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Unit Residen

Seksyen Pengurusan Perniagaan


Bahagian Pengurusan Aset
Jabatan Timbalan Naib Canselor (Pembangunan)
Universiti Teknologi Malaysia
Johor Darul Ta’zim
UTM.J.17.03.03.03/UR/SPP/BPA/JTNCP/010  | 07-5532549  | 07-5532553  | asrama@utm.my

BORANG PERMOHONAN PENYEWAAN BILIK SEMASA CUTI SEMESTER


ROOM RENTAL APPLICATION FORM DURING SEMESTER BREAK

BUTIRAN PERIBADI PEMOHON


APPLICANT PERSONAL DETAILS
Nama
Name
No. Kad Pengenalan No. Kad Matrik
Identification Card No. Matric Card No.
Kolej No. Blok / Bilik
College Block / Room No.
Semester Sesi
Semester Session
Tarikh Daftar Masuk Tarikh
Check-In Date Date
Tarikh Daftar Keluar Tandatangan Pemohon
Check-Out Date Applicant Signature

KEGUNAAN PEJABAT
OFFICE USE
Kaedah Bayaran [ ] Tunai [ ] Debit
Payment Method Cash Debit
Jumlah Hari Menginap Tandatangan & Cop
Numbers of Day Stay Signature & Stamp
Kadar Bilik Sehari RM
Room Rates Per Day
Jumlah Bayaran RM Tarikh
Total Payment Date

------------------------------------------------------------------------------------------------------------------------------------ ----------

BUTIRAN PERIBADI PEMOHON


APPLICANT PERSONAL DETAILS
(Sila tampal borang ini pada pintu bilik anda / Please paste this form onto your door room)
Nama
Name
No. Kad Pengenalan No. Kad Matrik
Identification Card No. Matric Card No.
Kolej No. Blok / Bilik
College Block / Room No.
Semester Sesi
Semester Session
Tarikh Daftar Masuk Tarikh
Check-In Date Date
Tarikh Daftar Keluar Tandatangan Pemohon
Check-Out Date Applicant Signature

KEGUNAAN PEJABAT
OFFICE USE
Kaedah Bayaran [ ] Tunai [ ] Debit
Payment Method Cash Debit
Jumlah Hari Menginap Tandatangan & Cop
Numbers of Day Stay Signature & Stamp
Kadar Bilik Sehari RM
Room Rates Per Day
Jumlah Bayaran RM Tarikh
Total Payment Date

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