PLEASE COMPLETE Telephone No:

SECTION A, B, C AND D.
ENGLISH Email: _______________________________
GREEN IDENTITY CARD APPLICATION FORM
FOR REGISTRATION OFFICER USE
This application has been reviewed and I satisfied with the details provided and further has no objection to approve this
Green Identity Card application.

DATE - -
Registration Officer Signature
PAYMENT:
a BND $15 BND $20 BND $50 BND $100 Receipt Ref No: _____________________
b BND $5 Receipt Ref No: _____________________
c Regulations 24 (3) B$ Receipt Ref No: _____________________
__________________________ Date: _____________________
NOTE:
__________________________ Received By: _____________________
SECTION A: APPLICANT DETAILS
Identity Card Number (If any) - Example 5 1 - 1 2 3 4 5 6

Full Name As In
The Passport
it(Not more than
120 characters)

Date of Birth - - Country of Birth

Gender Male Female Religion Blood Type
Nationality Marital Status

Home Address
Brunei Darussalam

Postcode Mukim District

SECTION B: EMPLOYMENT DETAILS / STATUS

Position / Status
Employer’s / Company’s / Sponsor’s Name

Employer’s /
Company’s /
Sponsor’s Address
in Brunei
Darussalam
Postcode Mukim District

SECTION C: DOCUMENTS ENCLOSED

PLACE OF DATE OF EXPIRY
TYPE OF DOCUMENT NUMBER
ISSUED ISSUED DATE
Passport
Immigration Pass
Foreign Workers License
SECTION D: DECLARATION
I declare that all details above are true.

Date - - _______________________________
Signature or Thumb Print of Applicant
 REMINDERS

i. Applicant must be properly dressed as photograph will be captured directly at the application counter.

ii. For female applicant who is wearing headscarf (tudung), it is advisable to wear it in dark coloured headscarf (tudung).

iii. Hair must be in neat and at an acceptable length especially for male applicant.

iv. Wearing of coloured contact lens is not permitted.

v. Immigration Pas must be more than 3 months validity upon submission of application.

vi. Documentations required are as follow:

A. FIRST APPLICATION
a. Passport (Original and Copy)
b. Foreign Workers License (Original and Copy)

B. RENEWAL APPLICATION
a. Passport (Original and Copy)
b. Previous Identity Card/ Identity Card Receipt (Original and Copy)
c. Foreign Workers License (Original and Copy)

C. REPLACEMENT OF LOST IDENTITY CARD APPLICATION

a. Valid Police Report on Lost Identity Card (Original)
b. Passport (Original and Copy)
c. Foreign Workers License (Original and Copy)

vii. Identity Card Payment:

a. New application and renewal BND$20.00

b. Replacement of Lost Identity Card (First Replacement) BND$25.00
c. Replacement of Lost Identity Card (Second Replacement) BND $55.00
d. Replacement of Lost Identity Card (Third and Subsequent Replacement) BND $105.00
e. Change of Details BND $15.00