Thank you for using the SG Arrival Card!

This SG Arrival Card is only valid for one time use for travel on the
expected date of arrival indicated below. You may choose to download or print a copy of this acknowledgement
and retain it for the duration of your stay. Please note that the SG Arrival Card is not a visa. The use of the SG
Arrival Card e-Service is free of charge.

The unauthorised consumption, possession, import, export and/or trafficking of any controlled drug is an offence
under Singapore's Misuse of Drugs Act . Under the Act, drug trafficking is punishable by death.

Providing false health and travel declarations is an offence under Section 64(b) of Singapore's Infectious Diseases
Act. The penalty for providing false or misleading information is a fine of up to S$10,000 and/or imprisonment of
up to 6 months. For subsequent offence(s), the penalty is a fine up to S$20,000 and/or imprisonment of up to 12
months. You are reminded that it is your responsibility to update and resubmit your declarations prior to your
arrival in Singapore if you had contact with a COVID-19 case, and/or if there is any change in your health status
and/or travel history.

You are required by law to give a report using Form NP 727/A/B/C if the total value of currency and/or bearer
negotiable instruments you are carrying exceeds SGD 20,000 (or equivalent in a foreign currency).

If you are bringing in any item, or carrying an item for someone else, but you do not know what it contains, you
must declare the item at the Red Channel.

You can refer to the ICA website at Entering and Departing Singapore (https://www.ica.gov.sg/enter-depart) for
more information on Singapore's entry requirements and the list of prohibited or controlled items.

Transaction Date: 26/02/2022 03:49 PM (Singapore Time)

Trip 1 Date of Arrival to Singapore 28/02/2022

DE No Full Name (In Passport) Passport Number

Z3684D5215 SUMATI CHANDRASEGARAN A52645330

Trip 2 Date of Arrival to Singapore 28/02/2022

DE No Full Name (In Passport) Passport Number

Z3684D5317 SUMATI CHANDRASEGARAN A52645330
DE No: Z3684D5215 BVL

Personal Information
Full Name (In Passport)
SUMATI CHANDRASEGARAN

Sex Date of Birth

FEMALE 08/06/1977
Place of Residence
MALAYSIA, JOHOR, JOHOR BAHRU

Country/Place of Birth Nationality/Citizenship

MALAYSIA MALAYSIAN
Passport Number Date of Passport Expiry
A52645330 20/07/2024
Mobile Number Identity Card Number (For Malaysians Only)
+60 175318677 770608017304
Email Address
ABBYYASH77@GMAIL.COM

Trip Information and Declaration

Trip Information
Date of Arrival to Singapore Date of Departure From Singapore
28/02/2022 28/03/2022
Mode of Travel
AIR
Mode of Travel (Details) Carrier Name/Flight Number
PRIVATE/CARGO AIRLINE TR473
Type of Accommodation in Singapore Name of Hotel
HOTEL FRAGRANCE HOTEL - BALESTIER
Last City / Port of Embarkation Before Singapore
MALAYSIA, JOHOR, JOHOR BAHRU
Next City / Port of Disembarkation After Singapore
MALAYSIA, JOHOR, JOHOR BAHRU
Others
Have you ever used a passport under different name to enter Singapore? NO

Name different from current passport

DE No: Z3684D5215 BVL

Health Declaration (Trip 1)

Please indicate all countries/regions that you have been in (including the
country/region of embarkation) or travelled to, (excluding transit and stopover
for air travel only) in the last 7 days prior to your arrival in Singapore.
MALAYSIA

Did you start to have any of the following symptoms in the last 7 days: fever, NO
cough, runny nose, sore throat, loss of sense of smell or shortness of breath?

Are you diagnosed or suspected to have COVID-19 infection in the past 90 NO

days?

Do you have an overseas digital vaccination certificate? N/A

Submission QR Code (For Official Use Only)

You may need to present this QR code for immigration clearance upon arrival in
Singapore when requested.
DE No: Z3684D5317 BVL

Personal Information
Full Name (In Passport)
SUMATI CHANDRASEGARAN

Sex Date of Birth

FEMALE 08/06/1977
Place of Residence
MALAYSIA, JOHOR, JOHOR BAHRU

Country/Place of Birth Nationality/Citizenship

MALAYSIA MALAYSIAN
Passport Number Date of Passport Expiry
A52645330 20/07/2024
Mobile Number Identity Card Number (For Malaysians Only)
+60 175318677 770608017304
Email Address
ABBYYASH77@GMAIL.COM

Trip Information and Declaration

Trip Information
Date of Arrival to Singapore Date of Departure From Singapore
28/02/2022 28/03/2022
Mode of Travel
AIR
Mode of Travel (Details) Carrier Name/Flight Number
PRIVATE/CARGO AIRLINE TR473
Type of Accommodation in Singapore Name of Hotel
HOTEL FRAGRANCE HOTEL - BALESTIER
Last City / Port of Embarkation Before Singapore
MALAYSIA, JOHOR, JOHOR BAHRU
Next City / Port of Disembarkation After Singapore
MALAYSIA, JOHOR, JOHOR BAHRU
Others
Have you ever used a passport under different name to enter Singapore? NO

Name different from current passport

DE No: Z3684D5317 BVL

Health Declaration (Trip 2)

Please indicate all countries/regions that you have been in (including the
country/region of embarkation) or travelled to, (excluding transit and stopover
for air travel only) in the last 7 days prior to your arrival in Singapore.
MALAYSIA

Did you start to have any of the following symptoms in the last 7 days: fever, NO
cough, runny nose, sore throat, loss of sense of smell or shortness of breath?

Are you diagnosed or suspected to have COVID-19 infection in the past 90 NO

days?

Do you have an overseas digital vaccination certificate? N/A

Submission QR Code (For Official Use Only)

You may need to present this QR code for immigration clearance upon arrival in
Singapore when requested.