EXPATRIATE INFORMATION ( DP11 FORM)

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					                                                     JABATAN IMIGRESEN MALAYSIA
                                                 IMMIGRATION DEPARTMENT OF MALAYSIA                                                        DP11
                                       MAKLUMAT PEGAWAI DAGANG / EXPATRIATE INFORMATION ( DP11)
Tandakan (X) Dalam Petak Berkenaan / Mark (X) in Approriate Box
A. MAKLUMAT SYARIKAT ATAU MAJIKAN / PARTICULARS OF COMPANY OR EMPLOYER                                                                 Jenis Permohonan
                                                                                                                                       Type Of Application
1. No Pendaftaran Syarikat / Registration of Company No                                               :
                                                                                                                                              Baru / New
2. Nama Syarikat / Majikan / Name Of Company / Employer
                                                                                                                                              Lanjutan / Extension




3. Alamat Syarikat / Majikan / Address Of Company / Employer:                                                                          Agensi Pelulus / Approving Agency

                                                                                                                                           JKPD             JPA        KHEDN

                                                                                                                                           MIDA             SC         BNM

                                                                                                                                           MDeC



Poskod / Postcode                                                                         Bandar / City
                                                                                                                                       Jenis Pas / Type Of Pass
4. No Telefon / Telephone No. :                                                       -
                                                                                                                                          Pas Penggajian / Employment Pass

5. No Faks/ Fax No. :                                                                 -                                                   Pas Lawatan ( Kerja Sementara ) /
                                                                                                                                          Visit Pass (Temporary Employment)
6. E-mail :
7. Pegawai Perhubungan Syarikat / Majikan / Contact Person from Company / Employer :

                                                                                                                                       Lain-lain / Others
8. Jawatan / Position :                                                                                                                    VDR
                                                                                                                                           Tempat / Place :

                                                                                                                                           ______________________
B. MAKLUMAT PEGAWAI DAGANG / PARTICULARS OF EXPATRIATE
                                                                                                                                           JP Visa
1. Nama Penuh / Full Name                                   :
                                                                                                                                           Pas Khas / Special Pass

2.Jantina / Gender :                                        Lelaki / Male                                 Perempuan / Female               Cooling Off Period

3. Tarikh Lahir / Date of Birth                                                                                                            Pinda Tempoh Sahlaku Pas /
                                                            :                                     /              /                         Amendment To Validity Of The Pass

4. Warganegara / Nationality                                :                                                                              Pindah Pas /
                                                                                                                                           Transfer Endorsement

5. Nombor Pasport / Passport No.                            :                                                                              Lain-lain – Sila Nyatakan
                                                                                                                                           Others – Please State
6. No Pasport Lama / Old Passport No.                       :
                                                                                                                                           __________________________

9. Tarikh Tamat Pasport / Passport Expiry Date                             :                      /              /                        ___________________________


10. Tempat Dikeluarkan / Place of Issue                                    :

11. Tarikh Dikeluarkan / Date Of Issue                                     :                      /              /

10. Tarikh Masuk Malaysia / Date Of Entry To Malaysia                                                 :                        /   /
11. Alamat di Malaysia / Address in Malaysia :




                                                                                                                                            Tampal Sekeping Gambar
                                                                                                                                               Pegawai Dagang
Poskod / Postcode                                                                         Bandar / City
                                                                                                                                           Paste A Photo Of Expatriate
12. Jawatan / Position                        :
                                                                                                                                                  (3.5cm X 5.0 cm)



13. Gaji Sebulan / Salary permonth : RM

14.Tempoh Pas Dipohon / Duration Of Pass Applied                                          :                    Bulan / Month

15. No Cukai Pendapatan / Income Tax No. :
C. AKUAN / DECLARATION
Saya memperakui bahawa maklumat / kenyataan di atas adalah benar :
I hereby declare that the particulars / informations furnished above are true :

Tandatangan majikan/ Signature of Employer                                        :                                                                  Cop Syarikat
Nama Penuh / Name                                                                 :
                                                                                                                                                  Company’s Stamp
No. KPT / No. Paspot / I/C. No. / Passport No.                                    :
Jawatan / Position                                                                :
Tarikh / Date                                                                     :
Bahagian Pas Penggajian

				
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Description: This is DP 11 Form (EXPATRIATE INFORMATION) from IMMIGRATION DEPARTMENT OF MALAYSIA