www.mida.gov.my
ICA 10
(18.09.2014)
APPLICATION FOR CONFIRMATION LETTER FOR A COMPANY EXEMPTED
FROM MANUFACTURING LICENCE UNDER
THE INDUSTRIAL CO-ORDINATION ACT 1975 (AMENDMENT)
Section A : Company Profile
ROC No.
Income Tax Ref.
No. (if applicable)
Company Name
Mailing Address
Tel. No.
Fax No.
Website
Email
Licence/Incentives
Approved By Other
Government Agencies
Products / Activities
Annual Production Capacity
Factory Location / Tel No. / E-mail
Source of Technology
Purpose of Application for
Manufacturing Licence
Exemption letter

Duty/Tax exemption

Government/private sector tenders

Foreign labours

Subsidies on utilities

Others (Please specify):
___________________________________
Section B : Project Cost
1. Cost of Fixed Assets :
Item
Value
a) Land
(RM)
b) Factory
(RM)
c) Plant/Machinery
(RM)
Annual Lease (if applicable)
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d) Other Equipment
(RM)
Total
(RM)
2. Pre-operational Expenditure
(RM)
3. Working Capital
(RM)
(Current Assets - Current Liabilities)
4. Total Project Cost (1+2+3)
(RM)
Section C : Financing
5. Capital Structure :
(RM)
1. Authorised Capital
2. Shareholders’ Fund
(a) Paid Up Capital
(i) Malaysian Individuals
 Bumiputera
 Non-Bumiputera
(ii) Company Incorporated in Malaysia*


(iii) Foreign Nationals / Companies (specify
Name and Nationality / Country of Origin)


Total of (i), (ii) and (iii)
(b) Reserves (excluding capital appreciation)
Total of (a) and (b)
*For 2(a)(ii), please provide equity structure as follows:
Name
Bumiputera
(%)
RM
Non Bumiputera
(%)
i)
ii)
6. Loan
(RM)
a) Domestic
b) Foreign (specify country of origin)
Total of (a) and (b)
7. Other Sources (please specify)
(RM)
a)
b)
Total of (a) and (b)
8. Total Financing
(Paid Up Capital + Reserves + Loan + Other Sources)
2
Foreign (specify
country) (%)
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Section D : Employment
Section E: Sales
9. Please provide information as per APPENDIX I.
Section E : Sales
10. Proposed Export (%):
11. Product Pricing Details :
% of ex-factory price for each product
Item
Product 1
Product 2
Product 3
100%
100%
100%
a) Cost of Raw Materials / Components
b) Cost of Labour
c) Other Costs
d) Manufacturing Profit
Total
Section F : Documents to be Submitted
a. a Two (2) Sets of Application Form.
b.
Manufacturing Process Flow Chart.
Please explain the major processes and indicate the processes according to the type and
machinery used as follows:
R – Robotic Machinery
A – Automatic Machinery
S – Semi-Automatic Machinery
M – Manual Operation
c.
The layout plan for the machinery and equipment in the approved manufacturer’s premise and to
indicate where the machinery and equipment will be located.
d.
Sales Tax Licence (CJ2 or JKED No.3) or certificate of exemption from Sales Tax Licence (JKED No. 3)
from Customs (if applicable).
e.
Business Premise Licence from the Local Authority.
f.
Latest printout of SSM Company Profile and Business Profile from the Companies Commission of
Malaysia (SSM).
g.
Memorandum of Association (M&A).
Section G : Declaration
I, …………………………………………………………………………………….., the Managing Director of
……………………………………………………………………………………………………………………
i.
ii.
iii.
hereby declare that to the best of my knowledge, the particulars furnished in this application are true.
hereby furnished all the documents required as stated in Section F of this form;
agree that the information pertaining to my company i.e. company name, nature of business, contact
details and status of manufacturing licenses; may be published by MIDA;
Date
Company’s Stamp/Seal
(Signature)
3
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APPENDIX I
Section D : Employment
Please note that the information is required to enable the government to undertake the appropriate
manpower planning to meet the specific manpower needs of companies proposing to establish
projects in Malaysia.
Number of Persons Employed by Average Monthly Salary* (RM)
<2000
2000<3,000
3,000<10,000
>10,000
Malaysian
1.
Managerial and Professional
2.
Technical and supervisory staff
with
(a)
Engineering/Technical
qualifications
(b)
Science qualifications
(c)
Other qualifications /
experience
Foreign
National
Malaysian
Foreign
National
Malaysian
Foreign
National
Malaysian
Foreign
National
Craft skills such as plant
maintenance mechanic,
tool & die maker,
machinist, IT personnel
(including CAD/CAM
designer & DCS
operator), Quality
Controller, Electrician,
Chargeman, Welder)
3. (a) Sales and clerical
(b) Other general workers
4.
Machine operators and
assemblers**
Total
Note:
*
include wages, salaries, bonuses, social insurance contribution and all employee benefits.
If there is more than one factory location, please provide the same information on a separate sheet of paper.
**
Machine operators and assemblers are those involved in the production/assembly line who receive mainly on-the-job training
for a period between 3 to 6 months,e.g. production operators.
4
:
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1.
Percentage of science and technical staff having degrees or diplomas with a minimum of
5 years experience (of the total workforce)
2. Number of Staff with Post Graduate (ie. Masters/PhD etc.) qualifications
3. In addition to the full-time employees as mentioned in the above tables, please provide the
number of workers which are outsourced (not under the company’s payroll)
3. If the company plans to outsource its production/ activities :
i. what is the estimated percentage from the total production/activities
ii. the percentage of outsourced staff from company’s total employees
5
……… %
……… %
______ %
:
______
:
______