Work Permit For A Foreign Domestic Worker Page 9

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Application for a foreign domestic helper work permit
Declaration by employer
Conditions and regulatory conditions of work permit applicable to the employer of the foreign domestic
worker
I declare that:
1. I have read and understood the applicable conditions and regulatory conditions of work permit set out in the Employment of
Foreign Manpower (Work Passes) Regulations c 91A, available at
2. In order for MOM to assess my application, I consent to the Government of Singapore and statutory authorities to getting
from and verifying information with any person, organisation or any other source. Further, I consent to the information
obtained in this process to be released to the Government of Singapore, its statutory authorities and their authorised agents.
3. 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.
4. I am not related to the foreign domestic worker.
5. I have / have not* used the services of an Employment Agency based in Singapore for the recruitment and/or application of
a work permit for this foreign domestic worker. (If applicable: Employment Agency Licence No.
________________________________. Please also ensure that the Employment Agency completes "Declaration by
Employment Agency”.)
6. The information in this application and any appeals I have made in relation to this application are, to the best of my
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.
*Delete accordingly
Name of employer
NRIC/Passport number
Signature of employer
Date (DD-MM-YYYY)
Declaration by current employer whose foreign domestic worker is applying for a change of
employer
I, __________________________________________________________ (Name of Current Employer) of NRIC / Passport No.
__________________________ agree to release my foreign domestic worker named above to the prospective employer,
___________________________________________________________ (Name of Prospective Employer).
Until the transfer is successful, I remain responsible for this foreign domestic worker. In the meantime, if the work permit of this
foreign domestic worker is expiring, I will either apply to extend her work permit or send her back to her home country.
Signature of current employer
Date (DD-MM-YYYY)
Ministry of Manpower Work Pass Division
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