Claim For Benefit Under the Welfare Benefits Scheme
 
     
 
  Please kindly fill in the form below for claim for benefit under the Welfare Benefits Scheme.
 
     
 
 
 
General Information
      Staff No.:
Full Name:   I/C No.:
Home Address :    
Postal Code :      
Date of Birth:       Age:    Marital Status:
         
Present Employer:   Date of Joining Employer:
Department   Contact No.:
Email:      
   
 
Details of Claim
A. State Benefit: (Medical/Death/Retirement)
B. Amount Claimed:
S$
C. Documents Attached In Support of Claim:
 
   
 
Verification Code
Please enter the verification code to proceed.
Change Image  
   
  Submit Enquiry Form Clear Enquiry Form