MALAYSIAN MEDICAL COUNCIL

APPLICATION FOR REMOVAL OF CONDITIONS & RESTRICTIONS

IN FULL REGISTRATION CERTIFICATE

1. Personal Information
Full Name of Applicant :
(as per NRIC/Passport)

NRIC/Passport No.*: Citizenship:

MMC Full Registration No.: Latest APC No.:
Residential Address

Postal Address

Tel (office): Tel (mobile): Email:

*Strike out whichever is not applicable

2. Reason for Application (Please tick (√))

To be included with supporting documents.

 Granted Malaysian Citizenship.

 Granted Malaysian Permanent Resident Status.
 Others (please elaborate):

4. Payment Details

KUMPULAN WANG MAJLIS PERUBATAN MALAYSIA

CIMB Islamic Bank Berhad
Account Number: 8600098716

Payment details (online banking /debit card/credit card )*:

Documents to be sent by Registered Post or Poslaju – in Malaysia(RM20) : Yes/No
Sum: RM Date:
Proof of payment / Transaction ID (if applicable):
*Strike out whichever is not applicable

4. Mode of collection (Please tick (√)) By Hand By Post On Behalf**

** For collections on behalf, please bring along an authorization

letter from the applicant on collection.

Date Signature of Applicant

 CHECKLIST:

The following documents need to be submitted by foreign medical practitioners already registered with the
MMC applying for removal of conditions and restrictions from their Full Registration Certificate.

1. A formal letter of application including the Application Form for Removal (Original + 1 copy)
of Conditions & Restrictions in Full Registration Certificate.
2. Certified true copy of Permanent Resident Identity Card. (2 copies)
3. Confirmation letter of Permanent Resident Status or Nationality from (Original + 1 copy)
Jabatan Pendaftaran Negara.
4. A Statutory Declaration - Should your printed name(s) in any of the (Original)
submitted document(s) differ (stating the name as on the identity card is
the same individual).
5. A RM500.00 fee to ‘Kumpulan Wang Majlis Perubatan Malaysia’
(online banking / debit card / credit card )*:

Note:
Documents should be certified according to the MMC’s Guideline for Document Verification in the MMC
website www.mmc.gov.my.

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Revised: 27 September 2019