FORM 4
Affix
a recent passportsized 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
FOR OFFICIAL USE
FIN No (if any) : I__I__I__I__I__I__I__I__I__I
EP CATEGORY
Identification Type and No. (for Malaysians only)
l__l__l__l
Gender
□ Male
□ Female
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)
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
3. I__I__I
PASS TYPE : ______
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
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$__________
I acknowledge receipt of original
documents presented for sighting
Signature: ____________________
Date: _______________________
b) Gross : S$__________
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)
Type & Serial No. of Travel Document Held
st
3. 1 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)
Date and Place of Issue
Applicant’s Children (if applicable)
No. of children who are S’pore Citizens
l__l__l
No. of children who are S’pore Permanent Residents
l__l__l
No of children who have other nationalities
l__l__l
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 – 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
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
□ Yes
□ No
□ Yes
□ No
□ Yes
□ No
i)
Singapore?
ii) Any other country?
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?
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
EP CATEGORY
Identification No. (for Malaysians only)
Applying for PR with you?
New ID No. : l__l__l__l__l__I__I – I__I__I – I__I__I__I__I
l__l Yes l__l No
l__l__l__l
ENT/ I__I__I__I__I__I__I/ I___I__I
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
(Denomination)
Province / State & Place of Birth
Gender
2. I__I__I
3. I__I__I
PASS TYPE : _____
□ Male
□ Female
Date of Birth
l__l__I / I__I__I / I__I__I__I__I
Day
Marriage Certificate No.
Month
Date of Marriage
Year
Country of Marriage
l__l__I / I__I__I / I__I__I__I__I
Day
Month
Year
Present Residential Address in Singapore
2. Highest Academic Qualifications Attained
(if different from item 3)
1. Occupation
3. 1st Degree, Type and Class
(e.g., B.A.(Hons) 2nd Upper)/Diploma
Salary per Month
Part-time study
Full-time study
Name of School / College/ University
(State Province / State & Country)
Type & Serial No. of Travel Document Held
Part-time study
Full-time study
Name of School / College / University
(State Province / State & Country)
Date and Place of Issue
a) Basic: S$____________________
b) Gross: S$____________________
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 APPLICANT’S PARENTS AND APPLICANT’S CHILDREN BY THE PRESENT MARRIAGE
Name in Travel
Document in BLOCK
LETTERS and FIN / ID
Card No.
Travel Document
Relationship
Date
of
Birth
(DD/MM/YYYY)
(1)
(2)
Race
Nationality
(3)
Country
of Birth
Occupation
Type
Number
Highest
Academic
Qualification
(e.g. B.A.
(Hons) 2nd
Upper)
Monthly
Income
Marital
Status
Country
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)
EDUCATIONAL RECORDS OF CHILD 2 (IF APPLICABLE)
Year
School / Institution
Attended
Highest Standard
Passed (State number
of ‘O’/’A’ level passes)
Country of
Study
From
Year
School / Institution
Attended
To
Highest Standard
Passed (State number of
‘O’/’A’ level passes)
Country of
Study
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
School / Institution
Attended
Highest Standard
Passed (State number
of ‘O’/’A’ level passes)
Country of
Study
From
To
Year
School / Institution
Attended
Country of
Study
From
To
Highest Standard
Passed (State number of
‘O’/’A’ level passes)
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
Date of Marriage
(DD/MM/YYYY)
(DD/MM/YYYY)
*Date of
Divorce/Decease
Present Whereabouts
(DD/MM/YYYY)
(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
Travel Document
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
□ Female
*Pink / Blue I__I__I__I__I__I__I__I__I__I
* 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
1. Occupation
Year
Salary per Month
(a) Basic: S$__________________
1. I__I__I__I__I__I
(b) Gross: S$__________________
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)
Part-time study
2. I__I__I
PASS TYPE : _____
Full-time study
Name of School / College / University
(State Province / State & Country)
4. l__l__l
Telephone No.:
Present Residential Address In Singapore
3. I__I__I
Residential :
5. l__l__l
Hand phone No :
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
Gender
Name of Sponsor's Spouse
□ Male
□ Female
Day
Month
Year
nd
5. 1 Degree, Type and Class (e.g. B.A. (Hons) 2 Upper / Diploma)
Full-time study
Part-time study
Name of School / College / University (State Province / State & Country)
6. Occupation
l__l__I / I__I__I / I__I__I__I__I
st
4. Highest Academic Qualifications Attained (if different from item 5)
Part-time study
Date of Birth
Full-time study
Name of School / College / University (State Province / State & Country)
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
Place of
Birth
Date of
Birth
Date of
Marriage
(DD/MM/YYYY)
(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 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