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1/2018]
INLAND REVENUE BOARD OF MALAYSIA
BORANG PENDAFTARAN FAIL CUKAI PENDAPATAN INDIVIDU
INCOME TAX FILE REGISTRATION FORM FOR INDIVIDUAL
A1 Nama / Name
A2 No. Pengenalan (No. Kad Pengenalan / Polis / Tentera) /
Identification No. (Identity Card / Police / Army No.)
A3 No. Pasport / Passport No.
A4 Jantina / Sex 1 = Lelaki / Male 2 = Perempuan / Female
A5 Status / Status 1 = Bujang / Single 2 = Kahwin / Married 3 = Janda / Duda / Divorcee / Widow / Widower
A7 Warganegara / Citizen
A8 Negara Mastautin / Country of Residence
A9 Alamat Surat-menyurat /
Correspondence Address
Poskod / Bandar /
Postcode City
Negeri /
State
A10 Alamat Kediaman / Residential Address
Poskod / Bandar /
Postcode City
Negeri /
State
A11 No.Telefon / Telephone No.
A12 e-Mel / e-Mail
B1 Pekerjaan / Employment
B2 Tarikh Mula Bekerja / (hh/bb/tttt) / (dd/mm/yyyy)
Commencement Date of Employment
B3 No. Staf / No. Gaji
Staff No. / Payroll No.
B4 Nama Majikan / Employer’s Name
Poskod / Bandar /
Postcode City
Negeri /
State
B7 No. Telefon Majikan /
Employer’s Telephone No.
1
C5 Alamat Premis Perniagaan /
Address of Business Premise
Poskod / Bandar /
Postcode City
Negeri /
State
D1 Nama / Name
D2 No. Pengenalan (No. Kad Pengenalan / Polis / Tentera) /
Identification No. (Identity Card / Police / Army No.)
D3 No. Pasport / Passport No.
D4 Tarikh Kahwin / Date of Marriage (hh/bb/tttt) / (dd/mm/yyyy)
Poskod / Bandar /
Postcode City
Negeri /
State
F3 No. Kelulusan Ejen Cukai /
Tax Agent’s Approval No.
F4 No.Telefon / Telephone No.
F5 e-Mel / e-Mail
AKUAN / DECLARATION
Saya / I
dengan ini mengakui bahawa maklumat yang diberikan di dalam borang ini adalah benar, betul dan lengkap.
hereby declare that the information given in this form is true, cor rect and complete.
Tandatangan /
Tarikh / Date (hh/bb/tttt) / (dd/mm/yyyy)
Signature