CONFIDENTIAL

APPLICATION FOR SECURITY CLEARANCDE

FOR FOREIGN PERSONNEL
ENCLOSURE (4) COPIES OF
PASSPORT SIZE PHOTOGRAPHS
NOTE:

The Application is to be submitted in 04 sets of forms.

Please complete all the details in the application forms
Inclusive the signature block and the date.
04 x copy of international passport (first page only of photo and details).
PART 1

PERSONAL PARTICULAR
1.

Name:

2.

Other Name (If Any):

3.

Nationality:

4.

Sex:

5.

Date of Birth:

6.

Profession and Appointment:

7.

Employer:

8.

Address in Malaysia:

9.

Contact number in Malaysia:

10.

Duration of stay in Malaysia:

11.

Passport Number International:

12.

Date of Issue:

13.

Place of Issue:

14.

Expiry date:

1
CONFIDENTIAL