JABATAN IMIGRESEN MALAYSIA

MACS APPLICATION FORM

MACS CATEGORIES: MACS-IRDA MACS

MACS TYPE: SHORT TERM (For those enter Malaysia for social visit) PHOTO

LONG TERM (For Malaysia long term pass holder) 3.5cm x 5.0cm

A. TRAVEL DOCUMENT DETAILS **Mandatory

1. FULL NAME As per passport

2. GENDER MALE FEMALE

3. D.O.B
DD/MM/YYYY

4. PASSPORT NO 5. NATIONALITY

6. DATE OF ISSUE 7. EXPIRY DATE

DD/MM/YYYY DD/MM/YYYY

8. PLACE OF ISSUE 9. PLACE OF BIRTH

B. PERSONNEL DETAILS **Mandatory

1. CORESPONDENT ADDRESS

2. CITY 3. COUNTRY

4. POSTCODE

5. CONTACT NO 6. OCCUPATION

7. EMAIL
C. PASS DETAILS **For Malaysia long term pass holder only
1. PASS TYPE

2. PASS NO

3. EXPIRY DATE
DD/MM/YYYY

D. VISA DETAILS **For foreigners required only

1. VISA TYPE

2. VISA NO

3. EXPIRY DATE
DD/MM/YYYY

E. SPONSOPSHIP DETAILS
1. NAME Employer/ Company/ Institution

2. ADDRESS

3. CITY 4. STATE

5. POSTCODE

6. CONTACT NO 7. FAX NO

8. BUSSINESS TYPE

APPLICANT SIGNATURE

______________________________ DATE: _____________________