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LEMBAGA HASIL DALAM NEGERI MALAYSIA INLAND REVENUE BOARD OF MALAYSIA

BORANG PENDAFTARAN FAIL CUKAI PENDAPATAN INDIVIDU

INCOME TAX FILE REGISTRATION FORM FOR INDIVIDUAL

BAHAGIAN A: / PART A: MAKLUMAT ASAS / BASIC PARTICULARS

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

A6 Tarikh Lahir / Date of Birth (hh/bb/tttt) / (dd/mm/yyyy)

A7 Warganegara / Citizen

A8 Negara Mastautin / Country of Residence

A9 Alamat Surat-menyurat / Correspondence Address

Poskod / Postcode

Bandar /

City

Negeri / State

A10 Alamat Kediaman / Residential Address

Poskod / Postcode

Bandar /

City

Negeri / State

A11 No.Telefon / Telephone No.

A12 e-Mel / e-Mail

BAHAGIAN B: / PART B: MAKLUMAT PEKERJAAN / PARTICULARS OF EMPLOYMENT

B1 Pekerjaan / Employment

B2 Tarikh Mula Bekerja / Commencement Date of Employment

(hh/bb/tttt) / (dd/mm/yyyy)

B3 No. Staf / No. Gaji Staff No. / Payroll No.

B4 Nama Majikan / Employer’s Name

B5 No. Majikan / Employer’s No. E

B6 Alamat Majikan / Employer’s Address

Poskod / Postcode

Bandar /

City

Negeri / State

B7 No. Telefon Majikan / Employer’s Telephone No.

BAHAGIAN C: / PART C: MAKLUMAT PERNIAGAAN / PARTICULARS OF BUSINESS

C1 Nama Perniagaan / Name of Business

C2 No.Pendaftaran Perniagaan / Business Registration No.

C3 Tarikh Mula Beroperasi / Commencement Date of Operations

(hh/bb/tttt) / (dd/mm/yyyy)

C4a Jenis Perniagaan Utama / Type of Main Business

C4b Kod Perniagaan Utama / Main Business Code

CP600 [Pin. 1/2018]

2

C5 Alamat Premis Perniagaan / Address of Business Premise

Poskod / Postcode

Bandar / City

Negeri / State

BAHAGIAN E: / PART E: PENDAFTARAN FAIL MAJIKAN / REGISTRATION OF EMPLOYER’S FILE ( bagi perniagaan di Bahagian C ) / ( for the business in Part C)

E1 Status Majikan / Employer’s Status 1 = Kerajaan / Government 2 = Berkanun / Statutory 3 = Swasta / Private

E2 Bilangan Pekerja / Number of Employees

BAHAGIAN F: / PART F: MAKLUMAT EJEN CUKAI / PARTICULARS OF TAX AGENT

F1 Nama / Name

F2 Alamat Firma / Address of Firm

Poskod / Postcode

Bandar / 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

No. Pengenalan / Pasport * / Identification / Passport No.* ( * 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 / Signature

Tarikh / Date (hh/bb/tttt) / (dd/mm/yyyy)

SILA KEMUKAKAN: / PLEASE SUBMIT: Salinan kad pengenalan atau passport. Photocopy of identity card or passport.

UNTUK KEGUNAAN PEJABAT

Honorifik

No. Cukai Pendapatan

No. Majikan E

BAHAGIAN D: / PART D: MAKLUMAT PASANGAN / PARTICULARS OF HUSBAND / WIFE

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)

D5 No. Cukai Pendapatan / Income Tax No.