Agri-Food & Veterinary Authority of Singapore
Food Supply & Resilience Group
Farming Industry Development Section / Food Supply Industry
Development Department
52 Jurong Gateway Road, #14-01 Singapore 608550
Tel: (65) 6805 2786
Reference Code: FM 003 - _____________________
WORK PERMIT SCHEME FOR AGRITECHNOLOGY SECTOR
APPLICATION FORM FOR INCLUSION INTO SCHEME
This form may take you 5 minutes to fill in.
You will need the following information to fill in the form:

Your AVA licence.

The CPF Agritechnology Sector Account Number of your business firm, company or limited liability
partnership.

The name of your Employment Agent, Employment Agency and their Licence Number, if any.
You need to forward the following documents:

A copy of the latest Business Profile extract from the Accounting Corporate Regulatory Authority
(ACRA); and

Copy of a valid Licence for Farm (Land-based Farming) or Licence for Fish Culture Farm (Seabased)
Please complete the Application Form and submit it to:
Agri-Food & Veterinary Authority (AVA)
Food Supply Industry Development Department
52 Jurong Gateway Road, #14-01,
Singapore 608550
PART I:
DETAILS OF APPLICANT
Company’s CPF Account
Number:
Name of AVA Licensed
Farm:
Plot Number:
Address of farm:
Correspondence
Address:
Name of Applicant:
Designation of
Applicant:
Telephone Number:
Mobile Phone Number:
Fax Number:
Email Address:
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Revised wef 15 Dec 2014
Agri-Food & Veterinary Authority of Singapore
Food Supply & Resilience Group
Farming Industry Development Section / Food Supply Industry
Development Department
52 Jurong Gateway Road, #14-01 Singapore 608550
Tel: (65) 6805 2786
Reference Code: FM 003 - _____________________
PART II:
DETAILS OF EMPLOYMENT AGENT
Only required to be filled in if this application is made by a Employment Agency [EA] on
behalf of applicant: [Please note that EAs should be accredited by MOM. A list of EAs
can be found at MOM’s website (www.mom.gov.sg)]
Name of Agent:
Name of Employment Agency:
MOM Licence Number of Agency:
Contact Telephone Number of Agent:
Email address of Agent:
Signature of Agent:
PART III:
UNDERTAKING
1.
I accept that my eligibility to employ foreign worker(s) under the Work Permit Scheme for
Agritechnology Sector is based on the recommendations of Agri-Food and Veterinary Authority
(AVA) to Ministry of Manpower (MOM). I further accept that these recommendations will be
based on AVA’s assessments of my farm.
2.
I undertake to ensure that:
a.
My foreign worker(s) will only work in the occupation and location as specified in their
work permit card(s), acceptable accommodation for my foreign worker(s) is/are provided
for, and their salaries paid promptly on a monthly basis.
b.
I will comply with all prevailing work permit conditions.
3.
In the event that my foreign worker(s) are accommodated in my farm, I undertake to ensure that
my foreign worker(s) are ONLY accommodated in structures that had been approved for dwelling.
4.
In the event that there is no structure approved for dwelling (i.e. dwelling house/worker’s
quarter), I undertake that I will accommodate my foreign worker(s) outside my farm.
5.
I accept that upon the expiry of work permit(s) of my foreign worker(s) after 2 years, my
eligibility to renew the work permit(s) of these worker(s) is/are subject to MOM’s approval based
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Revised wef 15 Dec 2014
Agri-Food & Veterinary Authority of Singapore
Food Supply & Resilience Group
Farming Industry Development Section / Food Supply Industry
Development Department
52 Jurong Gateway Road, #14-01 Singapore 608550
Tel: (65) 6805 2786
Reference Code: FM 003 - _____________________
on my quota eligibility. In addition, I agree to allow AVA to conduct regular reviews and checks to
ensure that my worker(s) are well managed by my farm.
6.
I accept that my eligibility for foreign worker(s) under the Scheme is premised on my farm’s
commitment to work with AVA and Singapore Workforce Development Agency (WDA) on local
manpower placement and training.
7.
I accept that failure to follow any of the above conditions will result in MOM terminating the work
permit(s) of my foreign worker(s) under the Scheme. In addition, my eligibility to hire foreign
worker(s) under the Scheme in the future may also be revoked and I may be liable to appropriate
administrative actions by MOM.
I declare that I have read and understood all of the conditions as stated in the undertaking. I
further declare that all of the information provided above is true and correct.
Signature of applicant and date
Signature
Date of application
[For official use only:]
Date application received:
Date checked:
Status of application:
* Rejected / Cleared for evaluation
Reason for rejection:
* Do not hold a valid Licence for Farm
Name of AVA Officer:
Goh Toh Kwang
Date / Initial:
Note: * Please delete accordingly
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