FORM 14 IMMIGRATION ACT [CHAPTER 133, SECTION – 55(1

FORM 14
IMMIGRATION ACT [CHAPTER 133, SECTION – 55(1)]
Notes:
* Tick (√) where appropriate
** Delete where appropriate
Affix a recent
Passport-size
photograph here
VISIT PASS
APPLICATION FOR A*
VISA & VISIT PASS
ENTRY VISA
PART I – PARTICULARS OF APPLICANT
Foreign Identification No. (FIN):
Sex:*
(leave blank if not applicable)
Male
Date of Birth:
For Malaysians Only (including old or new Malaysian IC)
D D
Marital Status:*
Separated
Female
M M
Y
Single
Married
Divorced
Widowed
Y Y Y
Identity
Card No.:
Colour:*
Red
Blue
Name:
Family Name/Surname
Given Name
Alias:
Family Name/Surname
Given Name
(leave blank if not applicable)
Name in Chinese Characters:
(If applicable)
Country of Birth:
State/Province of Birth:
Race: (e.g. Malay, Indian,
Chinese, Caucasian, etc)
Nationality:
Religion/Denomination:
:
Type of Travel Document Held:
(e.g. Passport, Certificate of Identity,
Document of Identity, etc)
Travel Document No.:
Travel Document
Issued Date:
Expiry Date:
D D
M M
Y
Y Y
Y
Country of Issue:
Place of Issue:
Disembarkation/Embarkation form no.:
(This form is the immigration white card issued to arriving foreigners)
IMM 14
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D D
M M
Y
Y Y Y
THIS FORM IS ISSUED FREE
PART I (continued)
Address in Singapore
Block/House No.:
Floor No.:
Unit No.:
Street Name:
Postal Code:
Tel No:
Building Name:
Address in Country of Origin
Country of Origin:
State/Province of Origin:
Address:
PART II –OTHER DETAILS
Occupation:
Highest Academic/Professional Qualifications Attained:
Purpose of visit:
Period of Visa/Visit Pass/Visa & Visit Pass Applied For:
Nationality of Spouse:*
Singapore Citizen
Singapore Permanent Resident
Others (Please Specify)
List countries in which applicant has resided for one year or more during the last 5 years.
Country
Address
Period of Stay
From
To
PART III – ANTECEDENT OF APPLICANT *
(a) Have you ever been refused entry into or deported from any country, including Singapore?
Yes
No
(b) Have you ever been convicted in a court of law in any country, including Singapore?
Yes
No
(c) Have you ever been prohibited from entering Singapore?
Yes
No
(d) Have you ever entered Singapore using a different passport or name?
Yes
No
If any of the answer is “YES”, please furnish details on a separate sheet of paper
IMM 14
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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),
No. :
, holder of Singapore (Pink/Blue**) NRIC
and residing at
Declare that :
The applicant,
parent
husband / wife / son / daughter**
others (Please specify)
is my
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
IMM 14
Signature of Sponsor
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