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1. Name of Applicant Company & Business Address:

Cipta Sawit Pelita (Bok Bakong) Sdn.Bhd________________________________________

Lot 2604, Block 32, Kemena Industrial Estate, Phrase 1, 97000, Bintulu, Sarawak, Malaysia.

2. Date and place of registration:

3rd September 2009, Miri Sarawak_____________________________________________

3. Telephone, facsimile number and contract person:

Tel: 086-316700, Fax: 086-311800, Contact Mr. Hii Poh Bing________________________

4. Submit Form 9, Form 24, Form 32A and Form 49 in 2 sets with background of respective
Directors/Shareholders in Appendix A.

Refers to the attachment provided.____________________________________________

5. Attach 2 copies of Memorandum and Articles of Association.

Refers to the attachment provided.____________________________________________

6. Attach 1 copy of bankers͛ reference attesting to the financial ability of the applicant
company.

_________________________________________________________________________


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Please provide information as per format in Appendix B.

Please refers to the details provided in Appendix B .________________________________

 Justification for application of Bumiputera status & details of agreemnent/ contractual

understandings entered into or to be entered into that will materially affect this application.

 Please refers to the Joint Venture Agreement enclosed._____________________________

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1. Type of Company

________Sedirian Berhad______________________________________________________
 2. Authorised Capital & Paid Up Capital

____Authorised Capital =1,000,000.00 & Paid Up capital=

RM100.00_______________

3. Sources of Capital: State the amount derived from equity, bank overdrafts, loan
or other sources respectively.

___Equity:
RM100________________________________________________________

4. Outline Budget for operation (Attach as Appendix)

Please refers to the Financial Projection as

attached.____________________________

5. Particulars of landed property owned by Applicant Company (in appendix if

necessary).

Please refer to the Appendix

enclosed._______________________________________

6. Employment (where applicable)

1. Breakdown of employment (in numbers):

Malaysian Foreign
Sarawakian Others Occupation Title Number
Bumi Non-Bumi
1) Managerial/ 1 3 - - -
Research
2) Supervisory 1 - - - -
3) Technical Sales - - - - -
4) Office staff 1 - - - -
5)Skilled Labour - - - - -
6)Unskilled labour 2 - - - -

I hereby declare that to the best of my knowledge and belief all the particulars furnished under this
application are true.

____________________________ ____________Hii Poh Bing___________

Date Signature & (Name of Applicant)

___________Managing Director_________
 Designation in the Company

Note:

1. only companies owned wholly by Sarawak Bumiputera with registered office within State of
Sarawak may apply.

2. Submit your application to the following address:

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1. Name/ NRIC No/ Sex:

Hii Poh Bing @ Hii Bou Ping, 590625-13-5697, Male_____________________________

2. Date and Place of Birth/ Race & Nationality:

25/06/1959, Malaysian Chinese & Malaysian___________________________________

3. Home address:

No, 611A, Good Park, Tanjung Batu Road, 97000, Bintulu, Sarawak, Malaysia__________

4. Business Address and Tel No:

Lot 2604, Block 32, Kemena Industrial Estate, Phrase 1, 97000, Bintulu, Sarawak, Malaysia_

Tel: 086-316700_____________________________________________________________

5. Percentage of Shares in Applicant Company:

42%______________________________________________________________________

6. Interest in other companies:

Yes/No. If Yes, list details in Apppendix B.

Yes, Please refers to Appendix B_________________________________________________

7. Particulars of Landed Property:

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8. Name/ NRIC No/ Sex:

Hii Tung Ding, 830117-13-5682, Female___________________________________________

9. Date and Place of Birth/ Race & Nationality:

17th January 1983, Malaysian Chinese & Malaysian___________________________________

10. Home address:

No, 611A, Good Park, Tanjung Batu Road, 97000, Bintulu, Sarawak, Malaysia______________

11. Business Address and Tel No:

Lot 2604, Block 32, Kemena Industrial Estate, Phrase 1, 97000, Bintulu, Sarawak, Malaysia_

Tel: 086-316700_____________________________________________________________

12. Percentage of Shares in Applicant Company:

0%________________________________________________________________________

13. Interest in other companies:

Yes/No. If Yes, list details in Apppendix B.

No_________________________________________________________________________
14. Particulars of Landed Property:
None_______________________________________________________________________


15. Name/ NRIC No/ Sex:

Dollah Chek @ Abdullah Chek, 600218-13-5119, Male_______________________________

16. Date and Place of Birth/ Race & Nationality:

18th February 1960, Malaysian Malay & Malaysian__________________________________

17. Home address:

___________________________________________________________________________

18. Business Address and Tel No:

P26SF, Advance Synergy Square, Jalan Matang 93050, Kuching, Sarawak, Malaysia.________

19. Percentage of Shares in Applicant Company:

_0%________________________________________________________________________

20. Interest in other companies:

Yes/No. If Yes, list details in Apppendix B.

No________________________________________________________________________
21. Particulars of Landed Property:


22. Name/ NRIC No/ Sex:

Koh Giak Thian, 570210-13-5742, Female___________________________________________

23. Date and Place of Birth/ Race & Nationality:

10th February 1957, Malaysian Chinese & Malaysian___________________________________

24. Home address:

No, 611A, Good Park, Tanjung Batu Road, 97000, Bintulu, Sarawak, Malaysia_______________

25. Business Address and Tel No:

Lot 2604, Block 32, Kemena Industrial Estate, Phrase 1, 97000, Bintulu, Sarawak, Malaysia____

Tel: 086-316700________________________________________________________________

26. Percentage of Shares in Applicant Company:

18%__________________________________________________________________________

27. Interest in other companies:

Yes/No. If Yes, list details in Apppendix B.

Yes, Please refers to Appendix B___________________________________________________

28. Particulars of Landed Property:

2A, Lorong 1, Rose Lane, Queensway, 96000, Sibu, Sarawak.

 54  c 
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NO Name of Name of Date % Interest of Paid Up Capital Annual Annual Sales Turnover Exported If any Number of Employees
Company Business Established Shareholders (RM) Production

QTY QTY Value Country QTY Value Local (S͛wk) Other Foreigners
Bumi Non- M͛sian
Bumi
th
1 Cipta Cipta 4 Oct Hii Poh Bing: 13,500,000.00 13,272.814 13,272.814 19,350,229.77 Japan 5,309.13 7,740,091.90 55 19 - 20
Briquettes Briquettes 1996 6.7 ton ts Ts
Sdn.Bhd Sdn.Bhd
Koh Giak
Euro 7,963.69 11,610,137.87
Thian:
Ts
11897

th
2 Cipta Cipta 17 Hii Poh Bing: 800,000.00 1,563.690 1,327.292 2,126,990.21 Japan 464.56 Ts 744,446.58 9 2 - 14
Briquettes Briquettes September 817 ton ts
(S) (S) 2008
Sdn.Bhd Sdn.Bhd Koh Giak
Thian: Greek 796.38 Ts 1,276,194.13
*17

local 66.37 Ts 106,349.50

nd
Cipta Cipta 22 May Hii Poh Bing: 5,317,000.00 - - - - - - 5 3 - -
3. Sawit Sdn. Sawit Sdn. 2006 817
Bhd Bhd
Koh Giak
Thian:
*17