Supplementary Application Form For Replacement (Page 2 of 2) in pdf

Supplementary Application Form For Replacement Page 2

SUPPLEMENTARY APPLICATION FORM FOR REPLACEMENT OF LOST

SINGAPORE PASSPORT

This form may take 5 minutes to complete.

You will need the following information to complete the forms:

•

Passport holder’s

NRIC No.

•

Passport Holder’s

Name and Address of

Employer

•

Parent/Legal Guardian’s NRIC No. (if Applicable)

PART II (to be retained by ICA)

Please complete this form by providing the information requested.

1. Applicant’s Occupation_____________________________________________________

2. Name & Address of Employer______________________________________________

3. Date & Time the passport was lost ____________________________________________

4. Describe how the loss occurred ______________________________________________

________________________________________________________________________

5. The date the passport was last used ___________________________________________

6. Reason the loss was not reported earlier _______________________________________

________________________________________________________________________

Note: Please note that the fee paid for the replacement of your passport is non-

refundable.

I, ______________________________________, holder of NRIC No: __________________

(Name)

declare that the information given in this form is correct. I have also been informed that the

passport reported lost will be invalidated with immediate effect and can no longer be used for

travelling even if found subsequently. If I recover my lost passport, I must surrender the said

passport within 14 days in person to Passports Section for physical invalidation.

_______________________________________

_____________________

Signature of*Applicant/Parent/Legal Guardian

Date

*Delete as necessary

Supplementary Application Form For Replacement Page 2