EMPLOYER'S DETAILS
HOUSEHOLD DETAILS
APPLICATION DETAILS
Name
*
Date Of Birth
*
Gender
*
Male
Female
NRIC
*
Email
*
Mobile Number
*
Home Number
Nationality
*
Residential Status
*
SINGAPOREAN
SINGAPOREAN PR
EMPLOYMENT PASS HOLDER
DEPENDENT PASS
LONG-TERM VISIT PASS
OTHER
Housing Type
*
LANDED PROPERTY
SHOP HOUSE
PRIVATE FLAT / APARTMENT
HUDC
NON-HDB PUBLIC FLAT/ APARTMENT
HDB (1 ROOMS)
HDB (2 ROOMS)
HDB (3 ROOMS)
HDB (4 ROOMS)
HDB (5 ROOMS)
OTHER
Marital Status
*
SINGLE
MARRIED
DIVORCED
SEPARATED
WIDOWED
Address
*
Passport No.
*
Passport Expiry Date
*
Employer's Spouse:
Name
*
Date Of Birth
*
Gender
*
Male
Female
NRIC
*
Mobile Number
*
Nationality
*
Residential Status
*
SINGAPOREAN
SINGAPOREAN PR
EMPLOYMENT PASS HOLDER
DEPENDENT PASS
LONG-TERM VISIT PASS
OTHER
Passport No.
*
Passport Expiry Date
*
Expected Job Scope:
*
Cooking
General household (e.g. cleaning, laundry or ironing)
Taking care of pets
Caregiving infant (below 18 months)
Caregiving toddler (from 18 months to 3 years old)
Child (above 3 to 12 years old)
Elderly
Person with special needs (e.g Autism, down syndrome, dementia or needs help with activities of daily living)
Able to use phone after work
Able to use phone during work
Other:
For MOM to assess your eligibility for levy concession, please list all the people who are staying in your house, excluding you and your spouse.
Name
NRIC/Fin/Passport No.
Date Of Birth
Relationship
Gender
Male
Female
Add
Branch
*
BUKIT TIMAH MANPOWER
Type of Application
*
STANDARD
Application is assessed based on the income of the employer, spouse or both.
SPONSORSHIP
For employers who are Singaporeans or permanent residents and at least 60 years old to apply based on the income of up to 2 family members who do not stay with them.
JOINT INCOME
For employers who are Singaporeans or permanent residents to combine income with a family member who stays with them and is not their spouse.
Monthly Income
*
Total monthly income based on the type of appplication
BELOW $2,000
$2,000 - $2,499
$2,500 - $2,999
$3,000 - $3,499
$3,500 - $3,999
$4,000 - $4,999
$5,000 - $5,999
$6,000 - $7,999
$8,000 - $9,999
$10,000 - $12,499
$12,500 - $14,999
$15,000 - $19,999
$20,000 - $24,999
ABOVE $25,000
Are you appling for a new helper, a replacement helper or an additional helper?
*
NEW HELPER
Select this if you do not have any existing migrant domestic worker.
ADDITIONAL HELPER
Select this if you have existing migrant domestic worker and want additional migrant domestic worker.
REPLACEMENT HELPER
Select this if you want to replace your current migrant domestic worker.
Whose income are you using?
*
THE EMPLOYER'S INCOME
THE EMPLOYER'S SPOUSE'S INCOME
COMBINE THE EMPLOYER'S INCOME WITH THEIR SPOUSE'S INCOME
How many people are sponsoring this application?
*
1 SPONSOR
2 SPONSORS
Is the employer living at the same address as the sponsor(s)?
*
YES
NO
Is the employer living at the same address as the joint applicant?
*
YES
NO
ABOUT JOINT/SPONSOR ONE
Name
*
Date Of Birth
*
Gender
*
Male
Female
NRIC
*
Mobile Number
*
Home Number
Email
*
Relationship With Employer
*
Marital Status
*
SINGLE
MARRIED
DIVORCED
SEPARATED
WIDOWED
Nationality
*
Residential Status
*
SINGAPOREAN
SINGAPOREAN PR
EMPLOYMENT PASS HOLDER
DEPENDENT PASS
LONG-TERM VISIT PASS
OTHER
Address
*
Passport No.
*
Passport Expiry Date
*
SPOUSE'S DETAILS:
Name
*
Date Of Birth
*
Gender
*
Male
Female
NRIC
*
Mobile Number
*
Nationality
*
Residential Status
*
SINGAPOREAN
SINGAPOREAN PR
EMPLOYMENT PASS HOLDER
DEPENDENT PASS
LONG-TERM VISIT PASS
OTHER
Passport No.
*
Passport Expiry Date
*
ABOUT SPONSOR SECOND
Name
*
Date Of Birth
*
Gender
*
Male
Female
NRIC
*
Mobile Number
*
Home Number
Email
*
Relationship With Employer
*
Marital Status
*
SINGLE
MARRIED
DIVORCED
SEPARATED
WIDOWED
Nationality
*
Residential Status
*
SINGAPOREAN
SINGAPOREAN PR
EMPLOYMENT PASS HOLDER
DEPENDENT PASS
LONG-TERM VISIT PASS
OTHER
Address
*
Passport No.
*
Passport Expiry Date
*
SPOUSE'S DETAILS:
Name
*
Date Of Birth
*
Gender
*
Male
Female
NRIC
*
Mobile Number
*
Nationality
*
Residential Status
*
SINGAPOREAN
SINGAPOREAN PR
EMPLOYMENT PASS HOLDER
DEPENDENT PASS
LONG-TERM VISIT PASS
OTHER
Passport No.
*
Passport Expiry Date
*
I consent to J Focus Manpower Pte Ltd processing my personal data for the purposes of account registration and work permit application. I hereby declare that all information provided in this form is complete, true and accurate. I understand and agree to the terms and conditions.
Under Personal Data Protection Act 2012 (PDPA), all information provided shall be kept strictly confidential and are only for MDW Work Permit application purposes.
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Signature of Employer
