Proposed Name of Company :
Name in
Malay/English
First Choice
Second Choice
Third Choice
Name in Other
Language (Optional)
First Choice
Second Choice
Third Choice
Contact Information:
First & Other
Names
Last Name
Address
E-mail
FAX
Phone
Principal Business Activity:
Directors of the Company:
Director 1
First & Other
Names
Last Name
Address
Nationality
Passport/Malaysian National
ID No.
Director 2 (Optional)
First & Other
Names
Last Name
Address
Nationality
Passport/HKID No.
Authorized Share Capital:
Shareholders of the Company:
Shareholder 1
First & Other
Names
Last Name
Address
Number of Shares
Shareholder 2 (Optional)
First & Other
Names
Last Name
Address
Number of Shares
Witness:
First & Other
Names
Last Name
Address
Occupation
How did you hear about us:
What additional information do you want to
send to us? (additional directors, shareholders, etc)
Please ensure that you have filled
in all the required fields correctly. 
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