NEW HIRE PROFILE FORM

TO BE COMPLETED BY HR:

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1. Please complete "Requestor Staff No.", "Request Date", "Requestor Name", "Department" and "Company". 2. Please scan this form (on first page) to SSC HR together with the printed Application Form, Signed Acceptance of Offer Letter, Approved Recommendation for Offer Form, Festive Advance Form (if applicable) , MEDEX002 Form , GTLA Beneficiary Form, Employee Profiles supporting documents and other company & government statutory specific documentation.
D D M M Y Y

Requestor Staff No. Requestor Name Department Company

Request Date

TO BE COMPLETED BY EMPLOYEE:
Instructions : 1. Please fill in the forms in UPPER CASE. 2. Please ensure that all information filled are complete and accurate before submitting to HR. 3. Please attach supporting documents where applicable and required. 4. Please attach passport-sized photo within the designated area. PID
Offer Letter Ref. No Title (Mark "X" where applicable) Title (1) Title (2) First Name (as per IC) Child Of Last Name (as per IC) Sex Birth Date Religion Marital Status Marital Status Since A R I E S C A H Y O N O N A N A N G Mr. Mrs. Ms. Encik Puan E.g. Dr., Ir., YM. Etc E.g. Tan Sri, Puan Sri, Dato', Datuk, etc. Enter first name (Enter family surname for Chinese) Bin , Binti , Bte, A/L , A/P , A/K etc Enter last/father's name Cik

Please attach passport-sized photo here

X 0 I S

Male 5 S I 0 L N 6 A G 9 M L E 1

Female DDMMYY Ethnicity X Bumiputera Race E.g. Single , Married , Widow , Divorced, Separated DDMMYY (Please leave vacant if marital status is Single) E.g. PETRONAS , JPA , MARA , UTM , USM etc Non Bumiputera Mark "X" where applicable

Education Sponsorship

N Personal Email

A. Bank Details

Bank Name

Please include proof of bankslip

Account No. Type of Account Bank Branch City Postcode Savings Current Mark "X" where applicable

B. Personal IDs
Birth Certificate No. NRIC No. Passport No. Passport Issuing Authority Passport Issuing Date Passport Type (Nationality) EPF No. Contribute to SOCSO? Yes No SOCSO No. DDMMYY Passport Expiry Date DDMMYY Malaysian, Singaporean, Japanese etc Old IC No.

C. Additional Tax Deduction

Income Tax Number Tax Office Kuala Lumpur, Ipoh , Kuantan etc

NEW HIRE PROFILE FORM

D. Married Spouse Particulars
First Name (as per IC) Child Of Last Name (as per IC) NRIC No. Passport No. Sex Location of Birth Country of Birth Nationality Spouse Employed? Yes No Male Female Birth Date DDMMYY Bin , Binti , Bte, A/L , A/P , A/K etc

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Town of birth as in birth certificate Country of birth as in birth certificate Malaysian, Singaporean, Japanese etc

E. Dependents Children Particulars Dependent (1)

First Name Child Of Last Name NRIC No. Birth Certificate No. Passport No. Sex Location of Birth Country of Birth Nationality Step Child? Child Type Is dependent handicapped? Education Level Yes Legitimate Yes Primary School No Adopted No Secondary School Child Custody? Others Married? Institute of Higher Learning Yes No Mark "X" if applicable. Male Female Birth Date DDMMYY Town of birth as in birth certificate Country of birth as in birth certificate Malaysian, Singaporean, Japanese etc Please complete either NRIC No. or Birth Certificate No. Birth Certificate (For children below 12 years of age) Bin , Binti , Bte, A/L , A/P , A/K etc

Mark "X" if applicable and include supporting documents Yes No Dependent Employed? Yes No

Professional Bodies

Mark "X" for highest education received

Dependent (2)
First Name Child Of Last Name NRIC No. Birth Certificate No. Passport No. Sex Location of Birth Country of Birth Nationality Step Child? Child Type Is dependent handicapped? Education Level Yes Legitimate Yes Primary School No Adopted No Secondary School Child Custody? Others Married? Institute of Higher Learning Yes No Mark "X" if applicable. Male Female Birth Date DDMMYY Town of birth as in birth certificate Country of birth as in birth certificate Malaysian, Singaporean, Japanese etc Please complete either NRIC No. or Birth Certificate No. Birth Certificate (For children below 12 years of age) Bin , Binti , Bte, A/L , A/P , A/K etc

Mark "X" if applicable and include supporting documents Yes No Dependent Employed? Yes No

Professional Bodies

Mark "X" for highest education received

NEW HIRE PROFILE FORM

E. Dependents Particulars (cont'd) Dependent (3)
First Name Child Of Last Name NRIC No. Birth Certificate No. Passport No. Sex Location of Birth Country of Birth Nationality Step Child? Child Type Is dependent handicapped? Education Level Yes Legitimate Yes Primary School No Adopted No Secondary School Married? Institute of Higher Learning Child Custody? Others Yes No Mark "X" if applicable. Male Female Birth Date DDMMYY Please complete either NRIC No. or Birth Certificate No. Bin , Binti , Bte, A/L , A/P , A/K etc

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Birth Certificate (For children below 12 years of age)

Town of birth as in birth certificate Country of birth as in birth certificate Malaysian, Singaporean, Japanese etc

Mark "X" if applicable and include supporting documents Yes No Dependent Employed? Yes No

Professional Bodies

Mark "X" for highest education received

Dependent (4)
First Name Child Of Last Name NRIC No. Birth Certificate No. Passport No. Sex Location of Birth Country of Birth Nationality Step Child? Child Type Is dependent handicapped? Education Level Yes Legitimate Yes Primary School No Adopted No Secondary School Child Custody? Others Married? Institute of Higher Learning Yes No Mark "X" if applicable. Male Female Birth Date DDMMYY Town of birth as in birth certificate Country of birth as in birth certificate Malaysian, Singaporean, Japanese etc Please complete either NRIC No. or Birth Certificate No. Birth Certificate (For children below 12 years of age) Bin , Binti , Bte, A/L , A/P , A/K etc

Mark "X" if applicable and include supporting documents Yes No Dependent Employed? Yes No

Professional Bodies

Mark "X" for highest education received

Dependent (5)
First Name Child Of Last Name NRIC No. Birth Certificate No. Passport No. Sex Location of Birth Country of Birth Nationality Step Child? Child Type Is dependent handicapped? Education Level Yes Legitimate Yes Primary School No Adopted No Secondary School Married? Institute of Higher Learning Child Custody? Others Yes No Mark "X" if applicable. Male Female Birth Date DDMMYY Town of birth as in birth certificate Country of birth as in birth certificate Malaysian, Singaporean, Japanese etc Please complete either NRIC No. or Birth Certificate No. Birth Certificate (For children below 12 years of age) Bin , Binti , Bte, A/L , A/P , A/K etc

Mark "X" if applicable and include supporting documents Yes No Dependent Employed? Yes No

Professional Bodies

Mark "X" for highest education received

NEW HIRE PROFILE FORM

F. Emergency Contacts
First Name Child Of Last Name Unit No & Street Town/City State Country Contact Number Area Code | Phone No. Postal Code Bin , Binti , Bte, A/L , A/P , A/K etc

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STATEMENT OF DECLARATION: I hereby declare that all information that I have provided above and the sheets attached hereto are true and correct. I understand that any false statement(s) may cause disciplinary action to be taken against me. By signing this declaration, I agree to authorize PETRONAS to investigate and verify my statement(s) and all information that I have provided.

Signature of Applicant

Date (DD.MM.YY)

TAMBAHAN FORMULIR DATA KARYAWAN

Tempat Lahir No. Jamsostek No. NPWP Alamat NPWP Nama Pemilik Rekening Bank : : : :
:

Penerima Santunan / Ahli Waris Nama

Alamat Lengkap

Hubungan

PENDIDIKAN
Dimulai dari yang paling baru No Sekolah/Universitas Jurusan Mulai Selesai IPK Strata

PEKERJAAN
Dimulai dari yang paling baru No Perusahaan Jabatan Uraian Tugas Mulai Selesai

TRAINING
No Nama Training/Workshop/Seminar Penyelenggara Tempat Tahun

Harap melampirkan : - Photo copy Kartu Keluarga - Photo copy K.T.P. - Photo copy Surat Nikah - Photo copy Surat Kelahiran (untuk semua anggota keluarga) - Photo copy Kartu Jamsostek lama, jika ada - Photo copy Ijazah/sertifikat training

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Dibuat oleh Tanggal

: :

Diperiksa oleh Tanggal

: :

*) soft copy dari dokumen ini harus dikirmkan kepada bagianHR

Strata

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