(SULIT & PERSENDIRIAN)

(PRIVATE & CONFIDENTIAL)

BUKU KECIL SENARAI ASET PERIBADI

PERSONAL ASSET INVENTORY BOOKLET
MILIK
OF

NAMA :
NAME

NO. K.P. :
NRIC NO.

TARIKH :
DATE

Sila gam dan hantarkan buku kecil anda yang lengkap kepada:
Please seal and send your completed booklet to:
PB TRUSTEE SERVICES BERHAD (7968-T)
17th Floor, Menara Public Bank
146, Jalan Ampang
50450 Kuala Lumpur

Buku kecil ini disediakan bagi membantu anda dan kami untuk menyimpan rekod butir-butir peribadi dan dokumen-
dokumen penting anda. / This booklet is prepared to assist you and us in keeping records of your personal details and
important documents.
 SULIT & PERSENDIRIAN
PRIVATE & CONFIDENTIAL

PENGEMASKINIAN BUTIR-BUTIR ORANG YANG PERLU DIHUBUNGI

UPDATE OF CONTACT PARTICULARS
Alamat (Pertukaran alamat
jika ada):
Address (change of address
if any):
No. KWSP: No. PERKESO:
EPF No.: SOCSO No.:
No. Cukai Pendapatan:
Income Tax No:
No. untuk dihubungi: [Rumah] [House] [Pejabat] [Office] [Telefon Bimbit] [Mobile]
Contact No.:
E-Mel/E-Mail:

Orang yang perlu dihubungi pada

No. untuk
waktu kecemasan:
dihubungi:
Contact Person in case of
Contact No.:
emergency:
Orang yang perlu dihubungi pada
No. untuk
waktu kecemasan:
dihubungi:
Contact Person in case of
Contact No.:
emergency:

SENARAI HARTA
LIST OF ASSET
Harta Bertanah/Harta Tak Alih
Landed/Immovable Properties
Jenis Harta dan Alamat Nama Pemilik Butir-butir Hak Pemegang
Type of Property and Address Bersama (jika ada) Milik gadaian (jika ada)
Name of Co Title Particulars Chargee (if any)
Owners (if any)

PERSONAL ASSET INVENTORY BOOKLET 1 FORMS/PBT004/REV010918

 SULIT & PERSENDIRIAN
PRIVATE & CONFIDENTIAL

SENARAI HARTA (bersambung...)

LIST OF ASSET (continued...)
Butir-butir Kenderaan
Details of Vehicles
Jenis Kenderaan Butir-butir Kenderaan Pemilik Sewa
Type of Vehicle Details of the Vehicles Beli (jika ada)
Chargee (if any)

Akaun Bank
Bank Accounts
Nama dan Alamat Bank Jenis Akaun No. Akaun
Name and Address of Bank Type of Account Account No.

Pelaburan
Investment

Pelaburan Ekuiti (Nama dan Alamat Broker) No Akaun CDS.

Equity Investment (Name and Address of Brokerage) CDS Account No.

PERSONAL ASSET INVENTORY BOOKLET 2 FORMS/PBT004/REV010918

 SULIT & PERSENDIRIAN
PRIVATE & CONFIDENTIAL

SENARAI HARTA (bersambung...)

LIST OF ASSET (continued...)
Unit Amanah (Nama dan Alamat Syarikat Pengurusan)
Unit Trust (Name and Address of Management Company)

Insurans/Insurance
(Insurans Hayat/Bertempoh/Kemalangan Diri/Hospital/ Insurans Lain)
(Life Insurance/Term/Personal Accident/Hospitalisation/Other Insurance)
Nama dan Alamat Syarikat Insurans Jenis Polisi No. Polisi Jumlah yang
Name and Address of Insurance Type of Policy Policy No. diinsuranskan (RM)
Company Sum Insured (RM)

Insurans Automobil/Automobile Insurance

Nama dan Alamat Syarikat Insurans Jenis No. Polisi Kenderaan yang
Name and Address of Perlindungan Policy No. Diinsuranskan
Insurance Company Type of Vehicle Insured
Coverage

PERSONAL ASSET INVENTORY BOOKLET 3 FORMS/PBT004/REV010918

 SULIT & PERSENDIRIAN
PRIVATE & CONFIDENTIAL

SENARAI HARTA (bersambung...)

LIST OF ASSET (continued...)
Insurans Harta/Property Insurance
Nama dan Alamat Syarikat Insurans Harta yang No. Polisi
Name and Address of Insurance Company diinsuranskan Policy No.
Property Insured

Insurans Hayat Kumpulan/Group Life Insurance

Nama dan Alamat Terkini Majikan

Name of Current Employer and Address

Peti Simpan Selamat/Safe Deposit Box

Nama Bank:
Name of Bank:

Alamat:
Address:

No. Peti:
Box No.:

Kunci disimpan di:

Key Located at:

Jika Nama Bersama, sila

nyatakan:
If Joint Name, please
specify:

PERSONAL ASSET INVENTORY BOOKLET 4 FORMS/PBT004/REV010918

 SULIT & PERSENDIRIAN
PRIVATE & CONFIDENTIAL

Pelaburan Lain/Other Investment(s)

Keahlian Kelab, Aset Asing, Lain-lain
Club Membership(s), Foreign Asset(s), Other(s)
Butir-butir Pelaburan Nama dan Alamat Entiti Pelaburan
Investment Particulars Name and Address of Investment Entity

LIABILITI/ LIABILITY(IES)
Pinjaman Bank, Sewa Beli, Kad Kredit, Lain-lain.
Bank Loan(s), Hire Purchase(s), Credit Card(s), Other(s)
Nama Pemiutang
Name of Creditor

Alamat
Address

No. Telefon
Telephone No.

Nama Pemiutang
Name of Creditor

Alamat
Address

No. Telefon
Telephone No.

PERSONAL ASSET INVENTORY BOOKLET 5 FORMS/PBT004/REV010918

 SULIT & PERSENDIRIAN
PRIVATE & CONFIDENTIAL

LOKASI DOKUMEN-DOKUMEN PENTING

LOCATION OF VITAL DOCUMENT(S)
Dokumen/Document Lokasi/Location
Wasiat
Will(s)

Sijil Deposit Tetap

Fixed Deposit
Certificate(s)

Suraikatan Hak Milik

Title Deed(s)

Kad Pendaftaran Kereta

Car Registration Card(s)

Kunci Peti Simpan

Selamat
Safe Deposit Box Key(s)

Dokumen-dokumen Lain
Other Documents(s)

Arahan/Nota/Peringatan:
Instruction/Note/Reminder:

Jika berlaku apa-apa pertikaian atau percanggahan antara teks Bahasa Inggeris dan terjemahan Bahasa Malaysia ini, maka teks Bahasa Inggeris
akan diterima pakai. / In case of conflict or discrepancy between the English text and the Bahasa Malaysia translation hereof, the English text shall
prevail.

PERSONAL ASSET INVENTORY BOOKLET 6 FORMS/PBT004/REV010918