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LAMPIRAN B

Nama Pengguna _________________________________________


No Akaun

_________________________________________

Stesen

______________

Tarif

______________

SENARAI SEMAK PERMOHONAN TARIF INDUSTRI KHAS TAHUN KEWANGAN ___________


Borang ini hendaklah diisi dan dikembalikan bersama permohonan lengkap untuk Tarif Industri Khas
Sila tandakan pada ruangan yang telah disediakan
A) Laporan Kewangan Terkini lengkap dengan perkara-perkara berikut :Tandatangan Lembaga Pengarah
Tandatangan dan cop Juruaudit Luar
Tandatangan dan cop Pesuruhjaya Sumpah
B) Salinan Bil Elektrik
Salinan bil elektrik 12 bulan dari bulan _______________________
hingga ______________________(bagi tempoh laporan kewangan)
Nama Pengguna di dalam bil elektrik mesti sama dengan Laporan Kewangan
C) Borang Apendix 1
Borang asal diisi dengan lengkap
Cop dan tandatangan Juruaudit Luar
Nota :a) Cost of goods sold dan operating expenses perlu dinyatakan dengan terperinci
b) Bagi Pengguna yang mempunyai lebih dari satu akaun elektrik samada di dalam premis yang
sama atau di lokasi yang berlainan, perlu memberi pecahan kos bagi setiap akaun di dalam
Apendix 1
TNB berhak melantik juruaudit luar untuk mengkaji dokumen-dokumen yang dikemukakan termasuk
Laporan Kewangan, Apendix 1 dan lain-lain. Segala kos yang diaudit tersebut akan ditanggung sepenuhnya
oleh pemohon. Pemohon perlu memberi jawapan lengkap untuk kesemua soalan/pertanyaan tambahan dari
TNB/juruaudit luar yang dilantik.
Dokumen yang lengkap perlu dimajukan kepada alamat seperti berikut ::
Pengurus Besar (Pengurusan Komersil), Jabatan Perkhidmatan Pengguna
Aras 16, Wisma TNB, Jalan Timur, 46200 Petaling Jaya, Selangor Darul Ehsan

ATTACHMENT B
Name of Company _________________________________________
Account No

_________________________________________

Station

______________

Tariff

______________

SPECIAL INDUSTRIAL TARIFF APPLICATION CHECKLIST FINANCIAL YEAR _____________


This form must be filled and returned together with the Special Industrial Tariff application.
Please tick the boxes provided.
A) Current Annual Report completed with the following details :Signature of Company Directors
Signature and stamp of External Auditors
Signature and stamp of Commissioner of Oaths
B) Copies of Electricity Bills
Copies of 12 months electricity bills from _______________________
to ______________________(for the period of the annual report)
The Company Name on the electricity bill must be the same as in the Annual Report.
C) Appendix 1 Form
Original form duly completed
Signature and stamp of External Auditors
Note :c) Cost of goods sold and operating expenses must be clearly detailed out.
d) For companies having more than one electricity account either in the same premise or at a
different location, must submit the cost breakdown and allocation for each account in
Appendix 1.
TNB reserves the right to appoint an independent external auditor to review the documents submitted
including the Annual Report, Appendix 1 and others. All related audit costs are to be borne wholly by the
applicant. The applicant is subject to disclosing full information to any questions/enquiries from
TNB/appointed external auditor.
Completed documents should be submitted to the following address :
General Manager (Commercial Management), Customer Service Department
Level 16, Wisma TNB, Jalan Timur, 46200 Petaling Jaya, Selangor Darul Ehsan

APPENDIX 1
PLANT / FACTORY :
(as per electricity bill)
TNBs account no :
Current Year
Last Year
(
)
(
)
__________________________________________
Business Revenue
1.
2.
3.
_________________________________________
Total

(1)
_________________________________________

Cost of Goods Sold *


1.
2.
3.
4.
_________________________________________
Total

(2)
__________________________________________

Operating Expenses **
1.
2.
3.
4.
5.
6.
_________________________________________
Total

(3)
_________________________________________
_________________________________________

Total Cost ( 2 + 3 ) = ( 4 )
_________________________________________

Profit Before Tax


Less : Taxation
Profit After Tax

(14)

__________________________________________
__________________________________________
__________________________________________

We certify that the revenue & expenses (direct & indirect) relating to the above premise
reflect a true and fair picture of the operation.

Certified by External Audior


( signed & stamped )

Notes :
** a. Operating expenses includes

TNBs Electricity bills


Other bills eg. Phones, water, rents, assessment & rates
Salaries, bonus, KWSP, gratuities
Medical expenses
Training & research & development
Entertainment
Depreciation (eg. Equipment, plant & machinery)
Transport & travelling
Professional & consultancy fees
Advertising & marketing expenses
Stationery
Insurance
Allocated Cost
Overhead
FOREX
Exceptional item
Etc

* b. Cost of Goods Sold includes


-

Raw materials
Direct labour
Direct overhead
Other inputs

c. % of electricity usage is
Electricity Cost = ( to 5% for eligibility )
Total Cost

Electricity Cost = Maximum Demand charge + Energy charge only


Total Costs = Cost of Goods Sold + Operating Expenses

d. Business Revenue = Business Revenue + All Other Income


( Netting off Other Income in Expenses is NOT permitted )