FIRST SCHEDULE FORMS [Regulation 2]

Form 1 [Regulation 3] TOURISM INDUSTRY ACT 1992

TOURISM INDUSTRY (REGISTRATION, CLASSIFICATION, RECLASSIFICATION AND RATING OF TOURIST ACCOMMODATION PREMISES) REGULATIONS 2003

APPLICATION FOR REGISTRATION OF TOURIST ACCOMMODATION PREMISES

FOR OFFICIAL USE

A. PARTICULARS OF APPLICANT 1. Full name of operator (company/individual)

Postal Order No./Bank Draft

Amount 2. Registered address of operator (Please state in capital letters) Receipt No. District Date State Postcode Received and checked by:

( ) Date:
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3. Name of tourist accommodation premises

(Please state in capital letters)

Address of tourist accommodation premises (Please state in capital letters)

District State Postcode 4. Particulars of company registration (if applicable) (i) company registration number
( Please attach Forms 24 & 49 of the Companies Regulations 1966 [P.U.173/1966] certified by the Registrar of Companies )

(ii) capital structure Capital Authorised Paid Up 5. Details of paid up capital Paid Up Capital Ringgit Malaysia (RM) Bumiputera Non-Bumiputera Foreign Citizen Total Percentage (%)
Ringgit Malaysia (RM)

Equity

B. DETAILS OF OWNER OF TOURIST ACCOMODATION PREMISES 1. Name of company/individual (Please state in capital letters)

2. Address of owner of tourist accommodation premises (Please state in capital letters)

District State Postcode

C. DETAILS OF TOURIST ACCOMMODATION PREMISES 1. Description of tourist accommodation premises (hotel, inn, boarding house, rest house, lodging house, bed and breakfast or others)

2. Facilities offered (a) Total number of rooms : .

(b)

Types of rooms : .

(c)

Total number of beds : ..

(d)

Others facilities and services provided. (Please specify in detail the facilities
and services offered)

.... ... .... .... .... .... ....

D. PARTICULARS OF STAFF Number Position Managerial Staff Support Staff

Citizen of Malaysia Non-citizen of Malaysia

E. DETAILS OF EXPERIENCE OF MANAGERIAL STAFF (Please use a separate sheet if necessary)

.................. ..... ..... .....................................................................................................................................................

F. MEMBERSHIP IN HOTEL ASSOCIATION (if applicable)
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Name Of Association :

Membership No. :

G. DECLARATION BY APPLICANT I hereby declare that the information contained in this application form and the documents enclosed are true.

.. Signature of applicant

. Companys seal

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