Application Card Card Credit Master

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					                                                                                                             Form FIN - CR


                      Particulars of Credit Card payment to S'pore Civil Defence Force
                     HQ SCDF Address:              91 Ubi Avenue 4
                                                   Singapore 408827
                                  Fax No:          68481628

1     Name of payer /company
      Address

      Tel No.
      Fax No.



      Signature (& Company stamp, if applicable)
2     Amount paid
3     Credit card no                                -                -               -
4     Credit Card Expiry Date                                                  (ddmmyyyy)
5     Card Type                                    Master
      (tick as appropriate)                        Visa
6     Bank                                         DBS
      (tick as appropriate)                        Other banks

7     Purpose of payment
      (tick as appropriate)                         1 Application for the following licences/permits:
                                                       a. Temporary Change of Use
                                                       b. Fire Certificate
                                                       c. Petroleum Storage Licence
                                                       d. Petroleum Transport Licence
                                                       e. Dangerous Trade Licence
                                                        Ref No:
                                                    2 Application for the following plan approvals:
                                                       a. Approval of fire safety plans
                                                          - BP / M&E Plan / FP plan (delete as applicable)
                                                       b. Modification/waiver of fire safety requirements
                                                       c. Record of works for minor addition/alteration
                                                          submission
                                                       d. Approval of building materials
                                                       e. Inspection/copy of records kept by FSSD
                                                        Ref No:
                                                        Location of Project:
                                                    3 Others (specify)
                                                        Ref No:

      For SCDF Finance Dept Use
I     Date of receipt of credit card particulars
II    Date keyed into credit card terminal
III   Credit card transaction reference no
IV    FISOPS System Receipt No
V     Name & Signature of Processing Officer


      For enquiries on payment matters, please contact the following officers from Finance Dept:
      1) Miss Christine Lim Tel: 6848 1618
      2) Mrs. Low Sock Fen Tel: 6848 1604

				
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