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notes:
* tick (") where appropriate
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~{翄3u鲖h?h (鲖(u駛韹kx橯) form 14a
immigration act [chapter 133, section 55(1)]
passports act [no. 33 of 2007] application for an entry visa 3u鲖eq僗~{翄
affix a recent passport-size photograph here
4?n褟 g gqgqgrn _
address in country of origin @b^\齎禰0w@w
country of origin:
@b^\齎禰
division/state/province of origin:
@b^\w齆
prefecture of origin
@b^\蜽^
county/district of origin
@b^\縎/:s
address :
0w@w
part ii other details vq諲酧o`
occupation:
l€n
highest academic/professional qualifications attained:
g貧f[哠
religion/denomination:
梉ye酧餘/梉>m
purpose of visit :
0r繈顅剉
date of intended arrival in singapore / period of visa applied for:
剺0r繈癳燫aw剉錯 g/2k3u鲖~{翄剉 gp?
how long do you intend to stay in singapore ?*up to 30 daysmore than 30 days╜剺(w癳燫awe\yuyen gy 30 )y厤菑 30 )y
if your intended stay in singapore is more than 30 days, please state the reason for your intended length of stay and the duration. 鍌╜剺\(w癳燫awe\yu厤菑 30 )y 鲖魦ft1uv^鑜f╜\e\yu剉 gp?0
nationality of spouse:*singapore citizensingapore permanent residentm憊p齎m|癳燫awlql
others (please specify)癳燫aw8lene\lvq諲鲖鑜f address in singapore (w癳燫aw剉0w@w
where will you be staying in singapore ?* ╜\(w癳燫awuoyoo縖
next-of-kin s place
relative s place
friend s place
hotel
others (please specify) 魐鹼睳^\y睳by g薙yr憲^vq諲 鲖鑜f
block/house no.|i鱏 : floor no. |ib\ : unit no.钑鱏 : postal code異 :
street name: tel no:
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building name:
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did you reside in other countries, other than your country of origin, for one year or more during the last 5 years ?*
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n
yes /f no &tif yes, please furnish details 鍌/f 鲖衏汷鴙sq鎷臽period of stay e\yu錯 gcountry 齎禰address 0w@wfrom 蜰to 髞
part iii antecedent of applicant * 3u鲖篘3u鲖虁of
(a) have you ever been refused entry into or deported from any country, including singapore?
╜/f&t珗鸑uo齎禰s靊癳燫aw 襜輣eq僗bc愒忁v齎
(b) have you ever been convicted in a court of law in any country, including singapore?
╜/f&t(w鸑uo齎禰s靊癳燫aw 剉誰媉 n珗$r gj
(c) have you ever been prohibited from entering singapore?
╜/f&t珗亂bk蹚eq癳燫aw
(d) have you ever entered singapore using a different passport or name?
yes /f yes /f yes /f
yes /f
no &t no &t no &t
no &t╜/f&t(uvq諲
tw[bgq蹚eq癳燫aw
if any of the answer is yes , please furnish details on a separate sheet of paper. 鍌錘
n鸑uon*n顣槝t{hh:n /f 鲖(u鍿nu樃~衏汷鎷臽0
part iv - declaration by applicant 3u鲖篘搳
i declare that the particulars and documents furnished in respect of this application are true and correct.
,g篘(宒k餢f,,g篘(w購齆3u鲖fn虘@b衏汷剉nrd崣egw^\瀃ncknx0
i undertake not to misuse controlled drugs or to take part in any political or other activities during my stay in singapore which would make me an undesirable or prohibited immigrant under the immigration act.
,g篘軴翄(we\yu癳燫aw g魰
n錸(u譙6ro僫r,b耂燫鸑uo?e籰'`;m≧bvq諲硩錘o,g篘b:n(w鹹l誰銷 n
n譙"k螐b珗亂eq僗篘隭剉;m≧0
i undertake to comply with the provisions of the immigration act and any regulations made thereunder or any statutory modification or re-enactment thereof for t
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