AKTA KERAJAAN TEMPATAN 1976 (LOCAL GOVERNMENT ACT 1976)

BORANG I (FORM I)
NOTIS JUALAN ATAU PINDAHMILIK (NOTIC OF SALE OR TRANSACTION)
(Seksyen 160 / Section 160)
Datuk Bandar / Mayor,
Majlis Bandaraya Johor Bahru

Saya/Kami (I / We) ___________________________________________________________________________________________

Beralamat (Address) __________________________________________________________________________________________
Dengan ini memberi notis sebagaimana dikehendaki di bawah seksyen 160 (1) Akta Kerajaan Tempatan 1976 mengenai yang
berikut :-
(Hereby give notice as required under subsection 160(1) of the local Government Act 1976 of the following :)
Prihal dan tempat letak Pegangan (Description and Situation) :
No. Lot (Lot No.) :______________________________ Mukim (Mukim) :________________________________________________
No. Hakmilik (Title No.) : __________________
Alamat Harta (Property Address) : _______________________________________________________________________________

Nama Pemindahmilik (Name of Transferor) : _________________________________________________________

(Nama Pemilik Asal/Previous Owner)
Nama Penerima Pindahmilik (Name of Transferee) :
1. _____________________________________________ No. K/P : _____________________
2. _____________________________________________ No. K/P : _____________________
3. _____________________________________________ No. K/P : _____________________
Alamat surat menyurat (Postal Address): __________________________________________________________________________
___________________________________________________________________________________________________________
No. Telefon (Phone No.) : _____________________________________

Nombor atau Simbol Suratcara (Number or Symbol Instrument) :

Rujukan (Ref.) : ___________________________ Jilid Pindahmilik (Tranfer Vol.) : ____________________
Folio (Folio) : _____________________________
Tarikh Suratcara didaftarkan (Date of Registration of Instrument): __________________________________

Harga Beli (Purchase Price) : __________________________ Tarikh beli (Date of Purchase) :____________________
Kenyataan (statement) : ________________________________________________________________________________________

Bertarikh (Date) : ________________________ Tandatangan (Signature) : ______________________________

Untuk Kegunaan Pejabat (For Office Use Only)

Bayaran (Payment) RM___________________ No. Resit (Receipt No.): __________________________
Tarikh (Date) : __________________________
Disemak & Disahkan oleh (Verified By):

_______________________________
(Tandatangan / Signature)