APPLICATION FOR A WORK PERMIT
USER ID :6967655
USER NAME :PROEN SCAFFOLD PTE. LTD.
WPNO :0 64962868 DOA :16/07/2024
COMPANY CPF SUBMISSION NO. :201332280M - PTE - 01 DATE / TIME :18 July 2024 01:48 PM
PART I PERSONAL PARTICULARS OF FOREIGN EMPLOYEE
*06496286816072024*
NAME :SUMON MD
DATE OF BIRTH :04/06/1998
NATIONALITY / CITIZENSHIP :BANGLADESHI COUNTRY / REGION OF :BANGLADESH
BIRTH
STATE / PROVINCE : PLACE / STATE / PROVINCE :
where the foreigner obtained his / her nationality OF BIRTH
/ citizenship
MARITAL STATUS :SINGLE SEX :MALE
RACE :BENGALI RELIGION :MUSLIM
MALAYSIAN OLD IC NO. : COLOR OF IC :
PRC IC NO. : MALAYSIAN NEW IC NO. :
BANGLADESH BIRTH : FIN :G8740108T
REGISTRATION NO.
TRAVEL DOCUMENT NO. :EK0843635 TRAVEL DOCUMENT TYPE :PASSPORT
TRAVEL DOCUMENT EXPIRY :05/09/2027 ENDORSEMENT TYPE :NOT IN SINGAPORE
DATE
EDUC :SECONDARY 1
YEARS OF WORKING EXP : NAME OF INSTITUTION :
EXPIRY DATE OF LTVP :
CATEGORY OF WORKER'S : IS WORKER PREVIOUSLY A :NO
LTVP / DP SINGAPORE CITIZEN OR
PERMANENT RESIDENT
FATHER'S NAME :MD LITON
MOTHER'S NAME :MST DORODI BEGUM
HAS WORKER EVER BEEN :NO
ARRESTED IN ANY COUNTRY /
REGION OR STATE BEFORE?
HAS WORKER EVER BEEN :NO
CONVICTED IN ANY COUNTRY /
REGION OR STATE OF AN
CRIMINAL OFFENCE BEFORE?
Addresses for the past 10 years Year of stay
Current address ALOKDIYA, CHOUBARIA, TANGAIL SADAR, TANGAIL 1998 till current
Address 1
Address 2
Address 3
Address 4
Address 5
FIWPS549 Page 1 of 5
WPNO : 0 64962868 DOA : 16/07/2024
PARTICULARS OF EMPLOYMENT
EMPLOYMENT STATUS :EMPLOYEE
NAME OF EMPLOYER :PROEN SCAFFOLD PTE. LTD.
OCCUPATION CODE :81509C
OCCUPATION DESCRIPTION :PROCESS MAINTENANCE & CONSTRUCTION WORKER
BASIC MONTHLY SALARY : S$572 HOUSING PROVIDED : YES
FIXED MONTHLY ALLOWANCES : NO FIXED MONTHLY DEDUCTIONS : NO
HOUSING, AMENITIES, & SERVICES ALLOWANCES : S$0 HOUSING, AMENITIES, & SERVICES : S$0
DEDUCTIONS
TRANSPORT ALLOWANCES : S$0 OTHER DEDUCTIONS : S$0
OTHER ALLOWANCES : S$0 TOTAL FIXED MONTHLY DEDUCTIONS : S$0
TOTAL FIXED MONTHLY ALLOWANCES : S$0 MONTHLY SALARY AFTER TAKING INTO : S$572
ACCOUNT
FIXED MONTHLY SALARY : S$572 FIXED MONTHLY ALLOWANCES AND
DEDUCTIONS
WORKING HOURS PER WEEK (EXCLUDING BREAKS) : 44.0 Hours WORKING DAYS PER WEEK : 5.500 Days
RATE OF PAY FOR EACH HOUR OF OVERTIME : S$4.50 per hour DAILY BASIC RATE OF PAY (FOR WORK S$24.00
WORK DONE ON EACH REST DAY/PUBLIC
HOLIDAY)
WORKER STAYING IN SINGAPORE :
VETTING AUTHORITY : SUPPORT FROM :
VA?
TRAINING DURATION :
SUPPORT AUTHORITY :
PARTICULARS OF FOREIGN EMPLOYEE'S SPOUSE
WORKER MARRIED TO SC / SPR :
NAME :
DATE OF MARRIAGE : PLACE OF MARRIAGE :
DATE OF BIRTH : NATIONALITY / CITIZENSHIP :
RESIDENTIAL STATUS : COLOR OF IC :
IC NO. (SC / SPR) : DATE OF SPR ISSUANCE :
MALAYSIAN OLD IC NO. : MALAYSIAN NEW IC NO. :
PASSPORT NO. :
FIWPS549 Page 2 of 5
WPNO : 0 64962868 DOA : 16/07/2024
PART I (A) DECLARATION BY FOREIGN EMPLOYEE
I declare that -
(a) I have read and understood the applicable conditions of work permit, as specified in the Employment of Foreign Manpower (Work
Passes) Regulations c.91A, available at www.mom.gov.sg.
(b) I have / have never* been convicted in any country/region or state of an criminal offence (if applicable, please provide details)
*Delete accordingly
(c) I consent, for the purposes of assessing this Application for a work permit, and the administration of work pass matters,
• For the Government of Singapore and statutory authorities to obtain from and verify information (including my medical
records and information relating to them) with any person, organisation or any other source, and
• To the release of all information obtained (including my medical records and information relating to them) to the
Government of Singapore, statutory authorities and their agents.
(d) For the purpose of my current and subsequent employments, I also consent for the Government of Singapore and its statutory
authorities to display my employment information on the MOM’s work pass systems, and to disclose such information to any
relevant person or organisation.
(e) The information as set out in PART I is true and correct; and that all documents I have submitted in support of this application for
a Work Permit are true copies of the authentic documents.
(f) I am aware that if I have stated or provided any information within this Declaration that I know to be false or do not believe to be
true, I may be subject to enforcement action including prosecution, the cancellation of the in-principle approval and the revocation
of my Work Permit.
(g) For the purposes of setting up my: (i) bank account and electronic fund transfer service account linked to the said bank account
(such as PayNow); and (ii) free Migrant Workers' Centre (MWC) membership, as part of this work permit application, I consent to
the Ministry of Manpower sending my personal particulars and work permit information to POSB and MWC.
(h) I consent to my personal data being collected, used and retained by Migrant Workers' Centre (MWC) for the purposes of
processing, administering and managing my MWC membership and my participation in MWC's programs and activities.
(i) I understand that a SingPass will help me to access Government e-services in Singapore and I give my consent to the Ministry of
Manpower to share my personal particulars with the SingPass issuing agency. This allows me to apply for a SingPass account at
a later time.
(j) I consent to the Ministry of Manpower displaying my work pass details when my work pass card is scanned using the Ministry of
Manpower's work pass mobile application.
(k) I give my consent for the Ministry of Manpower to use my contact details to contact me during emergencies and to send me
messages related to my work pass and employment in Singapore. I also consent for the Ministry of Manpower to share my
contact details with other Government agencies and statutory authorities for the same purposes.
Signature of Foreign Employee
Date: (DD-MM-YYYY)
FIWPS549 Page 3 of 5
WPNO : 0 64962868 DOA : 16/07/2024
PART II PARTICULARS OF COMPANY OR EMPLOYER
MAIN CONTRACTOR / SHIPYARD :
CPF SUBMISSION NO. OF MAIN SHIPYARD / MAIN CONTRACTOR :
NAME :PROEN SCAFFOLD PTE. LTD.
ADDRESS :1 SUNVIEW ROAD
#03-16 ECO-TECH@SUNVIEW
SINGAPORE 627615
BUSINESS ACTIVITY :PROCESS INDUSTRY MAINTENANCE
CPF SUBMISSION NO. :201332280M - PTE - 01 REGISTRATION NO. :201332280M PRIOR APPROVAL :
(ACRA) REF NO.
TELEPHONE :68980711 FAX :68980733
TEMPORARY PERMIT UPON APPROVAL OF APPLICATION? : NO
CHANGE OF EMPLOYER
IS CONSENT GIVEN FOR TRANSFER? :
NAME OF CURRENT EMPLOYER :
PART II (A) DECLARATION BY EMPLOYER
WP NO. : 0 64962868 DOA : 16/07/2024
NAME OF WORKER : SUMON MD
CPF SUBMISSION NO. : 201332280M - PTE - 01
NAME OF EMPLOYER : PROEN SCAFFOLD PTE. LTD.
I declare that I am authorised to bind the employer for the foreign employee named in PART I to the following -
(a) I have read and understood the applicable conditions and regulatory conditions of work permit, as specified in the
Employment of Foreign Manpower (Work Passes) Regulations c.91A, available at www.mom.gov.sg.
(b) The employer consents, for the purpose of assessing this application, for the Government of Singapore and its statutory
authorities to obtain from and verify information with any person, organisation or any other source. The employer also
consents to the disclosure of all information thereby obtained by the Government of Singapore, to statutory authorities and
authorised agents.
(c) The employer is aware that the Controller of Work Passes uses its Central Provident Fund contribution information to
determine the number of local workers employed by the employer hence determining the number of foreign employees that
it may employ. The employer has ensured that its Central Provident Fund contribution record of payments as employer
required under the Central Provident Fund Act (Cap.36) only reflects every citizen or permanent resident of Singapore who
is employed by the employer and at the appropriate contribution rate prescribed by law. The employer has made any
voluntary CPF contributions only through a separate CPF Submission Number (CSN).
(d) The employer has obtained written consent from the foreigner to apply for a Work Permit for him/her. I will produce this
consent when requested by the authority.
(e) The employer has ensured that the foreign employee fully understands the contents of PART I and that it was signed by the
foreign employee.
(f) For the purpose of setting up the foreign employee's bank account as part of this work permit application, I consent to the
Ministry of Manpower sending the employer's particulars and contact information to POSB.
(g) The employer consents to the Ministry of Manpower displaying work pass details when the foreign employee's work pass
card is scanned using the Ministry of Manpower's work pass mobile application.
(h) The employer has / has not* used the services of an Employment Agency based in Singapore for the recruitment and / or
application of a work permit for this foreign employee.
*Delete (If applicable: Employment Agency Licence No: ___________________________________. Please also ensure that the
accordingly employment agency completes PART III).
(i) The information as set out in PART II and any appeals the employer has made in relation to this application are, to the best
of my knowledge, true and correct; and that all documents submitted in support of this application and any appeals made in
relation to this application, are true copies of the authentic documents.
Name of Authorised Representative:
NRIC:
Designation:
Signature:
Date: (DD-MM-YYYY)
FIWPS549 Page 4 of 5
PART III PARTICULARS OF SINGAPORE EMPLOYMENT AGENCY AND DECLARATION OF FEES PAYABLE
IS A SINGAPORE EMPLOYMENT AGENCY USED FOR THE PURPOSES OF THIS APPLICATION FOR SUMON MD (WP NUMBER: 0
64962868) : NO
NAME OF SINGAPORE : _____________________________________ LICENCE NO. : _______________
EMPLOYMENT AGENCY
OPERATING ADDRESS : _____________________________________ TELEPHONE : _______________
FEE PAYABLE TO SINGAPORE EMPLOYMENT AGENCY
ANY FEES PAID BY THE EMPLOYEE TO THE SINGAPORE EMPLOYMENT AGENCY:
FEES FOR COSTS INCURRED : S$
OVERSEAS
AGENCY FEE : S$
PART III (A) DECLARATION BY SINGAPORE EMPLOYMENT AGENCY (applicable if the employer has used the services of a
Singapore Employment Agency.)
I declare that -
(a) I, the undersigned, am the Employment Agency personnel handling this application.
(b) I declare that I have obtained written consent from the employer and the foreigner to perform this transaction. I will produce this
consent when requested by the authority.
(c) I have explained the contents of the application and the applicable conditions and regulatory conditions of work permit, as
specified in the Employment of Foreign Manpower (Work Passes) Regulations c.91A to the foreign employee and the authorised
officer of the employer.
(d) The information as set out in this application and any appeals I have made in relation to this application is, to the best of my
knowledge, true and correct; and that all documents I have submitted in support of this application and any appeals I have made
in relation to this application, are true copies of the authentic documents.
Name of Employment Agency Personnel:
Employment Agency Personnel Number:
Signature:
Date: (DD-MM-YYYY)
FIWPS549 Page 5 of 5
