‘BADAN PENGURUSAN BERSAMA TREFOIL® SETIA CITY No 2 Jalan Sete Degang AH UISIAH, ‘Seti Alam, Sekayen U3, 40170 Shah Alam, Selangor Darl Ehean ‘Management HP No. o10-2500067 Emalltefollmanagement@gmailcom ACCESS CARD FORM Owner or Resident Particular Cente Ena ‘Acco68 Card PARIS ‘Application For New() Reactivation () CCancelition( 1 Acoees Car Ne lot 2 Aooass Card No Owner 3 Aeoass Gard No Subeard 4 Aeoess Gard No nadcra ayant Details [ACCESS CARD CHARGES ra 50.00 at OSSIDAMAGED CARD RIM 100.00 a PAYMENT METHOD CASH ( ) CHEQUE, ) ONLINE BANKING ( ) TOTAL PAID IMPORTANT “1 Aes card aus by management not vanterabi 2. Dovet expose card to rec sung or he 3. Leet damage card subject oan fo a dooms by the house es 4 This card wilbo daacvatea In the event ofa unpld alnanance fe, ost eozess card and (350 pon ownarrequst 5. ifs eas ound being abuse cr cloned, al access cars eters under te same anit wilbe (actvatad for eae pursoes and severe penalty, wil be posed lo he card {6 The management wil hot be responsble fr ay damage or mishandling of accss car 7. Aesess car wil be te33) or stacon win 3) tree working cays ram thespian date, ‘Gane Resident Sgnatire ‘tended By Nene" Date vetty By Date