通讯地址: Correspondence Address |
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邮政编码: Postcode |
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银行定期存款数额: Fixed Deposit Amount |
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存款人姓名: Name of Depositor |
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曾用护照号码(如有): Previous P/P No.(if any) |
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| X光胸透有无异常Chest X-rsy(Any evidence of active TB detected?) |
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| 有无任何传染疾病?Do you have any contiguous disease |
有
无 |
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亲属 Family |
姓名: Name |
拼音: Pin Yin |
身份证/护照号码 I/C/Passport No. |
出生日期: Date of Birth |
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Have you ever been refused entry into or deported from any country?
你是否曾经被某个国家禁止入境或驱逐出境?
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/Yes
否/No |
Have you ever been convicted in a court of law in any country?
你是否曾经触犯过一些国家的法律? |
/Yes
否/No |
Have you ever been prohibited from entering Singapore?
你是否曾经被新加坡政府禁止入境?
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/Yes
否/No |
Have you ever entered Singapore using a different Passport or Name?
你是否使用过其他护照或名字入境新加坡?
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/Yes
否/No |
If ‘Yes’,please give details,若以上任何一项答案为’是’,请详细说明。
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I hereby declare that all the particulars furnished by me in this application are true and correct.
我谨此声明以上所提供的一切资料属实。如有不属实,愿承担法律责任。 |
| 申请人签名 Signature of Applicant:
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| 代理姓名(如有)Agent’s Name(if any):
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