新加坡个人信息表
| 姓名 | 婚姻状况 | 配偶国籍 | |||
| 家庭电话 | 手机号码 | 学历 | |||
| 职业 | 单位电话 | 与同行人关系 | |||
| 以前是否去过新加坡（打勾） | 是 | 否 | |||
| 行程出发日期 | 返程抵达中国日期 | ||||
| 单位地址 | |||||
| 单位负责人姓名及电话 | |||||
| 如需多次出入新加坡或不是直接前往新加坡，请写明详细行程 | |||||
| 预计行程超过30天须说明理由（具体可停留天数须根据当地边防签发） | |||||
| 现住址 | |||||
| 您是否曾被任何国家（包括新加坡）拒签或拒绝入境或遣返回国，请写明时间、原因 | |||||
| 您是否曾被任何国家（包括新加坡）的法律下被控有罪 | |||||
| 您是否曾用其他名字或护照入境新加坡，如果有请写明情况 | |||||
| PART IV - DECLARATION BY APPLICANT | |||||
| I declare that the particulars and documents furnished in respect of this application are true and correct. 本人谨此声明，本人在这份申请书里所提供的一切资料均属实与正确。 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. 本人保证在居留新加坡期间不滥用受管制药物，或参加任何政治性活动或其他足以使本人成为在移民法令下不受欢迎或被禁入境人士的活动。 I undertake to comply with the provisions of the Immigration Act and any regulations made thereunder or any statutory modification or re-enactment thereof for the time being in force in Singapore. 本人保证遵守移民法令的规定以及该法令下的任何条例，或新加坡现行的对该法令所做的任何法定修改或重新制定。 I undertake not to involve in any criminal offences in Singapore. 本人保证在新加坡期间不涉及任何刑事罪行。 I undertake not to indulge in any activities which are inconsistent with the purpose for which the immigration passes have been issued 本人保证不沉溺于任何不符合贵局签发移民证件原意的活动。 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 ( Cap. 91A ). 本人进一步保证在居留新加坡期间，在没持有外国劳工雇佣法令签发的工作准证的情况下，不参与任何形式的就业，商业或职业。 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. 本人知道，在新加坡逾期居留或非法工作是很严重的罪行，而且罪名成立时的惩罚可能包括强制性监禁和鞭刑。 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. 本人明白，如果移民与关卡局总监确信本人或本人任何一名家庭成员违背了这份担保书或称为不受欢迎或被禁入境人士，他将取消我与我家人的移民证件，而我们可能必须在证件被取消后24小时之内离开新加坡。 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. 本人明白，提呈这份签证申请书以及持有签证都不能成为入境担保，本人能否入境，全视临入境前的情况而定。 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. 本人同意让贵局向任何视为恰当的消息来源获取或核实资料，以便对本人的移民证件作出评估。 | |||||
本人声明：以上所填内容完全属实，否则本人接受由此造成的所有风险和损失！
申请人签名： 申请日期： 年 月 日
