MINISTRY OF DOMESTIC TRADE, CO-OPERATIVES AND CONSUMERISM

REGISTRATION OF BUSINESS ACTIVITIES (SAFETY STANDARDS FOR TOY) A. APPLICANT INFORMATION

Business / Company Registration No. Business / Company Name File Ref. No. (MDTCC Office Use) KPDN(BK)

Headquarter Address

Premise Address (Please list in a separate attachment if more than one branch) Contact Person Tel No. Fax No. Email Address 1 Email Address 2 Website Address

B. BUSINESS INFORMATION (Please tick (/) on applicable)

HS Code Type of Business / Company [ [ [ [ [ [ [ [ ] Manufacturer ] Importer ] Exporter ] Distributor ] Wholesaler ] Retailer ] Conducting repackaging activities ] Others please state

Business Description

MDTCC

Self Declaration

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C. DOCUMENTS FOR SUBMISSION (Please tick (/) on applicable)

No. Please tick Yes (/), No (X) Documents MDTCC Office Use Yes (/), No (X)

Private Limited or Public Limited Company 1. 2. 3. 4. 5. 6. 7. 8. 9. Memorandum and Articles of Association Form 9 - Certificate of Incorporation of Private Company Form 13 - Certification of Incorporation of Change of Name of Company, if applicable Form 24 - Return of Allotment of Shares Form 32A - Form of Transfer of Securities, if applicable Form 49 - Return Giving Particulars In Register of Directors, Managers and Secretaries and Changes of Particulars Latest computer print out of company profile from Companies Commission of Malaysia Consent letter from owner of copyright or trademark or exclusive licensee, if applicable Companys catalogue, if applicable Sole Proprietor or Partnership 10. 11. 12. 13. 14. 15. 16. Form D - Certificate of Registration Form E - Renewal of Certificate of Registration, if applicable Latest computer print out of company profile from Companies Commission of Malaysia Certificate of Registration under Ordinan Nama-Nama Perniagaan for Sarawak Form B - Certificate of Registration under Commercial Licence Ordinance 1948 for Sabah Consent letter from owner of copyright or trademark or exclusive licensee, if applicable Businesss catalogue, if applicable Foreign Company 17. 18. 19. 20. 21. 22. 23. 24. Memorandum and Articles of Association or Bylaw Form 83 - Certificate of Registration of Foreign Company Form 83A - Certificate of Registration of Change of Name of A Foreign Company, if applicable Form 80A - Annual Return of Foreign Company Form 79 - Return by Foreign Company Giving Particulars of Directors and Changes of Particulars Latest computer print out of company profile from Companies Commission of Malaysia Consent letter from owner of copyright or trademark or exclusive licensee, if applicable Companys catalogue, if applicable

MDTCC

Self Declaration

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D. DECLARATION AND UNDERTAKING

In connection with this application, I, hereby: (a) undertake to supply all information required by Ministry of Domestic Trade, Co-operatives and Consumerism (MDTCC) for the purpose of company registration inline with the toy safety standards requirements for Malaysia; undertake that the submitted documents are true; agree to make declaration based on the format determined by MDTCC for the purpose of supply, or offer to or advertise for supply toys in Malaysia; understand the Ministry has the right to revoke the application in the event of any non compliance with regards to the toy safety standards; agree to maintain record by keeping a technical file with regards to the toy safety standards; agree to produce test report as determined by MDTCC upon request by Customs and / or MDTCC; undertake to be responsible and liable on the declaration made; agree that MDTCC may not process the application due to insufficiency and / or untraceability of the documents submitted; agree that MDTCC may revoke the application due to untraceability of the test report submitted; and understand that MDTCC may release information obtained in the course of processing the application to the public or government authorities so far as is prudent to warn in the opinion of MDTCC.

(b) (c) (d) (e) (f) (g) (h) (i) (j)

Signature of authorised representative:

Date:

Name:

Designation:

Please return form duly completed to: Director Consumerism Division Ministry of Domestic Trade, Co-operatives and Consumerism Level 4, No. 13, Persiaran Perdana Precint 2, 62623 Putrajaya MALAYSIA Tel No. : +603-8882 5957/5886/5862/5850/5599 Fax No. : +603 8882 5983 Email : toys@kpdnkk.gov.my Website : www.kpdnkk.gov.my

MDTCC

Self Declaration

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E. MDTCC OFFICE USE ONLY (Please tick (/) on applicable)

File Ref. No. Received by Signature KPDN(BK) Date

Processed by Designation Status of Application Reason (if pending or rejected) Accepted Pending Rejected

Signature and official stamp

Date

Comments:

MDTCC

Self Declaration

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