGE
Name in Travel
Document in BLOCK
LETTERS and FIN / ID
Card No.
Relationship
(1)
Date of
Birth
Race
(DD/MM/YYYY)
(2)
Nationality /
Citizenship
(3)
Travel Document
Country /
Place of Birth
Occupation
Type
Number
Highest
Academic
Qualification
(e.g. B.A.(Hons)
2nd Upper)
Monthly
Income
Marital
Status
Country /
Place of
Residence
*Applying
for PR
with you?
(Yes/No)
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)
School / Institution
Attended
Country / Place of
Study
EDUCATIONAL RECORDS OF CHILD 2 (IF APPLICABLE)
Year
From
To
Highest Standard
Passed (State number
of “O”/“A” level passes)
School / Institution
Attended
Country / Place of
Study
Year
From
To
Highest Standard
Passed (State number
of “O”/“A” level passes)
Signature of Applicant / Sponsor :________________________
Page 4 of 8
EDUCATIONAL RECORDS OF CHILD 3 (IF APPLICABLE)
School / Institution
Attended
Country / Place of
Study
EDUCATIONAL RECORDS OF CHILD 4 (IF APPLICABLE)
Year
From
To
Highest Standard
Passed (State number
of “O”/“A” level passes)
School / Institution
Attended
Country / Place of
Study
Year
From
Highest Standard
Passed (State number
of “O”/“A” level passes)
To
PART E – 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
(2)
Country / Place of Birth
Date of Birth
Date of Marriage
(DD/MM/YYYY)
(DD/MM/YYYY)
Present Whereabouts
*Date of Divorce/Decease
(DD/MM/YYYY)
Particulars of All Children (by all other marriages/illegitimate children/adopted children) :
Name of Children
Country / Place of
Birth
Date of Birth
(DD/MM/YYYY)
Travel Document
*Name of Father/Mother
Present Whereabouts
Type
Number
Applying for
PR with you?
(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
* Delete where applicable
Name in Travel Document in BLOCK LETTERS (Underline Surname)
☐ Female
Chinese Characters
(if applicable)
Alias (if any)
Nationality / Citizenship
Race
Relationship to Applicant
Country / Place of Birth
Date of Birth
Religion (Denomination)
l__I
I / I__I
I / I__I
Day
Month
Date of Marriage
Marriage Certificate No:
l__I
I / I__I
Day
Month
I__I__I
Year
Country / Place of Marriage
I / I__I
I__I__I
Year
1. Occupation
Salary per Month
a) Basic : S$____________
1. I__I
I__I__I__I
2. l__I
I 3. l__I
4. l__I
I
b) Gross : S$____________
2. Highest Academic Qualifications Attained
(if different from item 3)
3. 1st Degree, Type and Class
(e.g., B.A.(Hons) 2nd Upper / Diploma)
☐ Part-time study
☐ Part-time study
☐ Full-time study
Name of School / College / University
(State Province / State & Country / Place)
☐ Full-time study
Name of School / College / University
(State Province / State & Country / Place)
Present Residential Address in Singapore
I PASS TYPE : ___
5. l__I
Telephone No.:
Hand phone No.:
Residential :
Office :
I
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
Date of Birth
Gender
☐ Male
☐ Female
l__I
Day
I / I__I
I / I__I
Month
I__I__I
Year
4. Highest Academic Qualifications Attained (if different from item 5)
5. 1st Degree, Type and Class (e.g., B.A.(Hons) 2nd Upper / Diploma)
☐ Part-time study
☐ Part-time study
☐ Full-time study
Name of School / College / University
(State Province / State & Country / Place)
☐ Full-time study
Name of School / College / University
(State Province / State & Country / Place)
6. Occupation
Salary per Month
a) Basic : S$_________________
b) Gross : S$_________________
Signature of Applicant / Sponsor :________________________
Page 6 of 8
PART F – SPONSOR’S PARTICULARS (CONTINUED FROM PAGE 6)
Particulars of Sponsor’s All Other Marriages (Including Customary Marriages) :
Name of Spouse
Nationality /
Citizenship
Country /
Place of Birth
Date of
Marriage
Date of Birth
(DD/MM/YYYY)
(DD/MM/YYYY)
*Date of
Divorce/Decease,
where applicable
Present
Whereabouts
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 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 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
Page 9 of 8