(24.12.2013)
1. Company profile
(a) Name of applicant / company:
(b) Correspondence address:
Contact person:
Telephone no.:
E-mail:
Designation:
Fax no.:
Website:
(c) Date of incorporation:
(d) Income tax reference no.:
(e) Address of registered office:
Telephone no.:
Company registration no.:
Income tax branch office:
Fax no.:
1

2. Corporate Structure
(a) Particular of Board of Directors*:
Name and Residential Address Nationality % shares held in the company
Note: * If insufficient space, please provide the same information on a separate sheet of paper.
(b) 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.
Fulltime Employment
Category
Degree
Diploma/
Certificate
1.
Managerial Staff
(a) Company Directors
(b) Department Managers
(c) General Managers
Others (Please specify)
2.
Technical & Supervisory Staff
(a) Accountant and Auditors
(b) Human Resource Personnel
(c) Sales & Marketing Personnel
Others (Please specify)
3.
Clerical & Other Support Staff
(a) Secretaries
(b) Administrative Clerk
(c) Draughtman
(d) Accounting & Financing Clerk
(e) General Worker
(f) Security Officer
Others (Please specify)
Total
Malaysian
Others
Foreign National
Degree
Diploma/
Certificate
Others
Total
2

1. Percentage of managerial and technical staff having diplomas with a minimum of 5 years’ experience (of the total workforce)
%
2. Number of staff with Post Graduate (ie. Masters / PhD) qualifications.
3. In addition to the fulltime employees as mentioned in the above table, please provide the number of workers which are outsourced (not under the company’s payroll)
(c) Manpower according to income brackets:
Number of Persons Employed by Average Monthly Salary (RM)
Category
Malaysian
4.
Managerial Staff
(a) Company Directors
(b) Department
Manager
(c) General Managers
Others (Please specify)
5.
Technical &
Supervisory Staff
(a) Accountant /
Auditors
(b) HR Personnel
(c) Sales & Marketing
Others (Please specify)
6.
Clerical & Other
Support Staff
(a) Secretaries
(b) Administrative Clerk
(c) Account Clerk
(d) General Worker
(e) Security Officer
Others (Please specify)
Total
< 3000 3000 -<5000
Foreign
National
Malaysian
5000-<10,000
Foreign
National
Malaysian
>10,000
Foreign
National
Malaysian
Foreign
National
3

3. Details of MWC Developer
No
Details of MWC Developer(s) who has appointed applicant as its MWC Development
Manager:
Name
MWC Develope r’s Approval
Date
1
2
3
4. Company Status
(a) The company is newly incorporated and / or has not commenced any operations since its incorporation
Please tick applicable box
☐ Yes ☐ No
(b) Incentive approved by other Government agencies (if any): i. Has the company applied for/ ☐ Yes ☐ No obtained any other Malaysian
Government incentives (fiscal / non-fiscal incentives)?
If yes, please provide the type of incentive applied for:
_________________________________________________________ ii. If approved, please provide a copy of each of the approval letter, conditions and effective date of the incentive.

5.
No
1
Applicant’s Proposed Role / Services under Service Agreement (SA) with
Approved MWC Developer
Name of
Approved
MWC Developer
Date of
SA
Tenure of
SA
Scope of services
(Describe nature of services)*
Contract
Sum (RM)
2
3
* Please provide corporate slides on physical development project and development services offered to Approved
MWC Developer.
4

6. Estimated Investment (for the first 5 years)
Fixed Assets (RM) Year 20..
Land
Building
Plant & Machinery
Other Equipment / asset (please provide details on separate paper)
Total Investment
Fixed Assets
Land *
Year 20..
Year 20..
Year 20..
Year 20..
Year 20..
Building *
* Kindly indicate area in acreage for land and in square feet for building.
7. Financing Structure (for the first 5 years) (RM)
ITEM
(1) AUTHORISED CAPITAL
(2) SHAREHOLDER’S FUND
Year 20..
Year 20..
RM
Year 20..
Year 20..
%
(a) Paid-up Capital
(i) Malaysian Individual

Bumiputera

Non-Bumiputera
(ii) Companies incorporated in Malaysia*


(iii) Foreign nationals / companies (Specify name
& nationality / country of origin)*

Total of (i), (ii) and (iii) 100%
5

(3) LOAN
(a) Domestic
(b) Foreign

Total Loan
(4) OTHER SOURCES

Total Sources
TOTAL OF (2), (3) & (4)
* Please refer below page for (2)(a)(ii) and (iii)
* For 2(a)(ii) & (iii), please provide equity structure as follow:
ITEM
Name of Company No.1
Bumiputera
Non-Bumiputera
Foreign nationals / companies
(Specify name & nationality / country of origin)*


TOTAL
Name of Company No.2
Bumiputera
Non-Bumiputera
Foreign nationals / companies
(Specify name & nationality / country of origin)*

TOTAL
6
%
100%
100%

8. Financial Projections:
Please complete table below:
(In
RM 000’)
Gross Revenue
Operating
Expenses
Profit Before
Tax
Year 20.. Year 20.. Year 20.. Year 20.. Year 20..
7

9. Declaration
I , , the
(name) (designation) of
(name of company)
(i) hereby declare that to the best of my knowledge, the particulars furnished in this application are true.
(ii)* have engaged / is planning to engage the services of the following consultant for my application :
Company Name
Address
Contact Person
:
:
:
Designation
Telephone no.
Fax no.
:
:
:
E-mail :
I take full responsibility for all information submitted by the consultant(s).
Date (Signature)
(Company’s Stamp or Seal)
* Please complete this section if the company has engaged / is planning to engage the services of consultant(s) to act on behalf of the company. Please provide information on a separate sheet of paper if space is insufficient.
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MWC DEVELOPMENT MANAGER SUBMISSION CHECKLIST
Please prepare three (3) sets and kindly submit the following items together with this application form:
☐ Form 9 - Companies Act, 1965
(Certificate of Incorporation of Private Company)
☐ Form 24 - Companies Act, 1965 (Relevant forms reflecting paid up capital)
☐
☐
Form 44 - Companies Act, 1965
(Notice of Situation of Registered Office)
Form 49 - Companies Act, 1965
(Particulars of Directors, Managers and Secretaries)
Memorandum and Articles of Association ☐
☐ Agreement with MWC Developer
(i.e. letter / agreement appointing applicant to provide management, consultancy, supervisory or marketing services in relation to the activity of the developer in MWC)
☐ If the Company has been incorporated for more than a year, please furnish a copy of the management / audited accounts
9