Employment Pass Questionnaire Form Dear client, this questionnaire will assist us in determining the Employment Pass submission process.

This form will autosave whenever changes are made.

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Existing or Previous Pass Holder
Applicant's Personal Information
Applicant's Education/Membership Details
Applicant’s Spouse Education/Membership Details
Applicant’s Employment Details
Additional information on Applicant
Declaration by Applicant
Supporting Documents Required
Declaration and Authorization

Please resolve the following before submitting:

Attach your travel document

Attach your education certificate(s)

Attach your proof of membership(s) in societies and organisations

Attach your resume

Attach your existing or previous pass issued by MOM

Attach your marriage certificate

Attach your spouse education certificate(s)

Attach your spouse proof of membership(s) in societies and organisations

*Email Contact:

Please enter an email address

*Mobile Number:

Please enter your mobile number

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1Existing or Previous Pass Holder

Employer's Business registration number/UEN - (ACRA)

Please enter your employer's Business registration number/UEN

Employer's Company name:

Please enter your employer's company name

*Are you currently still holding any work pass? *Have you previously held any work pass? Date of cancellation of previous pass if any (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

*What pass are you currently or previously holding?

*Pass No:

Please enter pass number

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2Applicant's Personal Information

*Applying For *Duration of pass applied *How soon? (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

*Are you a partner, sole proprietor or director of any company? Business Registration Number/UEN (if any) *Name (as on travel document)

Please enter your name

Alias *Sex *Marital Status *Date of Birth (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

*Nationality

Please select a country

For Malaysians

*Malaysian Old Identity Card Number

Please enter an identity card number

*Malaysian New Identity Card Number

Please enter an identity card number

*Malaysian Identity Card Colour

*Country of Birth

Please select a country

*State/Province of Birth

Please select a state

*Country of Origin

Please select a country

*Race *Religion

Your travel document details

*Passport number

Please enter your passport number

*Expiry date (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

*Are you currently living in Singapore?

Your current Singapore address

*Block/House number

Please enter your block/house number

Floor number Unit number Building name *Street name

Please enter your street name

*Postal code

Please enter your postal code

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3Applicant's Education/Membership Details

3A. Education Details

Please fill in the two highest qualifications.
Note this is a key criterion in the assessment of the applicant's eligibility for a work pass and should be provided where applicable

(1) Awarding Body/Institution/University of the qualification

*Awarding Body/Institution/University

Please enter your highest education details

*Country

Please enter the country of your highest education

*State/Province

Please enter the state of your highest education

Main Campus or Affiliating College Attended (applicable only for India qualification)

*Qualifications (e.g. Honours Degree, state class/division; Diploma)

Please enter your highest education details

*Specialisation

Please enter your highest education details

*Faculty

Please enter your highest education details

*Period of study from (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

*Period of study to (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

*Mode of Study

Please enter your highest education details

(2) Awarding Body/Institution/University of the qualification

Awarding Body/Institution/University Country

State/Province

Main Campus or Affiliating College Attended (Applicable only for India qualification)

Qualifications (e.g. Honours Degree, state class/division; Diploma) Specialisation Faculty Period of study from (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

Period of study to (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

Mode of Study

For Malaysian only

Complete the relevant information below if the qualification is STPM or MICSS

Sijil Tinggi Persekolahan Malaysia (STPM)

No. of Principal passes - C (inclusive of General Studies/Pengajian Am)

Please enter a number

No. of Subsidiary passes - C (inclusive of General Studies/Pengajian Am)

Please enter a number

Did you pass General Studies/Pengajian Am?

Malaysia Independence Chinese Secondary School (MICSS) United Examination Certificate

No. of Passes attained (inclusive of Bahasa Inggeris/English language)

Please enter a number

Did you pass Bahasa Inggeris/English language?

3B. Societies/Organisations Membership (Past five years to date)


Society/Organisation Position held Period from (dd/mm/yyyy) Please enter a valid date in dd/mm/yyyy format Period to (dd/mm/yyyy) Please enter a valid date in dd/mm/yyyy format

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4Applicant’s Spouse Education/Membership Details

Is your spouse a Singapore citizen, PR or any pass holders?

*Spouse's Name

Please enter the name of your spouse

*Spouse’s Identification type *Spouse’s FIN/NRIC number

Please enter the FIN/NRIC number of your spouse

*Spouse’s Date of Birth (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

*Marriage certificate number

Please enter your marriage certificate number

4A. Spouse's Education Details

Please fill in the two highest qualifications.

(1) Awarding Body/Institution/University of the qualification

*Awarding Body/Institution/University

Please enter the highest education details of your spouse

*Country

Please choose a country

*State/Province

Please choose a state

Main Campus or Affiliating College Attended (Applicable only for India qualification)

*Qualifications (e.g. Honours Degree, state class/division; Diploma)

Please enter the highest education details of your spouse

*Specialisation

Please enter the highest education details of your spouse

*Faculty

Please enter the highest education details of your spouse

Period of study from (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

Period of study to (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

*Mode of Study

(2) Awarding Body/Institution/University of the qualification

Awarding Body/Institution/University Country

State/Province

Main Campus or Affiliating College Attended (Applicable only for India qualification)

Qualifications (e.g. Honours Degree, state class/division; Diploma) Specialisation Faculty Period of study from (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

Period of study to (dd/mm/yyyy)

Please enter a valid date in dd/mm/yyyy format

Mode of Study

For Malaysian only

Complete the relevant information below if the qualification is STPM or MICSS

Sijil Tinggi Persekolahan Malaysia (STPM)

No. of Principal passes - C (inclusive of General Studies/Pengajian Am)

Please enter a number

No. of Subsidiary passes - C (inclusive of General Studies/Pengajian Am)

Please enter a number

Did you pass General Studies/Pengajian Am?

Malaysia Independence Chinese Secondary School (MICSS) United Examination Certificate

No. of Passes attained (inclusive of Bahasa Inggeris/English language)

Please enter a number

Did you pass Bahasa Inggeris/English language?

4B. Spouse Societies / Organisations Membership (Past five years to date)


Society/Organisation Position held Period from (dd/mm/yyyy) Please enter a valid date in dd/mm/yyyy format Period to (dd/mm/yyyy) Please enter a valid date in dd/mm/yyyy format

Not applicable

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5Applicant’s Employment Details

5A: Working Experience of Applicant

Total Period of Working Experience

*Years

Please enter your total years of working experience

*Months

Please enter your total months of working experience

Total Period of Relevant Working Experience
(Relevant to the occupation declared in Part 5C)

*Years

Please enter your relevant years of working experience

*Months

Please enter your relevant months of working experience

Working Experience


Period from (dd/mm/yyyy) Please enter a valid date in dd/mm/yyyy format Period to (dd/mm/yyyy) Please enter a valid date in dd/mm/yyyy format Company Name Occupation Last drawn monthly salary (SGD)

5B: Salary Details

*Salary payable by

As specified in Employment Contract:

Fixed Monthly Salary = Basic Monthly Salary + Fixed Monthly Allowances
Example SGD5,000 = SGD4,500 + SGD500

*Fixed Monthly Salary (SGD)

Please enter your fixed monthly salary

*Basic Monthly Salary (SGD)

Please enter your basic monthly salary

5C: Address and Duties to be Performed

*Occupation

Please enter your occupation

Address where foreign employee’s duties are to be performed

*Block/House number

Please enter your working address

Floor number Unit number Building name *Street name

Please enter your working address

*Postal code

Please enter your working address

*National Environment Agency Licence Type: (For Food Establishment only)

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6Additional information on Applicant

a. Do you own any companies in other countries? b. Are you currently in the process of negotiating any contracts/in possess of letter of intent for the Singapore-established company? c. Do you have business plan for the Singapore-established company d. Have you hired any staff for the Singapore-established company? e. Do you previously have any unresolved matters with Singapore Authorities? (MOM, IRAS, ICA etc.) f. Do you have any testimonials, reference letter from past employers/clients or universities (for fresh graduate)? g. Have your application been rejected by MOM before?

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7Declaration by Applicant

Have you ever:

a. Been refused entry into or deported from any country?

b. Been convicted in a court of law in any country?

c. Been prohibited from entering Singapore?

d. Entered Singapore using a different passport issued by a different country?

e. Entered Singapore using a different name?

f. Been a Singapore Citizen or Singapore Permanent Resident?

g. Stayed in Singapore?

Length of stay in Singapore due to study

*Year(s)

Please enter a number

*Month(s)

Please enter a number

Length of stay in Singapore due to work

*Year(s)

Please enter a number

*Month(s)

Please enter a number

Length of stay in Singapore due to other purposes

*Year(s)

Please enter a number

*Month(s)

Please enter a number

h. Been issued a work visa by another country?


Country of issue Please select a country Length of visa Year(s) Please enter a number Month(s) Please enter a number

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8Supporting Documents Required

ONE CLEAR COPY of the following documents in ENGLISH

If your supporting documents are not in english, please submit a copy of the original papers and the official English translation done by translation service providers, High Commission/Embassy or notary public.

Maximum size of 2MB for each file in jpg/doc/pdf/zip format.

*Travel Document Page showing the personal particulars and travel document number.
Please include pages reflecting amendments to details (e.g. name, expiry date), if any.
File with size up to 2MB is required.

Front and back copy of the existing or previous pass issued by MOM (*required if you are a passholder)

File with size up to 2MB is required.

For Malaysian only – Front and back copy of Malaysia NRIC
File with size up to 2MB is required.
Educational document(s)
- *Educational Certificates
  File with size up to 2MB is required.
- Diploma/degree qualifications from India
  - Transcripts and marksheets
    File with size up to 2MB is required.
- Diploma/degree qualifications from China
  - Certificate of Graduation (毕业证书)
    File with size up to 2MB is required.
  - Verification proof of educational certificates from any one of the following independent verification channels:
    - Dataflow (http://www.dataflowgroup.com)
    - The China Higher Education Student Information job portal (http://job.chsi.com.cn/)
    - The China Academic Degrees and Graduate Education Information (http://www.cdgdc.edu.cn)
    File with size up to 2MB is required.

NEA Licence (For Food Establishment only)

File with size up to 2MB is required.

Proof of membership(s) in societies and organisations (*required if you are a member in Section 3B above)
File with size up to 2MB is required.
*Resume
File with size up to 2MB is required.

Spouse Documents

*Official marriage certificate
File with size up to 2MB is required.
Spouse’s travel document page
File with size up to 2MB is required.
Spouse’s front and back page of pass issued by MOM (if applicable)
File with size up to 2MB is required.
Spouse’s front and back page of Malaysian NRIC (if applicable)
File with size up to 2MB is required.
*Spouse’s educational certificates
File with size up to 2MB is required.
Spouse’s proof of membership(s) in societies and organisations (*required if your spouse is a member in Section 4B above)
File with size up to 2MB is required.

Certificates of incorporation with company name for your companies in other countries

File with size up to 2MB is required.

Contracts/in possess of letter of intent for the Singapore-established company

File with size up to 2MB is required.

Business plan for the Singapore-established company

File with size up to 2MB is required.

Details and status update of unresolved MOM matters

File with size up to 2MB is required.

Testimonials, reference letter from past employers/clients or universities (for fresh graduate)

File with size up to 2MB is required.

Past rejection letters from MOM

File with size up to 2MB is required.

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9Declaration and Authorization

Declaration is not checked

I declare that the above information are true and accurate.

Declaration is not checked

I hereby authorized Paul Hype Page Management Services Pte. Ltd. to process my work pass application.

Declaration is not checked

I have given the consent to the Government of Singapore to obtain from and verify the information with any person, organisation, or any other source for assessing the application.