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1.0 PROFILE PEMOHON
Applicant's Profile
1.1 NAMA SYARIKAT
Co. Name
1.2 AKTIVITI
Activity
1.3 PEMEGANG SAHAM
Shareholders
(Senaraikan 3 tertinggi)
(List of 3 highest)
%
(a)
(b)
(c)
(d) Lain-lain Others
1.4 MODAL BERBAYAR
Paid Capital
RM
1.5 ALAMAT KILANG/PREMIS
Co. Address
1.6 BIL PEKERJA
Nos. Of Worker
Tempatan (Local) :
Asing (Foreigner):
2.0 MASALAH/ISU
Problem/Issue
2.1 PERKARA
Issue
2.2 KETERANGAN MASALAH
Issue Details
2.3 JABATAN TERLIBAT
Department Concerned
2.4 TARIKH PERMOHONAN
Application Date
2.5 NO. RUJUKAN
Reference No.
2.6 SENARAI PELAN-PELAN (JIKA ADA)
List Of Plans (If Any)
(a)
(b)
(c)
(d)
3.0 SUSULAN/ULUSAN
JABATAN / AGENSI
Comments by Concerned Department
TARIKH
Date
JABATAN
Department
ULASAN JABATAN
Department's Comments
4.0 ULASAN IMPLIKASI KELEWATAN
Late Delivery Implications
4.1
4.2
4.3
4.4
5.0 PERKARA LAIN
Other Matters
5.1
6.0 BUTIR-BUTIR PEMOHON
Applicant's Detail
6.1 NAMA
Name
6.2 JAWATAN
Designation
6.3 ALAMAT
Address
6.4 NO. TELEFON
Tel. No.

NO. FAX
Fax No.

E-MAIL
E-mail




6.5 TANDATANGAN DAN COP SYARIKAT
Signature & Company's Chop
 
6.6 TARIKH
Date
7.0 ULASAN
Comments By
By COI
Working
Comittee
7.1
7.2

 

 
 
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