BORANG CFI./13 FORM CFL/13 JABATAN TENAGA KERJA SEMENANJUNG MALAYSIA PENDAFTARAN KONTRAKTOR TENAGA KERJA {SEKSYEN 334 (1) AKTA KERJA 1955) REGISTRATION OF CONTRACTOR FOR LABOUR (SECTION 33A (1) EMPLOYMENT ACT 1955) ‘TANGGUNGJAWAB KONTRAKTOR TENAGA KERJA DUTY OF CONTRACTOR FOR LABOUR TBorang Eo Cea dengan lng Hepa Dejsbat Tenge Was (wast av KORTRRRTOR TENAGA RERA stp Sal berahendal sa bern mt membellan peer bap manzenan prinsipl/ antler stbhonzotor atten pendatoran Ii for al be creed exch tine the CONTRACTOR FR LABOUR tendo por nda espe my mpl tan rine entrar subcontractors and adit the completed form te nares Labor Oe for Itepurpssef asain 2 Beran yang lng hendshhaotr he Peebt Tenaga Kora terekt dalam tompoh mat bela (14) hat ‘sum nesbeballan nar an alr oth Pia Tena Ker. The completed frm so be obited within fourteen (1) days 20 the nesrt boo fe Bre oping te mone ond strode ee te Lar fe PERINGATAN. REMINDER aga aaah akon SHAT Aa Reva 1955 oak sat eslaban inva oayen HINGT) ARS Te {aa dan deat esha oleh dens Wd wee RM 10.00 Fare to comp) wth section 24() of he Enplomen Act 195 effec dr secton SAGs) of te Acton f Canad ob fed eter Bo LO. BAHAGIANI PARTI WARTUMAT KONTRARTOR TENAGA KERJA (SILA GUNAKAN HURUF BESAR) PARTICULARS OF CONTRACTOR FOR LABOUR (PLEASE USE CAPITAL LETTERS) 1 Seemann OCC) ame of cmp biess ae OOCCeCeEEeorreer a Daerah [Ber Fenoode Diarev/atr 3. Nombor penéstaren aysttet/periagean(peictunggn/nerkongeia) aNa telefon Telephone na. a tate Fore. ‘Aamateme! Email ede -Aarat tempat peer digae (Gekranya Berens dria tae) Place of emplynen (fife from oboe) No.telefon Telephone no. fake Marnatemel Ell odtress Makmat orang yang bolo babu Gantt pers 1a Name Nome 112 No teen bi Hondphone re i i l T1 CG a CT LTTTTT tT Dasma Jaana Distr Leal [ LETTTT4 east ‘ete CLT) OD Co CLT TT) CLT CT LTT im TITTITTTTtTirryr) BAHAGIAN IT PARTI MAKLUMAT PRINSIPAL/KONTRAKTOR/ SUB-KONTRAKTOR VANG AKAN PARTICULARS OF PRINCIPAL /CONTRACTOR/ SUB-CONTRACTOR TO BE SUPPLIED DIBEKALKANPEKERJA WITH EMPLOYERS a Nama propa toner? subshontrttor Nome ofprnctso/eenteactor/ ‘Subsconractr omatberdatar Regard ores:14 Nombor pendataran sata parigane (pei ungsl/perhangta) Company /oesiesreqstroon ramble proprietor /barershi) I TUTPET TT tt at 18 Sehtor/Sactar ea ae LETT ] 16 Jeri peruahosn/Typerofindotey COLL CLTerrercert eee a 18 No fake IEEE ee ] os 19 Alamatemet Eee LITT 1 ieee 20 Alemat tempat pekeriadlgajlkan LILLI LT) waenmemenmeties PTE] eee (atte fomabov TLELEIILoLoLei 1 ELE TLE LT] Chay OE Tone ae Pe eee LLETITTT TI 2 nen ooo coo a 2 Aten a a creeBAHAGIAN I PARTI AR AT KORTE AN RERIA WANG AN DTRERATEAN PARTICULARS OF CONTRACT AND EMPLOYEES TOBE SUPPL eee ove CS CO CO camiecronrae rmore = } OE) CO) 25 Tarn por san dela mo ooo Date employee) snpped 216 ong kara yng aan ibekalha kepada prinspal)Kaeatr/sb-kontator oof employe) a besupphedtprislpel/controctor/ sb contactor iangan pekeia/Naofempoeer 2 Lae EeeEeecden Temps Teialfon : |e froma [eprom] em) e Ptotal | oy |p | fetal | etorgin | = HUMAN TOTAL (Sie gina laps avs Faangan TTR meno (Greate ce enerie ihe coum step) TRGONECARASAL OD PEAR OCUPTONAT OE coum CODE Tani gu ade) Tangesh | 800 ata 1136 [Perlong Penge inde | ov at: 327 [open La A oan | sue 96 fortran i) pins | Pat (ty sat 51 [Peon Ferien (4). 7 into | 1b |} Permpwen ats see ema |e it feeran viet | nar fox) ste Sie [renovate Siitinte | Ut |) Foal 23tie [pegach Pt stn GT PA tend | 7 tL [andr Et adn ‘ine | crm 21231_Msane lang koe tics | 0 720i [iid endo | a0 737 anion lagna [Fas PR tame | u seemed Bc Repeat Son Pgh siz pamna ati emma ora Sa [Pene us ino] Pea Sa ee Go Si [ker im Srye Wieder Meni el)BAHAGIAN PART IV PENGARUAN KONTRARTOR TENAGA KERJA CONTRACTOR FOR LABOUR'S DECLARATION. Dengan ini saya mengaku dan mengesahkan babawa segala maklumat yang dberikan adalah benar dan bet ‘hereby decane and confer tha ll inforenation proved herein is true and correct. TTovikh Date cop syarikat ‘Tendatangan Signeure Nama Hamme Jawatan Designetion ‘etn Pega! Bashtif/Pengerah Usa Penguras Besar Pea ‘hie vec fcr /Moneging Detr/cenere! Monogr [Durr Stamp of company ‘Tonk mass AKUAN PENERIMAAN ACKNOWLEDGEMENT Nem ae None Iawatan Desgnetion Cop ras aatan Deportments oe) top ‘Segala makdumat yang diberikan dalam borang int adalah SULIT “All information provided in ths formes CONFIDENTIAL