Borang Tambang Percuma
Borang Tambang Percuma
1.
Nama
: ...................................................................................................
2.
Gred / Pangkat
: ...................................................................................................
3.
Alamat Rumah
: ...................................................................................................
...................................................................................................
...................................................................................................
4.
Wilayah Asal
: ...................................................................................................
5.
: .................................................................
6.
: .................................................................
7.
: .................................................................
8.
: .................................................................
9.
Nama
Umur
Hubungan
i.
...
........................................
ii.
...
........................................
iii.
...
........................................
iv.
...
........................................
v.
...
........................................
vi.
...
........................................
B.
C.
i.
ii.
iii.
PENGAKUAN PEGAWAI
Saya mengesahkan bahawa segala maklumat yang diberikan di atas adalah
benar.
: ..........................................................................................
KEGUNAAN PEJABAT
*LULUS / TIDAK LULUS
...........................................................
Nama
...........................................................
Jawatan
...........................................................
Tarikh
...........................................................