BORANG MAKULMAT SAKSI
KEPADA PEMINJAM, PENJAMIN PERTAMA DAN
PENJAMIN KEDUA
 

 
NAMA : ____________________________________________________________________________
TARIKH LAHIR : ____________________________________________________________________________
NO. KAD PENGANALAN : ________________TARAF WARGANEGARA_________________________
ALAMAT RUMAH TETAP : ____________________________________________________________________________
  ____________________________________________________________________________
  ____________________________________________________________________________
PEKERJAAN : ____________________________________________________________________________
JUMLAH PENDAPATAN
SEBULAN :
________________________
NAMA & ALAMAT MAJIKAN: ____________________________________________________________________________
  ____________________________________________________________________________
  ____________________________________________________________________________
ALAMAT TEMPAT BERTUGAS: ____________________________________________________________________________
  ____________________________________________________________________________
  ____________________________________________________________________________
TELEFON RUMAH : ________________________
TELEFON PEJABAT : ________________________
 
TARAF SAKSI : ( PEGAWAI KUMPULAN PENGURUSAN DAN PROFESIONAL, CONTOHNYA PEGAWAI DAERAH, PENGETUA / GURU BESAR SEKOLAH KERAJAAN )
 
TARIKH: _____________________________________
  TANDATANGAN SAKSI & COP JAWATAN