Daftar Pembayar Cukai-Lembaga Hasil Dalam Negeri

MAKLUMAT MAJIKAN
Employer Information

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* These are mandatory fields required

Nama Majikan*
Name of Employer*

Jawatan Tertinggi Majikan*
Employer Highest Designation*

Please Select Employer Highest Designation

No. Rujukan Cukai*
Tax Reference No.*

Please Select

No. Pengenalan Jawatan Tertinggi*
Identification No. of Highest Designation*

Kad Pengenalan Baru Pasport

nnnNew Identification Card No.

Passport

No. Pendaftaran SSM
SSM Registration No

Tarikh Beroperasi
Date of Operation

Day / Month / Year

Status Perniagaan
Status of Business

Please Select

Status Majikan*
Status of Employer*

Please Select

Alamat Surat Menyurat*
Correspondence Address*

Poskod*
Postcode*

Bandar*
City*

Negeri*
State*

Please Select State

No. Telefon
Telephone No.

No. Faks
Fax No.

No. Telefon Bimbit
Handphone No

e-Mel
E-mail

Bilangan Pekerja
No. of employees

Jumlah Pekerja Menerima Pendapatan Setahun Kurang
RM 30,000
The number of employees with income less than RM30000

Jumlah Pekerja Menerima Pendapatan Setahun Melebihi RM 30,000
The number of employees with income more than RM30000

Nama pengarah/pemilik/kongsi utama*
Name of Director / Owner / Principal Partner *

Alamat Kediaman*
Residential address*

Poskod*
Postcode*

Bandar*
City*

Negeri*
State*

Please Select State

Klik jika alamat premis perniagaan sama seperti alamat surat-menyurat di atas
Click if the address of business premise is the same as correspondence address above

Nama*
Name*

No. Pengenalan*
Identification No.*

Kad Pengenalan Baru Pasport

nnnNew Identification Card No.

Passport

dengan ini mengakui bahawa maklumat yang diberikan di dalam borang ini adalah benar, betul dan lengkap.
hereby declare that the information provided in this form is true, correct and complete.

Tarikh
Date

18-10-2017

Jawatan*
Designation*

Pengarah Setiausaha Syarikat Ejen Cukai

dddDirector

Company Secretary

Tax Agent