Foreign Worker Levy GIRO application form
(For Business Employers)
This form may take 3 minutes. Form BFWL 09/2022
IMPORTANT: Do not fax or email this form as original signature(s) is required. The bank account
holder must sign against any changes made. Do not use correction fluid or tape. Forms with
incomplete or illegible details will be rejected.
Section 1: For Applicant’s completion
1 Applicant’s Particulars and Authorisation
CPF Submission Number (CSN)
- - ►DDA reference no.
Registered Name of Business Entity
1. I/We authorise the Bank to process the Billing Organisation’s (BO), Ministry of Manpower, instructions to debit and
credit my/our bank account.
2. The Bank is entitled to reject the BO’s debit instruction if my/our account does not have sufficient funds and charge
me/us a fee for this. The Bank also has the discretion to allow the debit even if this results in an overdraft on the account
and impose charges accordingly.
3. This authorisation will remain in force until the Bank sends a written notice to my/our address last known to the Bank,
upon the Bank’s receipt of my/our written revocation, or upon the Bank’s receipt of the BO’s notice of expiry.
Name of Account Holder (as in Bank’s records)
Signature(s)/Thumbprint(s)2 as in
Bank’s records
Bank’s Name
Bank Account Number SWIFT BIC (if applicable)1
Contact Number Email Address Date (DD/MM/YYYY):
1 Only for Citibank, HSBC, and Maybank account holders. Please refer to www.mom.gov.sg/bank-swift-codes or check with your bank if you are unsure.
2 For thumbprint(s), you must approach your Bank with your identification documents for verification. For signature(s), you can approach your Bank for verification.
2 What to do next?
Mail the completed form to: Levy GIRO Team, Work Pass Division, MOM, 18 Havelock Road S(059764)
You will be notified by your bank on the outcome of the GIRO application.
You may also log in to your banking app to check the application status.
Once your GIRO application is approved, Your first GIRO deduction will take place in the following month.
Section 2: For MOM’s completion
MOM’s Account Details SWIFT BIC: DBSSSGSGXXX Account Number: 003-958497-0
Debiting Account Details SWIFT BIC: Account Number:
Section 3: For Bank’s completion
To MOM: The application is REJECTED as: ► Please tick all the applicable reasons.
Signature/Thumbprint differs Wrong account number Authorised Signature and Bank’s Stamp
from bank’s records
Signature/Thumbprint is Amendments not countersigned by
incomplete/unclear Bank Account Holder
Account is operated by Others: Name: Date:
signature/thumbprint
Ministry of Manpower Work Pass Division
Web https://www.mom.gov.sg Contact Us https://www.mom.gov.sg/contact
Do not staple or glue. Completely seal all edges with clear tape.
How to use the Business Reply Envelope?
Tape here Tape here
Tape here
Step 1 Step 2 Step 3
Fold along the dotted lines. Enclose your documents Completely seal the edges with
Fold the top and bottom within the sleeve created clear tape to secure your
sections inwards with the in Step 1. documents inside.
mailing address in front.
Postage will be
paid by addressee.
For posting in
Singapore only.
BUSINESS REPLY SERVICE
PERMIT NO. 09640
MINISTRY OF MANPOWER
Work Pass Division
Attn: Levy GIRO team
18 Havelock Road
Singapore 059764
BFWL
Notes on paying your levy by GIRO:
• The monthly levy will be deducted on the 17th of every month (or the next working day if the 17th is a weekend or public holiday). If the deduction is unsuccessful, you
will be charged a late payment penalty. Bank charges may apply for unsuccessful deductions.
• If you have an existing GIRO arrangement, the levy will continue to be deducted from that account until this new GIRO applica tion takes effect, unless otherwise notified.
• The GIRO arrangement will be used for levy payment of all existing and future foreign workers, until it is terminated, or a new GIRO arrangement overrides it. Please
terminate your GIRO arrangement if you would like to stop deductions from this bank account.
Other payment methods
Before your GIRO takes effect, please pay your levy using PayNow QR in Check & Pay Levy by the due date as stated in your levy bill to avoid late payment penalties.
Payment channel Payment mode How to make payment
Check & Pay Levy PayNow QR 1. Log in to www.mom.gov.sg/checkpaylevy.
2. Select PayNow as a payment mode and a QR code will be generated. If you are viewing this QR code from
your mobile device, save or capture a screenshot of the QR code on your phone.
3. Use your mobile banking app on your phone to scan the QR code or import the QR code image.
4. Check the details of the fund transfer. Make sure you see “Foreign Worker Levy” as the registered payee
before submitting your request.
