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EMPLOYEE PERSONAL DATA FORM

Staff No :

Full Name (as per NRIC) Alias (if any)

Company Date Joined

Designation Date Confirmed

Department / Site Job Grade


Permanent Address Correspondence Address

Tel No. : Tel No. :

H/P No. :

Date of Birth Place of Birth Nationality Gender

Male Female

NRIC No. (old) NRIC No. (new) Race / Religion Marital Status
Single Married
Divorced Widowed

EPF No. : SOCSO No. : Income Tax No. / Branch:

Reference: Reference: Reference:


Old NRIC New NRIC Old NRIC New NRIC Old NRIC New NRIC

Bank & Branch : Account No.:

DETAILS OF SPOUSE
Spouse Name Spouse Occupation Employer's Name and Address

Date of Birth NRIC Number Income Tax No. / Branch:


Reference: Old NRIC New NRIC

DETAILS OF CHILDREN (Please attach separate list if not sufficient)


Name Gender Date of Birth Age

FOR FOREIGNER ONLY


Passport No: Visa No :
Nationality: Permit No:
Type of Pass Approved: Expiry Date:

Specimen Signature: Specimen Initial:

IN CASE OF EMERGENCY. Please Contact the following:


Name: Contact No: Relationship:

NEXT OF KIN
Name: Contact No: Relationship:

ACKNOWLEDGEMENT & CONSENT


I hereby acknowledge that the information given above are true and consent given for my salary to be credited to the bank account as stated
above.
Signature : Date :

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