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Instructions Authorised EA Name Employer to fill in Part A Person submitting this form to EA to fill EA to verify and to fill in Part C PRESCRIBED AUTHORISATION FORM FOR EMPLOYMENT AGENCY EA FOR FOREIGN EMPLOYEE This authorisation letter shall only be valid for 14 days from the date of employer s authorisation and only for the application / renewal / cancellation of the foreign employee s listed below. Authorisation for choose only one. Separate forms to be used for other options. Application for Foreign Employee s Renewal for Foreign Cancellation for Foreign Part A To be completed by Employer S/No* Name of Foreign Employee s Passport / FIN / WP No* Work Pass Type WP / S-Pass / EP Business Stamp and Date Business Name Business UEN Business Address Representative Signature Rep* Designation Rep* NRIC No*/ FIN Rep* Contact No* Employer is to ensure that Part A is duly completed before signing and dating the authorisation* Do not pre-sign a form or sign a form with Part A incomplete. Prospective employers are to cross out rows in Part A that are not filled* to EA Not applicable if employer/Rep is submitting form personally Form Name Registration No* Signature / Date EA to verify and enclose copy of identification card Note EAs should verify the details of business authorised as www. yellowpages. com*sg not rely only on information or contact numbers provided* EAs should contact HR personnel of the business employer directly to confirm that the person submitting this form to the EA is authorised to do so on behalf of the business employer. EAs are advised to inform MOM immediately if the person submitting this form on behalf of the business employer refuses to provide his/her ID card and contact number for verification* Checklist for Employment Agencies Personnel I am aware of Para 9 of Employment Agencies Licensing Conditions I have spoken to and verified with employer to confirm his / her authorisation I have verified and enclosed a copy of identification card of employer or person submitting this form Yes Form FW001 version 1 May 2012. Authorisation for choose only one. Separate forms to be used for other options. Application for Foreign Employee s Renewal for Foreign Cancellation for Foreign Part A To be completed by Employer S/No* Name of Foreign Employee s Passport / FIN / WP No* Work Pass Type WP / S-Pass / EP Business Stamp and Date Business Name Business UEN Business Address Representative Signature Rep* Designation Rep* NRIC No*/ FIN Rep* Contact No* Employer is to ensure that Part A is duly completed before signing and dating the authorisation* Do not pre-sign a form or sign a form with Part A incomplete. Prospective employers are to cross out rows in Part A that are not filled* to EA Not applicable if employer/Rep is submitting form personally Form Name Registration No* Signature / Date EA to verify and enclose copy of identification card Note EAs should verify the details of business authorised as www. Prospective employers are to cross out rows in Part A that are not filled* to EA Not applicable if employer/Rep is submitting form personally Form Name Registration No* Signature / Date EA to verify and enclose copy of identification card Note EAs should verify the details of business authorised as www. yellowpages. com*sg not rely only on information or contact numbers provided* EAs should contact HR personnel of the business employer directly to confirm that the person submitting this form to the EA is authorised to do so on behalf of the business employer.

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