FORM 14A

Affix a recent
Notes:
IMMIGRATION ACT 1959 [SECTION – 55(1)]
Passport-size
photograph here
* Check the box where appropriate

APPLICATION FOR ENTRY VISA

PART I – PARTICULARS OF APPLICANT

Name:
(Full name as shown in S U R N A M E F I R S T N A M E M I D D L E
travel document)
N A M E ( A S P E R P A S S P O R T )
Alias:
O N L Y I F P R I N T E D O N
P A S P O R T
Date of Birth: Sex:*
D D M M Y Y Y Y Male Female AS PER PASSPORT
D D M M Y Y Y Y

Marital Status:* Single Married Separated Divorced Widowed Cohabited Customary

BELOW DETAILS ONLY REQUIRED IF TICKED MARRIED, WIDOWED
Nationality/Citizenship
of Spouse:* Singapore Citizen NRIC No.
Singapore Permanent Resident NRIC No.

Others (Please Specify):

Country/Place of Birth: I N D I A
State/Province of Birth: A S P E R P A S S P O R T
Race: (e.g. Malay, Indian,
Chinese, Caucasian, etc)
I N D I A N

Nationality/Citizenship: I N D I A N

Type of Travel Document Held:* International Passport Diplomatic Passport Official Passport
Service Passport Document of Identity Certificate of Identity
Others (please specify)

Travel Document No.: P P T N O .

Travel Document
Issued Date:
D D M M Y Y Y Y Expiry Date: D D M M Y Y Y Y
D D M M Y Y Y Y D D M M Y Y Y Y

Country/Place of Issue: A S P E R P A S S P O R T

For Chinese Nationals Only

PRC ID Number

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IMM 14A THIS FORM IS ISSUED FREE
Address in Country/Place of Origin/Residence

Country/Place of Origin/
Residence:
I N D I A

Division/State/Province
of Origin/Residence: A S P E R P A S S P O R T

Prefecture of Origin/
Residence: L E A V E B L A N K

County/District of Origin/ L E A V E B L A N K
Residence:

Address: AS PER PASSPORT

PART II – OTHER DETAILS

Email Address:
P E R S O N A L E M A I L I D
Contact Number: M O B I L E N O .
Occupation:
S E R V I C E / B U S I N E S / S T U D E N T

Highest Academic/ No Formal Education Primary Secondary Pre-University

Professional
Qualifications Attained:* Diploma University Post-Graduate

Annual Income in AS PER YOUR LATEST INCOME TAX

Singapore dollars (SGD):

Religion: H I N D U / I S L A M / C H R I S H T I A N

Expected Date of Arrival in Singapore: DATE OF ARRIVAL IN SINGAPORE

D D M M Y Y Y Y

Type of Visa:* Single Journey Double Journey Triple Journey Multiple JourneyALWAY TICK MULTIPLE

Purpose of visit:* Social Business AS PER YOUR REQUIRMENT

Details of purpose:
TOURISM/BUSINESS MEETING/FAMILY VISIT/MEDICAL PURPOSE/TRAINING/JOINING SHIP

How long do you intend to stay in Singapore:* Less than 30 days More than 30 days AS PER YOUR TRAVEL DATES

If your intended stay in Singapore is more than 30 days, please state the reason for your intended length of stay and the
duration
NEED PROPER EXPLANATION AS TO WHY ARE YOU STAYING FOR MORE THAN 30 DAYS

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IMM 14A THIS FORM IS ISSUED FREE
Address in Singapore AS PER YOUR DOCUMENTS PLEASE MENTION COMPLETE ADDRESS WITH POSTAL CODE AND CONTACT NO.
EVEN FOR BUSINESS APPLICATION HOTEL DETAILS ARE MANDATORY.
Where will you be staying in Singapore?:*

Next of Kin’s Place Relative’s Place Friend’s Place Hotel Others (Please specify):

Block/House No.: Floor No.: Unit No.: Postal Code:

Street Name: Contact No:

Building Name:

Did you reside in other countries/places, other than your country/place of origin, for one year or more during the last 5 years ?*
IF IN LAST FIVE YEARS YOU HAVE STAYED OUTSIDE YOUR OWN COUNTRY FOR MORE THAN A YEAR PLEASE FILL
Yes NoTHIS PART OF THE FORM WITH CORRECT INFORMATION.

If yes, please furnish details Period of Stay

Country/Place Address From To

Details of Travelling Companion

(Only for applicant who is 12 years old or less at the point of application. Details are not required if applicant is accompanied by an
airline representative.)

Relationship of
Travelling
Companion
To Applicant: THIS IS TO BE FILLED ONLY FOR CHILDREN APPLICATION WHO ARE 12
YEARS OR BELOW
Name:

Date of Birth: Sex:*

Male Female
D D M M Y Y Y Y

Nationality/Citizenship:

Travel Document
Number:

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IMM 14A THIS FORM IS ISSUED FREE
PART III – PARTICULARS OF LOCAL CONTACT
Details of Local Contact or Company/Hotel in Singapore FOR BUISNESS APPLICATION ONLY WRITE COMPANY NAME, CONTACT NO. AND
EMAIL ID OF THE COMPANY.
Name of Local Contact
/Company/Hotel:

FOR FAMILY VISIT WRITE THE NAME OF THE INVITOR WHO HAS SIGNED THE INVITATION LETTER,ALONG WITH
Relationship of HIS/HER MOBILE NO AND EMAIL ID.
Local Contact/Company/
Hotel to
FOR TOURIST ONLY WRITE NAME OF THE HOTEL YOU ARE STAYING
Applicant:

Contact No.: Email Address:

PART IV – ANTECEDENT OF APPLICANT* READ CARE FULLY AND THEN ANSWER ASK THE AVA IF ANY DOUBTS

(a) Have you ever been refused entry into or deported from any country/place, including Singapore? Yes No
(b) Have you ever been convicted in a court of law in any country/place, 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
OLD PASSPORT TRAVELS AND BEFORE MARRIAGE NAME TRAVELS HAVE TO BE TICKED NO. TICK YES ONLY IF YOU HAVE TRAVELLED ON A
DIFFERENT GIVEN NAME OR A DIFFERENT CATEGORY OF PASSPORT OR A DIFFERENT COUNTRY PASSPORT.
If any of the answer is “YES”, please furnish details below
IF ANY QUESTIONS ANSWER IS YES PLEASE GIVE A BRIEF EXPLANATION YOU CAN CONSULT YOUR AVA FOR CLARIFICATION

SIGN HERE
ONLY SIGN HERE IF YOU HAVE TYPED YOUR FORM ON A COMPUTER
HAND WRITTEN FORMS DON NEED A SIGNATURE HERE

PART V - DECLARATION BY APPLICANT

I declare that all information submitted in this application is true, accurate and complete to the best of my knowledge and belief. I
understand that, if I have concealed relevant information or provided false, inaccurate or misleading information, I may be prosecuted
and any facilities, rights or privileges granted under this application may be withdrawn.

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 1959.

I undertake to comply with the provisions of the Immigration Act 1959 and any regulations made thereunder 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, business or occupation whilst in Singapore without a valid work pass
issued under the Employment of Foreign Manpower Act 1990.

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. SIGNATURE AS PER YOUR PASSPORT, FOR CHILDREN IS BELOW
18 BOTH PARENTS NEED TO SIGN ON THEIR FORMS

Date Signature of Applicant

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IMM 14A THIS FORM IS ISSUED FREE