Successful Submission

This Withdrawal Applica�on form has been submi�ed successfully.

Submission Date 01 Nov 2023 12:57:22

Status SUBMITTED FOR HIGHER LEARNING INSTITUTION CONFIRMATION

Reference No. DEUUM010002027187

Thank you for using e-Pengeluaran Services.

The request has been submi�ed to the Higher Learning Ins�tu�on for verifica�on. Registra�on is subjected to Higher Learning Ins�tu�on
feedback.

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Personal Details

Name MOHD ADIB BIN OMAR

ID No. 860131-01-5625

Correspondence Address

Address NO 16A

KAMPUNG SUNGAI KLUANG

Postcode 83100

City RENGIT

State JOHOR

Country MALAYSIA

Contact Information

Mobile Phone 0199339117

E-mail aredeep8035@gmail.com

Type of Withdrawal Educa�on

Pay To Higher Learning Ins�tu�on

Par�cipa�ng Ins�tu�on UNIVERSITI UTARA MALAYSIA

Level of Study/Course Sarjana Muda/Bachelor

Applica�on For Self

Course Start Date - Course Completed/Quit 17/01/2019 - 06/11/2023

/Failed Date

Student Name MOHD ADIB BIN OMAR

Student ID Type MyKad No.

Student ID No 860131015625

Student Reference No. 267473

Eligible Amount 3,652.63

Fees and Payment Details (Applied amount subject to withdrawal eligibility)

Payment to Higher Learning Ins�tu�on (RM) 2,732.00

Payment to Member (RM) 0.00

Applied Amount (RM) 2,732.00