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MAKLUMAT MAJIKAN
Employer Information
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Maklumat Asas
Basic Information
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
:
       
Maklumat Pekerja
Employee Information
 
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
:
           
Maklumat Majikan
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
Akuan (Pengarah/Ejen Cukai/Setiausaha Syarikat)
Declaration (Director / Tax Agent / Company Secretary)
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
: 20-09-2017      
Jawatan*
Designation*
: Pengarah Setiausaha Syarikat Ejen Cukai
dddDirector Company Secretary Tax Agent
 
 
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