Pembangunan Sumber Manusia Berhad Act, 2001
[Pembangunan Sumber Manusia Berhad (Registration of Employers
and Payment of Levy) Regulation 2001]
FORM 1A
[Subregulation 4A(1)]
EMPLOYER INFORMATION STATEMENT
1.
(a)
Name of Business : ______________________________________________
(b)
Telephone No. : _______________
(c)
Facsimile No. : ____________
2.
Registration number of Business / Company / MyCoID ___________________
3.
Company Registered / Enterprise / Business Address : ________________________
____________________________________________________________________
____________________________________________________________________
4.
Type of Industry / Business / Activity : ____________________________________
5.
Number of Employees :-
6.
(a)
Malaysian Citizen : ______________________________________________
(b)
Non Citizen of Malaysia : _________________________________________
(c)
Total Number of Employees : _____________________________________
Company paid-up capital. Please mark (X) in the appropriate box :
(a)
Less than RM2.5 million
(b)
RM2.5 million and above
I hereby certify that all the information given above is to the best of any knowledge to be true
and complete.
Date
:
______________________________
Signature
:
______________________________
Name
:
______________________________
Designation
:
______________________________
(Chairman or Executive Director or
General Manager or Human Resources
Manager)
________________
Company’s Chop
PLEASE TAKE NOTE : That you are required to submit Form 9, 24, 49 of the Companies
Regulations 1966[P.U.173/66] and the Company’s latest Annual Return together with this
Form”.
Made 17 April 2002.
[KSM.PUU(50) Jld.(8); PN(PU2)616]
DATUK DR. FONG CHAN ONN
Minister of Human Resources