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BORANG PENDAFTARAN
REGISTRATION FORM
FAIL CUKAI PENDAPATAN INDIVIDU
INDIVIDUAL INCOME TAX FILE
LEMBAGA HASIL DALAM NEGERI MALAYSIA
INLAND REVENUE BOARD MALAYSIA
A1
Nama
Name
A2
No. Pengenalan (No. Kad Pengenalan / Polis / Tentera)
Identification No. (Identity card / Police / Army No.)
A3 No. Pasport / Passport No.
A6
Tarikh Lahir (hh/mm/tttt)
Date of Birth (dd/mm/yyyy)
A7 Warganegara / Citizen
A8
Negara Mastautin / Country of
Residence
A9
Alamat Surat – menyurat /
Correspondence Address
Poskod Bandar
Postcode City
Negeri
Country
A10
Alamat Kediaman / Residential
Address
Poskod Bandar
Postcode City
Negeri
Country
A11 No.Telefon / Telephone No.
B1 Pekerjaan / Employment
B2
Tarikh Mula Kerja / Date of
Employment
B3
No.Staf / No. Gaji
Staff No. / Payroll No.
B4 Nama Majikan / Employer’s Name
Poskod Bandar
Postcode City
Negeri
Country
B7
No. Telefon Majikan / Employer’s
Telephone No.
C1
Nama Perniagaan
Name of Business
C2
Jenis Perniagaan Utama
Type of Main Business
C3
No.Pendaftaran Perniagaan
Business Registration No.
C4
Tarikh Mula Operasi
Date of Commencement of Operation
1
C5
Alamat Premis Perniagaan
Address of Business Premise
Poskod Bandar
Postcode City
Negeri
Country
D1 Nama / Name
D4
Tarikh Kahwin (hh/mm/tttt)
Date of Marriage (dd/mm/yyyy)
D5
No. Cukai Pendapatan /
Income Tax No.
E2
Jumlah Pekerja / Number of
Employees
E3
Bilangan Pekerja Terima Pendapatan Tahunan :
Number of Employees Receive Annual Income :
(a) Kurang daripada RM 30,000 (b) Melebihi RM 30,000
Less than RM 30,000 More than RM 30,000
Poskod Bandar
Postcode City
Negeri
Country
F4 No.Telefon / Telephone No.
F5 e-Mel / e-Mail
AKUAN / DECLARATION
No. Pengenalan / Pasport
Saya Identity / Passport No.
I * Potong yang tidak berkenaan
Delete whichever is not relevant
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, correct and complete.
Tandatangan Tarikh :
Signature Date :