WTA(_________)

WARRAT TO ACT
We, Mr./Ms.________________________________(IC/PSP No..................................................)

and Mr./Ms._________________________________(IC/PSP No……………………………….),

being the duly voted/appointed leaders of the following colleagues/workers that have come to
consensus/agreement that we should act on their behalf legally & specifically as follows :

o. ame IC/Passport o Signature

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do hereby appoint Messrs.______________________________________, as our legal counsel to

act in and/or to appoint as deemed fit any other legal counsel and/or initiate any & all necessary
legal proceedings against any & all parties be it the Ministry of Health ("MOH") of Malaysia, the
National Pharmaceutical Regulatory Agency (NPRA), and/or the relevant Pharmaceutical
Company that has supplied their relevant products to the Malaysian Government and/or
Regulatory body/bodies with their unlawful waivers/indemnity terms that violate ours and/or that
of our colleagues’/workers’ basic human rights, to therefore defend our constitutional rights
under the Constitution & Laws of Malaysia in tandem with our human rights as enshrined under
the United Nations Charter of Universal Basic Human Rights so as to enable us, as their
voted/appointed representatives to be able to make a conscientious and informed decision in
objection, to the MOH programme to vaccinate the above named, our fellow colleagues/workers,
with these Irreversible Gene Therapy pharmaceuticals that have been unadvisedly & hastily
categorised as COVID19 Vaccines under the Emergency Use Authorisation(EUA), from the
World Health Organisation.

We understand that this legal representation shall be on a pro bono basis.

Signed for and on behalf,

______________________ _________________________
Name : Name :
………………………………………………………………………………………………...

I, Mr. ____________________________________(NRIC No…………………………….) do

hereby accept this Warrant to Act under the terms and conditions as spelled out above on this the
________day of ___________2021.

…………..............................
Name :
Legal Counsel

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