Onboarding Form

Personal Details
Title

Mr.

Preferred Name

FAIZAL
New NRIC No.
820202-14-585
DC 1-08, BLOK DELIMA, PANGSA DESA BAIDURI, JLN. PERSIARAN PANGSA BA
CHERAS, K.L
Mobile Phone Number
013-

Home Address
Telephone Number

02/02 /1982

Ethnicity
Nationality
Marital Status

SYERIFAIZAL BIN MUSTAPHA

syerifaizal@yahoo.com.my

Email Address
Date of Birth

Name (as per IC)

Gender

(DD/MM/YYYY)

Place of Birth

MALAY

Religion

MALAYSIAN

W.P K

If non-Malaysian, pls specify:

Marriage Date

MARRIED

EPF No

17135613 Income Tax No

(if applicable)

820202145851

Income Tax Branch

Maybank A/C No

112399081195

(Personal Account Only)

Issued Date

Work Permit No.

(DD

e.g.SG01234567-01(0)

SOCSO No e.g. A1300009Y

For expatriates only

24 /05/2009

Expiry Date

Family Details
Spouse Details
Name (as per IC)

NUR SITI BAIZURA BINTI BADROL

New NRIC No

830324-10-5494

Gender

FEMALE

Date of Birth

24 /03 /1983

Income Tax No

NIL

Ethnicity

Occupation

MALAY
Religion
MUSLIM
DC 1-08, BLOK DELIMA, PANGSA DESA BAIDURI, JLN. PERSIARAN
PANGSA BAIDURI, 56000 CHERAS, K.L
HOUSEWIFE
Employer Name
NIL

If a Gamuda employee,

Company

Address

(DD/MM/YYYY)

Department

Childrens Details
Child 1

Child 2

Name

NUR SYERI ALEESYA NATASYA

New NRIC No
Gender

100226-10-1882
FEMALE

Name

NUR SYERI

New NRIC No

14121

Gender

FEMALE

Date of Birth

18/12 /2014

Status

SINGLE

Occupation (if employed)

Occupation (if employed)

Child 3

Child 4

Date of Birth
Status

26 /02 /2010
SINGLE

(DD/MM/YYYY)

Name

Name

New NRIC No

New NRIC No

Gender

Gender

(DD/

Date of Birth

/ /

(DD/MM/YYYY)

Status

Date of Birth

/ /

Status

Occupation (if employed)

Occupation (if employed)

Contact Persons / Next of Kin In Case of Emergency

Name 1

SYERIIQBAL BIN MUSTAPHA

Name 2

NOOR SYER

Relationship

BROTHER

Relationship

SISTER

Contact No

012-7946943

Contact No

013-4853646

Address

CHERAS

Address

BATU CAVE

Next of kin?

Yes

Next of kin?

Yes

Professional Memberships
1. Membership Type
Issuing Body

Valid From

(MM/YYYY)
Expires On

(MM/YYYY)
Expires On

(MM/YYYY)

2. Membership Type
Issuing Body

Valid From

(MM/YYYY)

Personal Vehicle
*Only applicable for MG parking and/or petrol card.
Will you be requiring a Pass Card for Menara Gamuda
Parking?
Car Registration No.

Vehicle cc
Driving License No.
(Only for drivers)

Yes / No
Car Model

Vehicle Colour

Renewal Date

/ /

Declaration

I hereby give consent for payment of my wages through my above-stated bank accounts or via cheque. I declare that the
have stated above are true and correct to the best of my knowledge and belief. I understand that any false or omitted info
the withdrawal of any conditional offer made, or dismissal or other disciplinary action if I am appointed. I hereby also agre
conditions attached.

________________________________

____________________

Signature

Date

For office use only

Employees Name

Commencement date

Employee ID

Grade

Division / Dept.

Company

Based at which Building?

Menara Gamuda

Menara MK

If others, please specify:

Employee Access Card

No.

(20 digits, prin

02-14-5851
NGSA BAIDURI, 56000
013-3233 773
MALE
W.P K.LUMPUR
MUSLIM

5/2009

(DD/MM/YYYY)

SG 20769480100

xpiry Date

UR SYERI AREESA SOFEA

141218-10-1984

/2014

(DD/MM/YYYY)

/ /

(DD/MM/YYYY)

OOR SYERI FAZIDA ZETTY

853646

CAVE

YY)

YY)

/ /

(DD/MM/YYYY)

re that the particulars which I

mitted information may result in
y also agree to all the terms and

(DD/MM/YYYY)

digits, printed behind pass card)