Nama Pemohon:
(Name of Applicant)
No. Matrik/No. Pekerja:
(Matric No./UKM Per)
No. K/P:
(Passport No)
Status:
(Marital Status)
Warganegara: Jantina:
(Nationality) (Gender)
No. Telefon: Tarikh Lahir:
(Telephone) (Date of Birth)
Alamat Email: No. Telefon:
(Email Address) (Telephone No.)
Alamat Tetap: No. Fax:
(Permanent Address) (Fax No.)
Tarikh Masuk: Tarikh Keluar:
(Check in date) (Check out date)
Cara Bayaran: Kod Peruntukan:
(Method of Payment) (Provision Code)
Perakuan Pemohon:
(Declaration)
Dengan ini saya mengesahkan segala butiran yang tercatat adalah benar dan berjanji akan mematuhi segala peraturan Universiti.
(I declare that the above information given is correct to be best of my knowledge and I agreed to abide by the rules and regulations of the University.)
--- Tandatangan
(Signature)
--- Tarikh
(Date)
KHAZANAH-UKM
Aras 2, Bangunan Pentadbiran Keris Mas,
Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor Darul Ehsan Malaysia Telefon+603-8921 4519/4841 Faksimili: +603-8925 5072 E-mel: khazanah@ukm.edu.my
Khazanah-UKM
UKM-SPKP-KZN-PK02-BO01 No. Semakan: 00 Tarikh Kuatkuasa: 01/03/2019 BORANG PERMOHONAN SEWAAN PERUMAHAN
BAHAGIAN PENTADBIRAN (Rental Management Unit)
Jenis Perumahan (sila tanda (/) dalam ruang yang disediakan):
(Choice of Housing – please mark (/) in the column given)
Pangsapuri UKM Seksyen 1 Bandar Baru Bangi Pangsapuri UKM Seksyen 3 Bandar Baru Bangi Rumah Teres Seksyen 16 Bandar Baru Bangi Pangsapuri UKM Taman Tenaga Jalan Reko Kajang UKM Kampus Teluk Intan
Pusat Latihan Kesihatan Masyarakat (PULAKEM), Beranang
Ingin dimaklumkan permohonan anda *Diluluskan/Menunggu/Tidak diluluskan.
(This is to inform you that your application *Approval/Not Approved)
--- --- Tandatangan
(Signature)
Tarikh (Date)
PERHATIAN: Anda diminta memaklumkan kepada pihak pentadbiran sekiranya ada
tambahan/pembaharuan maklumat. Kelulusan tertakluk kepada kekosongan dan peraturan penginapan.
(IMPORTANT NOTE: You are required to inform the Rental Management Units for any changes of particulars. Approval are subjected to rooms availability and housing aggrement)
KHAZANAH-UKM
Aras 2, Bangunan Pentadbiran Keris Mas,
Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor Darul Ehsan Malaysia Telefon+603-8921 4519/4841 Faksimili: +603-8925 5072 E-mel: khazanah@ukm.edu.my
Khazanah-UKM
UKM-SPKP-KZN-PK02-BO01 No. Semakan: 00 Tarikh Kuatkuasa: 01/03/2019 BORANG PERMOHONAN SEWAAN PERUMAHAN
