BIO-DATA OF FOREIGN DOMESTIC WORKER (FDW)

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BIO-DATA OF FOREIGN DOMESTIC WORKER (FDW) *Please ensure that you run through the information within the biodata as it is an important document to help you select a suitable FDW (A) PROFILEOF FDW A1 Personal Information Ref No.: AFD 1.175 1. Name: SITI MUZAROAH 2. Date of birth : 24-01-1980 Age : 37 Y.O 3. Place of birth : KENDAL 4. Height & weight: 152 cm 57 kg 5. Nationality: INDONESIA 6. Residential address in home country: DK.SANTREN, RT003/RW005, DS.LEBO, KEC.GRINGSING, KAB.BATANG 7. Name of port / airport to be repatriated to: PHOTO (half/fulll bodied and coloured) 8. Contact number in home country:087711722576 9. Religion: MOSLEM 10. Education level: JUNIOR HIGH SCHOOL 11. Number of siblings: 4 BROTHERS 12. Marital status : MARRIED 13. Number of children: - - Age() of children (if any): A2 Medical History/Dietary Restrictions 14. Allergies (if any): 15. Past and existing illnesses (including chronic ailments and illnesses requiring medication): Yes No Yes No i. Mental illness No vi. Tuberculosis No ii. Epilepsy No vii. Heart disease No iii. Asthma No viii. Malaria No iv. Diabetes No ix. Operations No v. Hypertension No x. Others: 16. Physical disabilities: No 17. Dietary restrictions: No 18. Food handling preferences: Yes Pork Yes beef Others: NOT Afraid of dog A-1

A3 Others 19. Preference for rest day: rest day(s) per month. 20. Any other remarks: (B) B1 SKILLS OF FDW Method of Evaluation of Skills Please indicate the method(s) used to evaluate the FDW s skills (can tick more than one): Based on FDW s declaration, no evaluation/observation by Singapore EA or overseas training centre/ea Interviewed by Singapore EA Interviewed via telephone/teleconference Interviewed via videoconference Interviewed in person Interviewed in person and also made observation of FDW in the areas of work listed in table S/No Areas of Work Willingness 1. Care of infants/children yes Experience If yes, state the no. of years Assessment/Observation Please state qualitative observations of FDW and/or rate the FDW (indicate N.A. of no evaluation was done) Poor Excellent...N.A 1 2 3 4 5 N.A Please specify age range: 2. Care of elderly yes 3. Care of disabled 4. General housework yes 5. Cooking yes Please specify cuisines: 6. Language abilities (spoken) 7. Other skills, if any COOKING, CLEANING HOUSE,CARE CHILDREN AND ELDERLY A-2

Interviewed by overseas training centre / EA (Please state name of foreign training centre / EA: ) State if the third party is certified (e.g. ISO9001) or audited periodically by the EA: Interviewed via telephone/teleconference Interviewed via videoconference Interviewed in person Interviewed in person and also made observation of FDW in the areas of work listed in table S/No Areas of Work Willingness 1. Care of infants/children Yes Experience If yes, state the no. of years Assessment/Observation Please state qualitative observations of FDW and/or rate the FDW (indicate N.A. of no evaluation was done) Poor Excellent...N.A 1 2 3 4 5 N.A Please specify age range: 2. Care of elderly Yes 3. Care of disabled 4. General housework Yes 5. Cooking Yes Please specify cuisines: 6. Language abilities (spoken) 7. Other skills, if any COOKING, CLEANING HOUSE,CARE CHILDREN AND ELDERLY (C) C1 EMPLOYMENT HISTORY OF THE FDW Employment History Overseas Date From To Country (including FDW s home country) Employer Work Duties Remarks 2009 2012 Malaysia Mr.Ibrahim Her main duty is taking care of children 1 y.o (Boy) other that she can do general housekeeping, washing chlothes, ironing, cooking, mopping. There are 4 person in the house (mam,sir and 2 childrens) 2013 2015 Saudi Arabiah Mr. Saleh Her main duty is taking care of granmother 80 y.o other that she can do general housekeeping, washing chlothes, ironing, cooking, mopping. There are 13 person in the house (mam,sir and 11 childrens) She is obedience,hard working,caring,honest,pat ience,inisiatif She is obedience,hard working,caring,honest,pat ience,inisiatif

C2 Employment History in Singapore Previous working experience in Singapore Yes No (The EA is required to obtain the FDW s employment history from MOM and furnish the employer with the employment history of the FDW. The employer may also verify the FDW s employment history in Singapore through WPOL using SingPass) C3 Feedback from previous employers in Singapore Feedback was/was not obtained by the EA from the previous employers. If feedback was obtained (attach testimonial if possible), please indicate the feedback in the table below: Employer 1 Feedback Employer 2 (D) AAILABILITY OF FDW TO BE INTERIEWED BY PROSPECTIE EMPLOYER FDW is not available for interview FDW can be interviewed by phone FDW can be interviewed by video-conference FDW can be interviewed in person (E) OTHER REMARKS THIS MAID ABLE FOR ELDERLY,CHILDREN AND GRAND MOTHER AND BABYCARE,HOUSE WORK AND COOKING SITI MUZAROAH FDW Name and Signature EA Personnel Name and Registration Number I have gone through the 4 page biodata of this FDW and confirm that I would like to employ her Employer Name and NRIC No. ***************

IMPORTANT NOTES FOR EMPLOYERS WHEN USING THE SERICES OF AN EA Do consider asking for an FDW who is able to communicate in a language you require, and interview her (in person/phone/video conference) to ensure that she can communicate adequately. Do consider requesting for an FDW who has a proven ability to perform the chores you require, for example, performing household chores (especially if she is required to hang laundry from a high-rise unit), cooking and caring for young children or the elderly. Do work together with the EA to ensure that a suitable FDW is matched to you according to your needs and requirements. You may wish to pay special attention to your prospective FDW s employment history and feedback from the FDW s previous employer(s) before employing her. A-4