SGArrivalCard 231120241223

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Thank you for using the Singapore Arrival Card!

This Singapore Arrival Card is only valid for one time use for travel
on the expected date of arrival indicated below. You may choose to download or print a copy of this
acknowledgement and retain it for the duration of your stay. Please note that the Singapore Arrival Card is not a
visa. The use of the Singapore Arrival Card e-Service is free of charge.

The unauthorised consumption, possession, import, export and/or trafficking of any controlled drug is an offence
under Singapore's Misuse of Drugs Act . Under the Act, drug trafficking is punishable by death.

Providing false health and travel declarations is an offence under Section 64(b) of Singapore's Infectious Diseases
Act. The penalty for providing false or misleading information is a fine of up to S$10,000 and/or imprisonment of
up to 6 months. For subsequent offence(s), the penalty is a fine up to S$20,000 and/or imprisonment of up to 12
months. You are reminded that it is your responsibility to update and resubmit your declarations prior to your
arrival in Singapore, and/or if there is any change in your health status and/or travel history.

You are required by law to submit a Cash (CBNI) Declaration if you are entering or leaving Singapore carrying
Physical Currency or Bearer Negotiable Instruments worth more than S$20,000 (or its equivalent in foreign
currency).

If you are bringing in any item, or carrying an item for someone else, but you do not know what it contains, you
must declare the item at the Red Channel.

You can refer to the ICA website at Entering and Departing Singapore (https://www.ica.gov.sg/enter-depart) for
more information on Singapore's entry requirements and the list of prohibited or controlled items.

Transaction Date: 23/11/2024 12:23 PM (Singapore Time)

Trip 1 Date of Arrival (DD/MM/YYYY) 23/11/2024

Disembarkation/ Full Name (In Passport) Passport Number


Embarkation (DE)
Number
X3071S1410 SRI SUHARMI X1248754
Disembarkation/Embarkation (DE) Number: X3071S1410 NG

Personal Information
Full Name (In Passport)
SRI SUHARMI

Sex as indicated in passport Date of Birth


FEMALE 09/07/1973
Place of Residence
INDONESIA, CENTRAL JAVA, OTHERS IN CENTRAL JAVA

Country/Place of Birth Nationality/Citizenship


INDONESIA INDONESIAN
Passport Number Date of Passport Expiry
X1248754 03/02/2027
Mobile Number Email Address
+62 085135306824 [email protected]

Trip Information and Declaration


Trip Information
Date of Arrival (DD/MM/YYYY) Date of Departure
23/11/2024 24/11/2024
Purpose of Travel
Holiday/Sightseeing/Leisure
Mode of Travel
SEA
Mode of Transport Vessel Name
FERRY MAJESTIC
Type of Accommodation in Singapore Accommodation (Others)
OTHERS TRANSIT
Last City / Port of Embarkation Before Singapore
INDONESIA, RIAU ISLANDS, BATAM
Next City / Port of Disembarkation After Singapore
INDONESIA, RIAU ISLANDS, BATAM
Others
Have you ever used a passport under different name to enter Singapore? NO
Disembarkation/Embarkation (DE) Number: X3071S1410 NG

Health Declaration (Trip 1)

Do you currently have fever, cough, shortness of breath, headache or vomiting? NO

Do you currently have rash? NO

Have you visited any of the listed countries in Africa or Latin America in the NO
past 6 days prior to your arrival in Singapore?

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