Sticker - Application Form: Particulars of Applicant

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PERBADANAN PENGURUSAN ELAEIS2

PANGSAPURI PERKHIDMATAN ALAM IDAMAN,


BLOK 19, JALAN BAIT U8/1,SEKSYEN U8 BUKIT JELUTONG
40150 SHAH ALAM, SELANGOR DARUL EHSAN
TEL : 03-7845 5974 EMAIL: elaeis2.cashier@gmail.com

STICKER - APPLICATION FORM


PARTICULARS OF APPLICANT

NAME
MUHAMMAD IKMAL BIN ROSELI
NRIC NO /
930815-10-5331 I / WE ARE THE
PASSPORT NO
TELEPHONE NO
OWNER TENANT
(APARTMENT)
TELEPHONE NO
03-78313641 UNIT NO #######
(OFFICE)
MOBILE NO 011-26227562 EMAIL ikmalroseli7@gmail.com

PARTICULARS OF VEHICLE
SERIAL NO
VEHICLE REGISTRATION SERIAL NO
NO STICKER VEHICLE MODEL CAR PARKING NO
NO NEW STICKER
RETURNED
1 BMF 990 HONDA CITY A140
2 VDH 9434 YAMAHA NMAX
3
4
5

DECLARATION
I/We hereby agreed and understand that the car stickers issued to me/us is subject to the following
terms and conditions :
1 Tenants must provide "Written Authorization from the Owner" upon issuance of new car sticker
2 The car stickers is part of the security system for Perbadanan Pengurusan Elaeis2 and should be prominently
displayed on the vehicle windscreen when entering and/or parked within the apartment / condominium premises
at all times . The car sticker is issued to the vehicle listed herein and shall not interchangeable
3 The car stickers must be retuned to the management for cancellation when the vehicle registration is changed
4 The new sticker will be charges for RM 5.00
5 Damaged stickers can be returned to management and charge RM5.00 will be implement
6 The management reserve the right to withdraw or cancelled any car sticker sue to safety or security reason
7 PERBADANAN PENGURUSAN ELAEIS2 reserves the right issue new sticker at its sole discretion
8 Vehicles Are Parked At Owner's Risk.

IKMAL 03.02.2021
APPLICANT SIGNATURE DATE OF APPLICATION

OFFICE USE ONLY


PAYMENT RECEIVED RM PAYMENT
OFFICIAL RECEIPT NO RECEIVED
OLD CAR STICKER NO
SUPPORTING LETTER
APPROVED BY

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