BADAN PENGURUSAN BERSAMA RENTAK PERDANA IJOK A1/28

Pusat Komuniti Jalan Rentak Perdana, Rentak Perdana, LBS Alam Perdana,
42300, Bandar Puncak Alam, Selangor Darul Ehsan
Email: morentakperdana@gmail.com No Tel: 03-61930913

APPLICATION TO PURCHASE ACCESS CARD Date: ________________

a) Name of Owner : __________________________________________________
b) Contact No : __________________________________________________
c) Unit No : __________________________________________________
d) No of card : __________________________________________________

Reason of purchase (Please Tick):

 Loss of card Remaining No of card : _______________

 Extra access card (Tenant/Family members) No of card applied : _______________
 Damaged/Faulty access card
 Letter of Appointment
 Others: _____________________

NOTE

1. Each Access Card cost RM50.00, The total amount to be paid RM ________ to purchase.

Bank : MAYBANK
Account No : 562843559022
Name of account : BADAN PENGURUSAN BERSAMA (JMB) RENTAK PERDANA

2. For online transaction, please email the payment receipt to morentakperdana@gmail.com.

I understand that the provisions of the access card will put the onus of security on our residents. It meant our solely
and strictly for use of residents off _____________________________ only. I agree that for security reason, in any
case of loss of the access card, a police report should be made immediately and a copy to be submitted to The
Management for recording purposes.

Applied by,

_________________________
For Office Use: Approved/ Not Approved
Name :
Date : Online

Serial no/s : _____________________

Collected by
Remark : _____________________

Received By : _____________________
_________________________
Date : _____________________
Name :
Date :