FORM A – REGISTRATION OF CONTRACTOR’WORKER
(TO BE COMPLETED IN DUPLICATE
AND SUBMITTED TO THE HUMAN CAPITAL DEPARTMENT)
Name of Worker: ………………………………………………………………….…………………
Nationality
: ………………………………………………………………….…………………
PHOTOGRAPH
For Malaysian ( * Attach photocopy of NRIC)
NRIC No. (New): …………………………….………….... (Old): ………………………………
Home Address:……………………………………………….……………….………………………
………………………………………………………………………………………… Tel No: .………………………………………………..
Signature of Worker : ………………………………………………………. Date : …………………………………………………..
For Foreign Workers (* Attach Photocopy of relevant pages of passport)
Passport No : ……………………………………………………... Expiry Date : ………………….…………………………………
Work Permit Details:
Expiry Date : …………..…………………… Employer : ……………….…..………………………………………………………….
Signature of Worker : ……………………………………..………………. Date : …………………………………………………..
VETTED BY EMPLOYER (CONTRACTOR)
Name of Company : …………………….………………………..………………………………………………………………………..
Address : ……………………….…………………………………..……………………………………………………………………………
Tel No : ………………………………………….…………………. Fax No : …………………….………………………………………
Verification & Confirmation: I hereby confirm that the above particulars are correct.
Name of Contractors Authorized Representative : ..……………….………….……………………………………………
NRIC No : ……………………………………………….. Signature : …………..…………………… Date : ……..………………..
TO BE COMPLETED BY THE HUMAN CAPITAL DEPARTMENT
Received on : …………………..…….. Verified by : …………………………………. APPROVED / NOT APPROVED
Remarks:
Name / Signature / Date
FORM B – STATISTICS ON WORKERS (LABOUR) SUPPLIED BY CONTRACTORS
MONTH OF: ………………………..………………….
COMPANY: …………………………………………..…….DEPARTMENT: …………………………………………………………………
DETAILS OF CONTRACTOR
Name Of Contractor (Company)
Tel No:
Fax No:
Authorized Representative / Contract Person
DETAILS OF CONTRACT (* Attach contract if there is one – 1st time submission)
No of workers supplied (on average per day)
Total cost incurred (for the month)
RM
Estimated total cost per annum (where applicable)
RM
Basis of payment, as agreed
Nature of services (please describe)
Were the services already in place since January 2004?
YES / NO
If NO in which month (in 2004) did the service commence …………………………………………………………….
Are the services still required? YES / NO
If YES, until when …………..……………………….. if NO when will it be discontinued
Prepared by:
…….……………………………………...…
(Name)
…………………………………….…….
(Signature)
…………………………………….
(Date)
…………………………………….…….
(Signature)
…………………………………….
(Date)
Reviewed by
(Head of Department):
…….……………………………………...…
(Name)