Work Permit For A Foreign Domestic Worker Page 10

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Application for a foreign domestic helper work permit
Declaration by Employment Agency
This declaration must be completed by the Employment Agency or intermediary who is making the
application on behalf of the employer. (If more than one Employment Agency or intermediary is used,
please download additional declaration sheets from MOM's website.)
I declare that:
1. I am the Employment Agency personnel handling this application.
2. To the best of my knowledge, the foreign domestic worker (if she has not worked as a foreign domestic worker in Singapore
before) has had a minimum of eight years of formal education and has educational certificates as documentary proof of this.
3. I have explained the contents of the application and the applicable conditions and regulatory conditions of this work permit,
as set out in the Employment of Foreign Manpower (Work Passes) Regulations c 91A, to the foreign employee and the
employer.
The information in this application and any appeals I have made in relation to this application are, to the best of my
4.
knowledge, true and correct; and that all documents submitted in support of this application and any appeals made in
relation to the application, are true copies of the authentic documents.
Name of Employment Agency personnel
Employment Agency stamp
Employment Agency personnel number
Contact no. of Employment Agency personnel
Employment Agency licence no.
Signature of Employment Agency personnel
Date (DD-MM-YYYY)
Ministry of Manpower Work Pass Division
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Parent category: Business