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Warganegara / Pemastautin Tetap / Citizen / Permanent Resident
Bukan Warganegara / Non Citizen
Sila masukkan maklumat No.K/P Baru :
Please enter your new NRIC :
No Pasport:
No. Polis / Police No.
No. Tentera / Armed Forces No.

 
Nama*
Name*
:
 
 
Honorifik
Honorific
:

Please Select
Gelaran
Title
  :

Please Select
 
 
 
Jantina*
Sex*
:

Please Select
Tarikh Lahir*
Date Of Birth*
:

Day / Month / Year
 
         
 
Warganegara*
Citizen*
:
 
 
Warganegara Malaysia*
Malaysian Citizen*
:
 
 
Negara Mastautin/ Domisil*
Country of Residence / Domicile *
:
 
 
Status* / Status*
:
Please Select
 
 
Tarikh Cerai/Mati* : Day / Month / Year
 
 
Dalam Negeri Luar Negara
lllllLocal ooOverseas
 
Alamat Surat
Menyurat
:
 
 
 
 
 
 
 
 
Poskod / Postcode
:
 
 
Bandar
City
:
 
 
Negeri State
:
Please Select
 
 
 
 
Klik Jika Alamat Kediaman Sama Seperti Alamat Surat Menyurat Di Atas
 
 
Dalam Negeri Luar Negara
lllllLocal ooOverseas
 
 
Alamat Kediaman*
Residential Address *
:
 
 
 
 
 
 
 
 
Poskod / Postcode
:
 
 
Bandar / City
:
 
 
Negeri / State
:
Please Select State
 
 
No. Telefon Bimbit* Mobile Phone No.*
:
       
No. Telefon Rumah Telephone No.
:
       
E-mel* / E-mail *
:
   
 
 
MAKLUMAT PASANGAN( Perlu Diisi Jika Pembayar Cukai Memilih Status KAHWIN )
SPOUSE INFORMATION (You are required to fill in these fields if you select the status MARRIED)
 
Nama* / Name*
:
 
 
No. Rujukan Cukai
Income Tax No.:
:
 
 
No.K/P Baru*
New NRIC No.*
:
No. Tentera
Armed Forces No.
:
 
 
No. Polis
Police No.
  :
No. Pasport
Passport No.
:
 
     
 
No. Imigresen (Jika bukan pemastautin)
Immigration No (If non resident)
:
 
 
Tarikh Kahwin*
:
Day / Month / Year
 
   
 
Pekerjaan*
Occupation* employment
:
Please Select Occupation
 
 
Tarikh Mula Bekerja
Date of Commencement of Employment
:
Day / Month / Year
 
 
Nama Majikan
Name of Employer
:
 
 
 
Dalam Negeri Luar Negara
lllllLocal oooooOverseas
 
 
Alamat Majikan
Address of Employer
:
 
 
   
 
 
   
 
 
Poskod / Postcode
:
 
 
Bandar / City
:
 
 
Negeri / State
:
Please Select State
 
 
 
No Majikan
Employer’s No.
:
E
 
Jumlah Pendapatan Tahunan
Total Annual Income
:
RM
 
 
Anda Perlu Muat Naik / Menghantar Dokumen Daftar Perniagaan Bersama Dokumen Pengenalan Diri Anda.
(Jika Anda Bukan Warganegera)
 
 
   
 
 
Nama Perniagaan Name of Business
:
 
           
 
Jenis Perniagaan Utama
Main Business Type
:  
           
 
No. Pendaftaran Perniagaan
Business Registration No.
:
 
           
 
Tarikh Mula Operasi Commencement Date of operations
:
Day / Month / Year
 
 
 
Dalam Negeri Luar Negara
lllllLocal oooooOverseas
 
 
Alamat Premis Perniagaan
Address of Business Premise
:
 
 
  :
 
 
  :
 
 
Poskod / Postcode
:
 
 
Bandar / City
:
 
 
Negeri / State
:
Please Select State
 
 
No Telefon (Premis Perniagaan)
Telephone No. (Business Premise)
:
 
E-mel Perniagaan Business e-Mail
:
 
 
PENDAFTARAN FAIL MAJIKAN (Jika pihak tuan ingin mendaftarkan fail majikan, sila isi ruangan ini)
EMPLOYER REGISTRATION FILE (Please fill in these fields to register employer file.
 
Jawatan Tertinggi Majikan
Employer Highest Position
:
Please select employer highest position
 
Status Majikan Employer Status
:
Please select employer status
 
Bilangan Pekerja*
Number of Employees*
:
 
               
Jumlah Pekerja Menerima Pendapatan Setahun Kurang RM 30,000
Number of Employees withAnnual Income Less Than RM30,000
:
Jumlah Pekerja Menerima Pendapatan Setahun Melebihi RM 30,000
Number of Employees withAnnual Income More Than RM30,000
:
 
                   
No. Pendaftaran Perkeso Majikan Employer’s SOCSO Registration No.
:
 
 
                 
No. Pendaftaran KWSP Majikan Employer’s EPF Registration No.
:
       
                 
MAKLUMAT PENTADBIR HARTA PUSAKA (Perlu Diisi Jika Pembayar Cukai Memilih Status MATI)
INFORMATION OF EXECUTOR / ADMINISTRATOR (You are required to fill in these fields if you select DECEASED status)
 
Nama Pentadbir Harta Pusaka
Name of Executor / Administrator
:
 
 
No. K/P Baru
New NRIC No.
:
No. Tentera
Armed Forces No.
:
 
 
No. Polis
Police No.
  :
No. Pasport
Passport No.
:
 
Alamat Kediaman/
Kediaman Pentadbir
Harta Pusaka
Residential /
Executor Residential
Address
:
 
   
 
   
 
Poskod / Postcode
:
Kawasan Pos
Post Area
:
 
Bandar / City
:
 
Negeri / State
:
Please Select State
 
 
Nama Firma Ejen Cukai / Ejen Cukai
Name of Tax Agent Firm / Tax Agent
:
         
 
No. Kelulusan Ejen Cukai / Lesen Audit
No. of Tax Agent Approval / Audit License
  :
       
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