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Work Permit Renewal Application Form

This document is a declaration form for employers renewing a work permit for their foreign domestic worker. It outlines the employer's obligations to the worker including paying salary, providing accommodation and medical care, and arranging passage home. It also requires the employer to declare they will ensure the worker complies with vaccination requirements and informs them of any medical conditions that could impact supervision of the worker. Finally, it notes that signing the form indicates understanding and agreement to abide by the obligations and that providing false information could result in prosecution.

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1K views2 pages

Work Permit Renewal Application Form

This document is a declaration form for employers renewing a work permit for their foreign domestic worker. It outlines the employer's obligations to the worker including paying salary, providing accommodation and medical care, and arranging passage home. It also requires the employer to declare they will ensure the worker complies with vaccination requirements and informs them of any medical conditions that could impact supervision of the worker. Finally, it notes that signing the form indicates understanding and agreement to abide by the obligations and that providing false information could result in prosecution.

Uploaded by

yamojodnab
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Foreign Domestic Worker Work Permit Renewal Declaration Form

Use this form only if you are an Employment Agent acting on behalf of an employer

To be signed by the employer and


uploaded as part of the renewal
process

Declaration by the employer


1. In order to renew a work pass under the Employment of Foreign Manpower Act (“EFMA”), I declare that:
a. I am fully aware of and shall fulfil my obligations as an employer of a foreign domestic worker under the
EFMA and the Employment of Foreign Manpower (Work Passes) Regulations (“EFMR”) which includes the
following:
• Pay her salary promptly
• Pay for her upkeep and maintenance, including medical treatment
• Provide acceptable accommodation for her
• Should she die while in Singapore, pay for her burial or cremation and pay for her body and belongings
to be returned to her home
• Take her to the Controller of Work Passes when required by Ministry of Manpower
• Inform the Controller of Work Passes in writing within seven days when her employment ends or her
work pass is cancelled
• Arrange and pay for her passage home, after giving her reasonable notice, and paying her outstanding
salary
• Shall employ her in accordance with the Work Pass Conditions and Regulatory Conditions applicable to
her
b. I shall take reasonable steps to ensure that my foreign domestic worker complies with the EFMA and the
EFMR; and such steps shall include reporting to the Controller of Work Passes if I know that she is
noncompliant; and
c. I have obtained my foreign domestic worker’s written consent to continue her employment with me.
d. I do not have any medical condition(s) that will impair my ability to supervise and ensure the well-being of my
foreign domestic worker.
e. I consent to the Government of Singapore and statutory authorities to obtain and verify information, including
information relating to my medical condition(s), with any person, organisation or any other source, and retain
such information for the purpose of assessing my suitability as an employer of foreign domestic worker(s).
Further, I consent to the information obtained in this process to be released to the Government of
Singapore, its statutory authorities and any authorised agents.
f. I consent to MOM displaying the work pass details when my foreign domestic worker's card is scanned using
MOM's work pass mobile application.

2. In relation to the COVID-19 vaccination status of the foreign domestic worker, I declare that I will inform and
ensure that the foreign domestic worker adheres to all vaccination requirements, as set out in:
https://www.mom.gov.sg/vac-reqmts.
This is undertaken in accordance with the following where applicable – the prevailing guidelines of the Singapore
Ministry of Health and Ministry of Manpower, or the Employment of Manpower (Work Passes) Regulations 2012.
To meet the requirements above, I declare that I have read the guidelines contained in :
https://www.mom.gov.sg/vac-reqmts.

3. When a new security bond is needed, I declare that:


a. I have furnished my security bond

Ministry of Manpower Work Pass Division


Web http://www.mom.gov.sg Page 1 of 2
Foreign Domestic Worker Work Permit Renewal Declaration Form

Declaration by the employer

b. I understand that the Controller of Work Passes has imposed on me a security bond for the sum of FIVE
THOUSAND SINGAPORE DOLLARS (SGD 5,000) payable to the Government of the Republic of Singapore
to ensure that I comply with my obligations under the EFMA and the EFMR [including those in 1(a) above];
c. I understand that if I breach any of my obligations as an employer of a foreign domestic worker, my Security
Bond may be forfeited fully or in part. I also understand that if there is only partial forfeiture, the Government
of the Republic of Singapore may forfeit the rest at a later point in time for the same breach or a different
breach.

4. By signing this form, I indicate that I have read and understood this declaration; and intend to be bound by it. I am
aware that if I have wilfully stated in it anything which I know to be false or do not believe to be true, I may be
prosecuted.

Name of helper FIN of helper

Name of employer NRIC/FIN of employer

Signature of employer Date (DD-MM-YYYY)

Ministry of Manpower Work Pass Division


Web http://www.mom.gov.sg Page 2 of 2

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