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 APPLICANTS 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

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)

Male

ENT/ I__I__I__I__I__I__I/ I___I__I

Female

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$__________
st

2. Highest Academic Qualifications Attained

(if different from item 3)

3. 1 Degree, Type and Class

nd
(e.g., B.A.(Hons) 2 Upper / Diploma)

Part-time study

Part-time study

Full-time study

Name of School / College / University

(State Province / State & Country)

Type & Serial No. of Travel Document Held

Full-time study

Name of School / College / University

(State Province / State & Country)

Date and Place of Issue

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

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 7

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

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 spouses family or a third party in relation to the sponsoring of this
application?

Yes

No

(ii)

your spouse, your spouses 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 7

PART C PARTICULARS OF APPLICANTS SPOUSE

FOR OFFICIAL USE

(To be filled in only if applicants 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

2. I__I__I

Gender

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

st

3. 1 Degree, Type and Class

nd
(e.g., B.A.(Hons) 2 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 7

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

Name in Travel Document in

BLOCK LETTERS and FIN / ID
Card No.

Relationship

Date
of
Birth

(1)
Race

(2)
Nationality

(3)
Country
of Birth

(DD/MM/YYYY)

Father

Mother

Travel Document
Occupation
Type

Number

Academic
Qualification
(e.g. B.A.
nd
(Hons) 2
Upper)

Monthly
Income

Marital
Status

Country
of
Residence

Applying
For PR with
you?
(Yes/No)

Son/Daughter

Son/Daughter

Son/Daughter

5
6

Son/Daughter

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 4 of 7

FOR OFFICIAL USE

PART F SPONSOR'S PARTICULARS

Singapore Identity Card :

Gender

*Pink / Blue I__I__I__I__I__I__I__I__I__I

Male
Female

* 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$__________________

st

2. Highest Academic Qualifications Attained

(if different from item 3)

3. 1 Degree, Type and Class

nd
(e.g. B.A. (Hons) 2 Upper / Diploma)

Part-time study

Part-time study

Full-time study

Name of School / College / University

(State Province / State & Country)

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
st

Date of Birth

l__l__I / I__I__I / I__I__I__I__I

Day

Month

Year

nd

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

5. 1 Degree, Type and Class (e.g. B.A. (Hons) 2 Upper / Diploma)

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

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

6. Occupation

Salary per Month

(a) Basic: S$__________________
(b) Gross: S$__________________
Signature of Applicant / Sponsor: ________________________________
Page 5 of 7

PART F SPONSORS PARTICULARS (CONTINUED FROM PAGE 5)

Particulars of Sponsors 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 6 of 7

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 Identify 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.

_________________________________
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 7 of 7