Letterhead ( Employer Only ) STAMPS

Date : ………………..

The Director of Inland Revenue Department

Inland Revenue Board
Collection Branch
UG 21, Wisma KWSG
Jalan Attap
50460 Kuala Lumpur

Dear Sir,

Mr/Mrs : …………………………
Passport No : ………………………….
Income Tax File No : ………….…….………..

INDEMNITY LETTER

In consideration of your granting repayment of tax overpaid in the case of the above
named taxpayer amounting to RM………………….. by cheque drawn in our
name(………………employer name……………………..), we hereby indemnify you
from and against all actions, proceedings, damages, costs, claims, demands, expenses or
losses which you may suffer, incur or sustain by reason or on account of your issuing the
repayment cheque in our name.

2. We also hereby undertake and agree that, the payment of RM ……………………

to us, shall be sufficient discharge as per your obligations for repayment concerning the
above mentioned tax payer.

3. We also assure and declare that no suit or legal action will be instituted against
the Inland Revenue Board either by us or by any parties or our employee by reason of
granting the above refund.

To expedite your prompt processing of the tax refund, we furnish our bank account
details as follows :

Payee Name : ……………………………………

Name and address of banker : ……………………………………
Bank account no : ……………………………………
Correspondence address : ……………………………………

Yours faithfully,

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( Managing Director )