* Tick (√) where appropriate
** Delete where appropriate
APPLICATION FOR A* VISIT PASS VISA & VISIT PASS ENTRY VISA
Affix a recent
Passport-size
photograph here 貼照片
=====
PART I – PARTICULARS OF APPLICANT
Foreign Identification No. (FIN):
(leave blank if not applicable) 首次申請的沒有，空著
Sex:* 性別
Male 男 Female 女
Date of Birth: 生日，按日-月-年的順序
D D M M Y Y Y Y
Marital Status:*
Single Married Separated Divorced Widowed 單身，結婚，分居，離婚，喪偶
For Malaysians Only (including old or new Malaysian IC)
不用填
Name:
Family Name/Surname 姓
Given Name 名
Alias: 不填
Name in Chinese Characters: 中文名字
Country of Birth: China （出生地）
State/Province of Birth: 省份
Race: (e.g. Malay, Indian, Chinese, Caucasian, etc) 種族，填“Chinese”
Nationality: Chinese
Religion/Denomination: : Free thinker
Type of Travel Document Held: (e.g. Passport, Certificate of Identity,
Document of Identity, etc) Passport 如果沒有護照就不填（但批下來的時候壹定要有護照的吧）
Travel Document No.: GXXXXXXX 護照號碼
Travel Document Issued Date: Expiry Date: 護照的辦法日期和有效期
Country of Issue: China
Place of Issue: 護照的辦法地點，填省份
Disembarkation/Embarkation form no.: 不用填
(This form is the immigration white card issued to arriving foreigners)
Address in Singapore Block/House No.: Floor No.: Unit No.: Postal Code:
Street Name: Tel No:
Building Name:
新加坡的地址
Address in Country of Origin
Country of Origin:
State/Province of Origin:
Address:
中國的地址
PART II –OTHER DETAILS
Occupation: 職業
Highest Academic/Professional Qualifications Attained: 最高學歷
Purpose of visit: 訪問目的，填“visit relatives”或“visit friend”
Period of Visa/Visit Pass/Visa & Visit Pass Applied For: 1 month
Nationality of Spouse:* Singapore Citizen Singapore Permanent Resident
Others (Please Specify) 配偶的國籍（新加坡人，新加坡PR，外國人（China))
List countries in which applicant has resided for one year or more during the last 5 years.
Period of Stay
Country
Address
From
To 過去五年居住去過的國家（居住超過壹年的）
PART III – ANTECEDENT OF APPLICANT *
(a) Have you ever been refused entry into or deported from any country, including Singapore? Yes No 是否被任何國家拒絕入境或驅逐
(b) Have you ever been convicted in a court of law in any country, including Singapore? Yes No 是否在被法庭定過罪（任何國家)
(c) Have you ever been prohibited from entering Singapore? Yes No 是否被禁止進入新加坡(d) Have you ever entered Singapore using a different passport or name? Yes No [b] 是否用其他護照或名字進入過新加坡[/b]
If any of the answer is “YES”, please furnish details on a separate sheet of paper
壹般都填No，否則麻煩了
PART IV - DECLARATION BY APPLICANT
Date Signature of Applicant 申請人簽名及日期
PART V – DECLARATION BY LOCAL SPONSOR ( Not applicable if you are applying for Entry Visa only)
擔保人信息
Section B - For application sponsored by an individual only
I, (name of sponsor), 擔保人姓名 , holder of Singapore (Pink/Blue**) NRIC 新加坡身份證號碼
No. : and residing at 新加坡的住址
Declare that :
The applicant, is my
parent
husband / wife / son / daughter**
others (Please specify) 申請人是我的父母，或丈夫/妻子/兒子/女兒，或其他（比如friend ）
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 Signature of Sponsor 擔保人簽名及日期
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