PKL/BF/v1.

6
“SHUTTLE HOPE” Muara - Labuan Ferry Service
BOOKING RESERVATION FORM *
**RECONFIRMATION REQUIRED**
All completed forms to be faxed to +673 2772000 or email to INFO@PKLJAYA.COM

Driver/Passenger Full Name as in Passport Passport No. Date of Birth Passport Expi y Date Nationality Sex
dd/mm/yyyy dd/mm/yyyy (M/F)

1) Dr Hj Mohd Yusni Hj Mohd Yasin C0478965 17/01/1973 31/07/2023 Brunei M

2) Dr Harliza binti Haji Haris A51256600 23/10/1973 05/02/2024 Malaysia F
3) Muqri Syahiran Abdul Latif Mallari EC6324622 29/07/2008 05/01/2021 Filipino M
4) Abid Muazzam Abdul Latif A51075414 03/04/2014 11/06/2024 Malaysia M
5) Wani Syuhaida Abdul Latif A40107248 14/03/2017 05/05/2022 Malaysia F
6) Sri Rahayu C1527128 07/03/1997 09/10/2023 Indonesia F
7)Haji Mohd Yasin Bin Haji Tengah C0480039 04/06/1947 07/08/2023 Bruneian M
8)Hajah Masnah Binti DP Haji Abdul Wahab C0480041 03/11/1945 07/08/2023 Bruneian F
Vehicle Details (IF BRINGING VEHICLE)
Vehicle Registration Number BAT 610 Vehicle Make / Model: Hyundai H1
Travel Dates (Please indicate ✔ ONE WAY or RETURN) One Way ( ) Return (  )
MUARA TO LABUAN Date dd/mm/yyyy 14 December 2018 MUARA TO LABUAN DAY/TIME  9am

LABUAN TO MUARA Date dd/mm/yyyy 15 December 2018 LABUAN TO MUARA DAY/TIME  4pm

Valid Telephone Contact: 8633536/8632526 Valid Email Address: yusliza73@gmail.com

Signature: Office Use Only: Total Price :
(Name) Terminal axes:
(Date) Confirmed / Cancelled

* * * THANK YOU FOR CHOOSING THE SHUTTLE HOPE * * *

* * * Subjected to PKL Jaya Sdn Bhd Terms & Conditions of Carriage * * *