TUNTUTAN TUNAI

(CASH CLAIM)

(POS M.0. 6)

229990-M
KIRIMAN WANG
(MONEY ORDER)
Tandakan (√ ) Di Ruang Berkenaan
(Please Tick (√) The Appropriate Column)
Matawang Asing
RM Sen
(Foreign Curency)
Jenis Dalam Negeri Luar Negeri
(Type) (Domestic) (Foreign)
atau ____________________________________________________________
Amaun Kiriman Wang
(Money Order Amount) (or)
KW Biasa
(Ordinary MO)

KW Telegraf
(Telegraphic MO)
Untuk Kiriman Wang Ekspres / Telegraf
(For Express / Telegraphic Money Order) KW Ekspres
(Express MO)
Mesej: ______________________________________________________________
Pejabat Pembayar
(Message) ____________________________________________________________ (Payment Office) _________________________________________

No. Tel. Penerima: _____________________________________________________

(Payee’s Tel. No)
UNTUK KEGUNAAN PEJABAT
(For Office Use)
Nama Penerima: _______________________________________________________

(Payee’s Name) _______________________________________________________

Alamat (Address): ______________________________________________________ RM Sen

_____________________________________________________________________ Amaun
Komisen
_____________________________________________________________________ B Tambahan
B Telegraf
B T Telegraf

Nama Pengirim: _______________________________________________________ Jumlah

(Sender’s Name) ______________________________________________________

No. Kad Pengenalan: ___________________________________________________

(I.C Number)
No. Kenderaan: _______________________________________________________
____________________________________ No Tel: _________________________

T.T. / C.I.J Pengirim:

(Sender’s Signature / Thumbprint)

Jenis Pejabat Pengeluar Tarikh Nombor Stok

Keluaran

_____________________________
Cap Tarikh T/tangan Pegawai Pengeluar

Resit Permohonan Kiriman Wang

(Money Order Application Receipt)
TUNTUTAN TUNAI
Nama Penerima:
(CASH CLAIM)
(Sender’s Name)
No. K/P Penerima:
(Sender’s IC No)
229990 - M No Kenderaan:
Nama Pejabat Pos:
…………………………..
Jumlah Bayaran: Pegawai Pengeluar
Tarikh: Issuing Officer

(UNTUK SIMPANAN PENGIRIM)

Cap Tarikh (TO BE KEPT BY REMITTER)