Fujitsu (Malaysia) Sdn. Bhd.

( 420052-H )

New Entrant Form/Application

Hiring Manager:
Document Flow: Hiring Manager > Selected Candidate > Hiring Manager/Recruiter
1. This form is to be sent to the selected candidate by the Hiring Manager or Recruiter.
Department :
2. The selected candidate is to complete the form and ensure that all mandatory fields are completed.
3. (*) denotes mandatory fields, incomplete forms will not be processed.
4. Upon completion, please forward the soft copy back to the hiring manager or recruiter.

Part A Personal Particulars

*Candidate's Full Name
Preferred Name :
(as per identity card)
*Identity Card Type/ Number ID Type Number
(please select) *Date of Birth (dd/mm/yyyy)
NRIC/Certificate of Identity
Passport Number
* Permanent Resident (PR) since
when (if applicable)
(dd/mm/yyyy)

Start Date Expiry Date

Work Permit details
(dd/mm/yyyy)
Nationality :

*Religion (please select) Type Number

*Gender (please select) Male Female Employee Provident Fund

*Statutory Contribution/
Registration Number SOCSO Yes No
(for Malaysia only)
Single Married Income Tax
*Marital Status (please select)
Divorced Others Zakat

Type Number

* Contact Number Mobile

* Home Address
(please select)
Postal code (if applicable): Home

* Bank Name * Bank Branch

* Bank Account Number
Part C - Sports Club Membership
I hereby authorize the Human Resource Department to deduct RM5.00 from my monthly salary with effect from the month of _________________.
This deduction is for subscription for the Fujitsu Sports & Recreational Club.
Part D - Academic Achievements (please provide certificate(s) to local HR)
Highest Qualification
From To
College Qualification Achieved Major field of Study Country
(dd/mm/yyyy) (dd/mm/yyyy)

Part E - Employment History

Last employment before joining Fujitsu
From To
Company Name Last Position Held Last Monthly Remuneration
(dd/mm/yyyy) (dd/mm/yyyy)

Note: Upon successful recruitment, you are required to produce your latest payslip to local HR, and Fujitsu reserves the rights to verify information without your
consent.
Part F - Family Background
Spouse Information

* Spouse's Name ( as per identity card) *Date of Birth (dd/mm/yyyy)

*Spouse's Income Tax File
* Spouse's IC/ ID Number Number

*Spouse's Employment Status

* Spouse's Contact Number employed/ unemployed

* Spouse's Employer Name

Children's Information
*Full Name *Date of Birth
*IC/ Birth Certificate Number * Gender (please select) Occupation
( as per identity card) (dd/mm/yyyy)

Issue : 1.0 Page 1 of 2

Date : 23/02/2012
Author : HRD
Doc. Ref. :
Fujitsu (Malaysia) Sdn. Bhd. ( 420052-H )

New Entrant Form/Application

Immediate Family Member(s)

*Full Name *Date of Birth
Identity Card Number * Gender (please select) *Relationship
(as per identity card) (dd/mm/yyyy)

*Emergency Contact

Name Relationship
Type Number

Home
Address Contact Number :
Mobile

Postal code (if applicable) Office

Part G Employee Declaration:

a) Do you have any relative(s) or friend(s) working in FMS? Yes / No
If "yes", please provide name(s) and state the relationship:

b) Have you experienced any serious financial problems, e.g. bankruptcy? Yes / No
If "yes", please provide details:

c) Have you been convicted of a crime? Yes / No

If "yes", please provide details including date(s), place(s), nature of offence(s) and result(s)

d) Have you been dismissed from previous employment? Yes / No

If "yes", please provide details:

e) Have you suffered from any serious illness or disability/handicap? Yes / No

If "yes", please provide details:

I hereby declare that the information provided by me is complete and true to the best of my knowledge. I am aware that any misrepresentation or omission may preclude an employment offer or may
result in withdrawal of an employment offer or separation from employment. I authorize investigation of all information provided by me in the application process. I understand that any offer of
employment is contingent on the completion of a satisfactory background investigation, drug screen and verification of employment eligibility. I also understand that employment with FMS is at will, and
the employment relationship may be ended by either party at any time, with or without notice.

Employee's Signature Date

Part H (to be completed by Payroll)

Completion of SAP Date
Update in Country Distribution Date

Notes：The confidentiality of all personal information and documents you provide to FMS during the course of your employment will be protected pursuant to FMS policies, but such
information and document maybe used for certain company businesses. You authorize and give consent for FMS to use these personal data and documents for such business
purposes or other situations FMS feels appropriate."

Issue : 1.0 Page 2 of 2

Date : 23/02/2012
Author : HRD
Doc. Ref. :
 Confidential Document
Fujitsu (Malaysia) Sdn. Bhd. ( 420052-H )

New Entrant Form/Application

Hiring Manager: Taiga

Document Flow: Hiring Manager > Selected Candidate > Hiring Manager/Recruiter
1. This form is to be sent to the selected candidate by the Hiring Manager or Recruiter.
Department :
2. The selected candidate is to complete the form and ensure that all mandatory fields are completed.
3. (*) denotes mandatory fields, incomplete forms will not be processed.
4. Upon completion, please forward the soft copy back to the hiring manager or recruiter.

Part A Personal Particulars

*Candidate's Full Name
SHANKAR T. RAMACHANDRAN Preferred Name : SHANKAR
(as per identity card/Passport)
*Identity Type/ Number ID Type Number
*Date of Birth (dd/mm/yyyy) 10/01/1990
NRIC/Certificate of Identity 900110-14-6953
Passport Number *Nationality : MALAYSIAN

*Religion Type

*Gender (please select) Male (Please tick here) Female *Statutory Contribution/ Employee Provident Fund
Registration Number
Single (Please tick here) Married SOCSO
*Marital Status (please select)
Divorced Others Income Tax

* Contact Detail Type

Mobile
* Home Address
No. 33, Jalan 26/27B Taman Desa Setapak, 53300 Kuala Lumpur, Malaysia Home

Postal code (if applicable): 53300 *Personal email address interpersonalist@gmail.com

* Bank Name ( Preferrabily Maybank Account) MAYBANK * Bank Branch Maybank (Taman Melawati, KL)

* Bank Account Number 112205123530

Part B - Sports Club Membership

I hereby authorize the Human Resource Department to deduct RM5.00 from my monthly salary with effect from the month of _________________.

This deduction is for subscription for the Fujitsu Sports & Recreational Club.

Part C - Academic Achievements (please provide certificate(s) to HR)

Highest Qualification
From To
College Qualification Achieved Major field of Study
(dd/mm/yyyy) (dd/mm/yyyy)
2011 2013 Asia Pacific University Diploma Information Technology

2008 2010 Tunku Abdul Rahman College Diploma Multimedia Design

Part D - Employment History

Last employment before joining Fujitsu
From To
Company Name Last Position Held Last Monthly Remuneration
(dd/mm/yyyy) (dd/mm/yyyy)
25/10/201 3/3/2019 Joey Yap International Sdn Bhd Social Media Executive RM 3,300

10/4/2017 14/8/201 Euronet Worldwide (Ria Money Transfer) Customer Service Representative RM 3,300

22/6/201 Scicom (MSC) Berhad Executive Agent RM 2,000

28/1/2014

Note: Upon successful recruitment, you are required to produce your latest payslip to local HR, and Fujitsu reserves the rights to verify information without your consent.

Part E - Family Background

Spouse Information

* Spouse's Name ( as per identity card) *Date of Birth (dd/mm/yyyy)

*Spouse's Income Tax File

* Spouse's IC/ ID Number Number

*Spouse's Employment Status

* Spouse's Contact Number employed/ unemployed

* Spouse's Employer Name

Children's Information
*Full Name *Date of Birth
*IC/ Birth Certificate Number * Gender (please select) Occupation
( as per identity card) (dd/mm/yyyy)

Issue 2
Date 4/1/2013
Author : HRD
Doc. Ref. :
Fujitsu (Malaysia) Sdn. Bhd. ( 420052-H )

New Entrant Form/Application

Immediate Family Member(s)

*Full Name *Date of Birth
Identity Card Number * Gender (please select) *Relationship
(as per identity card) (dd/mm/yyyy)
KUNASEKARI T. PARAMASIVAN 491126-05-5322 27-11-1949 FEMALE MOTHER

PURUSHOTH KUMAR N/A 15-11-1979 MALE BROTHER

MOHANADASS N/A 21-05-1983 MALE BROTHER

*Emergency Contact

Name Kunasekari Relationship Mother

Type

No. 33, Jalan 26/27B Taman Desa Setapak, 53300 Kuala Lumpur Home
Address Contact Number :
Malaysia Mobile
Postal code (if applicable): 53300 Office

Part F Employee Declaration:

a) Do you have any relative(s) or friend(s) working in FMS? Yes / No NO
If "yes", please provide name(s) and state the relationship:
Name:
Relationship :

b) Have you experienced any serious financial problems, e.g. bankruptcy? Yes / No NO
If "yes", please provide details:

c) Have you been convicted of a crime? Yes / No NO

If "yes", please provide details including date(s), place(s), nature of offence(s) and result(s)

d) Have you been dismissed from previous employment? Yes / No NO

If "yes", please provide details:

e) Have you suffered from any serious illness or disability/handicap? Yes / No NO

If "yes", please provide details:

I hereby declare that the information provided by me is complete and true to the best of my knowledge. I am aware that any misrepresentation or omission
may preclude an employment offer or may result in withdrawal of an employment offer or separation from employment. I authorize investigation of all
information provided by me in the application process. I understand that any offer of employment is contingent on the completion of a satisfactory background
investigation, drug screen and verification of employment eligibility. I also understand that employment with FMS is at will, and the employment relationship
may be ended by either party at any time, with or without notice.

Employee's Signature Shankar Date 7/6/2019

Notes：The confidentiality of all personal information and documents you provide to FMS during the course of your employment will be protected pursuant to
FMS policies, but such information and document maybe used for certain company businesses. You authorize and give consent for FMS to use these personal
data and documents for such business purposes or other situations FMS feels appropriate."

Issue 2
Date 4/1/2013
Author : HRD
Doc. Ref. :
: Taiga

Number

Yes No

Number

017-2517417

03-41497673

ail.com

k (Taman Melawati, KL)

Country

Malaysia

Malaysia

onthly Remuneration

RM 3,300

RM 3,300

RM 2,000

hout your consent.

Occupation

Page 1 of 2
*Relationship

MOTHER

BROTHER

BROTHER

Mother

Number

0341497673

0162952275
N/A

entation or omission
stigation of all
atisfactory background
loyment relationship

7/6/2019

protected pursuant to
S to use these personal

Page 2 of 2