Form 14 - Application For A Visit Pass/visa & Visit Pass/ An Entry Visa Page 3

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PART IV - DECLARATION BY APPLICANT
I hereby declare that all the particulars furnished by me in this application are true and correct.
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.
I undertake to comply with the provisions of the Immigration Act and any regulations made there under or any statutory modification or re-enactment
thereof for the time being in force in Singapore.
I undertake not to involve in any criminal offences in Singapore.
I undertake not to indulge in any activities which are inconsistent with the purpose for which the immigration passes have been issued
I further undertake not to be engaged in any form of employment or in any business, profession or occupation in Singapore whether paid or unpaid,
without a valid work pass issued under the Employment of Foreign Manpower Act (Cap. 91A).
I am aware that overstaying or working illegally in Singapore is a serious offence and on conviction, the penalties may include mandatory imprisonment
and caning.
I understand that if the Controller of Immigration is satisfied that I or any member of my family breaches this undertaking or becomes an undesirable
or prohibited immigrant, he will cancel my immigration pass and the passes of the members of my family, and we may be required to leave Singapore
within 24 hours of such cancellation.
I understand that this application for and possession of a visa does not guarantee entry into Singapore and permission to entry is entirely discretionary
at the point of entry.
I give my consent for your department to obtain and verify information from or with any source as you deem appropriate for the assessment of my
application for immigration facilities.
Date
Signature of Applicant
PART V – DECLARATION BY LOCAL SPONSOR
( Not applicable if you are applying for Entry Visa only)
(
A local sponsor is required to complete either Section A or Section B below)
Section A - For application sponsored by a company only
Name and Address of Company:
We hereby sponsor this application and certify that it is made for the purpose as stated by the applicant.
The statements made in this application are true and correct.
We shall be responsible for the cost of the applicant’s repatriation and maintenance pending such repatriation, if
necessary.
Name, NRIC and Designation/Capacity
Official Stamp of Company/Firm
Signature of person acting
on behalf of the Company/Firm
and Date
Section B - For application sponsored by an individual only
I, (name of sponsor),
, holder of Singapore (Pink/Blue**) NRIC
No. :
and residing at
Declare that :
The applicant,
is my
parent
husband / wife / son / daughter**
others (Please specify)
I hereby sponsor this application and certify that it is made for the purpose as stated by the applicant.
The statements made in this application are true and correct.
I shall be responsible for the cost of the applicant’s repatriation and maintenance pending such repatriation, if
necessary.
Date
Signature of Sponsor
IMM 14
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