MALAYSIA Nomination Form Nomination Deadline
ASEAN BUSINESS AWARDS 30 June 2010
ASEAN Most Admired Enterprises
CHECK-LIST
Before you send in your nomination form, please ensure these items are followed and completed:
Complete this nomination form and return to your ABA National Gateway by 30 June 2010:
DATO’ SYED AMIN ALJEFFRI
ASEAN-BAC Malaysia (National Gateway)
c/o Kuala Lumpur Malay Chamber of Commerce Malaysia
No. 79 C (3rd Floor), Damai Complex
Jalan Datuk Haji Eusoff, 50400 Kuala Lumpur, Malaysia
Tel: + 603 4042 4711 | Fax: + 603 4042 1540 | Email: zulhilmy@yahoo.com
Companies may also submit nomination form directly to:
ASEAN-BAC SECRETARIAT OR KPMG LIMITED
70 A, Jl. Sisingamangaraja (Competition Strategic Partner)
Jakarta 12110, Indonesia 16th Floor, Pacific Place
Tel: + 6221 726 2991 ext 491 | 722 0705 (DL) 83B Ly Thuong Kiet Street
Fax: + 6221 722 0539 Hoan Kiem Dist., Hanoi, Vietnam
Email: aseanbac@asean.org Tel: 84 (4) 3946 1600| Fax: 84 (4) 3946 1601
E-mail: timaman@kpmg.com.vn
Online nomination form may be obtained directly from above organizations, or downloaded from www.asean-bac.org
Nomination form must be signed by the Chief Executive Officer, or equivalent
Enclose copy of the Registration Certificate of the Company
If financial statements are audited, please enclose a set of the Audited Statements
Enclose copy of the Residence, Passport or Identification Card of the Nominee (CEO of the Company, or equivalent)
Enclose copy of latest Annual Reports if available and sustainability/CSR reports as relevant
The nomination form can be completed by anyone, including the nominated organization. Entry submission, with supporting
documents and materials, should be in English.
Any information provided in this form will be confidentially treated and will only be used by the Strategic Partner and Judges
during the review and selection process. The award entry submission will not be returned.
SECTION 1: ELIGIBILITY CRITERIA
LARGER SIZE COMPANY
To be considered for the ASEAN Business Awards, the category for a larger company must:
1. Be an ASEAN-incorporated enterprise with at least 40% ASEAN-owned equity and have operational presence in two or
more ASEAN countries
2. Be in operations for a minimum of five years and must have three years of financial statements
3. Fulfill one of the following conditions:
- Annual revenue of a minimum of US$20 million
- Fixed assets of more than US$10 million
- Minimum of 300 employees
SMALL AND MEDIUM ENTERPRISE (SMEs)
To be considered for the ASEAN Business Awards, the category for an SME must:
1. Be an ASEAN-incorporated enterprise with at least 40% ASEAN-owned equity preferably with operational presence in
two or more ASEAN countries
2. Be in operations for a minimum of three years and preferably two years of financial statements
3. Fulfill one of the following conditions:
- Annual revenue of less than US$20 million
- Fixed assets equal to or less than US$ 10 million
- Less than 300 employees
If the nominated company meets with all the eligibility conditions, please return the completed nomination form, typed or
handwritten. All nominations shall be acknowledged by the National Gateway.
SECTION 2: GENERAL INFORMATION
A. Organization Information
Organization Name (English): _____________________________________________________________________
(Chinese / Malay / Tamil / Others):
Organisation Address: ___________________________________________________________________________
Telephone:______________________ Fax : _______________________ Email: : ___________________________
Website (if any): ________________________________________________________________________________
B. Key Personnel (Nominee)
Chief Executive Officer or equivalent | Salutation: Mr. Mrs | Ms.
_____________________________________________________________________________________________
Chief Operating Officer or equivalent | Salutation: Mr. Mrs | Ms.
_____________________________________________________________________________________________
Chief Financial Officer or equivalent | Salutation: Mr. Mrs | Ms.
_____________________________________________________________________________________________
C. Capital Structure
(i) Individual Shareholders
Please provide the names of all main individual shareholders and their nationalities (please attach a separate sheet if
the space provided is insufficient):
Name of Shareholder Nationality Designation in Organisation Percentage of Shareholding
(ii) Company Shareholders
Please provide the names of all main company shareholders, if relevant
(please attach a separate sheet if the space provided is insufficient):
Company Number Percentage of
Name of Company Country of Registration Business Activity
Registration No. of Staff Shareholding
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SECTION 3: BUSINESS INFORMATION
A. Main Business Activities (Please tick where appropriate)
Agriculture / Agribusiness/Fisheries
Business / Engineering Services
Food & Beverage
Healthcare Services
Hospitality / Travel / Tourism
Information and communications Technology / High Tech
Transportation/Logistics
Mining/energy
Real Estate / Construction
Wholesale / Distribution / Retail
Manufacturing (electronic, automotive, textiles, apparel, etc.)
Others (please specify) ____________________________________________________________________
Please provide a brief description of the organization and its business in no more than 150 words.
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B. Please rank your strength of the categories conferred under ABA 2010
(1 being strongest and 4 being weakest)
___ Growth ___ Employment ___ Innovation ___ Corporate Social Responsibility
Please provide an elaboration on why you should be considered for the category you have chosen in no more than
250 words (please refer to Attachment A).
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C. Financial Information
(i) In which year was the organisation incorporated? ____________________________
(ii) In which country was the organisation incorporated? __________________________
(iii) Please indicate if the organisation is listed on any stock exchange(s):
◘Yes ◘ No
If organisation is listed, please indicate year of listing and the stock exchange(s) it is listed on
___________________________________________________________________
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(iv) Please indicate the following organization’s details:
FY 2007 – 2008 FY 2008 – 2009 FY 2009-2010
(US$) (US$) (US$)
a Revenue
- Local Revenues
- Overseas Revenues
- Intra-ASEAN Revenue (as a
percentage of Overseas Revenue)
b Shareholders' Equity
- ASEAN
- Non-ASEAN
c Profit before tax
d Total fixed assets
e Number of employees
f Operating costs
- Salaries and benefits
- Cost of sales
- Financial costs
Note: Data must be converted to United States Dollar Equivalent applying the exchange rate at the end of
each particular fiscal year.
(v) Please indicate if the financial statements are audited:
◘Yes ◘ No
If financial statements are audited, please enclose a set of the audited statements
(vi) State the geographical presence of the organization (manufacturing and project sites, sales offices, wholly-
owned subsidiaries, etc.) of the organization (country & city)
___________________________________________________________________
(vii) Please indicate if the nominated organisation has been subjected to any investigation or litigation:
◘Yes ◘ No
If the nominated organisation has been subjected to investigation or litigation, please provide brief details
(You may enclose the details as a separate sheet)
____________________________________________________________________
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SECTION 4: REFERENCES
Please provide below the professional advisors who have assisted the nominated organisation in its enterprise efforts.
(a) Bank
Banker
Bank
Tel: Email:
(b) Audit Firm
Auditor
Audit Firm
Tel: Email:
(c) Other Advisor
Name
Firm
Tel: Email:
(d) Other Advisor
Name
Firm
Tel: Email:
SECTION 5: DECLARATION
To be completed only by the Chief Executive Officer / Managing Director / Chief Financial Officer or equivalent) of
the organisation nominated for this Awards:
I hereby declare that the facts stated in this application together with the accompanying information are true and
correct, to the best of my knowledge, and satisfy the eligibility criteria. I understand that the financial information
provided will be used strictly by the panel of judges in the judging process and not for public release unless I agree
to its release. I further authorize the use and public release, in connection with the ASEAN Business Awards, of
organisation’s name, non-financial information, photographs, video and audio recordings from any source. I agree
that no compensation shall be due to me or my organisation for such usage.
Name: ________________________________ Designation: ________________________________
Signature: ______________________________ Date: : ________________________________
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ATTACHMENT A
Information important to the judges will include, but is not limited to:
Categories Most Admired Most Admired Most Admired Most Admired Enterprise in the
Enterprise in the Enterprise in the Enterprise in the “Corporate Social
“Growth” category “Employment” “Innovation” Responsibility” Category
Category Category
Judging % Profit Growth Number of new jobs Number of Environmental excellence in
Criteria Long term vision created patents filed production and business
for sustainable Staff retention rate R&D budget (as process
growth Training expense per a percentage of Environmentally sustainable
Return on employee revenues) business strategy
investment Creation of a positive Innovative Link of business to social or
Return on assets work environment products community development
% annual Availability of good Innovative Employee volunteering
revenue growth health care business programs
Proper appraisal processes
system
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