Resignation

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SEKRETARIAT LPKS, JABATAN KETUA MENTERI, TINGKAT 11, WISMA BAPA MALAYSIA, PETRA JAYA, 93502 KUCHING.

RESIGNATION FORM
PERSONAL DETAIL
NAME: NEW IC NUMBER: GENDER PERMANENT ADDRESS: EMAIL ADDRESS: PHONE (H): QUALIFICATION : MARITAL STATUS: NAME OF BANK FOR ALLOWANCES: PHONE (O): DEGREE SINGLE DIPLOMA MARRIED WIDOW WIDOWER PHONE (H/P) : MALE FEMALE RELIGION :

DETAILS OF EMPLACEMENT
LAST EMPLACEMENT : SUPERVISORS NAME: PERIOD OF PLACEMENT: DATE JOINED: REASON FOR RESIGNATION: YEAR(S) MONTH(S) LAST DATE OF DUTY : DAY(S)

IF ACQUIRING NEW JOB


POSITION: SALARY: COMPANY NAME: COMPANY ADDRESS: COMMENT(S) ON CBG:

DECLARATION
Hereby, I declare that all the information above is true. Signature: ____________________ Supervisors Comment : Signature:____________________ Date :__________________________ Date :__________________________

TO BE FILLED BY SUPERVISOR

Please complete this form and kindly fax to 082-311140/082-449490 (Attn: Ms. Banta Ak Jayang) Any enquiries please contact 082-446212/ 445211

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