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Keterangan Kenderaan/Vehicle Details:

Kategori Kenderaan/

Vehicle Category

Persendirian/ Private

Komersil/ Commercial

Kerajaan-Diplomat/ Government-Diplomat

Bil. Pendaftaran/

Registration No.:

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

Buatan & Modal

Make & Model

Please enter Model

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:

Please select date.

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

Please enter owner name.

Other Details

Remarks