FORM 04 FOR OFFICE USE ONLY

Received Date :
Reference No :

PROJECT TITLE: ___________________________________________

PRODUCTION COMPANY: ___________________________________________
DATE OF APPLICATION: ___________________________________________
SECTION 1 APPLICANT PRODUCER INFORMATION

Registered Company Name:

Company Registration Number: Registration Number:

Registered Company Address: Contact Person: Designation:

Business Phone: Mobile Phone:

Mailing Address:
Fax: E-mail:

Names of Company Director(s) Nationality Residency (past two years) Address of Company Director(s)

Shareholder(s) in the
Applicant Company Nationality Residency (past two years) Percentage (%) of ownership

* If the applicant Company is a subsidiary, please state the ultimate holding company by including a copy of the group company structure with details on common
shareholdings and directorships with this application

If the production company is different from the applicant company OR if a Special Purpose Vehichle (SPV) is established for the Project, please
provide the following details:

Registered Company Name:

Place of Registration: Registration Number:

Registered Company Address: Contact Person: Designation:

Business Phone: Mobile Phone:

Mailing Address:
Fax: E-mail:

Names of Company Director(s) Nationality Residency (past two years) Address of Company Director(s)

Shareholder(s) in the Applicant

Nationality Residency (past two years) Percentage (%) of ownership
Company
CREATIVE CONTROL
Please state and include supporting documents on who will have creative rights, including the right to be consulted, to veto or to give approval
with respect to the script, cast, crew, music, sound mix, budget items and final cut in the Project.

Name Nationality Residency (past two years) Approval Responsibilities

CHAIN OF TITLE AND UNDERLYING RIGHTS

Owners of the option on the material Nationality Residency (past two years)

Owner(s) of copyright Nationality Residency (past two years) Percentage (%) of ownership

RECOUPMENT AND RETURNS

Please provide details of who will receive recoupment from the exploitation of the Project.

Name Nationality Residency (past two years) Approval Responsibilities

SECTION 2 FILM/PROJECT INFORMATION

PROJECT TITLE
FORMAT (Please colour the boxes accordingly and refer to the Film In Malaysia Incentive (FIMI) Guidelines for Foreign Production for definitions)
Filming format Film Digital

Is this a co-production? (please provide a copy of the co-production agreement) Yes No

Type of Project (please supply a synopsis of the Project):

Feature Film including theatrical documentary features, animated features and IMAX

A single episode programme

A single episode documentary

A series or season

Drama
Total number of episodes Total number of episodes to produce in Malaysia

Animation
Total number of episodes Total number of episodes to produce in Malaysia

Documentary
Total number of episodes Total number of episodes to produce in Malaysia

Reality Shows & Game Shows

NOTE: FIMO may require viewing material which represents the proposed Project e.g. a prior season of a series or photo stills to assess the viability of the
Project. If this becomes necessary, you will be contacted to furnish the materials. Project for assesment purposes.

RUNNING TIME OF THE PROJECT:

For a Project that is a Feature film: Total running time (in minutes):

For a Project that is NOT a Feature film:

mins. = total
X actual episode actual running
No. of episodes length time:
Example: Number of episodes: 13 x actual episode length 22 mins = total actual running time: 286 mins

FOR PRODUCTION APPLICATION - ANTICIPATED PRODUCTION DATES:

Commencement of preparation of production (i.e. Preproduction): date / months / year
Commencement of Principal Photography (shooting date or for an animated film, the start date for animation date / months / year
activities):

Date of completing production activity(Including Post Production): date / months / year

Date to apply for the FIMI Final Certificate (2 Months after completing production activity): date / months / year

FOR POST-PRODUCTION APPLICATION - ANTICIPATED POST-PRODUCTION DATES:

Commencement of preparation of post-production: date / months / year
Date of completing post-production activity: date / months / year
Date to apply for the FIMI Final Certificate (2 Months after completing post-production activity): date / months / year

Credited Scriptwriter(s) Nationality Residency (past two years)

Is the work an original work by the Scriptwriter? Yes No

Is the work rewritten from a previous script (not a previous draft)? Yes No

SUMMARY OF PRODUCTION SCHEDULE

Weeks in Weeks Outside
Production location in Malaysia Production location ouside
Production Phases Total Weeks Malaysia Malaysia (if
(please indicate territory or state) Malaysia (please state country)
applicable)

Research & Development

Pre-production:

Principal Photography

Post-production edit including

TOTAL Production time (weeks):

OFFSHORE PRODUCTION (OUTSIDE MALAYSIA):
Please state reasons for offshore production.

CREW
Place of residency for the last (2)
Name(s) of individual(s) credited as the Excutive Producer(s) Nationality
years

Place of residency for the last (2)

Name(s) of individual(s) credited as the Producer(s) Nationality
years

Place of residency for the last (2)

Name(s) of individual(s) credited as the Director(s) Nationality
years

Please provide a list of key production personnel as follows:

Personnel Name Nationality Residency (past two years)

DOP
Editor
Production Designer
Composer
CGI/VFX Producer/Supervisor
Costume Designer
Sound Recordist
Other:
Additional personnel for documentaries:
Special Photography
Researcher
Other:
Additional personnel for animation:
Animation Director
Storyboard Artist
Other:

CAST Please furnish a copy of contracts for verification of QMPE expenses.

Please list the nationality of the Principal Characters protrayed in the script (not actual cast). If the Project is a documentary, commercial, game show or reality
show, please supply nationality of on-screen presenters or voice characters.

Principal Character's Name Nationality of Character

Please provide a list of key cast as follows. Please indicate Principal Actors with a "P".
Character Cast name Nationality Residency (past two years)
P:
P:
P:
Additional cast for documentaries:
Narrator
On-Screen presenter
Additional cast for animation:
Lead Voice
Lead Voice
Lead Voice
Lead Voice
SECTION 3 QUALIFYING MALAYSIAN PRODUCTION EXPENDITURE (QMPE)

FIMI is calculated based on the total amount of audited Qualifying Malaysian Production Expenditure (QMPE) as identified in the FIMI Guidelines. If the actual QMPE incurred is
more than 3% cost over-runs of the approved production costs indicated in the Provisional Certificate, then the applicant producer must obtain approval from FIMI Approval
Committee for the cost over-runs. Please be advised that the relevant financial and production documentation will be audited by a member of FINAS Audit Panel in which costs
to undertake such auditing activities will be borne by the applicant producer.

1. PROJECT BUDGET

MYR:
TOTAL PRODUCTION EXPENDITURE:
MYR:
TOTAL QUALIFYING MALAYSIAN PRODUCTION EXPENDITURE QMPE:
MYR:
TOTAL 30% QMPE:

NON-MALAYSIAN
TOTAL MALAYSIAN ESTIMATED 30% OF
EXPENDITURE (MYR EXPENDITURE EXPENDITURE (MYR QMPE
'000) (MYR '000) '000) (MYR '000)

ABOVE THE LINE EXPENDITURE

Story & Script 0
Development 0
Producers 0
Directors 0
Principal Cast 0
TOTAL ATL 0 0 0 0

UNIT FEES AND SALARIES

Prod Management 0
Prod Accounting 0
Assistant Director(s)
Script Supervisor
Camera Crew
Sound Crew
Lighting Crew
Grips Crew
Costume Crew
Make-Up Crew
Hair Crew
Prop Crew
Art (Design) Crew
Action Vehicles
Livestock
Construction
SFX & Armoury
VFX & Animation
OHSS & Safety
Tech Advice
Second Unit
Overtime & Loadings
TOTAL UNIT FEES & SALARIES 0 0

NON-MALAYSIAN
TOTAL MALAYSIAN 30% OF QMPE
EXPENDITURE (MYR EXPENDITURE (MYR EXPENDITURE (MYR (MYR
'000) '000) '000) '000)

PRODUCTION COSTS
Casting Fees
Supporting Cast
Stand-ins and Doubles
Stunts
Extras (Crowd)
Costumes
Makeup & Hair
Locations
Stage Rental
Props & Sets
Action Vehicles
Livestock
VFX(Physical)
Animation and Puppetry
Film & Lab - Shoot
Stock Footage & Archive
Camera Equipment
Sound Equipment
Lighting Equipment
Grip Equipment
Unit Facilities
Safety
Rentals & Stores
Travel & Transport
Hotel, Living, Catering
Insurances
Office Expenses
Offshore Shoot
Second Unit Expenses
TOTAL PRODUCTION COSTS
0 0

NON-MALAYSIAN
TOTAL MALAYSIAN % OF QMPE
EXPENDITURE (MYR EXPENDITURE (MYR EXPENDITURE (MYR (MYR
'000) '000) '000) '000)

POST PRODUCTION
Post: Crew Wages
Post: Office & Rentals
Post: Travel & Hotel
Post: Lab (Image)
Post: CGI/VFX
Post: Sound
Music
Publicity & Stills
Delivery
TOTAL POST PRODUCTION 0 0

NON-MALAYSIAN
TOTAL MALAYSIAN % OF QMPE
EXPENDITURE (MYR EXPENDITURE (MYR EXPENDITURE (MYR (MYR
'000) '000) '000) '000)

BELOW THE LINE

Legal
Completion Bond
Bank Charges

TOTAL BELOW THE LINE

TOTAL

FILMING LOCATION
Please
2. FEESlistFORMalaysian
PROPOSED SERVICES TO BE CONTRACTED IN MALAYSIA
filming
Please listlocations and
proposed contracts for Malaysian Individuals or companies to provide support services for the Project.
where they will be
shot.
SERVICE ROLE COMPANY ANTICIPATED FEE (MYR)
Please include the proposed responsibilities of Malaysian individuals or companies that would provide support services for the Project

3. RELATED PARTY EXPENDITURE

Related party expenditure is defined as expenditure by a party (individual or group) who is related in some way to the initial party. A related party could include a family
member or relative, stockholder, or a related corporation.

Please outline below (or attach a list of) any anticipated related party expenditure that will be incurred in the making of the Project (eg. EP/Producer fees, editing facilities,
camera hire etc).
NAME / COMPANY ROLE / SERVICES ANTICIPATED FEE (MYR)

4. FINANCIAL SOURCES
If known, please indicate financial sources. When your project enters production, you will be contacted to confirm financial sources. For cash flow, please indicate method(s)
used to cash flow the project (ie. equity investment, distribution advance/guarantee, licence fee/presales, etc).

A. FINANCIAL RESOURCES FOR CASH FLOW

COUNTRY OF ORIGIN NAME / FINANCIAL INSTITUTION / INVESTMENT ENTITY TYPE OF FINANCING AMOUNT (MYR)

B. GOVERNMENT GRANTS, REBATES, REFUND AND/OR OTHER INITIATIVE/FUNDING EXCLUDING LOANS

Will the applicant access and/or has accessed any State/ Federal Government rebates, grants or refunds
(including offsets and excluding production investment) in relation to the project?

COUNTRY OF ORIGIN NAME / FINANCIAL INSTITUTION / INVESTMENT ENTITY TYPE OF FINANCING AMOUNT (MYR)

C. BROADCASTER INVESTMENT

COUNTRY OF ORIGIN NAME / FINANCIAL INSTITUTION / INVESTMENT ENTITY TYPE OF FINANCING AMOUNT (MYR)

D. FILM/TELEVISION PRODUCTION COMPANY INVESTMENT

COUNTRY OF ORIGIN NAME / FINANCIAL INSTITUTION / INVESTMENT ENTITY TYPE OF FINANCING AMOUNT (MYR)

E. DISTRIBUTION COMPANY / SALES AGENT INVESTMENT

COUNTRY OF ORIGIN NAME / FINANCIAL INSTITUTION / INVESTMENT ENTITY TYPE OF FINANCING AMOUNT (MYR)

F. PRODUCER / DIRECTOR / WRITER OWN FUNDS (INCLUDING DEFERRALS)

COUNTRY OF ORIGIN NAME / FINANCIAL INSTITUTION / INVESTMENT ENTITY TYPE OF FINANCING AMOUNT (MYR)
G. OTHER PRODUCTION ASSISTANCE

COUNTRY OF ORIGIN NAME / FINANCIAL INSTITUTION / INVESTMENT ENTITY TYPE OF FINANCING AMOUNT (MYR)

H. PRIVATE, EITHER EQUITY OR NON EQUITY, INVESTMENT

COUNTRY OF ORIGIN NAME / FINANCIAL INSTITUTION / INVESTMENT ENTITY TYPE OF FINANCING AMOUNT (MYR)
SECTION 4 DISTRIBUTION

In order to qualify for FIMI the Project must be:

1. Produced for exhibition to the Malaysian public in a cinema or by way of television broadcasting; or
2. Produced for distribution to the Malaysian public as a video recording (whether on tapes, digital video
discs or otherwise) and
3. Produced and distributed for national and/or international market(s).

A. DISTRIBUTION FOR FEATURE FILMS (INCLUDING FEATURE DOCUMENTARY)

Please outline any negotiations held to date with theatrical/cinema distributors and/or exhibitors. You should note that a planned agreement for
theatrical distribution of a Film from a recognised theatrical distributor with a track record in Malaysia will be required for FIMI Approval
Committee to be satisfied that the project has a bona fide intent for theatrical release. Please document discussions and include any agreements if
they have been offered. All projects will be considered on a case-by-case basis.

COMPANY DISCUSSION DATES DISTRIBUTION REGION ANTICIPATED DATE TO AIR

Is a sales agent currently attached to the project?

If the answer is YES, please provide:.
NAME OR AGENCY EMPLOYED DISTRIBUTION REGION

NOTE: • If available, evidence of Distribution/Transmission/Broadcast Agreement or Deal Memorandum

• If available, evidence of Malaysian and foreign sales agent.
SECTION 5 CULTURAL TEST (OPTIONAL)

The Cultural Test is the assessment on the Malaysian cultural elements which features genres relating to local cultural values or traditional elements that is
contained in the Project. The Cultural Test is assessed in accordance with a point-based system where each Project obtains specific additional percentage of cash
rebate up to the maximum of 5% as may be determined by the FIMI Approval Committee or on appeal, FIMI Appeal Committee for fulfilling the relevant list of
criteria in the table below.

Assessment of the Cultural Test will only be made after submission of the Final Certificate Application Form. As such, the percentage of additional cash rebate to be
awarded (where eligible) will only be stated in the Final Certificate.

For Applicant Producer who wishes to apply for the additional 5% cash rebate, kindly fill in the table below.

A. CULTURAL TEST FOR FILMS (FOREIGN PRODUCTION)

To be eligible for the maximum percentage of the additional cash rebate in each of the category below, the Project must portray the relevant cultural elements.

ELIGIBILITY
NO CULTURAL ELEMENTS REMARKS(*)
(Please tick)
1 Location
(a) Portray Malaysia as a positive country;

(b) Portray Malaysia as an interesting tourist destination;

(c) Display the beautiful view and destination in Malaysia; and/or

(d) Promoting Malaysia indirectly.

2 Cultural Values

(a) Display the culture or lifestyle in Malaysia, for example food,

language, heritage, traditional etc; or

(b) Display the characteristics of customs and traditions of Malaysians

or cultural events, for example wedding ceremony, festivals, birth etc.

3 Involvement or Hiring of Local Production Cast and Crew

Involvement or Hiring of any of the following local production cast and

crew in the Project:

(i) Director
(ii) Co-Director
(iii) Second Unit Director
(iv) First Assistant Director
(v) Screenwriter
(vi) Leading role by actor or actress
(vii) Director of Photography (DOP)
(viii) Second Unit of DOP
(ix) Editor
(x) Production Designer
(xi) Sound Editing
(xii) Sound Mixing
(xiii) Visual Effects
(xiv) Supervisor
(xv) Composer
(xvi) Costume Designer
(xvii) Key Make Up
(xviii) Key Hair Artist
(xix) Stunt Director
(xx) Stunt Coordinator

NOTE: * For the purpose of this Provisional Certificate Application Form, please provide the brief information on the cultural elements that is contained in the
Project based on the criteria provided. However, for the purpose of the Final Certificate Application Form, you are required to provide the specific
information/explanation on the cultural elements including, among others, the exact scene and/or play time in the Project. For the criteria on involvement or hiring
of Local Production Cast and Crew, Applicant Producer shall provide the full particulars of the individual(s), the job description and the contract of the local cast and
crew involved in the Project and shall ensure that the name and position of the local cast and crew is included at the credit title of the film. Failing which, the Project
may not be eligible for the cultural test assessment.
SECTION 5 ADDITIONAL INFORMATION

Are there plans to showcase /promote / market the project in any film festival or Yes No
relevant exhibit?
If the answer is YES, please provide:.

A. ANTICIPATED PARTICIPATION IN FILM FESTIVALS / RELEVANT EXHIBITS

COUNTRY OF ORIGIN NAME OF FESTIVAL / EXHIBITION ANTICIPATED DATE

B. STATUTORY DECLARATION

The applicant must complete a Statutory Declaration to accompany the application certifying that the contents of the application for the
Provisional Certificate are true and correct. (See Attachment “A” for Statutory Declaration.)

The Malaysian Statutory Declarations Act 1960 requires a Statutory Declaration to be made before a commissioner of oaths (if affirmed in
Malaysia) or a notary public (if affirmed outside Malaysia).

A full list of prescribed persons before whom a Statutory Declaration may be made and the legislation governing this provision can be sourced
online from the Malaysian Attorney-General’s Department at
http://www.agc.gov.my

C. CONFIDENTIALITY

Please note that all information provided by the applicant will be held by FIMO, the FIMI Approval Committee and FINAS on a strictly commercial-
in-confidence basis. Some information may be provided to the Ministry of Communications and Multimedia Malaysia, the Malaysian Inland
Revenue Board and the FINAS Board in accordance with government provisions. These parties will be bound to treat all such information as
commercial-in-confidence.

D. APPLICANT ACKNOWLEDGEMENT

FULL NAME OF APPLICANT:

SIGNATURE OF APPLICANT: DATE: date/month/year

Company official stamping

FULL NAME OF APPLICANT(S):

SIGNATURE OF APPLICANT: DATE: date/month/year

Company official stamping
Statutory Declaration

I _____________________________, (Authorised applicant’s name, NRIC/ Passport No., address and office held) do solemnly and
sincerely declare and confirm on behalf of __________________ (Name of applicant company) (“Company”) that:

(a) The Company is an eligible producer for the purpose of FIMI with either:
1) being a company duly incorporated under the Malaysian Companies Act 2016 with a valid Malaysian Company Registration Number
issued by the Companies Commission of Malaysia (CCM) and has a valid and subsisting FINAS film production license; OR
2) A foreign production company who has appointed and commissioned a Malaysian production services company that: (i) is a private
limited company duly incorporated under the Malaysian Companies Act 2016 and registered with CCM; and (ii) has a valid and
subsisting FINAS production license OR
3) A private limited production services company incorporated by a foreign production company under the Malaysian Companies Act
2016 and registered with CCM (i) with foreign shareholding and (ii) has a valid and subsisting FINAS production license.

(b) the Company has acquired the underlying rights and all other rights and consents necessary for the development, production and
exploitation of the _______________________(“Project”);

(c) the Company has the necessary rights required to undertake preproduction and production activities in connection with the
underlying rights of the Project, including without limitation the preparation and submission of treatments, synopsis, outlines and/or
screenplays based on the scripts, pre-sales and arrangements for financing and/or distribution of the Project;

(d) the Project:

• Does NOT contain issues deemed insulting, offensive and/or portraying Malaysia in a negative light.
• Does NOT insult, offend and affect the sensitivity of any religions in Malaysia.
• Does NOT threaten the security and harmony of Malaysia.
• Does NOT prohibited for distribution, inter alia in Malaysia. • Does
NOT contain other material that could give rise to any civil or criminal liability under the applicable law in Malaysia.

(e) the Company will be held responsible for the actions of all cast and crew members of the production throughout their stay in
Malaysia such that their actions and behaviours are in no way considered to infringe on the sensitivity of the Malaysian cultural, social
and religious practices.

(f) all information provided in relation to the Project is true in all material respects and is not, by omission or otherwise, misleading
and all documents and agreements provided to the Film in Malaysia Office (FIMO) in relation to the creative services and production
of the Project are true, complete and in full force and effect.

(g) it is a criminal offence to induce FIMO and/or FIMI Approval Committee to grant and make available and/or continue to grant and
make available the Film In Malaysia Incentive (FIMI) as aforesaid on the basis of a false declaration and that the penal consequences
may include imprisonment and/or fine under the Penal Code.

(h) this Statutory Declaration is made for Film In Malaysia Incentive (FIMI) and that the information contained in the Provisional
Certificate Application Form, and the documents attached to it, is correct and true in every particular and I make this solemn
declaration by virtue of the Statutory Declarations Act 1960, and subject to the penalties provided by the Statutory Declarations Act
1960 and the Penal Code for the making of false statements in statutory declarations, conscientiously believing the statements
contained in this declaration to be true in every particular.

SUBSCRIBED and SOLEMNLY declared by the abovenamed.

Full Name:
NRIC / Passport No.:
at:
on this day of: day/month/year

Before me,

Commissioner for Oaths / Notary Public

CHECKLIST: Prior to submitting your application

FOR FIMO USE

SECTION DOCUMENT PLEASE CHECK ONLY

1 Copy of FINAS production license.

Evidence of Malaysian residency company or a foreign resident with a permanent establishment:

1 including Malaysian Company Registration Number, registered address, names and addresses of
directors, and details of any period in which the company was not a permanent resident.

(a) Constitution (Memorandum & Article of Association (M&A)) / Written confirmation duly signed
by a director confirming that the Company does not have Constitution;
(b) Form 9 (Certificate of Incorporation) OR Companies Act 2016 Section 14 & 15;
(c) Form 24 (Complete Return Of Allotment of Shares Form) / Annual Return OR Companies Act
1 2016 – Section 46;
(d) Form 49 (Notification of Change in the Register of Directors, Managers and Secretaries Form) OR
Companies Act 2016 – Section 58 & 236(2);
(e) CCM Search of not more than three (3) months; and
(f) Winding Up Search of not more than three (3) months.

Document verifying the status of the Applicant Producer company—that is, the legal agreement
1
with a parent/associate company and/or establishing the applicant producer company.

1 If the project is a co-production, copy of the co-production agreement.

Documents confirming the Applicant Producer’s responsibility for all the activities required to make
2 the production OR post production in Malaysia (including responsibility for costs incurred by non-
Malaysian companies for activities in Malaysia)

2 A copy of all of the documents relating to the “Chain of Title” and underlying rights.

2 Relevant document indicating creative contributions, recoupment and returns.

If applicable, copy of agreements verifying the transfer of ownership in copyright, which identifies
the copyright owner at the time of the application. Note, this is only relevant where purchase or
2
licensing of Malaysian copyright is being claimed as QMPE including copyright in promotional
material.

2 Copy of PUSPAL approval for filming in Malaysia

2 Synopsis of the project.

2 Copy of the script and its source material OR previous script if it is a rewritten work

If applicable, evidence of expenditure on development of the project, script and company’s trustee
2 status.

If part of a series, indicate relevancy and significant creative similarities & differences between the
2 project and previous season’s concept, characters, settings, production locations and crew. Please
supply a soft copy of the previous season for comparative purposes.

2 A ‘travel spreadsheet’ for travel within into and out of Malaysia?

3 Estimated Project Budget?

3 Documented evidence and terms of financial resources?

Relevant documentation to indicate distribution or exhibition of the project? A letter of

3 confirmation of distribution/exhibition deals on an official letterhead will demonstrate this.

3 Evidence of Malaysian and foreign sales agent.

3 Statutory declaration made by an authorised signatory.

5 List of total cost/crew, local cost/crew, Bumiputera cost/crew.