Sample Application Form

We highly advise utilizing the example

completed application form as a guide when
completing your own application.
 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 L A S T N A M E F I R S T N A M E
travel document)

Alias:

Date of Birth: Sex:*

Male Female
D D M M Y Y Y Y

Marital Status:* Single Married Separated Divorced Widowed Cohabited Customary

Nationality/Citizenship
of Spouse:* Singapore Citizen NRIC No.
Singapore Permanent Resident NRIC No.

Others (Please Specify):

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

Nationality/Citizenship:

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.:

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

Country/Place of Issue: C I T Y A N D C O U N T R Y

For Chinese Nationals Only

PRC ID Number

1
IMM 14A THIS FORM IS ISSUED FREE
Address in Country/Place of Origin/Residence

Country/Place of Origin/
Residence: U S A
Division/State/Province
of Origin/Residence: C A L I F O R N I A
Prefecture of Origin/
Residence: C I T Y
County/District of Origin/ C O U N T Y
Residence:

Address: NOTE : ADDRESS SHOULD BE US ADDRESS, NOT the COUNTRY OF ORIGIN

PART II – OTHER DETAILS

Email Address:

Contact Number:

Occupation:

Highest Academic/ No Formal Education Primary Secondary Pre-University

Professional
Qualifications Attained:* Diploma University Post-Graduate

Annual Income in
Singapore dollars (SGD):

Religion:

Expected Date of Arrival in Singapore:

D D M M Y Y Y Y

Type of Visa:* Single Journey Double Journey Triple Journey Multiple Journey

Purpose of visit:* Social Business

Details of purpose:

How long do you intend to stay in Singapore:* Less than 30 days More than 30 days

If your intended stay in Singapore is more than 30 days, please state the reason for your intended length of stay and the
duration

2
IMM 14A THIS FORM IS ISSUED FREE
Address in Singapore

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 ?*

Yes No

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:

Name:

Date of Birth: Sex:*

Male Female
D D M M Y Y Y Y

Nationality/Citizenship:

Travel Document
Number:

3
IMM 14A THIS FORM IS ISSUED FREE
PART III – PARTICULARS OF LOCAL CONTACT
Details of Local Contact or Company/Hotel in Singapore

Name of Local Contact

/Company/Hotel:

Relationship of
Local Contact/Company/
Hotel to
Applicant:

Contact No.: THIS CANNOT BE LEFT BLANK Email Address: THIS CANNOT BE LEFT BLANK

PART IV – ANTECEDENT OF APPLICANT*

(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

If any of the answer is “YES”, please furnish details below

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.

Date Signature of Applicant

4
IMM 14A THIS FORM IS ISSUED FREE
APPLICATION FORM – 14 A
 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
travel document)

Alias:

Date of Birth: Sex:*

Male Female
D D M M Y Y Y Y

Marital Status:* Single Married Separated Divorced Widowed Cohabited Customary

Nationality/Citizenship
of Spouse:* Singapore Citizen NRIC No.
Singapore Permanent Resident NRIC No.

Others (Please Specify):

Country/Place of Birth:

State/Province of Birth:

Race: (e.g. Malay, Indian,

Chinese, Caucasian, etc)

Nationality/Citizenship:

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.:

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

Country/Place of Issue:

For Chinese Nationals Only

PRC ID Number

1
IMM 14A THIS FORM IS ISSUED FREE
Address in Country/Place of Origin/Residence

Country/Place of Origin/
Residence:

Division/State/Province
of Origin/Residence:

Prefecture of Origin/
Residence:

County/District of Origin/
Residence:

Address:

PART II – OTHER DETAILS

Email Address:

Contact Number:

Occupation:

Highest Academic/ No Formal Education Primary Secondary Pre-University

Professional
Qualifications Attained:* Diploma University Post-Graduate

Annual Income in
Singapore dollars (SGD):

Religion:

Expected Date of Arrival in Singapore:

D D M M Y Y Y Y

Type of Visa:* Single Journey Double Journey Triple Journey Multiple Journey

Purpose of visit:* Social Business

Details of purpose:

How long do you intend to stay in Singapore:* Less than 30 days More than 30 days

If your intended stay in Singapore is more than 30 days, please state the reason for your intended length of stay and the
duration

2
IMM 14A THIS FORM IS ISSUED FREE
Address in Singapore

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 ?*

Yes No

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:

Name:

Date of Birth: Sex:*

Male Female
D D M M Y Y Y Y

Nationality/Citizenship:

Travel Document
Number:

3
IMM 14A THIS FORM IS ISSUED FREE
PART III – PARTICULARS OF LOCAL CONTACT
Details of Local Contact or Company/Hotel in Singapore

Name of Local Contact

/Company/Hotel:

Relationship of
Local Contact/Company/
Hotel to
Applicant:

Contact No.: Email Address:

PART IV – ANTECEDENT OF APPLICANT*

(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

If any of the answer is “YES”, please furnish details below

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.

Date Signature of Applicant

4
IMM 14A THIS FORM IS ISSUED FREE
 SINGAPORE VISA
Visa Application Checklist

APPLICATION INFORMATION
Name of Customer
Type of Visa
Reference Number
Phone number
Email address
DOCUMENT CHECKLIST VFS OFFICER COMMENTS
Original Passport valid for 6 months fromdate of entry
in Singapore,

Appointment Confirmation Letter for online

payment or Money Order/Cashier’s Check payable to
“VFS Services (USA) Inc”

One Passport Sized color Photo taken within the last 3

Months showing current appearance (Refer website for
detailed specifications).

Application Form – 14A Duly Filled and Signed - Any

incomplete information or false declaration will result
in Applicationbeing delayed or rejected.
Email address and US Contact Number must be
Included in page 4 of the form 14A,
Note: application must be signed in the same way as
what is on the applicant’s passport

Form 39A/ Letter of Introduction must be duly- filled by

Local Singapore registered business entity; Digital
signatures on the form will not be accepted. If
attending a Conference, Invitation letter from
Conference organizers may also be accepted. Digital
signatures on the form will not be accepted.

Supporting documents if you have selected “YES” to

Questions in PART IV– ANTECEDENT OF
APPLICANT FORM 14A

Copy of passport bio page and observation pages/

Amendments (if any).

Notarized Copy of US Green Card both sides / Clear

copy of the valid US visa/
Renewal Notice/Advance Parole/ If student,copy of F1
visa and all pages of I-20.

Confirmed Travel Itinerary showing customer

name in Bookings made (if booking under other
name, provide proof of relationship).

Proof of Accommodation (except transit ) orsupporting

letter of intended hotel stay if unable to provide proof at
the time of application or Form 39A/ Letter of
Introduction from a Singapore National withSingapore
Identity Card (Both Sides) .

Return Label for original passport to be sent

back to customer post verification (postal
applications)
 FEES PAYABLE AT THE VISA APPLICATION CENTRE AT THE TIME OF APPOINTMENT

Visa fees Service fees Additional Service fees

Important Notes

• Processing time can take up to 5 business days from the date of receipt of complete applications at the visa
application center. Each visa application will be considered on its own merits and some applications may take
up to 15 business days.
• Applications may not be lodged earlier than 30 days before the intended entry at the port.
• A copy of the valid visa to the next destination should be obtained (if applicable).

Form 14A Clarifications

• Name: To be filled in the same sequence as it appears on your passport/travel document. Typically,
passports indicate your surname/family name first, followed by your first/given name.
• Application form must be signed in the same way as what is on the applicant’s passport
• Country and Place of Issue: These refer to the “Place of Issue” on your passport biodata page, which is
typically a state, district or city. For the Country of Issue, fill in the country which relates to the
city/state/district listed as “Place of Issue” on your travel document/passport.
• Address in country of origin: Fill in your last known or current address in the country of your nationality.
• Countries previously/currently resided (page 2): Fill in the address/addresses of any countries you have
resided in (i.e. USA) outside of the country of your nationality.

• Only for Blue Identity Card holders - In case you have not surrendered your Blue Identity Card, you are
required to submit it to the Singapore Consulate-General in San Francisco before applying for your visa.
(Please note that processing time for such cases will be longer and dependent on the ICA).

Declaration

I, agree that in case of an

incomplete application, there might be delays or rejections. I also agree to accept the terms and
conditions of service and data protection and privacy policy available on
www.vfsglobal.com/Singapore/USA.

Signature of the Applicant: Date: