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MALAYSIA CHINA HYDRO JOINT VENTURE Kompleks Sime Darby, Persiaran Kewajipan USJ 7 47600 Subang Jaya, Selangor,

Malaysia. DESPATCH FORM PART A No 1 Medical Claim Document Details Date 6/12/2011 Due Date 6/12/2011 Remarks

Request by:

Sender by:

Name: Alin Zakaria Date: 6/12/2011 Time: 9am PART B

... Name: Date: Time:

Company Address: Received by:

... Name: Date: Time: Confirmed by: Signature of Sender Acknowledged by: Signature of Requestor

... Name: Date: Time:

... Name: Date: Time:

REMARKS: Part A) It is compulsory for requestor to sign up part A before giving any document(s) to the sender. Part B) To be signed by receiver. Part C) To be confirmed by the sender and acknowledged by the requestor upon completion of the assignment. *The original form should be returned to HR department.