satauie TENAGA AprucaTion ron Fen sc osoassans | vy NASIONAL BERWAD ELECTRICITY SUPPLY. service ea ie aes [Contract Account No Please note that only submitted app ; lication with complete and correct information will be processed. Wate For Application Under Individual Name : Sabtation : Ghen Tae 5 Name of Applicant: JABATAN PENGAIRAN DAN. Miykad/ Passport =: 630701-03-5449 SAURAN MALAYSIA PENGURUSAN LEMBANGAN SUNG MUR Mothers Name WAN ROKIASINTIWAN—patectinh = obuLE963 Kowiox ‘Home/Office No + 044388216 Fax No +: 044388119 Mobile No + 0123750070 Email Address + plsm@gov.my: est umber Next kin TUANHAIZANALFORYBIN Nextfin PhoneNo + 0338868569 HAN AUD PcaRatt OPERAS is Ce I 2. Adcress of Preme 1 RLPINTU AIRJLN BUTTERWOATH TRAM BATU CBBDD SUNG PETAN EDA status of Suply + SUPPLY APPLICATION GROUP MOVE N «. Premive Type + GOVERNMENT: AGRICULTURE 4: Corespondence Address PLSMAA¥GSALAN KOTAUALA MLA 06500 KOTA KUALA MUDA KEDAH © Supply Requedoate = 2.Apr2017 }PPLICANT’S DECLARATION SECTION: Ue ereby aerate cna! bpd by ma fhe hsng Sveloe a aed ere isa omar eptetedwehGaey Commision 1/ we ssf pernason athe contacto Saat ncetay worked oy sorte, 2 Aywtenerby ae thote wigin concen lanpecs an a ela set leas hve bets lee se andar eked by nary Canevatan 3. tf wenerey are tobe bounsby aterm ans consonant ecy apply of 8 a ata (Tema Cendonh 4, Temnted oc Occnina arises | lundersardard apvetrat asthe regard concur or cry tts prea i Sabie for amy tee conned dung teferaner ale ec stcy erod ncn areata ny es dare ste by TH as permitec une tbe ES agree so ese sheer Ts tataon ano eqpmert aH si prem ek enone one rig the erate a eupeey ped 1 rneraby gre oasis TS san thane’ permton to come the eres the sad emis agree hte fale to cran the conser of te unr may day he wactry pl eomaion othe sd grees. pene stotct a a ern penton xute f sh oke ay sen g at neee © Satonntenengby sf non ena tome rare eta Le aah Tens acne nue hl cane canna nin gnc et Cnn Ht ae adr \ Gennekeaten apts cremate mentee appyseiaid grat oe st Se ie Sc ori tyme tee ct rpm ann eat att tyre aaa en na rat naan eon reconnect Besgarer cra, eset Perguvsan Lenbany Jatin Pergoten dan Seer, Mal Pagers