Immigration Application Form

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Name of Sponsor : ________________________________
Controller of Immigration
Address : _______________________________________
Singapore
_______________________________________
Telephone No. : __________________________________
Date : _________________________________________
Dear Sir,
Re : __________________________________________________________________________ *MALE/FEMALE
(Name of Applicant)
PASSPORT NO: _____________________
*
I/We, (name of sponsor), _________________________________________, holder of Singapore (*PINK/BLUE)
NRIC No : _____________________ agree to abide by the following conditions for the issue of a *Visit Pass/ Student's
Pass to the abovementioned person:
(a)
that he/she shall 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;
(b)
that the purpose of stay in Singapore is solely for a social, business, or professional visit; or as a tourist
/study only, and no other pass, extension of stay or permanent stay will be sought for in Singapore;
(c)
that he/she shall not be adopted by me or any Singapore citizen or permanent resident in
Singapore;
(d)
that he/she shall not indulge in any activities which are inconsistent with the purpose for which the Visit
Pass/Student's Pass has been issued;
(e)
he/she shall not engaged in any form of employment paid or unpaid, or in any business, profession or
occupation, or in any activity which, in the opinion of the Controller of Immigration, is detrimental to the
security, reputation and well-being of Singapore;
(f)
that he/she shall not smoke, administer to himself/herself or otherwise consume or be in anyway
engaged in the trafficking of any controlled drug as defined in the Misuse of Drugs Act, (1985 Edition), or
any written law for the time being in force relating to the control of dangerous or otherwise harmful drugs;
(g)
that he/she shall not be involved in any criminal offences in Singapore;
(h)
that he/she shall not remain in Singapore after the expiry of the Visit Pass/Student's Pass;
(i)
that he/she shall surrender the Student's Pass for cancellation within 7 days of the date of cessation or
termination of studies; (for applicants of Student’s Pass only)
(j)
that I inform your department when he/she leaves the Republic and his/her means and date of departure;
(k)
that I shall be responsible for the cost of his/her repatriation and maintenance pending such repatriation,
if necessary;
(l)
*I/We declare that she *is/is not pregnant. (To attach a medical certificate indicating the expected date of
delivery if applicant is pregnant);
(m) *I/We further agree to furnish the Immigration & Checkpoints Authority a Security Deposit of $ ________
in the form of Banker’s Guarantee/Cashier’s Order as a condition for the approval of a Visit
Pass/Student’s Pass valid for ___________ months and understand that a breach of any or all of the
aforesaid conditions will render the Security Deposit being forfeited.
Only for application where Local Sponsor is an individual:
_______________________
_______________________
#
Signature of Local Sponsor
NRIC
(Pink / Blue) No.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Only for application where Local Sponsor is a company / firm:
______________________________________________
Signature of person acting on behalf of the company / firm
____________________________
__________________________
Name, NRIC No and Designation
Official Stamp of company / firm
* Delete where appropriate
# Sponsor’s Singapore Identity Card must be produced at every application/submission
V-39 I

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