SENARAI SEMAK / CHECKLIST

PERMOHONAN PAS KHAS APPLICATION FOR SPECIAL PASS

NAME OF APPLICANT : --------------------------------------------------------------------------------------------------

FACULTY : --------------------------------------------------------------------------------------------------

TELEPHONE NUMBER : --------------------------------------------------------------------------------------------------

E-MAIL : --------------------------------------------------------------------------------------------------

BIL.

NO.

DOKUMEN YANG DIPERLUKAN

REQUIRED DOCUMENTS

LENGKAP ( √ )

COMPLETE ( √ )

1 Isi Borang DP11 (Jika Pemegang Pas Penggajian)

Fill up DP11 Form (if Employment Pass Holder)

2 Isi Borang DP11A (Untuk Tanggungan)

Fill up DP11A Form (For Dependant)

3 Isi Borang IMM.55 (Jika Pemegang Pas Ikhtisas)

Fill up IMM.55 Form (if Professional Visit Pass Holder)

4 1 Salinan Pasport (Muka surat pertama dan visa terkini)

1 Copy of Passport (1st pages and latest visa)

5 Passport Asal

Original Passport

6 Yuran proses RM 100.00

Processing fee RM 100.00

7 Jadual tiket penerbangan

Itinerary flight ticket

Pass/Visa Expired by:

Itinerary Flight Ticket: Must be 30 days after visa expiry date

Please submit all the documents to:

MS. AZLEN AB RAHMAN

International Relations Centre (UKM Global) Universiti Kebangsaan Malaysia Level 2 Chancellory Building Tel. No. : +603-8921 5057 | Email : len.rahman@ukm.edu.my

Submit by: One (1) week before the visa expiry date