You are on page 1of 1
PREPAID CUSTOMER REGISTRATION FORM ‘Borang Pendaftaran Pelanggan Prabayar Cows taru 1 nin Pty seman tar Honor : porter ‘SM Seal Number /Nember St Slt EEC e RSE Fae e eer) Name (as NFIG/ Passport / Nara ang KP /paspor9 (Oy merece] mesox ones aintin spray ce the ated dagen teeta tame rd Corser ot he Seca ated ‘aos arash wth a a san marantnon boar sa mgt a rr rarer oa rasan Sat sarinjry aera (er Bs geen ee dito ch ‘msn sec na i rarer Amman ge aman ni Sonar Targa owes CO OO DO MM YY } Natoelty erpaegee ain ayaa [71 Neelasian /Bukan Warganegere sew NCH Ba ee re a fe fees DD omterxrtame lites eer [Ey Petow or Amy 0 “KP Pols ta Tonio [Dy Werke remit ke SEEEESEEEEEP EEE) ower § C/O Tank Lane + TE menrtaett — ] Foie Porerin ‘ens (Abert Desir Simp / Cap Penge vert a fort. Sasa ape be tary Paes corer soe rect Beas rn pauroun 3 ha ah Term Sy prc ‘asl Satie /TanctrgenPengacar Doale Code Koa Pongo owermen COO DO MM VY Proceed by/Oprcans oleh owes C0070 DD MM VY Site Neger Postcode Posted mame! Comments / Kamen Gh Back No 2 ta PWU 7A Ca Gia Oana Darran 720i Png a Soar

You might also like