Work Pass Division

18 Havelock Road Singapore 059764 Tel: 6438 5122 www.mom.gov.sg mom_wpd@mom.gov.sg

EntrePass Application Form (Form 8)

This form may require you to take 30 minutes to fill in. You will need the following information to fill it: The applicants Foreign Identification Number (if applicable) The applicants old/new Malaysian Identity Number (if applicable) The applicants Malaysian International Passport Number (applicable to Malaysian only) The correspondence address in Singapore The applicants educational qualification and work experience details The applicants spouse personal particulars (if accompanying spouse is a Singapore citizen / Permanent Resident / Employment Pass / S Pass or Work Permit holder) The employing companys Unique Entity Number (UEN) The employing companys Registration Number (ACRA) for past business ventures The business plan details

Note:

An administrative fee of $70 will be charged for every EntrePass application submitted. Please submit your application and make the fee payment over the counters at any SingPost post offices (MOM-appointed collecting agent). Payment can be made via Cash, Cashcard or NETs. MOM regularly updates its forms. The copy that you have downloaded more than 30 days ago may be outdated, and may not be used. To ensure that you use the latest version, please download the latest copy at http://www.mom.gov.sg.

FORM 8 APPLICATION FOR AN ENTREPASS

INSTRUCTIONS: 1. For *, please tick () where appropriate. 2. Indicate Not applicable or N.A. where necessary. Do not leave any blank. 3. Please check your application status via EP Online under View Application Status. (http://www.mom.gov.sg>Services & Forms>Employment Pass>Application Status Check) 14 days after your application is submitted. Affix a recent passport-sized photograph here

Type of application:* New Application Change from Work Permit

PART 1 BASIC PARTICULARS OF APPLICANT

Foreign Identification Number (FIN):

[leave blank if not applicable]

1A: Personal Particulars Name: (as on travel document, excluding salutations, e.g. Mr, Miss, Professor, Doctor)

Alias:

Sex:* Marital Status:* Date of Birth - dd/mm/yyyy:

For Malaysian only:

Female Divorced

Male Married Separated Nationality: Single Widowed

Malaysian Old Identity Card Number:

Malaysian New Identity Card Number:

Malaysian Identity Card Colour:*

Blue

Pink

Country of Birth: Country of Origin: - country where the person obtained his first
citizenship by birth or parentage

State/Province of Birth: State of Origin:

Race:* Caucasian Malay

Chinese Others

Indian

Religion:* Buddhist Muslim

Christian Others

Free Thinker Sikh

Hindu Taoist

1B: Travel Document Information Travel Document Type:* Travel Document Number: Hong Kong Special Admin Region International Passport Date of Issue - dd/mm/yyyy: International Cert of Identity Macau SAR Travel Permit Date of Expiry - dd/mm/yyyy:

MOM (WPD) 008/01092013

-1-

Form 8 EntrePass Application

1C: Residential Address in Singapore Is the applicant currently staying in Singapore?* No. You do not need to provide any more details Yes. Please fill in the address below: Block/House Number: Street Name: Floor Number: Unit Number: Building Name: Postal Code:

Email Address:

Telephone number:

PART 2 APPLICANTS EDUCATION / MEMBERSHIP DETAILS

Please fill in the two highest qualifications that were awarded to the applicant.

2A: Education Details

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

Country: Name:

State/Province:

Main Campus or Affiliating College Attended: (Applicable only for India qualification) Qualifications#: (e.g. for Honours Degree, state class/division; Diploma)

Specialisation: (e.g. Civil engineering)

Faculty: (e.g. Engineering)

Period of Study - dd/mm/yyyy From: Mode of Study:* Distance Learning To: Full-Time Part-Time Yes No

Has the applicant submitted supporting documents for this qualification before?*

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

Country: Name:

State/Province:

Main Campus or Affiliating College Attended: (Applicable only for India qualification) Qualifications#: (e.g. for Honours Degree, state class/division; Diploma)

Specialisation: (e.g. Civil engineering)

Faculty: (e.g. Engineering)

Period of Study - dd/mm/yyyy From: Mode of Study:* Distance Learning To: Full-Time Part-Time Yes No

Has the applicant submitted supporting documents for this qualification before?*

MOM (WPD) 008/01092013

-2-

Form 8 EntrePass Application

2B: Societies/Organisations Membership

Past five years to date. (1) Society/Organisation Membership

Name of Society/Organisation:

Position Held:* Period - dd/mm/yyyy From:

Chairman Treasurer

Member Vice Chairman To:

President Vice President

Secretary

(2) Society/Organisation Membership

Name of Society/Organisation:

Position Held:* Period - dd/mm/yyyy From:

Chairman Treasurer

Member Vice Chairman To:

President Vice President

Secretary

PART 3 PARTICULARS OF APPLICANTS SPOUSE

Please complete Part 3 and Part 4 if spouse is a Singapore Citizen, Singapore Permanent Resident, Employment/S Pass Holder or Work Permit Holder.

Spouse accompanying applicant is:* a Singapore Citizen Name of spouse: a Singapore Permanent Resident on Employment / S Pass holder or Work Permit holder

Spouses FIN / NRIC Number:

Spouse Identification Type:* FIN NRIC

Spouses Date of Birth - dd/mm/yyyy:

PART 4 CITIZENSHIP/RESIDENTIAL STATUS OF APPLICANTS CHILDREN

Status: Singapore Citizen Singapore Permanent Resident Others

Number:

MOM (WPD) 008/01092013

-3-

Form 8 EntrePass Application

PART 5 APPLICANTS TRACK RECORD

Prior Working Experience

Please indicate in chronological order Period (dd/mm/yyyy) Name of Company From To Location of Company (State and Country)

Position Held

Nature of Duties

Prior Business Ventures**

Please indicate in chronological order.

Only list business ventures in which you were a founder, partner or shareholder. Name of Company: Nature of Business: Place of incorporation: Position Held: Annual Turnover in the past 3 years Year: S$: RCB / ACRA Number (if available): Period - dd/mm/yyyy From: Year: S$: Year:

To: S$:

Name of Company: Nature of Business: Place of incorporation: Position Held: Annual Turnover in the past 3 years Year: S$: RCB/ACRA Number (if available): Period - dd/mm/yyyy From: Year: S$: Year:

To: S$:

Name of Company: Nature of Business: Place of incorporation: Position Held: Annual Turnover in the past 3 years Year: S$: RCB/ACRA Number (if available): Period - dd/mm/yyyy From: Year: S$: Year:

To: S$:

** Please attach a write up on any business-related achievements, if any (e.g. awards, intellectual property developed, etc) MOM (WPD) 008/01092013

-4-

Form 8 EntrePass Application

PART 6 BUSINESS PLAN Important Please submit a comprehensive business plan of not more than 10 pages to support your application. The business plan should include the following information: 1. 2. 3. 4. 5. 6. 7. 8. 9. Business idea a short, self-explanatory summary covering the proposed business concept Product / service the total product and service offering Market analysis the target market in terms of key customers, competition and market growth potential Market plan how the product/service will be marketed or distributed Operation plan resources needed to run the business Financial projections projected sales and net profit before tax for three years and breakeven point Management team key drivers of the business Supporting documents e.g. licensing agreements, product certifications, endorsements, etc. Documentary proof on sources of funding and availability of funds e.g. self funded, through venture capital funds, etc.

6A: Proposed/Registered Company General Information Is your proposed business already registered as a Private Limited Company in Singapore?
(If yes, ACRA record to be provided)

Yes

No

Accounting and Corporate Regulatory Authority (ACRA) Registration Number: Unique Entity Number (UEN):

This will be the name of company reflected on the 2-in-1 secure card if application is successful.

Name of Employing Company/Society/Organization:

Tel Number: Correspondence Address of Company/Organization: Block/House Number: Floor Number: Unit Number: Street Name:

Fax Number:

Building Name: Postal Code:

6B: Proposed Business Sector Please tick only 1 box Caf/Restaurant Financial Services Retail Community & Personal Services Education/Training Manufacturing Others. Please specify:

Information Technology
Trading

Note: For any amendments to the nature of business after the application is successful, you will have to submit a new application. An administrative fee of $70 will be charged upon submission

Nature of Business:

Operating Address of Company/Organization where business activities are conducted: Block/House Number: Floor Number: Unit Number: Building Name: Street Name: Postal Code:

All successful applicants are required to inform Work Pass Division of the companys operating address within 3 months after the pass is issued if the information is not available at the point of application.

Occupation:

Refer to the List of Standard Occupation before you fill in the Occupation field. If the occupation you indicate cannot be found in the list, a close match will be assigned by Work Pass Division. For any subsequent amendments to this assigned occupation, you will have to withdraw the existing application and submit a new application. The prevailing administration fee will be charged upon submission.

Job Description: (Details to be given)

MOM (WPD) 008/01092013

-5-

Form 8 EntrePass Application

Please note that the fixed monthly salary includes only basic monthly salary and fixed monthly allowances. It is important that you read and understand the definition of fixed monthly salary, which can be found at http://www.mom.gov.sg. Fixed Monthly Salary = Basic Monthly Salary + Fixed Monthly Allowances E.g. S$5,000 = $4,500 + $500 As specified in Employment Contract:

Fixed Monthly Salary: Basic Monthly Salary:

S$ S$

.00 .00

will use the fixed monthly salary to assess the application. If the amount indicated as fixed monthly salary is more than the basic MOM monthly salary, MOM will take the difference as the 'fixed monthly allowances'. If there are no fixed monthly allowances, the amount of fixed monthly salary should be exactly the same as the basic monthly salary.

Projected Manpower over the next 3 years Year 1 No. of Employees: Projected Turnover over the next 3 years Year 1

Year 2 No. of Employees: Year 2

Year 3 No. of Employees: Year 3 S$:

S$: S$: Amount of capital required to start up and commence operations (S$): Proposed percentage of shareholding (%):

Proposed paid-up capital (S$):

Sources of funding (e.g. self funded, through venture capital funds, etc.), please specify:

PART 7 DECLARATION BY APPLICANT

Please tick () accordingly.

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? If Yes, please indicate the purpose(s) of stay below. (i) (ii) (iii) Length of stay in Singapore due to study Length of stay in Singapore due to work
[excluding the period that is already declared under g(i)]

Yes Yes Yes Yes Yes Yes Yes Year(s) Year(s) Year(s) Yes

No No No No No No No Month(s) Month(s) Month(s) No

: :
:

Length of stay in Singapore due to other purposes

(h) been issued a work visa by another country? If Yes, please provide the most recent details below. (i) (ii) Country of Issue Length of Visa : : Year(s)

Month(s)

If any of the above answers from (a) to (f) is Yes, please provide details:

MOM (WPD) 008/01092013

-6-

Form 8 EntrePass Application

PART 8 SPONSORSHIP [Complete either (A) or (B)] (A) Declaration by applicant furnishing Bankers Guarantee
Note: The Bankers Guarantee has to be furnished during issuance of the pass.

I undertake to furnish a security deposit of S$3,000 in the form of a Bankers Guarantee for this application. I certify that this application is made for the purpose as stated by me. The statements made by me in this application are to the best of my knowledge true. I undertake to be responsible for my own stay, maintenance and repatriation. I also undertake to be responsible for the compliance by me of any quarantine and medical surveillance imposed on me under Regulation 8 (2A) of the Immigration Regulations.

Name of Applicant

Authorised Signature & Date

(B) Declaration by Local Sponsor COVENANT WHEREAS the Controller of Work Passes as a condition precedent to the issue to (hereafter called the Applicant) of an EntrePass to work in Singapore has required that (hereafter called the Sponsor) shall give security in respect of the Applicant. NOW THOSE PRESENTS witness that in consideration of the issue to the applicant of an EntrePass the Sponsor undertakes to: i. ii. iii. be responsible for the stay, maintenance and repatriation of the applicant; indemnify the Singapore Government for any charges or expenses which may be incurred by the Government in respect of the repatriation of the said applicant or any of his dependants; and be responsible for the compliance by the applicant of any quarantine and medical surveillance imposed on the applicant under Regulation 8 (2A) of the Immigration Regulations.
Name of Applicant Name of Sponsor

We hereby sponsor this application and certify that it is made for the purpose as stated by the applicant. The statements made by the applicant in this application are to the best of our knowledge true. We undertake to be responsible for the stay, maintenance and repatriation of the applicant.

Authorised Signature & Date

Official Stamp of Company / Firm:

Name & Designation / Capacity

Name: Designation / Capacity:

MOM (WPD) 008/01092013

-7-

Form 8 EntrePass Application

PART 9 DECLARATION & CONSENT BY APPLICANT [To be signed by applicant]

GENERAL

1. 2.

3.

I shall only engage in or participate in the business specified in this application. I understand that the following are conditions of the EntrePass: a. I shall operate my business only at the operating address stipulated in this document; b. If I am unable to provide the operating address in this document, I shall update the Controller on the operating address within 3 months of issuance of my EntrePass; c. I shall inform the Controller of any changes in the operating address within 7 days of such change; d. I shall cancel my EntrePass within 7 days of cessation of my business; e. I shall, for so long as my EntrePass is valid, inform the Controller of Work Passes of my residential address, in such form or manner as the Controller may determine, within 5 days after the commencement of my employment in Singapore after each change of my residential address, as the case may be; and I shall report in person to the Controller as and when I am required by the Controller to do so.

I acknowledge and accept all the above conditions. Further and in addition, I hereby declare that 1. 2. 3. 4. 5. I confirm that the information as set out in this application for EntrePass is to the best of my knowledge, true and correct. All documents submitted in support of this application for EntrePass are true copies of the originals. I understand that I may be prosecuted if I have provided any information which is false in any material particular or is misleading by reason of the omission of any material particular. I have not, directly or indirectly, engaged or used the services of an unlicensed employment agency. I give my consent to the Government of Singapore to obtain from and verify information with any person, organization or any other source for assessing my application. I hereby give my consent for the Comptroller of Income Tax to verify my income stated in my current and renewal applications, based on my assessment record for the current Year of Assessment, for the Controller of Work Passes. In the event my assessment record for the current Year of Assessment is not available or finalized at the point of verification, I understand the Comptroller of Income Tax will verify my income against my assessment record for the two previous Years of Assessment. I also hereby give my consent for the Comptroller of Income Tax to thereafter communicate the results of the verification to the Controller of Work Passes. I understand that if I breach any of the above conditions, I may be prosecuted and the Controller may revoke my EntrePass. Such breaches will be taken into account and they may affect my future Work Pass applications.

6.

I declare that I have read and understood the above.

Name of Applicant

Authorised Signature & Date

Passport Number

Identity Card Number

MOM (WPD) 008/01092013

-8-

Form 8 EntrePass Application

EntrePass Eligibility Criteria Checklist

INSTRUCTIONS: 1. Please indicate the criteria which you fulfil and provide the details in the form below. 2. You are advised to submit supporting documents to prove that you fulfil the criteria. 3. Incomplete submission will be rejected.

Receives funding/investment from a recognised third-party venture capitalist (VC) or business angel who is accredited by a Singapore government agency Name of investor: Investment amount: Date of investment: Holds an Intellectual Property (IP) that is registered with a recognised national IP institution Country where IP is filed: Name of institution where IP is registered: Name of inventor/s: Title of IP: Filing Status: Filed, pending approval Application Number: Application Date: Approved Publication Number: Publication Date: (S$)

Has ongoing research collaboration with a research institution recognised by Agency for Science, Technology and Research (A*STAR) or Institutes of Higher Learning in Singapore Name of research institute: Duration of research collaboration: Name of collaboration partner: Collaboration partners contact details: Details of research collaboration: Is an incubatee at a Singapore Government-supported incubator Name of incubator: Duration of incubation: Name of incubator manager: Incubator managers contact details: (Please specify period) (Please specify period)

MOM (WPD) 008/01092013

-9-

Form 8 EntrePass Application

WORK PASS DIVISION

DID YOU REMEMBER?

ANNEX A

1 set of original application form duly completed. Application form signed by applicant. EntrePass eligibility criteria checklist 1 CLEAR COPY of the following supporting documents*:
(*Non-English documents must be accompanied by an official English translation done by a certified translator, High Commission/Embassy or a notary public.)

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. Applicants past employment testimonials (if available). Business plan of not more than 10 pages with the following: (a) Business Idea A summary of the proposed business concept (b) Product or Service offered (c) Market Analysis The target market in terms of key customers, competition and market growth potential. (d) Market Plan How the product or service will be marketed or distributed. (e) Operation Plan The resources needed to run the business. (f) Financial Projections The projected sales and net profit before tax for three years and break-even point.

(g) Management team The key drivers of the business. (h) Supporting documents Examples include licensing agreements, product certifications, endorsements etc.

For companies/businesses registered with the Accounting and Corporate Regulatory Authority: (a) Companys latest business profile/instant information (b) A bank statement, from a Singapore-based company bank account, of at least $50,000.

Please do not submit original documents unless otherwise stated. Note: Any person who falsely declares salary, academic qualifications, or submits forged documents in the work pass application shall be guilty of an offence under the Employment of Foreign Manpower Act (Cap.91A).

MOM (WPD) 008/01092013

- 10 -