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Form of Application For Shares
Form of Application For Shares
Gentlemen,
I/We do hereby irrevocably authorized you to place my/our name(s) on the Company’s
Registers of Members as the holder(s) of the shares allotted to me/us pursuant to this application
and to send by post at my/our risk a share certificate in respect thereof.
* Mr./Miss/Madam
Full Name of Applicant : ROSMIZA BINTI MOHD YUSUF (f)
Identity Card No./ Passport No. : 750414-02-5682
Description : COMPANY DIRECTOR
Date of Birth : 14-04-1975
Address : NO 16, PEKAN MALAU,
09020 KULIM, KEDAH.
IMPORTANT - To comply with the Exchange Control Ordinance, 1953, the applicant(s) must
make the appropriate Declaration contained herein. No application will be considered unless this
condition is fulfilled.