January 16, 2021

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Keterangan Kenderaan/Vehicle Details:


Kategori Kenderaan/

Vehicle Category






Bil. Pendaftaran/

Registration No.:



Please enter Vehicle Registration Number.
Please enter Valid Vehicle Registration No.



Buatan & Modal

Make & Model



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No. Enjin/

Engine No.:



Please enter Engine number
Please enter Valid Engine No.



No. Rangka/

Chasis No.:



Please enter Chassis No.
Please enter Valid Chassis No.



Warna Kenderaan/

Vehicle Colour:



Please enter Vehicle Colour
Please enter Vehicle Colour



Tarikh Mansuh Lesen Kenderaan/

Vehicle License Expiry Date:







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Keterangan Pemohon/Applicant Details:


Bil. Kad Pintar/Bil. Paspot

IC.No (xx-xxxxxx)/Passport No.:



Please enter NRIC / Passport number.



Nama/

Name :



Please enter Name.



Alamat/

Address





Pos.Kod/

Post Code





Pemilik Berdaftar /

Registered Owner






Keterangan Pemilik/Owner Details :


Bil. Kad Pintar/Bil. Paspot

IC.No/Passport No.


Please enter owner’s NRIC / Passport number.



Nama/

Name


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Other Details



Remarks













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