ENT300 - Final Project - Fresh Chicken Farm

ETR 300
ENTREPRENEURSHIP
"BUSINESS PLAN"
FRESH CHICKEN FARM

NAME OF PARTNERS:
1.
2.
3.
4.
MOHAMAD SHUKRY B. MAKSAH

MUHAMMAD FAIRUZ B. JOHARI
MUHD. NURFAIZ B. BAHARUDDIN
AHMAD LUQMAN B.
MOHAMED SHAIHANI
2003230540
2003231714
2003231634
2003230883
Prepared For:
EN MALIKI B IBRAHIM (FKE)

EN HUSNY B BASIR (MEDEC)
DIPLOMA IN ELECTRICAL AND ELECTRONIC ENGINEERING
FACULTY OF ELECTRICAL ENGINEERING

DATE OF SUBMISSION
13 OCTOBER 2005
TABLE OF CONTENTS
PAGE
COVER LETTER
1-m
ACKNOWLEDGEMENTS
AGREEMENT OF BUSINESS
ORGANIZATION LOGO
iv
v-vii
1
INTRODUCTION
1.1 EXECUTIVE SUMMARY
1.2 BUSINESS PLAN PURPOSE
1.3 BACKGROUND OF OWNERS
1.4 PARTNER'S PROFILE
6-9
ADMINISTRATION PLAN
10
2.0 INTRODUCTION TO THE ORGANIZATION

i.
VISION
11
ii.
OBJECTIVE
12
iii.
BUSINESS ADDRESS
iv.
LOCATION PLAN
13
v.
TYPES OF BUILDING AND INFRASTRUCTURE
14
a) OFFICE LAYOUT
15
2.1 ORGANIZATION CHART OF FRESH CHICKEN FARM
16
2.2 LIST OF ADMINISTRATION PERSONNELS
17
2.3 SCHEDULE OF TASK AND RESPONSIBLITIES
18-20
2.4 SCHEDULE OF REMUNERATION
20
2.5 LIST OF OFFICE EQUIPMENTS AND SUPPLIES
21
2.6 ADMINISTRATION BUDGET OF FRESH CHICKEN FARM
22
MARKETING PLAN
3.0 INTRODUCTION
23
24
3.1 PRODUCT OR SERVICE DESCRIPTION

3.2 TARGET MARKET
25
3.3 MARKET SIZE

3.4 MAIN COMPETITORS
/.
STRENGTHS OF COMPETITORS
ii.
WEAKNESSS OF COMPETITORS
iii.
STRENGTHS OF FRESH CHICKEN FARM
3.5 MARKET SHARE

3.6 SALES FORECAST
3.7 MARKETING STRATEGIES
26
27
28
29 - 30
31
i.
PPRODUCT
ii.
PRICING
iii.
PLACE/DISTRIBUTION
32
iv.
PROMOTIONS
33
3.8 MARKETING BUDGET
34
OPERATION PLAN
35
4.0 INTRODUCTION
36
4.1 FLOW CHART OF OPERATION ACTIVITIES
37
i.
ii.
FLOW CHART CONVENTIONAL SYMBOLS
38
PROCESS FLOW CHART
39
4.2 OPERATIONS SYSTEM

i.
READY OF BOILER CLOSED HOUSE
ii.
INSTALL THE NECESSARY BROODING EQUIPMENT
40
a. DRINKER SYSTEM
41
b. FEEDING SYSTEM
42
c. PAD COOLING SYSTEM
43
iii.
CHICK PLACEMENT
iv.
CHICK QUALITY
v.
DAILY CONTROL AND QUALITY CONTROL
44
a. VENTILATION
45
b. FEED AND WATER
46
c. LIGHT
47
d. DISEASE CONTROL
e. BIO-SECURITY
vi.
GROWING PHASE
48
a. UNIFORMITY
b. MODIFICATION OF FEED AND NUTRIENT INTAKE
c. LIGHTING PROGRAMS
vii.
CATCHING PROCESS
viii.
DISINFECTION
49
50
4.3 BUSINESS OPERATION TIME

4.4 CAPACITY PLANNING
51
4.5 TOTAL COST
52
4.6 MATERIAL REQUIREMENTS (INPUT)

4.7 LIST OF OPERATIONS PERSONNEL
53
4.8 SCHEDULE OF TASKS AND RESPONSIBILITIES

4.10 MACHINE AND EQUIPMENT
i.
INFRASTRUCTURE DEVELOPMENT
ii.
EQUIPMENT AND MACHINERY
54
55-57
4.11 OPERATIONS SPACE LAYOUT PLAN
58
4.12 OPERATION OVERHEAD
59
4.13 OPERATION BUDGET
60
FINANCIAL PLAN
61
5.0 INTRODUCTION
62
i.
OBJECTIVE
63
5.1 PROJECT IMPLEMENTATION COST SCHEDULE
64
5.2 SOURCE OF FINANCE SCHEDULE
65
5.3 SUPPORTING SCHEDULES
66
i.
LOAN OF AMORTIZATION SCHEDULE
ii.
FIXED ASSET DEPRECIATION SCHEDULE
67 - 71
5.4 PROFORMA FINANCIAL STATEMENTS

i.
CASH FLOW PROFORMA (ANUALLY)
ii.
PROFORMA PROFIT AND LOSS ACCOUNT FRESH
72 - 73
74
CHICKEN FARM
iii.
PROFORMA BALANCE SHEET ACCOUNT FRESH
75
CHICKEN FARM
CONCLUSION / RECOMMENDATIONS
APPENDIXES
76 - 77
78
Diploma In Electrical and Electronic Engineering,

Faculty of Electrical Engineering,
Mara University of Technology,
Shah Alam Campus,
40450 Shah Alam,
Selangor.
En. Husny B. Basir

Lecturer of Fundamentals of Entrepreneurship (ETR 300)
MEDEC,Blok 13
Intekma Resort & Convention Centre (Level 4)
40450 Shah Alam
Selangor Darul Ehsan
Dear Sir,
Submission Of Business Plan
Referring to the matter above, Fresh Chicken Farm would like to submit the business
plan for your analysis and references. Fresh Chicken Farm would start our business with
partner and address mentioned below:Details of partners are as follows:1. Mohamad Shukry B. Maksah
2003230540
2. Muhammad Fairuz B. Johari
2003231714
3. Muhd. Nurfaiz B. Baharuddin
2003231634
4. Ahmad Luqman B. Mohamed Shaihani
2003230883
Business address:-
FRESH CHICKEN FARM

Lot 3307, Batu 7,
Lorong Sarkawi,
Jalan Kebun
42 450 Klang,
We have tried our best to prepare this business plan with all data compiles for your good
judgments. This working paper is a group effort and all experiences gained are valuable
lesson for entire group members.
We hope that our business plan will satisfy your requirement for this subject (ETR 300). We
also hope that our business plan can give some benefit to other people especially as a
reference material for the future.
Yours sincerely,
(Mohamad Shukry B. Maksah)

General Manager
(Muhd. Nurfaiz B. Baharuddin)

Marketing Manager
lammad Fairuz B. Johari)

Operation Manager
(Ahmad Luqman B. Mohamed Shaihani)

Financial Manager
in
ACKNOWLEDGEMENT
We would like to thank ALLAH S.W.T for His blessings that we were able to
finish this assignment. We would also like to thank our lecturers, En Maliki and En
Husny for the guidance and lectures that have given us a clear view on how to document
our business plan.
In preparing the plan, we have also come across several individuals and
interviewed them for information gathering. We would like to extend our gratitude to
them particularly En Baharen and En Azaruddin because of their willingness to spend
their time in answering our questions regarding chicken business.
Last but not least, we would also like to thank our classmates who have helped us
in answering questions related to the business plan. Their generosity and assistance are
greatly appreciated.
IV
AGREEMENT OF BUSINESS
The agreement letter has been made on 28 July 2005 between 4 partners of the
company and below is the list of partners and the agreed terms.
Mohamad Shukry B. Maksah
Muhd. Nurfaiz B. Baharuddin
850628-10-5221
850720-14-5883
41 Jin Sri Damak 50,
167 Jin. Tun Abdul Razak,
Taman Sri Andalas,
Taman Sri Andalas,
41200 Klang,
41200 Klang,
Selangor.
Selangor.
Muhammad Fairuz Bin Johari
Ahmad Luqman B. Mohamed Shaihani
851107-07-5455
850515-10-5559
99 Jin. Sri Damak 22,
11 Jin. SriSedeli5,
Taman Sri Andalas,
Taman Sri Andalas,
41200 Klang,
41200 Klang
Selangor.
Selangor.
Partners of Fresh Chicken Farm have agreed to all the terms and conditions that have
been discussed and all the terms and conditions of the company are stated as below:
1. The partners have agreed with the name of the company Fresh Chicken Farm
and all businesses with the company should apply the mailing address as
below:
FRESH CHICKEN FARM
Lot 3307, Batu 7,
Lorong Sarkawi,
Jalan Kebun
42450 Klang,
2. All partners agree with the reasonable salaries given to them.
3. Documents such as profit and loss statement, balance sheet and other confidential
documents shall not be revealed to others.
4. Every partner is entitled to participate in the management of the business.
5. Every partner knows of the risk and agrees that the liability for the company is
unlimited and we are ready to pay off all liabilities for the company with own
properties.
VI
Below are the signatures of all partners that have agreed with all the terms given above.
MOHAMAD SHUKRY B. MAKSAH

I/C: 850628-10-5221
MUHAMMAD FAIRUZ B. FOHARI

I/C: 851107-07-5455
MUHD. NURFAIZ B. BAHARUDDIN

I/C: 850720-14-5883
AHMAD LUQMAN B. MOHAMED SHAIHANI

I/C: 850515-10-5559
Vll
FRESH CHICKEN
FARM
DEFINITION OF THE LOGO
FRESH CHICKEN FARM
| z ) Represent the name of our company.
CIRCLE SHAPE
l~~> Represents unity between partners and all the

employees.
WHITE BIRDS
BLUE
Represent our products
Hy Represent the courage and hard work among the

partners and employees.
1.1 EXECUTIVES SUMMARY

This business is based on partnership where it consists of four (4) members.
The members consist of the General Manager, Administration Manager, Marketing
Manager, Operational Manager and Financial Manager. The business capital is
amounted to RM372,410 where the total contribution of each member is RM79,910
and the rest is from the Bank Pertanian loan.
FRESH CHICKEN FARM is a company related to the breeding the chicken

meat. Our market focus is for the Pertanian Pertiwi, a company that directly deals
with us, they will supply the day-old-chicks with the certain price and buy the chicken
back when it reach at certain age (normally at 50 days). For those who are interested
to buy the fresh chickens, we can't sell to them due to our contract with the Pertanian
Pertiwi.
Our business will be expected to commence on 2006 and our vision is to make
our company a well-known, established and satisfied by our customer in order to
expand our capacity of chickens and to attract other companies to deal with us with a
better price. This will be realized by the full cooperation and efforts among the
partners to promote this company.
Based on the objectives above, we are venturing into livestock industry.
Chickens' farming has the potential of being a profitable business if it's done in
modern way with large scale and systematically managed.
We will expect that our business will become more developed in the near
future because the demand for the chicken's meat is high and not many breeders use
the closed system. This will give more advantages for us to make our product more
profitable and stabile in the long run.
1.2
BUSINESS PLAN PURPOSE
The main purpose of this business plan is for the reference of several
audiences / parties such as:
1. The Entrepreneurs (Fresh Chicken Farm's managers).

To better understand the purpose of the business and act as guideline to
manage the business effectively and efficiently.
2. Financial Institutions.
Assist and help the financial institution to evaluate the capability of the
proposed project and provide loan for the business. Financial institution
involved in this business project is Bank Pertanian Malaysia.
3. Suppliers.
Help convince suppliers of the viability of our business venture thus benefiting
both the suppliers and our company in the long term business arrangement.
4. Company Staffs / Workers.

Help workers to understand the business's goals and objectives and give a
guideline to them regarding their job duties and responsibilities.
5. Customers.
Persuade and influence our customers regarding the products being offered
and gives assurance and confidence to them to have business with us.
13
BUSINESS BACKGROUND
Below is the business background for our company:Name of Business/Company : FRESH CHICKEN FARM
Address
: Lot 3307, Batu 7,

Lorong Sarkawi,
Jalan Kebun,
42450 Klang,
Selangor Darul Ehsan.
Telephone
: 03-31222372
Fax No.
: 03-31222375
Form of Business
: Partnership
Main Activities
: Providing services of breeding the chicken meat.
Date of Registration
: In progress
Number of Registration
: hi progress
Date of Commencement
: hi progress
Initial Capital
: RM 79,910
Name of Bank
: Bank Pertanian Malaysia
Account No.
: 40950003456
1.4
1.
PARTNER'S PROFILE
Name
Mohamad Shukry B. Maksah
Identity Card Number
: 850628-10-5221
Permanent Address
: 41 Jin. Sri Damak 50, Taman Sri Andalas,

41200 Klang, Selangor.
Telephone No.
: 019-3079070
Date of Birth
:28 th June 1985
Age
: 20 years old
Marital Status
: Single
Academic Qualification
: Diploma In Electrical Engineering
Courses Attended
: Entrepreneurship
Skills
: Computer related
Experience
:None
Present Occupation
: Undergraduate
Previous Business
:None
Experiences
: None
2.
Name
Muhammad Fairuz B. Johari
: 851107-07-5455
Permanent Address
: 99 Jin. Sri Damak 22, Taman Sri Andalas,

Telephone No.
: 017-3082892
Date of Birth
:7 t h November 1985
Age
: 20 years old
Marital Status
: Single
Courses Attended
: Entrepreneurship
Skills
:None
Experiences
: None
Present Occupation
: Undergraduate
Previous Business
: None
Experiences
: None
3.
Name
Muhd. Nurfaiz B. Baharuddin
: 850720-14-5883
Permanent Address
: 167, Jalan Tun Abdul Razak, Taman Sri

Andalas, 41200 Klang, Selangor.
Telephone No.
: 012-6045320
Date of Birth
: 20th July 1985
Age
: 20 years old
Marital Status
: Single
Courses Attended
: Entrepreneurship
Skills
: None.
Experiences
: None.
Present Occupation
: Undergraduate
Previous Business
: None
Experiences
:None
4.
Name
: Ahmad Luqman B. Mohamed Shaihani
: 850515-10-5559
Permanent Address
: 11 Jin. Sri Sedeli 5, Taman Sri Andalas,

Telephone No
: 012-9157455
Date of Birth
: 15th May 1985
Age
: 20 years old
Marital Status
: Single
Courses Attended
: Entrepreneurship
Skills
: None
Experiences
: None
Present Occupation
: Undergraduate
Previous Business
: None
Experiences
:None
Fl
yj J
7J
10
2.0 INTRODUCTION TO THE ORGANIZATION
Administration plan is first step of business to become more developed and

expounded in the future. It is important in every business. The effectiveness of
FRESH CHICKEN FARM is based on the administration that has been planned
systematically and followed by the proper planning before the business is established.
The important things that have been taken care of are well organization and
effectiveness in administration plan.
Several things that are included in this part are;
> Organization planning
> Organization chart
> Numbers of workers/labor
> Administration budget
> Office layout
> Remuneration Table
> Workers intensive
^ Position, responsibilities and specific task
Vision
It is FRESH CHICKEN FARM to be strength and famous farm over the world
as a quality and fresh "chicken" provider in order to fulfill an increase of market
demand for this favorite chicken by the year 2015. FRESH CHICKEN FARM should
be promoted to other countries to our vision that our local favorite chicken is to meet
a satisfying among foreigners.
11
Objective
1) Justly to compensate the employees and owners of FRESH CHICKEN
FARM.
2) Contribute to the development and growth of the country's economy and to
increase the percentage of Bumiputera involves in business
3) To create productivity among employees
4) To provide the best quality of "chicken" every time in order to attract more
customers
Business Address
Our business will be situated at the following address:
FRESH CHICKEN FARM
Lot 3307, Batu 7,
Lorong Sarkawi,
Jalan Kebun
42 450 Klang,
12
b) Location Plan
LORONGAKTBAKSR"
MARDI
HOUSE AREA
JAUWKH
FRESH
CHICKEN
FARM
-mrnmm
KESAS HIGHWAY
FROM KUA1A LUMPUR
PUUWMDAH
ECONSAVE
TESCO
HOUSE AREA
PROTON
SERVICE
CENTER
FROM HAH ALAM
ESSO
BUWTTWGGJ
(AMPIINGJAÎ
TEMPLE
GIANT
Shell
Hospital Besar
Klang
KLANG
13
Type of Building and Infrastructure

Among the facilities that are provided at our project site are:
1. Office
2. Toilet
We have chosen a project site which has all the necessary facilities and infrastructure
as a catalyst for the growth and development of our business, FRESH CHICKEN
FARM. Our business is situated only 45 minutes away from Kuala Lumpur through
KESAS highway.
Among the many infrastructures that can be found in the project site are:
a) An excellent highway system where it can facilitate the customers to frequent the
project site and buy our products. It will also make it more convenient for the
suppliers to come and supply the raw materials needed by our company.
b) Electricity power supply has already been provided by the Tenaga Nasional Berhad
along the Jalan Kebun.
c) Telephone line has already been made available by the Telekom Malaysia Berhad
and also water supply from the Water Department along Jalan Kebun.
14
OFFICE LAYOUT
<
)
1*-*
FINANCIAL
MANAGER
)GENERAL
MANAGER
i**
OPERATION
MANAGER
D
tF^
MARKETING
MANAGER
KEYS:
Chair
Computer
Sofa
Toilet
Telephone
White
Board
Table
15
2.1 ORGANIZATION CHART OF FRESH CHICKEN FARM
GENERAL MANAGER
ADMINISTRATION
MANAGER
FINANCIAL
MANAGER
OPERATION
MANAGER
MARKETING
MANAGER
WORKERS
WORKERS
The style of the organization chart is designed on functional style. The

organization structure on functional style is very effective to the any company which
are need peculiar specialize.
16
2.2 LIST OF ADMINISTRATION PERSONNELS
SERIES
POSITION
NO OF PERSONAL
General Manager
Operation Manager
Administration Manager
Marketing Manager
Financial Manager
Trained Workers
TOTAL
17
2.3 SCHEDULE OF TASK AND RESPONSIBLITIES
POSITION
TASKS AND RESPONSIBILITIES
Making connection and establishing contact

with
the
main
supplier,
PERTANIAN
PERTIWI SDN BHD.
Form the business policies and guidelines
Making decisions and solve all problems

faced by Fresh Chicken Farm.
Help the Marketing Manager to promote the

chicken products.
General Manager
Find out more information and do research

about setting up and operating a chicken's
farm successfully.
Choose quality livestock from the supplier,

PERTANIAN PERTIWI SDN BHD.
Responsible and liable for all business risks or

any problems regarding business or workers
To forecast sales and income
To administrate the business structure
Lay out all plans and ensure that all things are
done according to plans
Determine the wages and salaries received by

workers and contribute the percentage of the
salaries to EPF and SOCSO.
Make the decisions regarding administrative

tasks and office works.
Responsible for all mails and correspondences

connected with the business.
Administration Manager
To assist general manager in the business
To involve in guiding a new worker in case of

a new recruitment
Help to achieve the business target by

implementing business ideas and strategies
18
Find other strategies to help increase sales
Analyze the strengths and weaknesses of

competitors.
Marketing Manager
Handle
the
advertisement,
banners
and
signboard placement.
Make sure the customer receive good service.
Able to interact and try to make the customers

to have confidence in our business
To analyze the opportunity in the economy,

choose and grab the opportunity based on the
business
Find and place a suitable pricing for every

chicken product sold.
Deal in the buying of food for the chicken
Responsible for the training of new workers
Operations Manager
and monitor the job quality of all operation

workers.
Monitor th health of chickens.
To make sure that all stocks are in good

condition
To make sure all the stocks are enough to

meet the demand
Informing suppliers when there are extra

orders needed
Prepare the company financial report
Keep all the financial records and business

accounts in the safety place.
Record and monitor all the income received

and expenses incurred by the business.
Financial Manager
Responsible for controlling and managing

company's financial capital and cash flow.
19
Advice the manager regarding the financial

matters.
Make a budget of business example financial

statement, profit, and loss account, and
balance sheet
Search for the information of capital and asset

activities.
DESIGNATION
NO OF
MONTHLY
EPF
socso
EMPLOYEE
SALARY
(12%)
(2.5%)
TOTAL
(RM)
(RM)
(RM)
(RM)
General Manager
1,700.00
204.00
43.00
1,947.00
Operation Manager
1,300.00
156.00
33.00
1,489.00
Admin Manager
1,300.00
156.00
33.00
1,489.00
Marketing Manager
1,300.00
156.00
33.00
1,489.00
Financial Manager
1,300.00
156.00
33.00
1,489.00
Trained Workers
1,000.00
120.00
25.00
1145.00
TOTAL
7,900.00
948.00
200.00
9,048.00
20
2.5 LIST OF OFFICE EQUIPMENTS AND SUPPLIES
NO
1.
TYPE
QUANTITY
PRICE/UNIT
TOTAL
(RM)
(RM)
OFFICE EQUIPMENTS
a. COMPUTER (PARTNERS
2,500
CONTRIBUTION)
b. AIR CONDITIONER
1,180
1,180
c. TELEPHONE & FAX
1,000
1,000
d. FIRST AID
100
100
e. WHITE BOARD
120
120
f.
400
1,600
MACHINE
CABINET/FILE FOLDERS
g. ADDITIONAL
170
ACCESSORIES
6,670
TOTAL
2.
FURNITURES
a. CHAIRS
b. SOFA
c. TABLE
TOTAL
60
480
1 SET
1,100
1,100
150
600
2,180
21
2.7 ADMINISTRATION BUDGET OF FRESH CHICKEN FARM
TYPE
Fixed Asset
Monthly Expenses
Yearly Expenses
Cost
(RM)
(RM)
Salary, EPF, SOCSO
6,414
76,968
Stationary
50
600
Miscellaneous
100
1,200
500
6,000
(RM)
Fixed Asset:
Land &Building
138,000
Furniture
2,180
Office equipments
6,670
Renovation
Monthly Expenses:
Telephone bill
Other Expenses:
Registration & Licenses
100
1,200
Deposit
Insurance & Road Tax
Other Expenses
22
23
3.0 INTRODUCTION
Marketing is a social and managerial process by which individuals and group

obtain what they need and wants through creating and exchanging products and value
with others. It can be defined as an activity that are carried out systematically to
encourage and increase sales of products or services as long as the activities are in the
line with religious and ethical practices.
Marketing is basically an exchange activity that takes place between a
business entity and its customers. The customers can conclude individuals, others
business entities (e.g. wholesalers and retailers) and support organizations (e.g. banks
and government agencies). Marketing is a critical activity in any business because it
forms the backbone to the total business effort in achieving a profitable outcome.
Consequently, the challenge in any business is to produce and offer a product that
results in profit for the business and, more importantly, satisfies the target customer.
r
3.1 PRODUCT OR SERVICE DESCRIPTION
Our business will be name as 'FRESH CHICKEN FARM'... holding one

marketing concept where our operation, strategy and manufacturing are done
regarding customer's needs and wants. In the other words, the customer satisfy is a
major concerning in every effort and strategy to ensure that our business can be
compete and more longer in market.
We have chosen a business that deal with the distributor, whereby they are an
agreement that the distributor will supplies the chick to us, then we will breed its until
a certain level before the chicken return back to them. There are only 18,000 chicks
per batch that we will take. It takes a year the contract of this business.
24
3.2 TARGET MARKET
The target market is defined as the groups of customers that have needs and
wants that can be satisfied by the business through the supply of goods and services.
It's important for us to have a target market to determine our customers needs and
wants towards chicken.
Since that our business has a contract with other company, which is our
distributor, therefore, our target market is 'Pertanian Pertiwi Sdn Bhd'(distributor).
Our company does not have a specific area or outlet to distribute our product because
we have a deal with the distributor. In the agreement, it states that we will get the
supplies (chicks) from the distributor and after a certain level, we will sell it back to
the distributor.
3.3 MARKET SIZE
Market size refers to the total potential purchase of the target market. Since we
have a contract, so the market size is depend on the purchasing of our distributor.
According to our distributor, we had been informed that their annual sale is
RM15,779,840. Therefore this is our market size. The table below shows the target
market of their company.
OUTLET
EXPECTED PURCHASE
Per year (RM)
PERCENTAGE
(%)
Wet Market
5,52,944
35
Hotel
3,155,968
20
Restaurant
4,733,952
30
Factory / School Canteen
1,577,984
10
Individuals
788,992
15,779,840
100
TOTAL
25
3.4 MAIN COMPETITORS
In our business operating, there are many competitors that operate a same
business like us. Competitors actually refer to other businesses that offer similar,
substitute or an alternative products or services to the same target market. We have to
analyze the strengths and weaknesses of our competitors in term of size, experience,
and years in business, financial ability and product line in order to compete together
with them.
Here we have identify some entrepreneurial that operate chicken business
located in the same area:
Hj. Kamaruddin b Hj. Ellyas
Kim Too Siong
En Baharen M.Daie.
All the above competitors have been long in this business before we entered
the business. Therefore, most probably they have established themselves and have
more experience in facing towards customers. What can we do is trying to have a
good business and make the competitors as our activator to succeed in the business.
26
STRENGTHS OF COMPETITORS
> They have been in the business for a long time before us and make them
already have permanent customer.
> They have a large source of capital to expand their market.
> They have more experience in operating the business compared to us.
Customers know them well and more confident to work with them.
WEAKNESSS OF COMPETITORS
^ Their operation management is not systematically.
^ The price of the chicken is not suitable with the quality of the product selling.
> Their farm is 'open system', produce low quality product.
> Less promotion to spread widely their business.
STRENGTHS OF FRESH CHICKEN FARM

^ Our operating is more systematic to ensure that our chickens are grower in
better condition.
> Our price is suitable with the size of chicken selling.
> We care of the quality of the chicken selling to buyer.
> Applied high technology on the farm. (Close system)
> We have well in promotion and ensure a good relationship with our
distributor.
* Nevertheless, we have our weakness that we are still new in our business and have
less experience compared to other competitor.
27
3.5 MARKET SHARE
Market share refers to the estimated potential sales of the business after taking
into consideration of the market size and competitors influences. Based on our market
size, RM 15,779,840 we can estimate our 5% share of market.
The table below shows the market share before and after 'FRESH CHICKEN
FARM' entered market.
Name of
After
Before
%
Company
share
(RM)
Amount
Amount
(RM)
share
25
3,944,960
25
3,944,960
Kim Too Siong
20
3,155,968
20
3,155,968
En Baharen M.Daie
15
2,366,976
15
2,366,976
Others
40
6,311,936
35
5,522,944
788,992
100
15,779,840
Hj. Kamrauddin b.
Hj. Ellyas
'FRESH CHICKEN
FARM'
TOTAL
100
15,779,840
28
3.6 SALES FORECAST

Sales forecast is expected purchases from the identified target market. There
will be an increase in our sales every year for our three years forecast seems that the
high demand for chicken in the market. There is a possibility that the customers needs
a better quality of chicken and choose us as their new supplier.
The following table shows the forecasted sell for the first three years.
Sales Forecast for year 2006,2007 and 2008 (RM)
MONTH
NO OF
SELLING PRIZE
AMOUNT
UNIT (kg)
(RM/kg)
(RM)
January - February
41,055
3.20
131,376
March - April
41,055
3.20
131,376
May - June
41,055
3.20
131,376
July - August
41,055
3.20
131,376
September - October
41,170
3.20
131,744
November - December
41,170
3.20
131,744
246,500
3.20
788,992
Total-2007
246,500
3.20
788,992
Total - 2008
246,500
3.30
813,450
Total-2006
In our business, we have a certain period of time to produce our product.

Operation of our product will take about two month before it's will be market.
Therefore, we just can make a forecast per batch, which means every two-month we
will gain in sales.
We start our project in January and get 18,000 of chick from the distributor.
From the table above, our product that we sell to the distributor is 41,055, which is
17,850 of chicken with average weight 2.3kg in the first, second, and third batch (JanAug). We expect that 150 chicken will died. On the forth and fifth batch, there are
only 100 died. To achieve this target, we will make sure that our operation was good.
The distributor also will help us by giving an extra 200 of chicks in every batch. On
29
September to December, they will give us extra 250 of chicks because of the festival
season.
From the graph below, it shows that our selling forecast in year 2006, 2007
and 2008. In the agreement, the price for a chicken is fixed, RM3.20/kg. The graph
shows that the pattern of selling in year 2006 and 2007 is same and in 2008, it will
increase 3% by increasing our selling price to RM3.3O/kg while we renew our
agreement with the distributor.
Graph On Sales Forecast
136,000
135,000
134,000
Amount
133000
(kg)
132,000
131,000
_ _
n rr r
i
1
130,000
129,000
1 .,
D Year 2006
Year 2007
Year 2008
Month
30
3.7 MARKETING STRATEGIES

Our business operating is supplying the meat chicken. In this business, we are
dealing with other company as a distributor which they as an agent to distributed our
product. We supply the chicken and they processed the chicken for selling to the
customer. Therefore, our marketing strategy is to make the distributor more confident
towards our quality of product. In order to achieve our target, we have developed
appropriate marketing strategies to generate the sales from the target market. There
are four factors to be considered which are as follows;
a) Product
b) Price
c) Place (distribution)
d) Promotion
a) Product
Our farm provides a good quality of chickens, which are from a good
heredity (grade A) and free from infectious disease. We will operate our farm
carefully to ensure that it's always been satisfy by our distributor. In this business, the
distributor will give a guideline for us to control our quality of products. To achieve
the standard level of our product, we will make sure that our operation will operate
according to the guideline given. Besides, the distributor will come to our farm every
two weeks to make sure that our chickens have a good health.
Our business provides a clean environment of a farm, which is very important
for giving a view to our quality product. A good quality of chicken also comes from
their good quality of feed.
b) Pricing
The price of chicken is fixed based on our agreement with the
distributor. Otherwise, in order to put a price for our product, we are using
'competition-based pricing' concept and make a comparison regarding quality and
31
size of the chicken. The proper price fixed by our business is RM3.20/kg where
usually the price fixed by competitors is RM3.50/kg.
c) Place/Distribution
We have chosen Jalan Kebun at Klang as our project site based on some
factor;
Farm is far away from town and housing area
Farm have access to transportation and be able to operate all the time
Land are flat and have good drainage
The area is well ventilated
Seems that our location is in Klang , its will encourage the distributor to make a deal
with us.
d) Promotion
An impressive promotion is needed to ensure that our missions are achieved.
A step of promotion should be taken in order to achieve our vision to make everyone
known our potential and get a chicken supply from our company.
Promotions are based on;
Signboard
It's very important for each business to have a signboard to introduce the business
and let everyone know the location of the project site. Our business will have two
signboards that will be put in front of our office and the side of road that mention
the way to our farm.
Business card
Our business card will be given especially to our vendors who visit our farm.
It's make people know how to contact us as a manager to make a business or
directly come to our farm based on address given.
32
Website
We will make a business website for our company seems that Internet is the
most important communication tool among the communities nowadays. All
information regarding our business will be advertised in the homepage
MOHAMMAD SHUKEY
B. MAKSAH
(General Manager)
Fresh
GbkkenFarm
Lot 3307, Batu 7, Lorong

S&rkawi, Jalart Kebun,
42450 Klang,
Tel:03-31222372
H/p : 019-3079070
www. f reshchickenfa rm. com
MUHD NURFAIZ
B. BAHARUDDIN
(Marketing Manager)
Fresh
Chicken F&rtn

Sarkawi, Jalan Kebun,
42450 Klang,
Tel:03-31222372
H/p : 012-6045320
www. f reshchickenfa rm.com
MUHAMMAD FAIRUZ
B JOHARI
(Operation Manager)
Fresh
hickn Farm

Sarkawi, Jalan Elebun,
42450 Klang,
Tel: 03-31222372
H/p : 017-3082892
www. f reshchickenfa rm. com
33
AHMAD LUQMAN B.
MOHAMMED SHAIHANI
(Financial Manager)
Lot 3307, Batu 7, Loiong
Sarkawi, Jalan Kebun,
42450 Klang,
Tel: 03-31222372
H/p : 012-9157455
www. freshchickenfa rm. com
Fresh
3.8 MARKETING BUDGET

Remuneration Table Monthly
POSITION
MONTHLY
EPF
socso
TOTAL
SALARY (RM)
12%
2.5%
(RM)
(RM)
(RM)
156
33
Marketing
1300
1489
Manager
List Of Marketing Budget

Type
Fixed Asset Cost
Monthly Expenses
Other Expenses
(RM)
(RM)
(RM)
Fixed Asset
Signboard
500
Working Capital
Salary, EPF, SOCSO

Miscellaneous
200
Other Expenses
Business Card
100
34
35
4.0 INTRODUCTION
Operation Management
Operation management can be defined as the process of marshalling resources
to produce output through the transformation process. The operation process
comprises three main components, i.e. business input, transformation system and
output.
Business input refers to all resources required to produce a particular output.
Examples of input are manpower, raw materials, machines and equipment,
technology, information and capital. The transformation system refers to the activities
involved in transforming input into output. Among others, the processing system
involves planning of raw materials, designing of operational process, planning of
floor layout and distributing of manpower in the organization. Output refers to the end
product created as the result of the transformation process. Business output can be
categorized into either products or services. As input is transformed into output, it
acquires added value, whereby the value of the output is higher than the total input
value.
Our purpose focus in operational plan is to breed and to ensure chicken that
we supply is high quality to fulfill our customer needs and wants. With the quality,
exact time and place we planned at the lowest cost but give an optimum profit, which
will avoid misspend money.
It also to recognize and list down all the materials needed to effort by making
some arrangement for the quantity and quality of material needed and recognized
supplier.
36
4.1 FLOW CHART OF OPERATION ACTIVITIES

It is schematic representation of the operation process from the start until the end.
Ready of broiler closed house
Install the necessary brooding equipment
Received a day-old-chick (DOC)
Keep DOC in broiler close house
Check the chick quality
Daily control and quality control
Waiting for a growing process
Catching process
Distributor takes back the chicken
Disinfection process
37
FLOW CHART CONVENTIONAL SYMBOLS
SYMBOL
ACTIVITY
DESCRIPTION
Material are being

OPERATION
processed of planning and

calculating
Received and return the

TRANSPORTATION
chicken to the supplier and

delivered it to the customer
Inspection on the size,
weight, quality of the
INSPECTION
chicken we ordered and

delivered
DELAY
Waiting a growing process
Material and property are

STORAGE
stored in the storage
38
PROCESS FLOW CHART

1) Ready of broiler closed house
2) Install the necessary brooding equipment
3) Received a day-old-chick (DOC)
4) Keep DOC in broiler close house
5) Check the chick quality
6) Daily control and quality control
7) Waiting for a growing process
8) Catching process
9) Distributor takes back the chicken
10) Disinfection process
39
4.2 OPERATIONS SYSTEM

1) Ready of broiler closed house.
Our breeding project of day-old-chick required our company to build pens on
2.273 acres. Before we have building and
planning construction of a boiler house,
firstly we select a site that is on well-drained land and has plenty of natural air
movement. The house should be oriented on an east-west axis to reduce the amount of
direct sunlight on the sidewalls during the hottest part of the day. The house is singlestorey and has a wide of 350 feet x 40 feet x 7 feet. The design is such that chickens
are not exposed to injury. This is close house system, so there is an alarm signal.
These alarm signals are useful to give a warning during a blackout. Then the
generator will be used to provide a power electric.
40
2) Install the necessary brooding equipment
a) Drinker System
This system providing clean, cool water with adequate flow rate is
fundamental to good poultry production. Without adequate water intake, feed
consumption will decline and bird performance will be compromised. Our company
has used closed systems {nipple systems).The nipple drinkers operate at a flow rate of
50 to 60 ml/min. The pressure is adjusted to maintain water flow to meet the broiler's
water needs and to adjust it, we use regulator. Nipple drinkers will be adjusted to suit
chick height and water pressure. It must have evenly distributed pressure optimized
for output without contributing to excessive dripping.
41
b) Feeding System
Our company has used auto pan feeding system. This system is allowing for
unrestricted bird movement throughtout the house, has a lower incidence of feed
spillage, and improved feed conversion. In addition, pan feeders fill simultaneously
minimizing bird competition when the feed lines are charged. Automated chain
feeders allow for a minimum of 2.5 cm (lin) feeder space per bird. The maintenance
of feed track, corners, and chain tension is essential. If the height is not adjusted
properly, it can restrict bird movement within the house. The feed depth is controlled
by feed slides in the hoppers and will be closely monitored to prevent feed wastage.
L-
42
c) Pad Cooling System

We have to monitor level of ammonia, carbon monoxide, carbon dioxide,
hydrogen sulfide and oxygen. In closed house system from time to time to ensure it
does not affect health of chickens and workers. When the thermostats or probes
detects the temperature below 30C the water will be automatically flow out from the
front of the pens. The machine is calling the pad cooling system. Then the exhaust fan
will pull out any gases and air that are not at the good level. The suitable temperature
is according to stage of growth.
43
3) Chick Placement
We buy a chick from our head company, Pertanian Pertiwi. This day-old-chick
will be sending to us more than 18000 of chicks. These chicks are from same flock or
same age. The delay in placement can contribute to the dehydration of chicks,
resulting in higher chick mortality and reduced growth rate. Chick must be carefully
placed and evenly distributed near feed and water throughout the brooding area. The
light will be brought to full intensity within the brooding area once all chicks have
been placed. We have to monitor the distribution of the chicks closely during the first
few days. This can be used as an indicator for any problems in feeder, drinker,
ventilation or heating systems.
4) Chick Quality
Two hours after chick placement, we will be checking their quality. This is to
ensure they are comfortable with the temperature. Chicks too warm will try to move
away from heat, will be panting, will appear quiet and their wings may drop. Chicks
too cold will crowds towards the heat, will huddle in groups and be noisy. While,
chicks at the correct temperature will be evenly spread, show varied behavior (eating,
drinking, resting and interacting) and will be softly chirping. Characteristics of a good
quality chick are well dried, long fluffed down, bright round active eyes, look active
and alert, have completely healed navels, free of red hocks and should be free from
deformities.
44
5) Daily Control and Quality Control
a) Ventilation
In order to the proper temperature, ventilation needs to be considered.
Ventilation distributes heat throughout the house and maintains good air quality in the
brooding area. We have to monitor level of ammonia, carbon monoxide, carbon
dioxide, hydrogen sulfide and oxygen. In closed house system from time to time to
ensure it does not affect health of chickens and workers. When the temperature
transducer detects the temperature below 30C the water will be automatically flow
out from the front of the house. The machine is calling the cooling pad system. Then
the exhaust fan will pull out any gases and air that are not at the good level. The
suitable temperature is according to stage of growth
Description
Weekl
Week 2
Week3
Week4
Week5
Temperature
33C
32C
29C
29C
29C
Air speed
<50 ft/min
100 ft/min
200 ft/min
300 ft/min
400-500 ft/min
Thermostat
34C
32C
30C
30C
30C
Exhaust Fan
45
b) Feed and Water

Our broiler management is always making sure that both the feeders and
drinkers are in adequate supply relative to the stocking density and are approximately
placed. The nipple drinkers would be at chicks' eye level for the first 2 to 3 days of
age and then maintained slightly above chicks' head. Pressure would be such that
there is a droplet of water suspended from the nipple but no leakage. The birds' feet
are always being flat on the litter and a bird will never have to stand on its toes to
drink. Feed are provides in crumb form and placed on trays. Feeders will be raised
incrementally throughout the growing period so that the pan is level with the bird's
hack at all times. The feed level within the feeders will be set so that feed is readily
ivailable while spillage is minimized.
46
c) Light
Light intensity will be minimum of 20 lux (2 foot candles) in the darkness
place in the brooding area during the brooding phase. Light intensity, distribution,
color and duration affect the performance and welfare of the flock. Proper light
placement and distribution will encourage chicks to find feed, water and warmth
during the brooding phase.
d) Disease Control
The veterinary will come every week to monitor disease status in house on a
schedule basis. The culled chicken will be separate before its spread. The antibiotic or
vaccine will be put in water. The use of the correct medication and the timing of
treatment can be crucial in combating a disease problem. The preferred choice of a
drug or antibiotic for some disease may be harmful if used for the treatment of others.
e) Bio-security
Bio-security is the term used to describe an overall strategy or succession of
measures employed to exclude infectious diseases from a production site. Outlined
below are the key points that make us successful in bio-security program.
> Keep door and gate lock at all times.
> Farms are fenced.
> No pet animal that are allowed in or around poultry housing.
> Limit non-essential visitors to the farm.
> If equipment must come from another farm, it would be thoroughly
cleaned and disinfected before it comes onto the farm.
> Farms have a toilet and hand washing facilities separate from the
poultry house.
47
6) Growing Phase
a) Uniformity
Uniformity is measure of the variability of bird size in a flock. The coefficient
of variation (CV) is commonly used to describe variability within a population. A low
CV indicates a uniform flock whereas a high CV indicates an uneven flock.
Coefficient of Variation
CV% = standard deviation
To estimate the CV of a flock, we will divide the house into three sections. A
random sample of approximately 100 birds from each section, or 1% of the total
population will be weighed and the individual weights recorded. It is important to
weigh all birds within the catch pen excluding culls. Birds will be weighed daily for
the first two weeks of age and weekly thereafter.
Flock Uniformity
CV
Uniformity
Evaluation
80%
Uniform
10
70%
Average
12
60%
Poor uniformity
b) Modification of Feed and Nutrient Intake

Adjusting dietary nutrient density or the physical form of the feed (mash vs.
pellet) will influence broiler growth rates. Lower nutrient density diets may have a
negative impact on feed conversion and yield but will cost less to produce. An
analysis of dietary cost versus bird performance is essential in determining the best
option.
48
c) Lighting Programs
Lighting programs are a key factor in proper broiler management and are
fundamental to optimal performance. Lighting programs are typically designed with
changes occurring at predetermined ages and tend to vary according to the final target
market weight of the broilers.
Description
Light
Weekl
Week 2
Week 3
23 hours
20 hours
18 hours
||
0600
gj 0300 till g} 0100 till

morning
Week 4
Week5
Natural sun light
morning
7) Catching Process
Feed withdrawal will take place 8 to 12 hours before processing to reduce
carcass contamination. The purpose of feed withdrawal is to empty the digestive tract,
preventing ingesta and /or fecal material from contaminating the carcasses during the
evisceration process. When birds are fasted between 8 and 12 hours, the intestine is
almost completely empty yet strong enough to withstand the evisceration process
without rupturing.
Preparation for catching

> Water must be available until the start of catching
^ Lighting will be dimmed at the time of catching. If dimming is not
feasible, the use of blue or green bulbs will clam birds and reduce
activity.
> Remove or raise all equipment that may interfere with the catch crew.
> Careful management of the ventilation system is needed during
catching to ensure adequate house ventilation.
49
Dark strip curtains hung over the doors block out light during daytime
catching. These allow birds to remain quiet and will facilitate better ventilation.
Lightweight curtains can be used to partition the house into smaller pens. This can
reduce bird stress and diminish the risk of piling. Birds will be carefully placed in
clean crates or modules.
8) Disinfection
House will be disinfected thoroughly after every production cycle and left
empty for a suitable period of time (can stop breeding cycle of disease carrier) before
a new flock is brought in. Normally about 2 week. All farm equipment disinfected
thoroughly after use and kept in a clean and dry place.
43 BUSINESS OPERATION TIME
Our business operation starts from 9.30 am - 5.30 pm. We picked this time as
it is the appropriate time for any company / business to start and close their business
daily. In the daytime, chicken will be cared and well kept by our experienced workers
to make sure the safety and health of the birds. At night, they are allowed to roam and
wander in the farm but adequate food and water are still provided. They are the most
convenient animal to breed.
Operation time:
Monday - Friday
: 9.30 am - 5.30 pm
Saturday - Sunday : 10.30 am - 4.30 pm
Our operations include the process of feeding, health care and breeding.
50
4.4 CAPACITY PLANNING
Below are the lists for cost of raw material per chicken:
Raw Material
i.
Cost per chicken (RM)
Day Old Chicks
1.05
Starter Feed
0.60
iii.
Pre-Grower Feed
1.38
iv.
Grower Feed
1.32
v.
Finisher Feed
1.25
vi.
Vaccine and Medication
0.20
11.
5.80
Total
Average weight of a big chicken is 2.3 kg,
Total of raw material per chicken's weight = RM 5.80 / 2.3 kg

= RM 2.52
COST OF RAW
MONTH
NO OF UNIT
MATERIAL PER
(kg)
CHICKEN
AMOUNT (RM)
(RM/kg)
January-February
41,400
2.52
104,328
March-April
41,400
2.52
104,328
May-Jun
41,400
2.52
104,328
July-August
41,400
2.52
104,328
September-October
41,400
2.52
104,328
November-December
41,400
2.52
104,328
TOTAL YEAR 1
248,400
2.52
625,968
TOTAL YEAR 2
248,400
2.52
625,968
TOTAL YEAR 3
250,500
2.52
631,260
51
4.5 TOTAL COST

MONTH
AMOUNT
January-February
104,328
March-April
104,328
May-Jun
104,328
July-August
104,328
September-October
104,328
November-December
104,328
TOTAL
625,968
4.6 MATERIAL REQUIREMENTS (INPUT)
The following are the input of the operation process.
Raw Material
i.
Day Old Chicks
1.05
ii.
Starter Feed
0.60
iii.
Pre-Grower Feed
1.38
iv.
Grower Feed
1.32
V.
Finisher Feed
1.25
Vaccine and Medication
0.20
vi.
TotalI
5.80
52
4.7 LIST OF OPERATIONS PERSONNEL
POSITOIN
NO. OF PERSONNEL
Operation Manager
Farm Workers
4.8 SCHEDULE OF TASKS AND RESPONSIBILITIES
POSITION
RESPONSIBILITY/DUTY
> Gives a good co-operation as to
maintain the smoothness of the
operation
> To make sure the entire auto pan
feeding system, nipple drinking
system, brooding system and
control system are in good
Farm Workers
condition.
> To make an immediate report on
machine, equipment or other
damages.
> Gives a food or other daily routine
at the applicable time.
> Always obey the rules that fixed
by company.
53
POSITION
NO.
MONTHLY
EPF 12%
socso
SALARY
(RM)
2.5%
(RM)
Operation
TOTAL
(RM)
1,300
156
33
1,489
500(each)
120
25
1,145
2^00
276
58
2,634
Manager
Farm
Worker
TOTAL
54
4.10 MACHINE AND EQUIPMENT
a) Infrastructure Development
Cost (RM)
6,000
i.
Construction of access road
ii.
Land clearing
10,000
iii.
Fencing
15,000
iv.
Main Drain System
8,000
39,000
TOTAL
b) Equipment and Machinery
TOTALCOST
ITEM
1
TYPES
NO.
PAD COOLING SYSTEM
1.1
50" fan 1.0 hp 380 V with auto shutter
1.2
Cooling Pad 6"x 24"x 60"
80
1.3
5'xl0' S.S Frame for Cooling Pad
1.4
Water tank with capacity of 150 gallon
1.5
Install connection of water pipe
1.6
Water pump 1.0 hp
Total for item no. 1

2
(RM)
28,000
BOTH SIDE CURTAIN

Total for item no.2
6,200
55
AUTO PAN FEEDING SYSTEM
3.1
Feed Hopper
3.2
336' steel pipe complete with plastic pan and
0.5 hp motor
3.3
Hand winch
3.4
Height adjusted of the auto pan feeding
system-336'
3.5
1 Gallon Drinker for day-old-chick
200
3.6
Square chick tray for day-old-chick
200
23,000
Total for item no.3

4
NIPPLE DRINKING SYSTEM
4.1
Regulator
4.2
Nipple water PVC pipe and aluminum bar
340' long.
4.3
Hand winch
4.4
Height adjusted
4
of the nipple drinking
system-336'
14,600

5
5.1
BROODING SYSTEM
Brooder gas
15
4,200

6
CONTROL SYSTEM
6.1
Control system for 50" exhaust fan
6.2
Control system for water pump
6.3
Control system for Pan Feeding
1
8,000

7
ELECTRICAL SUPPLY
7.1
Sub-board
7.2
Lamp
50
7.3
Lamp post
56
7.4
Electrical wiring for lamp, fan and water

pump in broiler closed house.
12,000
Total item for no.7

8
GENERATOR
8.1
1 unit Gen-Set

9
9.1
10,000
WATER SUPPLY
1 unit water tank
1
5,000
Total for item no.9

10
Others
10.1
Trolley
10.2
Safety gear and tooling

TOTAL FOR ALL ITEM
200
2,000
113,200
Therefore the total costs are;

Cost of Infrastructure Development + Cost of Equipment and Machinery
= RM 39,000 + RM 113,200
= RM 152,200
57
4.11 OPERATIONS SPACE LAYOUT PLAN (BROILER CLOSED HOUSE)
o
o
KEYS
Feed Hopper
Storage and Control Room
[]
0.5 HP Motor
Auto Pan Feeding Lines
Regulator
Nipple Line
50" Exhaust Fan
Plastic pan
Water tank
Cooling Pad
58
4.12 OPERATION OVERHEAD
Below are the lists of estimated broiler production cost for overhead expenses:
Types
i.
Electricity
0.20
ii.
Water
0.08
iii.
Wood Shaving
0.08
iv.
Catching Crew
0.15
v.
Gas for brooding
0.08
Total
0.59
Total costs for operation overhead are:

= RM 0.59 X 18,000 chickens + Maintenance of Machinery + Miscellaneous
= RM 10,620+RM 250 +RM 200
= RM 11,070
NO.
ITEM
AMOUNT PER MONTH

(RM)
UTILITY
5,040
1.1 Water
1.2 Electricity
2
MAINTENANCE OF MACHINERY
TOOLS AND DYES
250
2,880
3.1 Wood shaving

3.2 Gas for Brooding
4
PARTIME WORKER (3 catching crew)
MISSELLANEOUS
TOTAL
2,700
200
11,070
59
4.13 OPERATION BUDGET
FIXED
PARTICULARS
ASSET
MONTHLY
OTHER
COST
EXPENSES
EXPENSES
(RM)
(RM)
(RM)
TOTAL
Fixed Asset
> Equipment and
113,200
113,200
39,000
39,000
Machinery
>
Infrastructure
Development
Working Capital
> Purchase of
104,328
104,328
1,145
1,145
11,070
11,070
Material
> Salaries,
EPFand
SOCSO
> Operation
Overhead
Other Requirements
> Deposit
5,000
5,000
> Other
2,500
2,500
7,500
276,243
Expenses
TOTAL
152,200
116,543
60
61
5.0 INTRODUCTION
The most crucial before starting a new business is how to get the capital and
how the capital will be use. Financial system is basic thing or features in a business
and it is the main source to control the journey of a business.
A complete set of account which is related with the organization journey will be
prepared by the chosen Financial Manager; to financial statement every year. It will
show the profit or loss of our company, assets, liabilities and the stability and growth
of our company's financial to make it faster. Besides, financial system can give us
clear picture about return of capital that will be gain or capital investment that has
been done.
The information of financial plan is gathered on the input from the
"ministrative budget, marketing budget and operation budget.
In the financial, we have prepared the working paper, schedule and financial
itement. The statements are:
> Project cost schedule of the project

> Sources of financial
> Schedule of loan repayment
> Schedule of hire purchase
> Schedule of fixed assets depreciation
> Cash flow pro-forma
> Profit and loss pro-forma
> Balance sheet pro-forma
62
OBJECTIVE
The objective of financial plan is;
> To determine the amount of money to be invested that is the project cost.
> To identified and propose the relevant source fund
> To ensure that the initial capital is sufficient
> As a guideline for implementation
> To know whether the business is competitive or not
^ To determine the potential of the business to generate profit
> Cash outflows and cash inflows in the business project
> Hire purchase installment payment
> Loan installment payment
> Depreciation on the fixed assets
> The company's capital structure
> The total cost that we need to start the business
> Cost or paid up capital involves for starting the business
63
5.1 PROJECT IMPLEMENTATION COST SCHEDULE
RM
Capital Expenditures/Investment in Fixed Asset
Land & Building
Furniture
Office and Equipments
Infrastructure Development
Sign Board
Machinery
Total
13 8,000
2,180
6,670
39,000
500
113.200
299,550
Working Capital/Monthly Expenses (for 2 month)

Administrative
Marketing
Operation
Day-old-chick (DOC)
Total
14,128
400
24,430
18.900
57,858
Other Expenses
Deposit
Company Registration & license Fees
Other Expenses for operation
Business Card
Total
Contingencies (2%)
TOTAL
5,000
100
2,500
100
7,700
7,302
372,410
64
5.2 SOURCE OF FINANCE SCHEDULE
Equity Contributions
RM
RM
Partners Contribution:
Mohamad Shukry bin Maksah
34,910.00
Muhammad Fairuz bin Johari
15,000.00
Muhd Nurfaiz bin Baharuddin
15,000.00
Ahmad Luqman bin Mahammed Shaihani
15,000.00
Sub-Total
79,910.00
External Sources
Bank Loan
Existing asset
290,000.00
2,500.00
Sub-Total
292,500.00
TOTAL SOURCES OF FINANCE
372,410.00
65
5 3 SUPPORTING SCHEDULES
LOAN OF AMORTIZATION SCHEDULE
Total Loans: RM 290,000.00

Interest rate: 4 %
Duration
: 4 years / 48 months
Method
: Flat Rate Method
YEAR
1
2
3
4
5
6
7
PRINCIPAL
INTEREST
TOTAL
REPAYMENT
BALANCE
72,500
11,600
84,100
217,500
72,500
11,600
84,100
145,000
72,500
11,600
84,100
72,500
72,500
11,600
84,100
66
FIXED ASSET DEPRECIATION SCHEDULE
Type of Asset : Furniture

Actual Price
: RM 2,180.00
Economic Life: 5 years

Method
Year
1
2
3
4
5
: Straight Line Method
Yearly Depreciation
Total Depreciation
(RM)
Balance
(RM)
436
436
RM 1,744.00
436
872
RM 1,308.00
436
1,308
RM 872.00
436
1,744
RM 436.00
436
2,180
67
Type of Asset : Equipment

Actual Price
: RM 6,670.00

Method
Year
Yearly Depreciation
Total Depreciation
(RM)
RM 1,334.00
1,334.00
5,336.00
RM 1,334.00
2,668.00
4,002.00
RM 1,334.00
4,002.00
2,668.00
RM 1,334.00
5,336.00
1,334.00
RM 1,334.00
6,670.00
Balance
(RM)
68
Type of Asset : Signboard

Actual Price
: RM 500.00

Method
Year
Yearly Depreciation
RM 100.00
Total Depreciation
(RM)
Balance
(RM)
RM 100.00
RM 400.00
RM 100.00
RM 200.00
RM 300.00
RM 100.00
RM 300.00
RM 200.00
RM 100.00
RM 400.00
RM100 .00
RM 100.00
RM 500.00
69
Type of Asset : Machinery

Actual Price
: RM 113,200

Method
Year
Yearly Depreciation
Total Depreciation
<RM)
RM 22,640.00
RM 22,640.00
RM 22,640.00
RM 45,280.00
RM 67,920.00
RM 22,640.00
RM67,920.00
RM 45280.00
RM 22,640.00
RM90,560.00
RM 22,640.00
RM 22,640.00
RM113,200.00
Balance
(RM)
RM 90,560.00
70
Type of Asset : Infrastructure Development

Actual Price
: RM 39,000

Method
Year
Yearly Depreciatioii
Total Depreciatioii
(RM)
RM 7,800.00
RM 7,800.00
RM 7,800.00
RM 15,600.00
RM 23,400.00
RM 7,800.00
RM23,400.00
RM 15,600.00
RM 7,800.00
RMS 1,200.00
RM 7,800.00
RM 7,800.00
RM39,000.00
Balance
(RM)
RM 31,200.00
71
5.4 PROFORMA FINANCIAL STATEMENTS

CASH FLOW PROFORMA (ANUALLY)
Yearl
(2006)
YEAR 2
(2007)
YEAR 3
(2008)
79,910.00
290,000.00
394,496.00
361,560.00
394,496.00
394,557.00
406,725.00
405,706.00
Total Cash Inflows
1,125,966
789,053.00
812,431.00
Cash Outflows
Administrative
Expenditure:
Salary, EPF, SOCSO
Stationary
Miscellaneous
Telephone
76,968.00
600.00
1,200.00
6,000.00
76,968.00
600.00
1,200.00
6,000.00
76,968.00
600.00
1,200.00
6,000.00
Marketing
Expenditure:
Salary, EPF, SOCSO
Miscellaneous
2,400.00
2,400.00
2,400.00
Operational
Expenditure:
Cash Purchases
Salaries, EPF,SOCSO
Operation Overhead
113,400.00
13,740.00
132,480.00
113,400.00
13,740.00
132,480.00
113,400.00
13,740.00
495,960.00
5,000.00
100.00
_
-
_
-
2,600.00
138,000.00
2,600.00
-
2,600.00
-
159,050 .00
Cash Inflows
Owners' Capital(cash)
Bank Loan
Sales
Collection of
Accounts Receivable
Deposit
Registration &
Licenses
Other Expenses
Purchase of Fixed
Assets - Land &
Building
Purchase of Fixed
Assets - Others
72
Loan Payment
Principle
Interest
72,500.00
11,600.00
72,500.00
11,600.00
72,500.00
11,600.00
Total Cash Outflows
735,998.00
433,848 .00
776,668 .00
EXCESS/(DEFICIT)
389,968.00
355,205.00
378,583.00
389,968.00
745,173.00
745,173 .00
1,123,756.00
Opening Cash
Balance
Ending Cash
Balance
389,968.00
73
PROFORMA PROFIT AND LOSS ACCOUNT

FRESH CHICKEN FARM
Proforma Profit and Loss Account for the Year Ending 31 Dec 2006
RM
RM
Sales
788,992
Less: Cost of Goods Sold
Opening Stock Purchases
Gross Profit
Less Expense:
Administration Expenses:
Salary, EPF, SOCSO
Stationary
Miscellaneous
Telephone
Marketing Expenses:
Salary, EPF, SOCSO
Miscellaneous
Operation Expenses:
Salaries, EPF & SOCSO
Operation Overhead
Financial Expenses:
Interest on Loan
Depreciation on Fixed Assets
Registration & Licenses
Other Expenses
113,400
76,968
600
1,200
6,000
2,400
13,740
132,840
11,600
32,310
100
2,600
Total Expenses
393,758
Net Profit before Taxes

Net Profit after Taxes
Accumulated Net Profit
395,234
395,234
395,234
74
PROFORMA BALANCE SHEET ACCOUNT

FRESH CHICKEN FARM
Proforma Balance Sheet for the Year Ending 31 Dec 2006
RM
Fixed Asset
Land & Building
Furniture
Equipments
Signboard
Machinery
Infrastructure Development
Total Fixed Asset
138,000
1,744
5,336
400
90,560
31.200
267,240
Current Asset
Deposit
Accounts Receivable
Cash
Total Current Asset
5,000
32,936
389.968
427,904
Total Asset
695,144
Owner Equity
Capital (Owner's Equity)
Accumulated Profit
Total Equity
477,644
Liabilities
Loans balance
Total Liabilities
217,500
TOTAL EQUITY AND LIABILITIES
82,410
395.234
217.500
695,144
75
Fi
Oil
76
CONCLUSION
Based on the business plan that has been done, we have not only shown the financial
performance of this business but also the capability of the business. Because this kind
of business is rather new, our company is confident that we can penetrate the market
share.
From our observation, we also found that the Malaysian's stable economic situation
and the Malaysian's fondness to try new type of food especially Chinese will help to
encourage our business to grow. Adding to the fact that chicken's meat is lower in
cholesterol that any other meat found in the market, we are also confident that this
will also attract the health-conscious people to try this new alternative food.
The organization team for FRESH CHICKEN FARM consists of 4 dedicated,

disciplined and motivated individuals with the same aim of strengthening the
company.
As a conclusion, we strongly believe that FRESH CHICKEN FARM has a potential

in running this business and has the competitive edge to succeed.
77
,\
I)
78
The environment of location before the project being proceeds
4- The location under construction.
4- Our products.
Mohammad Shukry B. Maksah

No. 41, Jalan Sri Damak 50,
Taman Sri Andalas,
41200 Klang
Selngor
To Whom It May Concern.
Dear Sir,
Agreement on using land at Lorong Sarkawi, Jalan Kebun, Klang Selangor.
I am, Siti Bt Hj. Abdul Rahman as the owner of the land located above, agree to let
my niece to develop that unoccupied land to open a broiler house with some
incentives as in return. I will not be accused if they had a problem or involved in
problem.
Thank You,
Your Faithfully
SitiBtHj. Rahman
(No. VC: 4297581)
October 2, 2005
FRESH CHICKEN FARM
Lot 3307, Batu 7, Lorong Sarkawi,
Jalan Kebun,
42450, Klang
Selangor Darul Ehsan.
Dear FRESH CHICKEN FARM,
Contract Farming With FRESH CHICKEN FARM At Jalan Kebun, Klang,

Selangor
We are please to inform you that we have accepted your proposal to rear 18,000 birds/ flocks about 1 house
on a piece of land specifies above with the concept of new broiler closed house.
You will have to construct the chicken's house according to Pertanian Pertiwi Sdn. Bhd. Specifications and
will sign a Contract Farming Agreement with Pertanian Pertiwi when the construction of the chicken house
is completed.
The company will then supply you day-old-chicks and feed according to the agreement that will be signed
when you have complete construct your chicken house. We will market all the birds when they reach market
size.
Thank you.
Yours faithfully,
Mr. Liau Chai Peng
Branch IManager(Klang)
Pertanian Pertiwi Sdn. Bhd.
IM -REGISTER,
Enactment.
(I.an.1 )0)
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TP 69A
{TELEKOM
^SSK
MALAYSIA
Rujukan
PERMOHONAN UNTUK PERKHIDMATAN PERNIAGAAN
(Telefon-Datel-Teleteks-Tetefax-Teleks)
NAMAPENUH
Untuk Kegunaan
Pejabat Sahaja
I ' 1
(Seperti dim K/Pengenalan/Paspot/Sljil Daftar Perniagaan)

Jika perkhidmatan adalah di bawah nama Peiniagaan/Kerajaan/Kedutaan,
dll., nyatakan Nama Pengguna dan Pangkat.
NAMAPENUH
PENGGUNA
I 1
1 1 1 1
Kod Kategon
Pelanggan
1 I
1 I
PANGKAT
II
No. Kad Pengenalan
No. Pendaftaran
Perniagaan
No. Paspot
Kod Negara
Negara
1 I
Tingkat
ALAMAT PERSURATAN : No.
No Lot/No. Pangsapuri :
I 1
II
Nama Jalan :
Tmn./Seksyen :
L_J
Peti Surat :
Bandar :
Bangunan
I
I
I
I
. I
I_J
Poskod :
I I
Negen :
LJ L
I
I 1 1 I l
I
A L A M A T PEMASANGAN (Jika berlainan daripada alamat persuratnn) '
No. I
Tingkat
I!
Bangunan :
Tmn./Seksyen ;
1 _L_ J
Poskod :
TANDAKAN
II
Nama Jalan :
Bandar :
No. Lot/No. Pangsapuri :
II
I
I
II
J I
I
I
J
) DALAM KOTAK
|.J
'
LJ
<i BERKENAAN
Negeri :
I
Lihat Sebelah
PERKHIDMATAIM DIPERLUKAPJ
ATD (ISO)
TALIAN IBUSAWATTERUS
SAMBUNGAN SELARI
RAOAS TELEFON TAMBAHAN
Bil Talian
Oikehendaki
PERKHIDMATAN
Jems/Model
Bil Nombor
Utama
Bil
Sambungan
P ABX
KEY
TELEFON
Bil
Stesen
Bil. Norpbor
Auxiliary
PERKHIDMATAN TELEMATIC
Jems/Model
Radas
PERKHIDMATAN
Jems/Model
Modem
Catatan "
DATEL
TELETEKS
TELEFAX
Menggunakan Nombor Telefon yang sediada
Jems Radas
PERKHIDMATAN
I"
Cadangan Kod Jawab-Balik
TELEKS
KEMUDAHAN TAMBAHAN/CIRI-CIRI KHAS DIKEHENDAKI .
CATATAN
Tahun
Bulan
Han
Tandatangan Pemohqn
TANDAKAN ( ^
) DALAM KOTAK YANG BERKENAAN
Jika menggunakan radas sendirf, sila kemukakan surat pembekal. Cuma radas Kelulusan STM/JTM (Kswasolia) boleh digunakan.
PNA. 42
PEJA&AT PENDAFTAR PERNIAGAAN
Permohonan Kelulusan Nama Perniagaan
(Tiada Bayaran Dikenakan)
Saya memohon menggunakan salah satu nama-nama perniagaan dibawah:

(a)
(b)
(c)
* Nama dan Alamat Pemiiik / Pekongsi
* No. Kad Pengenalan & Wama
((.junakan lampiran lamjika pemiiik lebih 3 orang)
(a)Nama:
Alamat:
Baru: .
Lama:
(b)Nama :
Baru:
Alamat:
Lama:
(c)Nama :
Baru:
Alamat:
Lama:
* Jenis perniagaan dijalankan :
# Tarikh
* Tandatangan Pemohon :
Nama
No. K/P :
# No. Rujukan:
# No. Rujukan:
# Catatan :
Tarikh:
(
Penolong Pendaftar Perniagaan

+ Sila lihat syarat kelulusan dimuka sebelah.
* Pemohon hendaklah melengkapkan ruangan-ruangan ini.
# Ruangan ini dibiar kosong.
Kuala Lumpur
Syarat-syarat Kelulusan
1.
Permohonan nama perniagaan yang tidak meraenuhi syarat di bawah akan ditolak:
a.
b.
c.
d.
e.
Nama perniagaan tidak bersesuaian dengan jenis perniagaan yang dijalankan.

Nama yang dipohon telah digunakan oleh peniaga lain.
Menggunakan nama diri yang bukan nama sebenar pemilik.
Menggunakan perkataan yang dikawal oleh Pendaftar.
Nama yang tertakluk di bawah Kaedah Pendaftaran Perniagaan 1957.
2.
Nama yang diluluskan tidak boleh dipinda/ditambah perkataan atau huruf.
3.
Kelulusan ini tidak boleh dipindah milik kepada orang lain.
4.
Permohonan baru perlu dibuat jika perniagaan tidak didaftarkan selepas tamat tempoh kelulusan
nama perniagaan.
5.
Permohonan yang mempunyai perniagaan lain yang telah tamat tempoh laku Sijil Perakuan
Pendaftarannya hendaklah memperbaharui Sijil Perakuan itu dahulu atau memfailkan Borang ' C .
6.
Pemilik/Pekongsi mestilah bermastautin di negeri di mana perniagaan dijalankan.
KELULUSAN INI MENJADI BATAL JIKA SATU ATAU SEMUA SYARAT DI ATAS TIDAK
DIPATUHI.
KAEDAH-KAEDAH PENDAFTARAN
PERNIAGAAN 1957
(KAEDAH 3)
PENDAFTARAN PERNIAGAAN
UNTUK KEGUNAAN PEJABAT

NO.PERAKUAN
BORANG
A
DIBIARKAN KOSONG
f>ENDAFTARAN PERNIAGAAN,
Saya/Kami yang bertanggungjawab menyerahkan butir-butir berikut mengenai perniagaan yang tersebut di bawah mi
untuk didaftarkan.
Saya/Kami menyerahkan Wang Kiriman/Wang Tunai sebanyak RM25/RM50 untuk bayaran pendaftaran dan untuk
êrakuan Pendaftaran.
A. MAKLUMAT PERNIAGAAN
1. NAMA PERNIAGAAN
2. TARIKH MULA BERNIAGA
3. PERJANJIAN PERKONGSIAN (PILIH SATU)

ADA (LAMPIRKAN SURAT PERJANJIAN)
TARIKH
TIADA
4. ALAMAT TEMPAT UTAMA/PENGKALAN PERNIAGAAN
4.1. BANDAR
4.2. POSKOD
4.3. NEGERI (KOD)
5.2. POSKOD
5.3. NEGERI (KOD)
.5. ALAMAT SURAT-MENYURAT (JIKA BERLAINAN DARI DI ATAS)
15.1. BANDAR
PERNIAGAAN 1957
(KAEDAH 3)
B. MAKLUMAT'CAWANGAN
NO PERAKUAN
BORANG
A
DIBIARKAN KOSONG
ALAMAT CAWANGAN
1. BANDAR
1.2. POSKOD
1.3. NEGERI(KOD)
1.2. POSKOD
1.3. NEGERI(KOD)
1.2. POSKOD
1.3. NEGERI(KOD)
ALAMAT CAWANGAN
.1. BANDAR
ALAMAT CAWANGAN
.1. BANDAR
PERNIAGAAN 1957
(KAEDAH 3)
C. IVIAKLUMAT PEMILIK
NO. PERAKUAN
Nota: Tiap-tiap pemilik hendaklah mengisi

butir-butir bahagian ini dalam
helaian berasingan.
BORANG
DIBIARKAN KOSONG
1. NAMA PEMILIK
2. JANTINA
LELAKI
PEREMPUAN
3. NO. PENGENALAN DIRI

KAD PENGENALAN
(BARU)
PASPORT
POLIS
TENTERA
KAD PENGENALAN (LAMA)
4. WARNA
BIRU
5. TARIKH LAHIR
MERAH
LAIN-LAIN
6. ALAMAT KEDIAMAN
6.1. BANDAR
7. BANGSA
6.2. POSKOD
6. KERAKYATAN
6.3. NEGERI (KOD)
9. PEMILIKAN
MELAYU
MALAYSIA
KETUANPUNYAAN
TUNGGAL
CINA
PENDUDUK TETAP
(NYATAKAN NEGARA ASAL)
KONGSI UTAMA
INDIA
KONGSI BIASA
BUMIPUTERA SABAH
10. TANDATANGAN PEMILIK
BUMIPUTERA SARAWAK
LAIN-LAIN
(SILA NYATAKAN)
PERNIAGAAN 1957
(KAEDAH 3)
t). MAKLUMAT JENIS PERNIAGAAN
NO. PERAKUAN

KOD JENIS PERNIAQAAN
BORANG
A
DIBIARKAN KOSONG
I. JENIS PERNIAGAAN
2. TARIKH
DIBIARKAN KOSONG
PERNIAGAAN 1957
(KAEDAH 3)
E. PENGESAHAN OLEH SEKUTU-NIAGA

NO. PERAKUAN
BORANG
A
DIBIARKAN KOSONG
Saya/Kami yang bertandatangan di bawah ini mengesahkan bahawa segala kenyataan yang dibuat dalam borang ini
adalah tepat dan mengaku bahawa saya/kami adalah sekutu dalam perniagaan bernama
NAMA PENUH
NO. KAD PENGENALAN/WARNA
TANDATANGAN/CAP IBU JARI KANAN
Saya mengaku bahawa tandatangan/cap ibu jari kanan di atas telah diturunkan pada akuan di atas ini di hadapan
saya setelah saya berpuashati bahawa orang yang menurunkan tandatangan/cap ibu jari kanan itu adalah sebenarnya
Drang yang namanya tersebut dalam akuan itu dan ia/mereka faham maksud akuan itu.
Bertarikh di.
.pada.
.haribulan
. tahun.
NAMA :
JAWATAN :
ALAMAT :
(TANOATANGAN DAN COP RASMI
PEGAWAI PENGESAH)
Catatan: Pengesahan di atas hendaklah disaksikan oleh - Ahli Parlimen atau Ahli Dewan Undangan
Negeri, Hakim, Majistret, Pegawai Kumpulan Pengurusan dan Profesional, Peguambela atau
Peguamcara, Penghulu, Penggawa, Jaksa Pendamai (J.P), atau Pesuruhjaya Sumpah.
AKTA KUMPULAN WANG SIMPANAN PEKERJA 1991

BORANG PENDAFTARAN AH LI
KWSP 3 (AHL)
KEGUNAAN KWSP
10. MAJIKAN.
NO. AHL1:
fama Ponuii I'ekcrja:
UNTUK KEGUNAAN KWSP
NO. Kad Pengehalan:
Jantina:
o. K/P Lamu/Paspot:
Tarikh Lahir: _
A'arganegara:
I KWSP 3 [
KWSP 4
I Mama Ringkas
Keiurunan
j T'/tangan Pengesah:
j Jaw at an:
I'arikh:
CAP IBU JARI AJHLI
ku d a n m o n i v s a h k a n b a h a w a bu{'::.-:\':;;ai J; aia^ -idaiah beiul d a n ')cn;:r
u! iVm..'. liul..:' boiiau d a n k c d u a C'-.i|i
i b i i .!.;! in'>; i - i i i n d i ; i i r ' i n k ; i ' ! d i h a d a p a n say
a.
Tandatangan:
.
(Majikan. Wakil Majikan atau Pegawai KWSP)
S:i\a m c n e a k u b a h a w a b u l i r - b u l i r
vanu tcrcai ! il di alas adalah bctul
dan
benai
mcngikut
KaJ
K1RI
KANAN
reii;:en<iian S
Tandatangan:
(Pekerja)
Tarikh:
Jawatan:
No. K/Pengenalan:
Tarikh:
L1HAT DI B F L A K A N G
i ' i KM <-
v'i.-v'--:
A d'P i \ K A N
i-:.AI")
i'lN(,I'.N;\LA\.
.i A NIC i A N D l i ' L K A I K A N
MA A1ILI':
LA.MAT All LI:
TUAN/PUAN
yNDAITARAN K W S P 3
lAdalah d i m a k l u m k a n pecniohonan T u a n / P u a n untuk menjadi ahli K W S P telah diterima dan kad keahlian akan dihantar
epada T u a n / P u a n sebaik sahaja urusan pendaftaran telah d i s e i n p u n i a k a n .
ckian.
f.p l'engernsi Hksekutif

Lembaga Kunipulan Wang Simpanan Pekerja.
tarikh:
ALAMAT TUAN/
PUAN
ALAMAT WARIS
TERDEKAT:
NO. TELEFON
POSKOD
POSKOD
BANDAR
BANDAR
NEGERI
NEGERI
NO. TELEFON
PERHATIAN:
SEKIRANYA TUAN/PUAN TELAH BERPINDAH ALAMAT, SILA ISIKAN BORANG KWSP 1866 DAN HANTAR
KE PEJABAT KWSP YANG BERHAMPIRAN DENGAN TEMPAT TINGGAL TUAN/PUAN.

BORANG PENAMAAN
Sava
No. K./P
KWSP4(A>!L)
dan No. Ahli
(NAMA AHLI)
menamakan mdividu seperti disebutkan
keatas diri sava.
di bawah un'uk menerima simpanan KWSP apabila berlaku kcniatian
NAM A
NO. K.P/SURAT BERANAK
PERTALIAN
SILA LIHAT DI BELAKANG

JANGAN DICERAIKAN
NAMA AHLI:
ALAVIA'I AHLI:
TUAN/PUAN
PENAMAAN KWSP 4
Adalah dimaklumkan penamaan Tuan/Puan bertarikh
l.Telah didaftarkan
2.Tidak dapat didaftarkan kerana belum mencapai 18 tahun/borang tidak lengkap.
Sekian.
b.p Pcnge.-usi Eksekutif

Lenibaga Kumpulan Wang Simpanan Pekcrja.
Tarikh:
BAHAG1AN
Penamaan ini bertarikh
Hniibulan
20
membaf.ilkan penainaan yang tcrdahulu
CAP IBU JAR! AHLI
AKUAN SAKSI
KIRI
KANAN
Saya dengan ini mengcsahkan kenyataan di alas telah dibuat

oleh ahli dan cap ibu jarinya telah diturunkan di hadapan sava.
Nama penuh saksi:
No k p saksi
Pekerjaan:
Alamat saksi:
PERHATIAN:
i) S e k i r a n y a c a p i b u j a r i k i r i / k a n a n r o s a k. si I a
tandaiangani pada scbelahan cap ibu jari lersebut
Tandatangan saksi.
Tarikh,
UNTUK
KBGUNAAN
KWSP
SAIIAJA
TARIKH TERIMA
'IARIKH DIDAFTAR
li) Jika s e o r a n g ahli K u m p u l a n Wang yang beragama

Islam mati dengan m e m b u a t p e n a m a a n mengikut
P e r a t u r a n - p e r a t u n n m i , orang atau b e b e i a p a orang yang
d i n a m a k a n itu h e n d a k l a h m e n e r i m a k i c d i t ahli \ a n g
mati itu s e b a g a i s e o r a n g wasi dan b u k a n n y a sebagai
b e n e f i s i a n dan hendaklah m e m b a h a g i - b a h a g i k a n kredit
itu mengikut U n d a n g - u n d a n g Islam.
KEGUNAAN KWSP SAHAJA
BUTIRAN AHLI
2 NOMBOR KAD PENGENALAN12 DIGIT
1. NOMBORAHU
! I I
KP
II I
I I
I
I
4 NOf/BORPOUS/TENTERA/PASPORT/DSB
3 NOMBORKADPENGENALAN7DIGIT
I I I
5. NAMA MENGIKUT KAD PENGENALAN/PASPORT
HURUFAWALAN
i II
I II
NAMAAHU
I I
1I
I I
I1
6 SEKTOR KERAJAAN
MOD PEMBAYARAN
WARAN
DRAF8ANKASING
ARAHAN1 BAYARAN
KREDITKEAKAUNBANK
BEKERJASENDIRI
SWASTA
KERAJAAN
TIDAK BEKERJA
7.JANTINA
LI
LFLAKI
PEREMPUAN
9 AMAUN YANG DIPOHON
KETURUNAN
SEN
RINGGIT MALAYSIA
1X11UJ
10 ALAMATAHLI
DISEMAKOLEH
[ TTTTTT
PEGAWAIPENYEMAK
ITn
T T l I 1 1 I 1 1 I I I I I II
r i IT
I TI I I I1
Li IT 1 LJLLXXl
TTT
rTXT"rrrT~rn~rT
POSKOD
NO K/TGN
BANDAR
NEGERI
U_L
11. NOMBOR TELEFON PEJABAT
TARIKri
DISAHKANOLEH
PEGAWAIPENGESAH
NOMBOR TELEFON RUMAH/EIMBIT
Ll I I I I FTZ
T I I I I
ADALAH SAYA DENGAN INI MENGAKU JAN Jl SEPERTIBERIKUT

1 MEMATUHI SEMUA SYARAT YANG DIKENAKAN OLEH LEMBAGA Dl BAWAH SKIM IN' DAN MEMAHAMIDENOAN PEMIUHAN INI LEMBAGA TIDAK AKAN
BERTANGGUNGJAWAB KE ATAS APA APA K
LEMBAGA Dl ATAS KERUGIAN TERSEBUT
2 APA-APA AMAUN YANG OIPINDAHKAN TIDAK TERMASUK DALAM PENAMAAN SAYA
3 SAYA JUGA FAHAM BAHAWA SAYA TIDAK BOLEH MEMBATALKAN PSRVOHONAN INI
12.
NO K/TGN
I I I I I
JENIS PENGELUARAN
NOMBOR AHLI
NOMBOR
TARIKH
KIRl
CAP IBU JARI KIRI

DILULUSKANOLEH:
PEGAWAIPEI.U1.US1
KANAN
DAN KANAN AHLI

(MESTI DITURUNKAN
DENGAN TERANG
DAN PENUH
MENGGUNAKAN
NO K/TGK
PAD CAP IBU JARI
I II
BERWARNA HITAM)
TARIKH
TARIKH
DILULUSKANOLEH
PEGAWAIPELULUS2
13. UNTUK DIISI OLEH INSTITUSI PENGURUSAN DANA (IPD)

KOD INSTITUSI PENGURUSAN DANA (RUJUK PANDUAN MENGISI BOR NG)
NOMBOR AKAUN/NO RUJUKAN PEMOHON
LHH
i i i i i i i i i
SAYA DENGAN INI MENGESAHKAN MAKLUMAT PDviOHON Dl ATAS

NO K/TGN
11
TARIKH
11
TANOATANGAN
TARIKH
NAMA PEGAWAI
COP RASMI
PANDUAN UNTUK MENGISI BORANG KWSP 9 F (AHL)

PEMBERITAHUAN PEMINDAHAN KREDIT UNTUK SKIM PELABURAN
SILA BACA PANDUAN INI DENGAN TELITI SEBELUM MENGISI BORANG BORANG PERMOHONAN MESTILAH
DIPENUHI DENGAN HURUF BESAR.
Nombor Ahll
Isikan sata digit di setiap ruang dengan didahului oleh dig.t '0' jika perlu seperti contoh di bawah
1. NOMBOR AHL!
r
Contoh
1234567
3 4 , 5 6
r
2.
Nombor Kad Pengenalan 12 Digit

Isikan nombor Kad Pengeiialan 12 digit t u a n / p u a n
digit, kosongkan rtiangan ini
Jlka t u a n / p u a n belum memiliki
Kad Pengtnalan 12
2. NOMBOR KAD PENGENALAN

Contoh
3.
610701-02-6157
1 0
1 7 , 0
1 I5

Isikan Nombor Kad Pengenalan 7 Digit termasuk huruf awalan, seperti contoh di bawah
3 . NOMBOR KAD PENGENALAN 7 DIGIT
4-
a)
1234567
3 4 , 5 6
b)
A 1234567
c)
K 1234567
d)
H 1234567
3 , 4
Nombor Polis/Tentera/Pasport/Dsb
Isikan Nombor Polis/Tentera/Pasport/Dsb termasuk huruf awalan, seperti contoh di
bawah
4. NOMBOR POLIS/TENTERA/PASPORT/DSB
5.
a'
I 1234567
* S 6 |7
b)
T 1234567
(5
Nama Mengikut Kad Pengenalan/Pasport

Tuliskan nama tuan/puan seoagaimana yang tercalat dalam kad pengenalan tuan/puan
Jlka sama menglkut kad pengenalan ialah Norman bin Abdullah sila tuliskan nama seperti di bawah
5. NAMA MENGIhUT KAD PENGENA1 AN/PASPORI
N
R' M' A I N
1_
6.
Sektor Pekeriaan
Tandakan ( V ) di dalam ruang yang disediakan.
( V ) dalam ruang berkenaan sepertl di bawah :
Jlka tuan/puan bekerja dalam sektor swasta, tandakan
? SEKTOR PEKERJAAN
BEKERJA SENDIRI
I
KERAJAAN
SWASTA
TIDAK BEKERJA
Jantina
Tandakan jantina tuan/puan dengan ( V ) dalam ruang yang disediakan. Jika lelaki, tandakan (V) di ruang
yang berkenaan seperti di bawah :
7. JANTINA
8.
LELAKI
PEREMPUAN
Keturunan
Isikan ruang dengan mengikut kod keturunan di bawah ini. Jika tuan/puan berketurunan Melayu, Isikan
seperti di bawah :
8. KETURUNAN
Melayu
Cina
India
Lain-lain
9.
1
2
3
4
5
6
7
Bidayuh
Kadazan
Iban
Amaun Dipohon
Isikan satu digit di setiap ruang dengan didahului oleh digit-digit '0' jika perlu. Jika amaun yang dikehendaki
oleh tuan/puan untuk pemindahan pelaburan (setelah berunding dengan IPD) adalah RM13,170.00, isikan
ruangan yang berkenaan seperti di bawah :
9. AMAUN DIPOHON
RINGGIT MALAYSIA
0
10.
SEN
Alamat Ahli
Tuliskan alamat surat menyurat tuan/puan dengan lengkap. Jika alamat surat menyurat tuan/puan adalah
Lot 10 Kg Parit Kadir Timur, Bukit Pasir, 84300 Muar, Johor Daru) Takzim, sila penuhl seperti berikut :
10. ALAMAT AHLI
POSKOD
8 4 3
BANDAR
M U A
NEGERI
J O H
I T
11.
Nombor Telefon
Isikan nombor telefon di ruangan yang disediakan dl bawah :
Contoh : Nombor Telefon Pejabat : 07 - 9859450
Nombor Telefon Rumah/Blmbit : 016 - 2070158
TELEFON RUMAH/BIMBIT
1
7
0
- ! 2 0
11. TELEFON PEJABAT

8
12.
_LLLLII I
Jenis Fengeluaran. Nombor Ahli. Nombor Kad Pengenalan dan Cap lbu Jar!
Isikan jenis pengeluaran, nombor ahli, nombor kad pengenalan serta turunkan cap ibu jari kiri dan kanan
tuan/puan dengan terang dan penuh menggunakan Pad Cap Ibu Jarl berwarna hltam.
13.
BUTIRAN UNTUK DIISI OLEH INSTITUSI PENGURUSAN DANA
i.
Kod Instltusi Pengurusan Dana

Isikan kod yang telah diperuntukkan oleh KWSP kepada Institusl Pengurusan Dana (IPD) :
Contoh : Kod 'AIM Unit Trust Bhd" ialah 007
Isikan seperti berikut di kotak yang berkenaan
Nombor Akaun / Nombor Rujukan Pemohon

Tullskan nombor akaun / nombor rujukan yang diperuntukkan oleh IPD kepada pemohon.
Contohnya : Jika nombor akaun pelaburan pemohon ialah 123456789100001, isikan ruangan
seperti di bawah :
LI
HI.
0 ' 0
Pengesahan Nombor Pollsl / Nombor Rujukan Pemohon

Turunkan tandatangan, tuliskan nama pegawai dan cop rasmi IPD serta tarikh pengesahan di ruangan
yang disediakan.
n
NAMA
NO. AHLI
1.0
2.0
TEL:(P)
(R),
PENTING
11
Borang permohonan yang telah lengkap diisi hendaklah diserahkan kepada Institusi Pengurusan Dana
(IPD) yang dplih
12
Salman dokumen hendaklah disahkan oleh pegawai Institusi Pengurusan Dana (IPD) yang dipilih
13
Setiap borang permohonan hendaklah ditulis dengan pena dakwat berwarna hitam Tuan/puan hendaklah
menurunkan cap ibu jan kin dan kanan dengan terang dan penuh menggunakan Pad Cap Ibu Jan
berwarna hitam
14
Tuan/puan hendaklah memastikan dokumer dokumen yang disertakan bersama-sama dengan borang
permohonan DIKLIPKAN dan tidak menggunakan dawai kokot (staples)
15
Semua sahnan fotostat dokumen hendaklah menggunakan kertas saiz A4
16
KWSP berhak menolak mana-mana permohonan yang tidak lengkap
DOKUMEN UTAMA
Tandakan ( V ) dalam kotak yang berkenaan
21
Borang permohonan KWSP 9F(AHL) - 3 Salman

(1 sahnan disimpan oleh IPD dan 2 salinan untuk kegunaan KWSP)
22
Salman Kad Pengenalan ajau

Salman Kad Pengenalan Polis/Tentera dan
Surat Pengesahan Majikan menyatakan nombor Kad Pengenalan Awam aan
nombor Polis/Tentera merujuk kepada orang yang sama
Tandatangan Ahli
Tankh
Tandatangan Penenma
Tankh
KUMPULAN WANG SIMPANAN PEKERJA

1OGOS2001
JENIS PENGELUARAN YANG DIPOHON: SILA TANDAKAN ( V ) Dl KOTAK YANG BERKENAAN

1. JENIS PENGELUARAN
KP
PENDIDIKAN
PENDIDIKAN ANAKAHU
BUTIRAN AHLI
HURUFAWALAN
NAMAAHU
2.NOMBORAHLI
3, NOMBOR KAD PENGENALAN 12 DIGIT
rrrr\
i I-I i i -i i
MODPEMBAYARAN
WARAN
DRAFBANKASING
ARAHAN8AYARAN
2
3
KREDITKE AKAUN BANK
5. NOMBOR POUS/TENTERA/PASPORT/DSB
4. NOMBORKADPENGENALAN7DIGIT
niTTTT I I I ! I I
6. KETURUNAN
7.JANTINA
LELAKI
PEREMPUAN
JENIS AKAUN
1
2
KONVENSIONAL
AL-WADIAH
8. NAMA MENGIKUT KAD PENGENAUN PASPORT
II
PENERiMABAYARAN
AHLI
INSTlTUSIPENGAJIAN
TiNGG!
INSTITUSIPEMBERI
PINJAMAN
I I I I I II I I
9.ALAMATAHU
i n i i n
POSKOD
BANDAR
TTTTl r r r r
NEGERI
i i i i i i i i i TTITTTT
NOMBOR TELEFON RUMAH/BIMBIT
I I I I I
M I N I
I I I
I I
DISEMAKOLEH:
PEGAWAIPENYEMAK
12. AMAUN DIPOHON UNTUK AHLI/ANAK AHLI

RINGGIT MALAYSIA
SEN
11. YURAN PENGAJIAN AHLI/ANAK AHLI

RINGGIT MALAYSIA
I
CAW
SEN
I I I I I
I I I I
UNIT
14. JENIS PEMBAYARAN
13. BAKIFINJAMAN PENDIDIKAN AHLI/ANAK AHLI

RINGGIT MALAYSIA
I I I I I
SEN
WARAN
ARAHANBAYARAN
DRAFBANKASING
KREDITKE AKAUN BANK
NO. K/TGN
TTTI
BUTIRAN AKAUN BANK (SEKIRANYA PEMBAYARAN DIBUAT KEPADA AHLI)
TARIKH.
16. KOD BANK
16. NOMBOR AKAUN BANK AHLI
' i i i i i i i i i i i i i i i i i i i
17. JENIS AKAUN
KONVENSIONAL
AL-WADIAH
BUTIRAM PELAJAR (ANAK AHLI) (SEKIRANYA MEI1OHON UNTUK PENDIDIKAN ANAK)

PEMBERITAHUAN
DISAHKANOLEH
PEGAWAIPENGESAH
18 NAMA PELAJAh Mf-Nbirs(JT KAD PENGENALAN
niErn
TTTTTTT
NO K/TGN
19 NOMBOR KAD PENGENAIAN 12 DIGIT
TARIKH
20 HUBUNGAN AH J DENGAN PELAJAR
AMAKTIRI
ANAK
ANAK ANGKAT
BUTIRAN LAIN
DILULUSKANOLEH
PEGAWAI PELULUS1
21 JAMA DAN CAWANGAN INSTITUSI PCNGAJIAN TINGGI
i
i
22 PERINGKATPENGAJIAN
P I
I I
23 TAHUN PENGAJIAN
H I
I I
I
I
24 LOKASI PENGAJIAN
NO K/TGN
25 NAMA PAN CAWANGAN INSTITUSI DFMBERI PINJAMAN
TARIKH
1X1 II
1
2
SAYA DENGAN INI MEMOhON UNTUKMENGELUA^KAN KREDITSAYADI KWSPtv'ENURUTPERUNTUKANAKTAKWSP 1991 SAYA JUGAAKAN
PATUHKEHLNDAK SEKCYCN 54(6)(G) PERUNTUKAN AKTAKWSP 1991
SAYA MEMBFt ARK AN KWSP MEMBUAT BAYARAN TER JS KEPADA INSTITUSI PFNGAJIAN TINGGI ATAU PEMBERI PIN JAMAN Dl MANA YANG
BERKtNAAN
PEGAWAI PELULUS 2
26
JENIS PENGi-LUARAN
NOMBOR AHII
NOMBOR
NO K/TGN
CAP IBU JARI KIRI
DAN KANAN AHLI
TARIKH
(MESTI DITURUNKAN
DENGAN TERANG
DAN PENUH
MENGGUNAKAN
PAD CAP IBU JARI
BERWARNA HITAM)
TARIKH
KIRI
KANAN
PANDUAN UNTUK MENGISI BORANG KWSP 9 H fAHLl

PENGELUARAN PENDIPIKAN ANAK
SILA BACA PANDUAN INI DENGAN TELITI SEBELUM MENGISI BORANG. BORANG PERMOHONAN MESTILAH
DIPENUHI DENGAN HURUF BESAR.
1.
Jenis Pengeluaran Yang Dipohon

Tandakan ( V ) dlmana berkenaan
2.
1.
JENIS PENGELUARAN
1.
PENDIDIKAN AHLI
2.
PENDIDIKAN ANAK AHLI
Nombor Ahli
Isikan satu digit di setiap ruang dengan didahului oleh digit '0' jika perlu, seperti contoh
Con ton
di bawah
: 01234567
2. NOMBOR AHLI
1 [_2
3.

Isikan nombor Kad Pengenalan 12 digit tuan/puan.
digit, kosongkan ruangan ini :
Jika tuan/puan belum memiliki Kad Pengenalan 12
Contoh : 610701 - 02 - 6157

3. NOMBOR KAD PENGENALAN 12 DIGIT
o| 7|o
o
4.

4.1
Isikan Nombor Kad Pengenalan 7 Digit termasuk huruf avvalan, seperti contoh di bawah:
a)
5.
1 i 2 [ 3 ' 4 fs \ 6~J~7
1234567
b)
A 1234567
c)
K 1234567
d)
H 1234567
3 4 1~5 ] 6 F 7
[K
T]2
1 I2!3
4| 5
6[ 7
Isikan Nombor Kad Pengenalan Polis/Tentera/Pasport/Dsb tennasuk huruf awalan, seperti contoh di bawah:
5. NOMBOR/POLIS/TENTERA/PASPORT/DSB
6.
a)
I 1234567
b)
T 1234567
HID
Keturunan
Isikan ruang dengan menglkut kod keturunan di bawah lnl. Jika tuan/puan berketurunan Melayu, isikan
seperti di bawah :
6. KETURUNAN| 1
Melayu
Cina
India
Latn-lain
1
2
3
4
Bidayuh
Kadazan
lban
5
6
7
7.
Tandakan jantina tuan/puan cU ngan ( \ ) dalain ruang yang disediakan

yang berkenaan seperti di bawah
7 JANTINA
Jika lelaki tandakan ( V ) di ruang
IELAKI
I'F REMPUAW

Tuhskan nama tuan/puan sebagaimana yang tercatat dalam kad pengenalin t u a n / p u a n
Jika sama mengikut kad pengf nalan ulah Norman bin Abdullah sila tuhskan nania seperti di bawah
8. NAMA MENGIKUT KAO I 1 NGENAI AN/P<\SPORT
'] O | R T M7~A^~N I
9.
] B
B | D
L ] L |~A ' H '
Alamat Ahli
Tuliskan alamat surat menyural tuan/puan dcngan lengkap Jika ilamat surat menyurat tuan/puan adalah
Lot 10 Kg Parit Kadir Timur Bukit Pasir 84300 Muai Johor Darul Tak/im Sila penuhi seperti berikut
LiO
1 0
1 I I M |U IRI
POSKOD
9 ALAMAT AHLI
P A R
I Tr
K[ G
_B J U K I
P A S
K A
1 R
1
1
BANDAR
j Q _J.T D
M1 U [ A I R
~8 4 ' 3}
NEGERI
^ , HTOI R!
10.
Nombor Telefon Pejabat & Nombor Telefon Rumah

Isikan nombor telefon pejabat dan uimah di ruangan yang disediakan di bawah
Contoh
Nombor Telefon Pejabat 07 9859450
Nombor Telefon Rumah/ Bimbit
10.
0 ' 7
11
TELEFON PEJABA1
r qT 8T" 9^4
016-2070158
TELEFON RUMAH 'BIMB1T

2 , 0 7 0 1 5
0 i 1 ' 6
Yuran Pengajian Ahli/Anak

Isikan satu nombor untuk Uap tiap satu ruangan Nombor kosong (0) di hadapan perlu dituhskan dalam
semua ruangan yang tidak dipenulu Jika yuian pengajian t u a n / p u a n atau anak t u a n / p u a n adalah
RM12 000 00, isikan ruangan \ang bei kenaan sepeiti di bawah
11 MIRAN I'ENGA.JIAN AHLI/ANAK
RINGGIT MALAYSIA T SEN
0 0 1J 2 l 0 0 I 0 Jo_O I
12.
Amaun Dipohon
Isikan satu nombor untuk tiap-tlap satu ruangan. Nombor 'kosong' (0) di hadapan perlu dituliskan dalam
semua ruangan yang tidak dipenuht. Jika tuan/puan memohon RM 10,000.00, isikan ruangan yang berkenaan
seperti di bawah :
12. AMAUN DIPOHON
RINGGIT MALAYSIA
SEN
_OJ 0 | 1 | 2 j 0 | 0 J 0 | 0
0
13.
Baki Piniaman Pendidikan Ahli/Anak Ahli

Isikan satu nombor untuk tiap-tiap satu ruangan. Nombor 'kosong' (0) di hadapan perlu dituliskan dalam
semua ruangan yang tidak dipenuhi. Jika tuan/puan memohon RM10.000.00, isikan ruangan yang berkenaan
seperti di bawah :
13. BAKI PINJAMAN PENDIDIKAN AHLI/ANAK AHLI
RINGGIT MALAYSIA I SEN
[ Oj_ 0J_1 | 0 0 0 j 0 ' 0 I 0
14.
Jenis Pembayaran
Tuan/puan boleh memilih salah satu cara pembayaran sepcrti berikut . Jika tuan/puan memllih Kredit Ke
Akaun Bank, sila tandakan ( V ) di ruangan yang berkenaan :
IS.
WARAN
ARAHAN BAYARAN
DRAF BANK ASING
KREDIT KE AKAUN BANK
Kod Bank
Isikan kod bank tuan/puan seperti contoh di bawah
Jika kod bank tuan/puan adalah Maybank
15. KOD BANK
RHB Bank
Maybank
Bumiputra Commerce
Public Bank
Hong Leong Bank
Hong Leong Finance
Affin Bank
EON Bank
16.
01
02
03
04
05
06
07
08
Arab Malaysian Bank

Alliance Bank
Southern Bank
Utama Bank
Bank Muamalat
Arab Malaysian Finance
BanL Islam
09
10
11
12
13
14
15
Nombor Akaun Bank

Jika nombor akaun bank adalah 1-23456 -789012-3, isikan ruangan berkenaan seperti di bawah
16. NOMBOR AKAUN BANK
1
6 .
17.
Jejiis Akaun
I s i k a n )( m-- a k a u n vans. 1 lipihl n h 1
( ) r|i m m s j a n \ a n e be i K> i> i n
17,
18,
i k i m a n p u tu infinilili Ak u r n Al W a d i a h
Mia l u u d a k i 1
) E \ ' I S AKAUN
KONVFNSIONAL
AI
in p u i'i
WADIAH
Nama Pelaiar (Anak Ahlii

T u h s k a n n a m a anak t u a n / p u a n
n a m a mengikut kad p e n g t n a l m
M b a ^ a n n a n a >ang u n a t a t dalam kail p< ngenalan anak t u a n / p u a n

lalah Muliamad bin Nounan, sila tuliskan aarna sepeiti di bawah
Jika
1 8 . KAMA I I I AJAK (ANAK AUI I)

M U H A M M A D
19
O K
M A N
Nombor Kad Pengenalan Pelajar

Isikan nombor Kad Pmfttiiilai
Contoh
7 8 1 1 0 5 0 " ! <>li>f->
i ' d ^ n i n iK t u i n | i\d{]
19. N O M B O R KAD PEN(,I \/\) ^

7
20.
OS
I'l I V J A R
i)
1 b
()
Hubungan Ahli Dengan Pelaiar

l a n d a k a n h u b u n g a n ahli d i n t i n pi i|ai ( a i n k t m m p u a n di n i a n g a n \ a n g d i s c d i a k a n
C o n t o h s e k i r a n v a h u b u n n a n i h l i d< i i " i n p c l a i a i i d i l a h i n a k k a n d u n g
20. HUBUNGA\
\N \K
21.
M i l 1 1)1 \ ( , A N I I I A I \ R
\ \ \ K ! <K\
W \K \ \ ( . k \l
Naima Dan Cawangan Institusi Pengajian Tinggi

T u l i s k a n n a m a d a n c a w a n g a n intiiuM pcnj,a]ian tmggi
C o n t o h iika n a m a m s t i t u s i pi nan<ui t m g ^ i t u a n / p u a n a t a u a n a k t u a n / p u a n m l a h
isikan scperti di b a w a h
22.
U i l M S h a h Alam
2 1 . NAMA DAN CAWANGAN IKSriTUSI PLNGAJIAN TINGGI

l 1 Ml
T s H A II
A I
A M
Peringkat Pengajian
I n l i s k i n p e n n g k a t p t n g a i n n l u u i pu \n u a u a n a k m a n p u a n nioiigikul kod sepeiti di b a w a h
22.
I]a/ah
Ija/ah I anpii in
I F RINGKAI PI NGA.JIAN
;
l a m I n n ^ a I t c. S e t i n f
Diploma
i 4
23.
Lokasi Pengaiian
Tuliskan lokasi pengajian tuan/puan atau anak tuan/puan mengikut kod seperti di bawah
Dalam Negara
24.
Lur Negara
Nama Dan Cawangan Institusi Pemberi Piniaman (Jlka Ada)

Tuliskan nama dan cawangan institusi pemberi pinjaman dengan lengkap
24. NAMA DAN CAWANGAN INSTITUSI PEMBERI PINJAMAN
M B| F
P
25.
E[T A L I
G|
|J
A Y
Jenis Pengeluaran. Nombor Ahll. Nombor Kad Pengenalan Dan Cap Ibu Jari
Isikan jenis pengeluaran, nombor ahli, nombor kad pengenalan serta turunkan cap ibu jari klri dan kanan
tuan/puan dengan terang dan penuh menggunakan Pad Cap Ibu Jari berwarna hitam.
NAMA
NO. AHLI
10.
TEL:(P)
PERHATIAN
1 1
Sekiranya permohonan diserahkan di kaunter, sila kemukakan dokumen asal beserta salinannya bagi
tujuan pengesahan oleh Pegawai KWSP
12
Sekiranya tuan/puan mengemukakan salinan dokumen sahaja, sila pastikan semua sahnan dokumen telah
disahkan oleh pegawai yang dibenarkan oleh KWSP seperti berikut lengkap dengan nama dan cop rasmi
pengesah (kecuali salinan dokumen-dokumen tertentu yang telah ditetapkan Pegawai
Pengesahnya oleh KWSP):1 21
Pegawai KWSP yang terdiri danpada

- Pegawai KWSP Gred 18 ke atas
- Pegawai Kaunter KWSP
1 2 2 Majikan Pemohon
1 2 3 Penghulu atau Penggawa
124 Jaksa Pendamai
2.0.
(R).
125
126
127
1 28
1 29
1210
Pengamal Perubatan yang berdaftar

Penguambeladan Penguamcara
Kumpulan Pengurusan/Profesional Kerajaan
Ahli Dewan Undangan Negen
Ahli Parlimen
Pesuruhjaya Sumpah
13
Sekiranya permohonan bersama, sila sediakan 1 set dokumen bagi setiap permohonan
14
Setiap borang permohonan hendaklah ditulis dengan pena dakwat berwarna hitam Tuan/puan hendaklah
menurunkan cap ibu jan kin dan kanan dengan terang dan penuh menggunakan Pad Cap Ibu Jan
berwarna hitam
15
Tuan/puan hendaklah memastikan dokumen-dokumen yang disertakan bersama-bersama dengan

permohonan DIKLIPKAN dan tidak menggunakan dawai kokot (staples)
16
Semua salinan fotostat dokumen hendaklah menggunakan kertas saiz A4
17
KWSP berhak menolak mana-mana permohonan yang tidak lengkap
DOKUMEN UTAMA
Tandakan (V) dalam kotak yang berkenaan
21
PENGELUARAN PENDIDIKAN AHLI

211
Borang permohonan KWSP 9H (AHL) - 2 salinan
2 12
Borang KWSP 3A (AHL) -1 salinan
213
Salman Kad Pengenalan ahli atau.

Salman Kad Pohs/Tentera dan Surat Pengesahan Majikan menyatakan
nombor Kad Pengenalan Awam dan Nombor Pohs/Tentera merujuk kepada
orang yang sama,
21 4
Sekiranya pembayaran dibuat kepada ahli, sila kemukakan salinan muka

hadapan Buku Akaun Bank yang mempunyai butir-butir akaun tuan/puan
atau Penyata Akaun Semasa yang asal Pemohon hendaklah menurunkan
cap ibu jan km dan kanan di atas salinan tersebut Sekiranya tuan/puan
menghantar melalui pos, salinan dokumen hendaklah disahkan oleh
Pegawai Bank berkenaan dan sek>fanya diserahkan di kaunter sila
kemukakan dokumen asal beserta salinannya bagi tujuan pengesahan
oleh Pegawai Kaunter KWSP
2.1.5. Surat tawaran kemasukan ke Institusi Pengajian Tmggi (merujuk Tahun 1,2,3
dan seterusnya)
(Sekiranya salman surat tawaran dikemukakan, hendaklah disahkan oleh Pegawai
IPTyang diben kuasa atau Pegawai KWSP seperti di para 1.2.1)
2 1 6. Surat pengesahan yang mengesahkan jumlah yuran pengajian yang dikeluarkan
oleh Institusi Pengajian Tmggi yang mengandungi butiran:
(a)
(b)
(c)
2.2
Nama dan nombor kad pengenalan ahli

Jems kursus di penngkat Diploma ke atas
Tahun pengajian
PENGELUARAN PENDIDIKAN ANAK AHLI

2 2 1 . Borang dan dokumen seperti para 2 1 . 1 - 2 1 4
2.2 2. Salinan Kad Pengenalan Anak Ahli
2.2 3. Salman SIJII Kelahiran AnaK/Sijil Pengesahan Anak Angkat /
(bukti pertahan bagi anak tin)
SIJII
Perkahwinan
2 2 4. Surat tawaran kemasukan ke Institusi Pengajian Tmggi (merujuk Tahun 1, 2,3

dan seterusnya)
(Sekiranya salinan surat tawaran dikemukakan, hendaklah disahkan oleh Pegawai
IPTyang diben kuasa atau Pegawai KWSP seperti di para 121)
2.2.5. Surat pengesahan yang mengesahkan yuran pengajian yang dikeluarkan oleh
Institusi Pengajian Tmggi mengandungi butiran (a) Nama dan nombor kad pengenalan anak ahli
(b) Jems kursus di penngkat yazah, yazah lanjutan atau yang setaraf dengannya
untuk ahli di Institut Pengajian Tmggi yang berkenaan
(c) Tahun pengajian
3.0.
DOKUMEN TAMBAH AN
3.1
Pembayaran Kepada Institusi Pengajian Tmggi Dalam Negara

Bagi Permohonan Ahli/Anak Dalam Tahun Pertama
(i)
Surat pengesahan pendaftaran danpada Institusi Pengajian Tmggi

a) Nama dan nombor kad pengenalan ahli/anak ahli
b) Jems kursus di penngkat Diploma ke atas untuk ahli dan di peringkat ijazah,
ijazah lanjutan atau yang setaraf dengannya untuk anak ahli di Institusi
Pengajian Tmggi yang berkenaan
c) Tahun pengajian
3.2
3.3.
Pembayaran Kepada Ahli Di Mana Ahli/Anak Ahli Mengikuti Pengajian Di Institusi Pengajian
Tmggi Luar Negara
(i)
Pasport
(n)
Visa pelajar (jika berkenaan)
Pembavaran Balik Kepada Ahli

(i)
Resit pembayaran yuran pengajian yang tidak melebihi 1 tahun dan tankh
permohonan.
(Sekiranya salinan resit pembayaran dikemukakan, hendaklah disahkan oleh
Pegawai IPTyang diben kuasa atau Pegawai KWSP seperti di para 1 2.1)
23.
Lokasi Pengalian
Tullskan lokasi pengajiP.n tuan/puan atau anak tuan/puan mengikut kod seperti dl bawah
Dalam Negara
24.
Lur Negara
Nama Dan Cawangan Institusi Pemberi Pinjaman (Jika Ada)

Tuliskan nama dan cawangan tnstltusi pemberi ptnjaman dengan lengkap :
24. NAMA DAN CAWANGAN INSTITUSI PEMBERI PINJAMAN
M B F
F I N A NI C[E
B H D
P E T A L
25.
I N
A Y
ZULU I
Jcnis Pengeluaran. Nombor Alili. Norabor Kad Pentfcnalan Pan Cap lbu Jari
Isikan jenis pengeluaran, nombor anil, nombor kad pengenalan serta turunkan cap ibu jari kiri dan kanan
tuan/puan dengan terang dan penuh menggunakan Pad Cap Ibu Jari berwarna hitam.
BUTIRAN A H L I
1 NOMBORAHLI
I I II
3
2 NOMBOR KADPENGENALAN12 DIGIT
IT
I1
I I I I
NOMBORKADPENGENALAN7DIGIT
4 NOMBOR POLIS/TENTERA/PASPORT/DSB
I I
HURUFAWALAN
NAMAAHLI
II
5 KETURUNAN
ITI
6 NAMAMENGIKUTKAD PENGENALAN/PASPORT
r i i i
1 I TTI
I M T\
FTTI
MOD PEMBAYARAN
WARAN
DRAFBANKASING
ARAHANBAYARAN
KREDITKE AKAUN BANK
I I I I
I I 1I
I I I I
7 JANTINA
LELAKI
PEREMPUAN
PERBELANJAAN SEBENAR / ANGGARAN

9 KOS DIBIAYAIOLEH MAJIKAN
I PERBELANJAANPERUBATAN
JENIS AKAUN
KONVENSIONAl
AL WADIAH
SEN
RINGGIT MALAYSIA
I I I
RINGGIT MALAYSIA
II
I I
SEN
10 ORANG MENERIMA RAWATAN
AMAUN OIBAYAR
SEN
RINGGIT MALAYSIA
II
1 AHLI 3ENDIRI
4 IBU
7 ADIK BERADIK
2 SUAMI
5 BAPA
8 ORANG YANG DILULUSKAN
3 ISTERI
6 ANAK
I I I
OLEH LEMBAGA
11 NAM^ ORANG YANG MENERIMA RAWATAN (JIKA BUKAM AHLI SE NDIRI)
I I
T
I I
KODPENERIMABAYARAN
AHLI
PUSATPERUBATAN
T T
I I I
I I
I I
12 NO KADPENGENALAN/SIJILKELAHIRANORANC YANG MENERIMA RAWATAN
I I I
\
I I I I I I I I I
I I
M
13 ALAMATAHLI
I I
I I
DISEMAKOLEH
PEGAWAIPENYEMAK
I I
I I
POSKOD
I I
BANDAR
IT IN
I I I I I I I I I I I
NEGFRI
CAW
UNIT
i n
I
I
T I
I I
TARIKH
i i i i
15 JENIS PEMBAYARAN
14. NOMBOR TELEFONPEJABAT
NO K/TGN
I I I
I I I I I I
LL
WARAN
ARAHANBAYARAN
DRAFBANKASING
KREDITKE AKAUN BANK
BUTIRAN AKAUN BANK (SEKIRANYA PEMBAYARAN DIBUAT KEPADA AHLI)

16 KODBANK
JLU
18 JENIS AKAUN
KONVENSIONAL
AL WADIAH
17 NOMBOR AKAUN BANK
I I I I I ITTT l i n
I TTI
I I
NOMBORAHU
EF T
NOKAOPENGENALAN
I I I I J U T I I J.
JEMSPENCELUARAN
BUTIR-BUTIR PESAKIT
NAMA SUAMI / ISTERI YANG SAH DARI SEGI UNDANG-UNDANG JIKA ADA
SILA NYATAKAN NAMA PENUH, NO KAD PENGENALAN DAN UMUR
(POTONG Dl MANA TIDAK BERKENAAN)
NAMA MENGIKUT KAD PENGENALAN
NO KAD PENGENALAN
UMUR
in)
IV)
NAMA ANAK-ANAK YANG SAH DARI SEGI UNDANG-UNDANG JIKA ADA, SILA NYATAKAN NAMA PENUH, JANTINA, NO KAD PENGENALAN DAN
UMUR
JANTINA
NO KAD PENGENALAN
UMUR
in)
NAMA IBU / BAPA YANG SAH DARI SEGI UNDANG-UNDANG JIKA ADA, SILA NYATAKAN NAMA PENUH, JANTINA, NO KAD PENGENALAN DAN
UMUR
JANTINA
NO KAD PENGENALAN
NAMA ADIK-BERADIK YANG BERUMUR 16 TAHUN KEATAS YANG SAH DARI SEGI UNDANG-UNDANG JIKA ADA
UMUR
SILA NYATAKAN NAMA PENUH,
JANTINA, NO KAD PENGENALAN DAN UMUR

i)
II)
IV)
JANTINA
NO KAD PENGENALAN
UMUR
BUTIRAN HOSPITAL / INSTITUSI PERUBATAN / KESIHATAN

PEMBERITAHUAN
DISAHKANOLEH:
PEGAWAIPENGESAH
19. NAMA HOSPITAL / INSTITUSI PERUBATAN / KESIHATAN
i I II I I I
Mill
II
I I I I I
I I I I I
I I I
I I I
NO K/TGN
20. ALAMAT HOSPITAL /INSTITUSI PEflUBATAN / KESIHATAN
Mill
I
I
TARIKH
I IIIII I I
I I II I I I I I I
I I I I I I I M M
I II I I I II
POSKOD
BANDAR
i i ii
i i
NEGERI
LL
1.
DILULUSKANOLEH:
PEGAWAIPELULUS1
111
I I I I II T
I I T IT I I I
SAYA DENGAN INI MEMOHON UNTUK MENGELUARKAN KREDIT SAYA Dl KWSP MENURUT PERUNTUKAN AKTA
KWSP 1991.
SAYA BERSETUJU SUPAYA JUMLAH KREDIT YANG DIKELUARKAN DARI AKAUN SAYA DIBAYAR TERUS KEPADA
HOSPITAL/INSTITUSI PERUBATAN/KESIHATAN MENGIKUT JUMLAH DALAM BIL YANG OIPERSETUJUI OLEH SAYA
(JIKA AHLI MENGGUNAKAN SURAT JAMINAN KWSP UNTUK MENERIMA RAWATAN)
21.
JENIS PENGELUARAN
NO K/TGN
NOMBOR AHLI
CAP IBU JARI KIRI
1ARIKH
DAN KANAN AHLI

(MESTI DITURUNKAN
DENGAN TERANG
DAN PENUH
MENGGUNAKAN
PAD CAP IBU JARI
BERWARNA HITAM)
TARIKHPEGAWAIPELULUS2
NO K/TGN
I I I I I
TARIKH
KIRI
NOMBOR
KANAN
PANDUAN UNTUK MENGISI BORANG KWSP 9D (AHL)

PEMBERITAHUAN PENGELUARAN KESIHATAN
SILA BACA PANDUAN INI DENGAN TELITI SEBELUM MENGISI BORANG. BORANG PERMOHONAN MESTILAH
DIPENUHIDENGAN HURUF BESAR.
1.
Nombor Ahll
Isikan satu digit di setiap ruang dengan didahului oleh digit '0' jiKa perlu, seperti contoh di bawah
Contoh : 1234567
1. NOMBOR AHLI
0
Nombot Kad Pengenalan 12 Digit

Isikan nombor Kad Pengenalan 12 digit tuan/puan.
12 digit, kosongkan ruangan ini :
Jika tuan/puan belum memilikl Kad Pengenalan
Contoh : 610701-02-6157
0

Isikan Nombor Kad Pengenalan 7 Digit termasuk huruf awalan, seperti contoh di bawah :
4.
a)
1234567
b)
A 1234567
c)
K 1234567
d)
H 1234567
Nombor Polls/Tentera/Pasport/Dsb
Isikan Nombor Kad Pengenalan Polls/Tentera/Pasport/Dsb termasuk huruf awalan, seperti contoh di bawah
5.
a)
b)
T 1234567
4. NOMBOR POLIS/TENTERA/PASPORT/DSB
4 5 6 7
2
3
1234567
" 4~1 5 "
Ketnrunan
Isikan ruang dengan mengikut kod keturunan di bawah ini. Jika tuan/puan berketurunan Melayu, isikan
seperti di bawah :
5. KETURUNAN [ 1
Melayu
Cina
India
Lain-lain
1
2
3
4
Bidayuh
Kadazan
Iban
5
6
7
6.

Tuliskan nama tuan/puan sebagaimana yang tercatat delam kad pengenalan tuan/puan. Jlka nama mengikut
kad pengenalan ialah Norman bin Abdullah, sila tuliskan nama seperti di bawah :
N O R
6. _NAMA MENGIKUT KAD PENGENALAN/PASPORT

r
N
B I I N
A B D U ! L
1JL
7.
Jantina
Tandakan jantina tuan/puan dengan K) dalam ruang yang disediakan
yang berkenaan seperti di bawah
Jika lelaki, tandakan K ) di ruang
7. JANTINA
LELAKI
PEREMPUAN
Perbelanjaan Perubatan
Sebenar/anggaran ialah bil perubatan yang telah atau akan dikenakan oleh pusat rawatan yang diktiraf.
Kos rawatan akan dikenakan oleh pusat rawatan yang diiktiraf. Jika kos rawatan yang dikenakan untuk
penyakit kanser ialah RM 10.000 00, isikan seperti di bawah
8. PERBELANJAAN PERUBATAN
SEN
RINGGIT MALAYSIA
0
9.
Kos Yang Dibiavai Oleh Maiikan

9. KOS YANG DIBIAYAI OLEH MAJIKAN
SEN
RINGGIT MALAYSIA
Kos rawatan yang dibiayai oleh majikan. Contohnya

Kos rawatan pesakit (isteri) RM 10,000.00
Biayai majikan: RM 4,000.00
Isikan seperti berikut .
10.
Orang Yang Menerima Rawatan

Tandakan hubungan pesakit dengan pemohon di ruangan berkenaan
Contoh: Pesakit ibu, tandakan ( ^ )
10. ORANG YANG MENERIMA RAWATAN
1. AHLI SENDIRI
4 IBU
7. ADIK-BERADIK
2. SUAMI
5 BAPA
8. ORANG YANG DILULUSKAN
3. ISTERI
6. ANAK
OLEH LEMBAGA
Nama Orang Menerima Rawatan (Jika bukaa ahli sendiri)

Jika orang yang menerima rawatan adalah ibu tuan/puan, isikan nama ibu tuan/puan di dalam petak-petak
yang berkenaan. Jika nama ibu t u a n / p u a n adalah Julia bte Ahmad, tuliskan seperti di bawah :
1 1 . NAMA ORANG MENERIMA RAWATAN (JIKA BUKAN \HL1 SENDIRI)
J
12.
No. Kad Pengenalan/ Sijlll Kelahiran Orang vang Menerima Rawatan

Islkan No. Kad Pengenalan orang yang menerlma rawatan. Contohnya, jlka No. Kad Pengenalan ibu tuan/
puan ialah 450903 - 01 - 2346, tullskan sepertl dl bawah :
12. NO. KAD PENGENALAN/ SIJIL KELAHIRAN ORANG YANG MENERIMA RAWATAN
0
13.
Alamat Ahli
Tullskan alamat surat menyurat tuan/puan dengan lengkap. Jlka alamat surat menyurat tuan/puan adalah
Lot 10, Kg Pant Kadlr Tlmur, Buklt Paslr, 84300 Muar, Johor Darul Takzlm, slla penuhl sepertl berlkut
1
U
POSKOD
8
13. ALAMAT AHLI

I
T
P A R
I
BANDAR
0
A. 1 R
NEGER1
J
14.
Nombor Telefon
Islkan nombor telefon dl ruangan yang dlsedlakan dl bawah :
Contoh : Nombor Telefon Pejabat : 07 - 9859450
dan
Nombor Telefon Rumah/Blmbit : 016 - 2070158

8

2 0
7 10 1 5 8
IS.
Jenis Pembavaran
Jika t u a n / p u a n memilih kaedah pembayaran kredit ke akaun bank, tanda K ) dl ruang yang berkenaan
sepertl dl bawah ;
I S . JENIS PEMBAYARAN
16.
WARAN
ARAHAN BAYARAN
DRAF BANK ASING
1'
Kod Bank
Isikan nombor kod bank dl ruangan yang disediakan seperti di bawah
Jlka kod bank tuan/puan adalah Maybank
16. KOD BANK
RHB Bank
Maybank
Bumiputra Commerce
Public Bank
Hong Leong Bank
Hong Leong Finance
Affin Bank
EON Bank
01
02
03
04
05
06
07
08
Arab Malaysian Bank

Alliance Bank
Southern Bank
Utama Bank
Bank Muamalat
Bank Islam
09
10
11
12
03
13
14
17,
Nombor Akaun Bank

Jika nombor akaun bank adalah 1-23456 -789012-3, islkan ruangan berkenaan sepertt di bawah :
3 I9 | 0
18.
Jenip Akaun
Jika akaun tuan/puan adalali jenis konvensional, tanda ( / ) di ruang yang berkenaan sepcrti di bawah
18. JENIS AKAUN
KONVENSIONAL
AL-WADIAH
19.
Nama Hospital/Institusi Perubatan/Kesihatan
Jika tuan/puan/pesakit mendapat rawatan daripada Pusat Pakar Utara Sdn. Bhd., sila tuliskan seperti di
bawah :
20.
19. NAMA HOSPITAL INSTITUSI PERUBATAN/KESIHATAN

P A K
A R A
A T
A1 R
U T
B
Alamat Hospital/Institusi Perubatan/Kesihatan

Jika alamat hospital berkenaan adalah No. 21, Jalan 11/2, 40000 Shah Alam, Selangor Darul Ehsan,
Tuliskan seperti di bawah :
20. ALAMAT HOSPITAL/INSTITUSI PERUBATAN/KESIHATAN
N
POSKOD
4
BANDAR
NEGERI
S
21.
Jenis Pengeluaran. Nombor Ahli. Npmbor Kad Pengenalan Dan Cap Ibu Jar!
Isikan jenis pengeluaran, nombor ahli, nombor kad pengenalan serta turunkan cap ibu jari kiri dan kanan
tuan/puan dengan terang dan penuh menggunakan Pad Cap Ibu Jari berwarna hltam.
NAMA
NO. AHLI :
1.0
TEL:(P)
PERHATIAN
1.1
Sekiranya permohonan diserahkan di kaunter KWSP, sila kemukakan dokumen asal beserta salinannya
untuktujuan pengesahan oleh Pegawai KWSP.
1.2
Sekiranya tuan/puan mengemukakan salinan dokumen sahaja, sila pastikan semua salinan dokumen telah
disahkan oleh pegawai yang dibenarkan oleh KWSP seperti berikut lengkap dengan nama dan cop rasmi
pengesah (kecuali salinan dokumen-dokumen tertentu yang telah ditetapkan Pegawai
Pengesahnya oleh KWSP):
1.2.1. Pegawai KWSP yang terdiri daripada
- Pegawai KWSP Gred 18 keatas
- Pegawai Kaunter KWSP
1.2.2. Majikan Pemohon
1.2.3. Penghulu atau Penggawa
1.2.4. JaksaPendamai
2.0
(R).
1.2.5.
1.2.6.
1.2.7.
1.2.8.
1.2.9.
1.2.10.

Peguambela dan Peguamcara
Kumpulan Pengurusan/Profesional Kerajaan
Ahh Dewan Undangan Negeri
Ahli Parlimen
Pesuruhjaya Sumpah
1.3
Sekiranya permohonan bersama, sila sediakan I set dokumen bagi setiap permohonan.
1.4
Setiap borang permohonan hendaKlah ditulis dengan pena dakwat berwarna hitam. Tuan/puan hendaklah
menurunkan cap ibu jari kiri dan kanan dengan terang dan penuh menggunakan Pad Cap Ibu Jari
berwama hitam.
1.5
Tuan/puan hendaklah memastikan dokumen-dokumen yang disertakan bersama-sama dengan borang

permohanan DIKLIPKAN dan tidak menggunakan dawai kokot (staples).
1.6
Semua salinan fotostat dokumen hendaklah menggunakan kertas saiz A4.
1.7
KWSP berhak menolak mana-mana permohonan yang tidak lengkap.
DOKUMEN UTAMA
Tandakan ( V ) dalam kotak yang berkenaan
2.1
Borang Permohonan KWSP 9D (AHL) - 2 salinan
2.2
Borang KWSP 3A (AHL) -1 salinan
2.3
Salinan Kad Pengenalan ahli, ateu
Salinan Kad Pengenalan Poiis/Tentera dan Surat Pengesahan Majikan menyatakan

Nombor Kad Pengenalan Awam dan nombor Polis/Tentera merujuk kepada orang
yang sama.
I
|
2.4
Salinan muka hadapan Buku Akaun Bank yang mengandungi butir-butir akaun tuan/puan slau
Penyata Akaun Bank Semasa yang asa! Pemohon hendaklah menurunkan cap ibu jari kiri dan
kanan di atas salinan tersebut. Sekiranya tuan/puan manghantar melalui pos, salinan dokumen
hendaklah disahkan oleh Pegawai Bank berkenaan dan sekiranya diserahkan di kaunter, sila
kemukakan dokumen asal beserta salinannya bagi tujuan pengesahan oleh Pegawai Kaunter
KWSP.
2.5
Laporan Perubatan yang tidak melebihi satu tahun yang mengandungi:

(a)
(b)
(c)
(d)
(e)
(f)
Butiran Pesakit
Keadaan Kesihatan semasa Pesakit
Tankh Laporan
Nama Pusat Perubatan
Nama dan Cop Rasmi Doktor
Tandatangan Doktor
(Sekiranya salinan Laporan Perubatan dikemukakan, hendaklah disahkan oleh Doktor/Hospital

berkenaan atau Pegawai KWSP seperti di para 121)
2.6
Surat pengesahan dan maiikan samada kos rawatan dibiayai oleh majikan atau tidak
[__
(Sekiranya pesakit adalah anak pengesahan majikan ibu dan bapa diperlukan dan sekiranya
pesakit bekerja, surat pengesahan majikan pesakit juga diperlukan Bagi pesakit Dasangan suami
isten, pengesahan majikan pesakit dan pasangan diperlukan)
27
Bil dan resit bayaran dan pusat perubatan yang tidak melebihi satu tahun dan tankh permohonan
(jika bayaran telah dibuat)
ATAU
Anggaran kos rawatan dan pusat perubatan atau pakar bagi rawatan yang dilakukan bagi ahli
yang memerlukan surat jaminan KWSP untuk mendapatkan rawatan
(Sekiranya salinan bil/resit bayaran/anggaran kos rawatan dikemukakan, hendaklah disahkan
oleh Doktor/Hospital berkenaan atau Pegawai KWSP seperti di para 1.2.1)
2.8
Bukti pertahan di antara ahli dan pesakit. (Jika pemohon bukan pesakit)
Tandatangan Ahli
Tankh
Tandatangan Penenma :
Tankh

1 OGOS 2001
KWSP9C (AML)
PERCUMA
AKTA KUMPULAN WANG SIMPANAN PEKERJA1991
PEMBERITAHUAN PENGELUARAN
MEMSEU / MEMBINA RUMAH ATAU MENGURANGKAN / MENYELESAIKAN PINJAMAN
PERHATIAN MANA-MANA ORANG YANG MEMBUAT APA-APA KENYATAAN YANG TIDAK BETUL ATA'J TIDAK BENAR ATAU MENGEMUKAKAN ATAU MEMBERIKAN APA-APA
DOKUMEN PALSU DALAM APA-APA BUTIR-BUTIR MUSTAHAK ADALAH MELAKUKAN KESALAHAN DAN AKAN MENYEBABKAN DIRINYA BOLEH DIDENDA ATAU DIPENJARA ATAU
KEDUA-DUANYA
1
JENIS PFNGELUARAN YANG DIPOHON SILA TANDAKAN I -J) PI KOTAK YANG BERKENAAN
1 JENIS PENGaUARAN
KP
PERTAMA
MEMBai / MEMBINA RUMAH
MENGURANGKAN / MENYaESAIKAN PINJAMAN
MENGURANGKAN / MENYaESAIKAN PINJAMAN PASANGAN
HURUF AWALAN
NAMA AHLI
KEDUA
BUTIRANAHU
2 NOMBORAHLI
4 NO KAD PENGENALAN 70IGIT/POUS/TENTERA/PASPORT/DSB
5 TARIKH SURATPERJANJIAN JUAL BELI
MOD PEMBAYARAN
WARAN
DRAF BANK ASING
ARAHAN BAYARAN
KREDITKEAKAUNBANK
7 NAMA MENGIKUT KAD PENGENALAN/PASPORT
JANTINA
1ELAKI
PEREMPUAN
1
10 JUMAH PINJAMAN / BAKI PINJAMAN
9 HARGA BaiAN / KOS PEMBINAAN

KOD PINJAMAN
SEN
RINGGIT MALAYSIA
RINGGIT MALAYSIA
SEN
AHLI
PASANGAN
11 SEKTOR PEKERJAAN
JENIS AKAUN
KONVENSIONAL
ALWADIAH
12 BUTIRANHARTA
BEKERJASENDIRI
NO LOT/PT
KERAJAAN
NO HS(M/D)
SWASTA
NO PARCEL
TIDAK BEKERJA
FLAT/APP/
KONDOMINIUM
13 ALAMAT HARTA
DISEMAKOLEH
PEGAWAI PENYEMAK
|
POSKOO
BANDAR
NEGERI
14 ALAMAT AHLI
CAW
UNfT
I
POSKOD
I I
BANDAf
NOK/TGN
NEGERI
TARIKH
16 JENIS PEMBAYARAN
15 NOMBOR TaEFON (PEJABAT)

NOMBOR TaEFON (RUMAH)
i
WARAN
ARAHAN BAYARAN
DRAF BANK ASING
KREDITKEAKAUNBANK
BUTIRAN BANK
17 KOD BANK
18 NOMBOR AKAUN BANK (Hanya untuk membei/membma mmah)
I I
19 JENIS AKAUN
20 NOMBOR AKAUN PINJAMAN PERUMAHAN

(Hanya untuk mengurang/menyetesakan pin|amanj
KONVENSIONAL
AL-WADIAH
6 KETURUNAN

50 TAHUN/55 TAHUN/DIVIDEN/KETIDAKUPAYAAN
KWSP98(AHL)
PERCUMA
PERHATIAN
MANAMAM ORAN& YANG MEMBUAT W APA KENYA MAN U N G TIDAK BETUL \TAU TIDAK BENAP A I A U M NGFMUKAKAN ATAU MEMBERiKAN APAAPA DOKUVLN PAISL
JALAM A H A / O A BUTIRBUTIR MUSTAhAK ADALAH MELAKJKAN KfcSALAHAN DAN AKAN MENYE8ABKAN ) RlNYA BOLEH DIDENDA ATAU DIPENJARA ATAU KEDUA DUANYA

KP
KJRLFAWALAN
\|AKA AHL
SILATANOAKAN (V) Dl KOTAKYANGBERKbNAAN

1 JENIS
L"X_"
50 TAHUN
i5 TAHUN
1
PtNGELLARAN
KE [IDAKUPAYAAN
DI/IDEN
'
MOD PFMBAYARAN
LNTUK PENGELUARAN 55TAHUN

FKIRANYA AHLI MASIH BEKERJA DAN NGIN IfcRUS
\FNCARUM TANDAKAN
(V) Dl RUANGAN BERKENAAN
NblN TERUS MENCARUM YA (
) "IDAK (
) JIKA M
bILA ISIKAN BORANG KWSP 20 (AHL) DAN KWSP ?0A AriL)
i iiiTiii/ nc^rrtCi I I A D I U DCUIIU
UNTUK
PENGELUARAN PENUH
TIDAK (
ADA PEMINDAHAN PELABURAN YA (
BUTIRANAHIl
/VARAN
2 NOMBOR AHII
DRAFBANKASING
1 I OMBOR KAD PENGENALAN 12 DIGIT
\RAHAN BAYARAN
KREDIT KEAKAl IN BANK
4
NOMBOR KAD PENC EN \LAN 7 DIGIT
KONVENSIONAL
Al WADIAH
NOMBfR POMS TENTERA/PASPORT/DSB
6 NAMA MENGIKUT KAD PENGENALAN/PASPARr
nzz
STATUS AKAJNAHU
nrrnm
nnznznn: nxizn
__JENISAKAUN
_L I
8 TARIKH LAHIR
h
I
10 SEKTOR PEKERJAAN
LEuAKI
Pt.NE.RiVK BAY/"AN
t. _
TJ
9 JANTINA
7 KETURUNAN
PEREMPUAN
AHL!
11 ALAMATAHU
UISEMAK OLEH
PFGAWAI PFNYFMAK
PJ&KOD
AW
I r
BANDAR
NEGfcRI
NIT
i n u i in iTxrn:
JZLT:
WARAN
N
NOMBOR TbLEFON RUMAH/BIMBIT
16 JENIS_AKAUN
14 KOOBANK
NO KTGN
11) NC MBOR AKAUN BANK
nn
KONVENSIONAL
nL WAOIAt
SAYA DENGAN INI MEMOHON UNTUK MENGELUARKAN KREDIT SAYA Di KWSP MENURUT PERUNTUKAN AKTA KWSP 1991
17
JENIS PENIGtLUARAN
ARKH
DILULoSKAN OLtH
PECAWM PELJLUS 1
NOMBOKAHU
T ""I
NOVRO'< Wf
K1SJ
CAP Bt i R K R ( AN
KANANAHLI
(MESTI DITJKUNKAN DtNOAN
TrRAMGDANPENJH
NO
J.
CAMBUJARIBf-RW RNA
H AM)
ARKH
PEGAWAI PELULUS 2
NO K/TGN
TARIKH
KREDIT KEAKAUN BANK
BUTIRAN AKAUN BANK
DISAHKANOLEH
PLGAWAI PENGESAH
L.
ARAHAN BAYARAN
BANK \SING
njznjrr
1 \RIKH
~T~T
L_
13 JENIS PEMBAYARAN
12 NOMBOR TELEFON PEJABAT
NO KTCN
1ARIKI-
j'
MNAH
LJ

SENARAISEMAKAN SKIM PENGELUARAN PERSARAAN
50 TAHUN/55 TAHUN/DIVIDEN
NAMA
NO.AHL!
1.0
TEL: (P)
(R)
PERHATIAN
1.1.
Sekiranya permohonan diserahkan di kaunter, sila kemukakan dokumen asal beserta salinannya
bagi tujuan pengesahan oleh Pegawai KWSP.
1.2.
Sekiranya tuan/puan mengemukakan salinan dckumen sahaja, sila pastikan semua salinan telah
disahkan oleh pegawai yang dibenarkan oleh KWSP seperti bcrikut lengkap dengan nama dan cop
rasmi pengesah : 1.2.1.
1.2.2
1.2.3
1.2.4
1.2.5
2.0
,.
Pegawai KWSP yang terdiri daripada

- Pegawai KWSP Gred 18 keatas
Pegawai Kaunter KWSP
Majikan Pemohon
Penghulu atau Penggawa
Jaksa Pendamai
1.2.6.
1.2.7.
Peguambela dan Peguamcara

Kumpulan Pengurusan/Profesional
Kerajaan
1.2.8. Ahli Dewan Undangan Negeri
1.2.9. Ahli Parlimen
1.2.10. Pesuruhjaya Sumpah
1.3.
Setiap borang permohonan hendaklah ditulis dengan pena dakwat berwarna hitam. Tuan/puan
hendaklah menurunkan cap ibu jari kin dar kanan dengan terang dan penuh menggunakan Pad
Cap ibu Jari berwarna hitam.
1.4.
Tuan/puan hendaklah memastikan dokumen-dokumen yang disertakan bersama-sama dengan

borang permohonan DIKUPKAN dan tidak menggunakan dawai kokot (staples).
1.5.
Semua salinan fotostat dokumen hendaklah menggunakan kertas saiz A4.
1.6.
KWSP berhak menolak mana-mana permohonan yang tidak lengkap.
DOKUMEN UTAMA
Tandakan (V) dalam kotak yang berkenaan.
2.1.
Borang permohonan KWSP 9B(AHL) - 2 salinan
2.2.
Borang KWSP 3A (AHL) - 1 salinan
2.3.
Salinan Kad Pengenalan

Salinan Kad Pengenalan Polis/Tentera dan
Surat Pengesahan Majikan menyatakan No. Polis/Tentera dan
No. Kad Pengenalan merujuk kepada orang yang sama
3.0
24
Salinan pasport bagi warganegara aslng

(Sila kemukakan salinan pasport yang lama sekiranya nombor pasport terkini
berbeza dengan rekod KWSP)
25
Salinan muka hadapan Buku Akaun Bank yang mengandungi butir-butir akaun
tuan/puan atau Penyata Akaun Bank Semasa yang asal. Pemohon hendaklah
menurunkan cap ibu jari kin dan kanan di atas salinan tersebut. Sekiranya tuan/puan
menghantar melalui pos, salinan dokumen hendaklah disahkan oleh Pegawai Bank
berkenaan dan sekiranya diserahkan di kaunter, sila kemukakan dokumen asal beserta
salinannya bagi tujuan pengesahan oleh Pegawai Kaunter KWSP
DQKUMEN TAMBAHAN
31
Sijil Kerakyatan/Syil Kelahiran (jika No Kad Pengenalan tiada dalam rekod KWSP)
Tandatangan Ahli
Tandatangan Penerima
Tarikh
:
KUMPULAN WANG SIMPANAN PEKER.JA

1 OGOS 2001
Tarikh

50 TAHUN/55 TAHUN/DIVIDEN/KETIDAKUPAYAAN
KWSP 9B (AHL)
PERCUMA
PERHATIAN : MANA-MANA ORANG YANG MEMBUAT APA-APA KENYATAAN YANG TIDAK BETUL ATAU TIDAK BENAR ATAU MENGEMUKAKAN ATAU MEMBERIKAN APA-APA DOKUMEN PAl.SU
DALAM APA-APA BUTIR-BUTIR MUSTAHAK ADALAH MF.LAKUKAN KESALAHAN DAN AKAN MENYEBABKAN DIRINYA BO1.EH DIDENDA ATAU DIPENJARA ATAU KEDUA-DUANYA
SILATANDAKAN (V) Dl KOTAK YANG BERKENAAN
50 TAHUN
2 | 55TAHUN
DIVIDEN
4 I KETIDAKUPAYAAN
1. JEMS
PENGELUARAN
UNTUKPENGELUARAN55TAHUN:
SEKIRANYA AHLI MASIH BEKERJA DAN INGIN TERUS
MENCARUM, TANDAKAN
(V) Dl RUANGAN BERKENAAN
INGIN TERUS MENCARUM YA (
) TIDAK {
j . JIKAYA,
SILA ISiKAN BORANG KWSP 20 {AHL) DAN KWSP 20A [AHL)
UNTUK PENGELUARAN PENUH :
ADAPEMINDAHAN PELABURAN. YA(
} TIDAK',
)
BUTIRAN AHLI
2. NOMBOR AHLI

JENISAKAUN
1
AL-WADIAH
EEUD
r r
5. NOMBOR POUS/TENTERA/PASPORT/DSB
__
KONVENSIONAL
LJL
imnmu-immrnm
STATUS AKAUN AHLI
7. KETURUNAN
cmnmujjjjjjjmnmni]
AKTIF
TUTUP
8. TARIKri LAHIR
(UNTUK PENGELUARAN D2-5)
9. JANTINA
10. SEKTOR PEKERJAAN
LELAKI
PEREMPUAN
PENERIMA BAYARAN
BEKERJA SENDIRI
SWASTA
KERAJAAN
TIDAK BEKERJA
AHLI
PENJAGA
rm
TUT
r r Hi..
OISEHAKOLEH :
Pf.GAWAIPENYEMAK
POSKOD
BANDAR
mr
CAW
11. ALAMATAHLI
mm:
(UNTUK PENGELUARAN D2-6)
~T
mi
i|
in
NEGERI
UNIT
n
NO. K/TGN
D"
IIL:
NOMBOR FELEFON RUMAH/BIMBIT
IZLTTTEEITT]
TARIKH :...
WARAN
ARAHAN BAYARAN
ORAF BANK ASING
BUTIRAN AKAUN BANK
OISAHKANOLEH :
PEGAWAIPENGESAH
16. JENISAKAUN
14. KOD BANK
i5. NOMBOR AKAUN BANK
XD
nmmm
KONVENSIONAL
AL-WADIAH
SAYA DENGAN INI MEMOHON UNTUK MENGELUARKAN KREDIT SAYA Dl KWSP MENURUT PERUNTUKAN AKTA KWSP 1991.
17.
JENIS PENGELUARAN
TARIKH
DILULUSKAN OLEH :
PEGAWAI PELULUS1
NOMBOR AHLI
NOMBOR K/P
KIRI
CAP IBU JARI KIRI DAN
KANAN AHLI
(MESTI DITURUNKAN DENGAN
TERANG DAN PENUH
MENGGUNAKANPAD
CAP IBU JARI BERWARNA
HITAM)
TARIKH
TARIKH :
PEGAWAI PELULUS 2
NO. K/TGN
LIITTIIIJ
TARIKH :
KANAN
j
|
i
|
I
PANDUAN UNTUK MENGIS! BORANG KWSP 9B (AHL)

PEMBERITAHUAN PENGELUARAN 50 TAHUN / 55 TAHUN / DIVIDEN / KETIDAKUPAYAAN
SILA BACA PANDUAN INI DENGAN TELITI SFBELUM MENGISI BORANG. BORANG PERMQHQNAN MESTILAH DIPENUHKAN DENGAN HURUF
BESAR.
1.
Jenis Pengeluaran
Siia tanda (V) dalam petak yang berkenaan Jika tuan/puan memohon pengeluaran 50 Tahun, tandakan (V) seperti di bawah
1. JENIS
PENGELUARAN
i_3_
50 TAHUN
55 TAHUN
DIVIDEN
KETIDAKUPAYAAN
Untuk Pengeluaran 55 Tahun

Sekiranya ahli masih bekerja dan mgin terus mencaoim, sila tandakan (V) di ruangan yang berkenaan.
INGIN TERUS MENCARUM
( V ) YA
) TIDAK
Untuk Pengeluaran Penuh

ADA PEMlNDAHAN PELABURAN, YA ( V )
TIDAK (
Nombpr Ahli
Isikan satu digit di setiao ruang dengan didahului oleh digit '0' jika perlu, seperti contoh di bawah:
Contoh : 1234567
2. NOMBORAHLI
0
3.
Nombor Kad Pengenalan 12 Digit Ahli

Isikan nombor Kad Pengenalan 12 digit tuan/puan Jika tuan/puan belum memiliki Kad Pengenalan 12 digit, kosongkan ruangan
ini:
Contoh : 460701-02-6157

0

a)
1234567
b)
A 1234567
L7 .LL
g
^
5.
c)
K1234567
d)
H1234567
Isikan Nombor Polis/Tentera/Pasport/Dsb, seperti contoh di bawah :
5. NOMLOR POLISffENTERA/PASPORT/DSB
a)
I 1234567
b)
T 1234567
'
1
1

Tuliskan nama tuan/puan sebagaimana yang tercatat dalam kad pengenalan. Jika nama mengikut kad pengenalan ialah Norman
bin Abdullah, sila tuliskan nama seperti di bawah;

N 0 R M A N
B JJ N
A B D U L L A H
i
Keturunan
Isikan ruang dengan mengikut kod keturunan di bawah ini. Jika tuan/puan berketurunan Melayu, isikan seperti di bawah:
7. KETURUNAN
1
1
2
3
4
Melayu
Cina
India
Lain-lain
Bidayuh
Kadazan
Iban
Tarikh Lahir
Isikan tarikh lahir tuan/puan mengikut susunan hari, bulan dan tahun. Jika tarikh lahii tuan/puan pada 1 Julai 1946, isikan seperti di
bawah:
8. TARIKH LAHIR
Jantina
Tandakan jantina tuan/puan dengan (S) dalam ruang yang disediakan. Jika lelaki, tandakan ( V ) di ruang yang berkenaan seperti
di bawah:
9. JANTINA
LELAKI
PEREMPUAN
10.
Sektor Pekeriaan
Tandakan (</) dalam ruang yang disediakan. Jika tuan/puan bekerja dalam sektor swasta, tanda (S) dalam ruang yang berkenaan
seperti di bawah:
10. SEKTOR PEKERJAAN
11.
BEKERJA SENDIRI
SWASTA
KERAJAAN
TIDAK BEKERJA
Alamat Ahli
Tuliskan alamat surat menyurat tuan/puan dengan lengkap. Jika alamat surat menyurat tuan/puan adalah Lot 10, Kg Parrt Kadir
Timur Bukit Pasir, 84300 Muar, Johor Darul Takzim, sila penuhi seperti berikut:
11. ALAMAT AHLI
"of
TK
|T
R I ] BI U
BANDAR
POSKOD
I'
NEGERI
I'
12.
Nombor Telefon
Isikan nombor telefon di ruangan yang disediakan di bawah.
Contoh : Nombor Telefon Pejabat: 07-9859450 dan Nombor Telefon Rumah/Bi.-nbit
016-2070158
sT7T4
NOMBOR TtLEFON RUMAH/BiWBIT
lil
13.
? J 0 |7 [0
|.
Jenis Pembavaran
Jika tuan/puan memilih cara pembayaran kredit ke akaun bank, tanda (S) di ruang yang berkenaan seperti di bawah .
WARAN
DRAFBANKASING
LARAHAN BAYARAN
I KREDIT KE AKAUN BANK
14.
KodJank
isikan nombor kod bank di ruangan yang disediakan seperti di bawah
Jika kod bank tuan/puan adalah Maybank
14. KOD BANK
rz
RHB Bank
Maybank
Bumiputra Commerce
Public Bank
Hong Leong Bank
Hong Leong Finance
Affin Bank
EON Bank
15.
01
02
03
04
05
06
07
08
Arab Malaysian Bank

Alliance Bank
Southern Bank
Utama Bank
Bank Muamalat
Bank Islam
Nombor Akaun Bank

Jika nombor akaun bank adalah 1-23456 -789012-3, isikan ruangan berkenaan seperti di bawah
1
16.
Jenis Akaqn
Jika akaun tuan/puan adalah jenis konvpnsional, tanda (*Q di ruang yang berkenaan seperti di bawah
16. JENIS AKAUN
KONVENSIONAL
AL-WADIAH
17.
Jenis Pengeluaran, Nombor Ahli. Nombor Kad Pengenalan dan Cap Ibu Jari
Isikan jenis pengeluaran, nombor ahl' dan nombor kad pengenalan serta turunkan cap ibu jari kin dan kanan tuan/puan
dengan terang dan penuh menggunakan Pad Cap Ibu Jari berwarna hitam
09
10
11
12
13
14
15

EMPLOYEES PROVIDENT FUND
SENARAI SEMAKAN SKIM PENGELUARAN MENINGGALKAN NEGARA
LEAVING COUNTRY WITHDRAWAL CHECKLIST
Nama Ahli
Member's Name
No Ahli
Member's No
Tel (P)
Tel(O)
(R)
(R)
No Pasport
Passport No
10
PENTING
IMPORTANT
1 1
Sekiranya permohonan diserahkan di kaunter KWSP sila kemukakan clokumen asal beserta salmannya untuk
tujuan pengesahan oleh Pegawai KWSP
When submitting the application form at the counter please produce ongmal documen's together with the photostate copies of the document
for the purpose of certification by EPF officers
" ?
bekiranya tuan/puan mengemukakan salinan dokumen sahaja sila pastikan semua saiman dokumen telah disahkan oieh
majikan tuan/puan dtau pegawai yang dibenarkan oleh KWSP seperti benkul lengkap dengan nama d a i cop rasmi
pengesah When submitting photostate documents please ensure that photostate copies of all the documents are certified true copy by vcur e 7)o/o> er or
authorized officers as follows complete with the name and official stamp of the officer concerned
1 21
Pegawai KWSP EPF Officer

Pegawai KWSP (Gred 18 ke ata)
EPF Officer (Grade 18 and Above) '
EPF Counter Officer
122
Pegawai Kedutaan Malaysia

Malaysian Embassy Officer
' 23
Notan Awam
Public Notary
13
Setiap borang permohonan hendaklah ditulis dengan pena dakwat berwdrna hjldDl Tuan/puan hendaklah menurunkan cap
bu jan kin dan xanan deîqan terang dan penuh menggunakan Pad Cap Ibu Jan bciyvarna hjtam.
Ldch withdrawal form must be completed using bjsoi ink pa Members must a/so affix higher nght and left thumbpnnt cleiriy and in lull
using black ink thumbpnnt psd
14
Tuan/puan henolakldh rr^mastikdn dokumen dokunen yang disertakan beibama sama dengan borang oermohonan
DIKLIPKAN dan tidak menggunakan dawai kokot (staples)
Please ensure that all documents forwarded togethei with the apulicatior form are CLIPPER md not stappled
15
Semua salinan fotostat dokumen hendaklah me iggunakin kertas saiz A4

All photostate cop'es of documents must be on A4 sue papr
16
KWSP berhak menolak mana manu permohoPcn yang idak lengkap

EPF reserves the ngh1 to 'eject incomplete application
20
DOKUMEN UTAMA
MAIN DOCUMENTS
Tandakan (V) dalam kotak yang berkenaan
Please tick (V) in the box where applicable
3.0
21
Borang Permohonan KWSP 9B (AHL) - 2 salinan
22
Borang KWSP 3A (AHL) - 1 salinan

Form KWSP 3A (AHL.) -1 copy
23
Salman muka hadapan Buku Akaun Bank yang mengandungi butir-butir akaun tuan/puan atau
Penyata Akaun Bank Semasa yang asal Pemohon hendaklah menurunkan cap ibu jan kin dan
kanan di atas salinan tersebut Sekiranya tuan/puan menghantar melalui pos, salinan dokumen
hendaklah disahkan oleh Pegawai Bank berkenaan dan sekiranya diserahkan di kaunter, sila
kemukakan dokumen asal beserta sahnannya bagi tujuan pengesahan oleh Pegawai Kaunter KWSP
Photostate copy of the front page of your bank book with details of your bank account number ox the original
copy of your current Account Bank Statement Applicants are required to affix left and right thumb print impression
on copies of the document Please forward the ongmal document together with a photostate copy to be certified
by the EPF Counter Officers at the counter Photostate copy of the bank book mus< be cenified true copy by the
respective bank's officer if submission ii through post
PEGAWAI DAGANG
EXPATRIATE
31
Salman pasport yang masih sahlaku yang jelas menunjukkan nama dan nombor pasport
(Sila serahkan salinan pasport yang lama sekiranya nombor pasport terkini berbeza denqan rekod KWSP)
Photostate copy of valid passport stating clearly your name and passport number
(Please forward photostate copy of old passport if current passport number differs from EPF records)
32
Bukti penamatan kerja

Proof of resignation/tenmnption of contract
- Surat penamatan kontrak oleh majikan
Acceptance of resignation/termination of contract by employer
ATAU
OR
- Penyata Perlepasan Cukai Pendapatan
Income tax clearance lefer
4.0
50
33
Pembatalan permit kerja (Tidak malebihi 3 bulan dan tankh permohonan)

Cancellation of work permit
(Not exceeding 3 months from the date of application)
34
Sila bekalkan alamat ahli di luar negara

Please give your overseas correspondence address
BEKAS WARGANEGARA MALAYSIA

rAYSIAN CITIZEN
4 1
42
Surat Penyerahan Kad Pengenalan dan Pelucutan Kewarganegaraan danpada Pejabat Pendaftaran Negara
Letter of surrendenng of the Identity Card and renounciation of citizenship from the Registration Office
43
Sila bekalkan alamat ahli di luar negara

PEKERJA ASING
FOREIGN WORKER
51
(Sila kemukakan salinan pasport yang lama sekiranya nombor pasport terkini berbeza dengan rekod KWSP)
(Pleaseforwardphotostate copy of old passport if current passport number differs from EPF recoros)
52
Sila bekalkan alamat ahli di luai negara

60
DOKUMENTAMBAHAN
ADDITIONAL DOCUMENT
61
SIJII Perkahwinan
(Sekiranya nama di dalam pasport berlainan dengan rekod KWSP)
Marriage Certificate
(If name in the passport aiffers from EPF records)
Tandatangan Ahli
Veinbf" > Signature
Tankh
Date
Tandatangan Penenma
Rf teiver s Signature
Tankh
Date

1 O&OS 2001
KWSP 96 (AHL)
PERCUMA

MENINGGALKAN NEGARA
PERHATIAN MANA-MANA ORANG YANG MEMBUAT APA-APA KENYATAAN YANG TIDAK BETUL ATAU TIDAK BENAR ATAU MENGEMUKAKAN ATAU MEM6ERIKAN APA-APA
IOKUMEN PALSU DALAM APA-APA BUTIR-BUTIR MUSTAHAK ADALAH MELAKUKAN KESALAHAN DAN AKAN MENYEBABKAN DIRINYA BOLEH DIDENOA ATAU DIPENJARA ATAU
DUA-DUANYA
ATTENTION
ANY PERSON WHO MAKES ANY UNTRUE OR FALSE STATEMEN1S OR PRODUCES ANY FALSE DOCUMENTS REGARDING ANY MATERIAL PARTICUtARS IS COMMITTING AN OFFENCE ANO IF FOimO GUL TY
SHALL BF LIABLE TO 'MPRISONMENT OR FINE OR BOTH

FOR EPF USE ONLY
BUTIRANAHLI
PARTICUIARS OF MEMBER
KP
DC
nxo
1 NOMBORAHU
2 NOMBOR KAD PENGENALAN 12 DIGIT
MtMBERS NUMBER
<1 DIGIT IDENTITY CARD NUMBER
OUT
4 NOMBOR POLIS/TENTERA/PASPORT/DSB
7 DIGI1 IDENTITY CARD NUMBER
nxxxixx
POLICEMUTARY/PASSPORTNUMBER/ETC
MOD PEMBAYARAN
MODE OF PAYMEN1
WARAN
5 NAMA MENGIKUT KAD PENGENALAN/PASPORT
6 KETURUNAN
Nl^MF AS PER THE APPLICANTS IDENTITY CARD/PASSPORT
RACE
WARRANT
ORAFBANKAS'NG
FORE'GN BANK DRAFT
APAHAN BAYARAN
] tW'KWlFSS
P K R F D I T K E AKAUN BANK
j c M b AKAUN
DIRECCREDITING
ARIKHL/HIR
I J\N1INA
DATEOF8IR~H
9 SEKTOR PEKERJAAN
GENDER
T
V
EMPLOYMENT SECTOR
SWASTA
MALE
BCKERJASENDIRi
i f ( . f EMPLOYED
PRIVATE
PEREMPUAN
KERAJAAN
TIDAK BEKERJA
FEMALE
GOVERNMENT
UNEMPLOYED
LELAKI
YPE OF ACCOUN1
KONVtNSIONA
I CONVENTIONAL
[ ALWADIAH
L ALWADIAH
10 ALAMATArlU
MEMBER S ADDRESS
DISEMAK OLEH
PEGAWAI PENYEMAK
CHECKED BY OFFICER IN CHARGE
POSKOD
BANDAR
POSTCODE
CITY
NEGERI
STATE
nzninzinin "i_ nzn :n _ m

12 JENIS PEMBAYARAN
DPC OF PAYMENT
11 NOMBOR TEL EF ON PEJABAT
rrxx
OFHCt IELEPHO'IE NUMBER

vVARAN
WARRANT
NOMBOR IFLEFON RUMAH

'ESIDlNCEJTLEPHONEI
ARAHAN BAYARAN
WARRANTLESS
DRAFBANKASINC
FOREIGN BANK DRAF i
DIRECT CREDITING
UMBER/HANWHONE
J LJ
BUTIRAN AKAUN BANK
PAPTICULARS
IAWKH
OATt
13 KODBANK
14 NOMBOR AKAUN BANK
BANK CODE
BANKAtÔLNlNbMbER
15 JENbAKALN
TYPE OF ACCOUM
KONVENSIONAL
CONVENTIONAL
AL WADIAH
AL WADIAH
OFBANKACK-OUNI
xixixxLxn
SAYA DENGAN INI MEMOHON UNTUK MENGELUARKAN KREDIT SAYA Dl KWSP MENURUT PERUNTUKAN AKTA KWSP 1991.
/ HEREBY APPLY TO WITHDRAW VY EPF CREDIT IN ACCORDANCE WITH THE EPF ACT 13S1
16.
JENIS
PENGELUARAN
TYPE OF
WITHDRAWAL
NOMBORAHLI
MEMBER'S NUMBER
PEMBERITAHUAN :
OISAHKAN OLEH:
PEGAWAI PENGESAH
CAP IBU JARI KIR! DAN

KANAN AHLI
(MESTI DITURUNKAN DENGAN
TERANG DAN PENUH
MENGGUNAKAN PAD
CAP IBU JARI BERWARNA
HITAM1
NOTIFICATION
VERIFIED BY
OFFICER IN-CHARGE
HH
H
jgjjj
NOMBOR K/P
IDENTITY CARD
NUMBER
Klfil
mm
LEEI
BlSiU
LEFT AND RIGHT THUMB IMPRESSION

OF THE MEMBER
(MUST BE CLEARLY AND FULL Y
AFFIXED USING BLACK INK
THUMBPRINT PAD)
NO K/TGN
STAFF REF NO
TARIKH
DATE
TARIKH
DATE
17. AKUAN SAKSI

WITNESS DECIMATION
"SAYA DENGAN INI MENGAKU DAN MENGESAHKAN BAHAWA BUTIR-BUTIR PEMOHON TERCATAT Dl ATAS ADALAH MENGIKUT KAD
PENGENALAN MALAYSIA / SINGAPURA / POLIS / TENTERA / PASPORT YANG SAVA TELAH PERIKSA SENDIRI DAN PEMOHON TELAH
MENURUNKAN CAP IBU JARI KIRI DAN KANANNYA Dl HADAPAN SAYA"
DILULUSKAN OLEH :
PEGAWAI PELULUS 1
APPROVED By
APPROVAL OFFICER 1
POLICE I MILITARY IDENTITY CARD I PASSPORT THAT I HAVE PERSONALLY EXAMINED AND THAT HE I SHE HAS DULY AFFIXED HIS I HER LEFT AND RIGHT
THUMB IMPRESSION BEFORE ME '
NAMA PENUH SAKSI

FULL NAME OP WITNESS
NO KAD PENGENALAN SAKSI

IDENTITY CARD NO OF WITNESS
ALAMAT SAKSI
NO K/TGN
STAFF REF NO
ADDRESS OF WITNESS
TANDATANGAN SAKSI
SIGNATURE Of WITNESS
JAWATAN DAN COP RASMI
TARIKH
DESIGNATION AND OFFICIAL STAMP
DATE
TARIKH
DATE
NOTA ;
ttSSE
BERIKUT ADALAH SENARAI ORANG YANG BOLEH MENJADI SAKSI
THE FOLLOWING PERSONS MAY ACT AS A WITNESS
PEGAWAI KWSP YANG TERDIRI DARIPADA
EPF OFFICER
PEGAWAI PELULUS 2
APPROVAL OFFICER 1
PEGAWAI KWSP GRED 18 KE ATAS
PEGAWAI KAUNTER KWSP
NO K/TGN
TARIKH
DATS
PEGAWAI KEDUTAAN MALAYSIA

MALAYSIAN EMBASSY OFFICER
EPF OFFICER GRADE (8 AND ABOVE
EPF COUNTER OFFICER
STAFF REF NO
MAJIKAN PEMOHON
APPLICANTS EMPLOYER
NOTARIAWAM
PUBLIC NOTARY
PANDUAN UNTUK MENGISI BORANG KWSP 9B (AHL)

PEMBERITAHUAN PENGELUARAN MENINGGALKAN NEGARA
GUIDELINES TO COMPLETE FORM KWSP 9B(AHL)
LEAVING COUNTRY WITHDRAWAL
SILA BACA PANDUAN INI DENGAN TELITI SEBELUM MENGISI BORANG. BORANG PERMOHONAN MESTILAH DIPENUHI
DENGAN HURUF BESAR.
PLEASE READ THESE GUIDELINES CAREFULLY BEFORE COMPLETING THE FORM. THE FORM MUST BE COMPLETED IN BLOCK LETTERS.
1
Nombor Ahli
Member Number
Isikan satu digit di setiap ruang dengan di dahului oleh digit '0' jika perlu, seperti contoh di bawah
Fill in the space with one number, starting with '0' as shown below
Contoh . 1234567
Example 1234567
1. NOMBOR AHLI
MEMBER'S NUMBER
KadPenaenalan 12 Diqit
Nombo
12-Diait Identitv Card Number
Isikan nombor Kad Pengenaian 12 digit tuan/puan Jika tuan/puan belum memiliki Kad Pengenalan 12 digit, kosongkan
ruangan mi
Fill in your 12-digit Identity Card number Leave this space blank if you do not have any
Contoh 610701-02-6157
Example 610701-02-6157
12 DIGIT IDENTITY CARD NUMBER
Nombor Kad Pengenalan 7 Digit / Polis/ Tentera/ Pasport / Dsb

7-Digit Identity Card / Police/ Military/ Passport Number/ Etc
Fill m /our 7-digit Identity Card number,mcluding the initial as shown below
3. NOMBOR KAD ÊNGENALAN 7 DIGIT
7 DIGIT IDENTITY CARD NUMBER
4.
a)
1234567
h)
A1234567
c)
K1234567
d)
H1234567
Police/Military/Passport Number/Etc
Isikan Nombor Polis/Tentera/Pasport/Etc termasuk huruf awalan, seperti contoh di bawah
Fill in your police/military'/passport number/etc, including the mtial as shown below
4. NOMBOR POLISH TNTERA/PASPORT/DSB
POLICE/MILITARY/PASSPORT NUMBER/ETC
a)
I 1234567
b)
T 1234567
Nama Mengikut Kad

Name As Registered In Identity Card I Passport
Tuliskan nama tuan/puan sebagaiinana yang tercatat dalam kad pengenalan tuan/puan Jika nama mengikut kad penqenalan
lalah Norman bin Abdullah sha tuliskan nama seperti di bawah
Write your name as registered in your identity card If your name as per your identity card is Norman bin Abdullah, please
complete your name as follows
NAMA MENGIKUT KAD PENGENALAN / PASPORT
NAME AS PER IDENTITY CARD / PASSPORT
!
Keturunan
Isikan ruang dengan mengikut kod keturunan di bawah mi Jika tuan/puan berketurunan Melayu, isikan seperti di bawah
Please complete this portion with rpference to the following For instance ifyou are a Malay
6. KETURUNAN
RACE
Melayu
Malay
Bidayuh
Bidayuh
Cina
Chinese
Kadazan
Kadazan
India
Indian
Iban
Iban
Lam-lam
Others
Tarikh Lahir
Date of Birth
Isikan tankh lahir tuan/puan mengikut susunan han, bulan dan tahun Jika tankh lahir tuan/puan pada 1 Julai 1961, isikan seperti di bawah
Fill in your date of birth accordingtothe date, month and year If your date of birth is 1 July 1361, please fill in as follows
7 TARIKH LAHIR
DATE OF BIRTH
H H
B B T T
D D
M M Y Y
0 1
Jantina
gender
Tandakan jantina tuan/puan dengan [/) dalam ruang yang disediakan
Jika lelaki, tandakan {/) di ruang yang berkenaan
seperti di bawah
Please tick{S) whichever is applicable Ifyou are a male, please fill in as follows
8. JANTINA
GENDER
LELAKI
MALE
PEREMUAN
FEMALE
9.
Sektor Pekerjaan Ahli

Employment Sector
Tandakan {/) dalam ruang yang disediakan JiKa tuan/puan bekerja dalam seklor swasta, tanda (V) dalam ruang yang
berkenaan seperti di bawah
Please tick {/) whichever is applicable If you are working in the pnvate sector, please fill in as follows
9. SEKTOR PEKERJAAN
EMPLOYMENT SECTOR
BEKERJA SENDIRI
SELF EMPLOYED
KERAJAAN
GOVERNMENT
10.
SWASTA
PRIVATE
TIDAK BEKERJA
UNEMPLOYED
AlamatAhli
Member's Address
Tuliskan aiamat surat menyyat tuan/puan dengan lengkap Jika alamat surat menyurat tuan/puan adalah Lot 10, Kg Pant
Kadir rmiur, Bukit Pasir, 84300 Muar, Johor Darul Takzim, sila penuhi seperti Derikut
Please complete yow full address If your address is Lot 10, Kg Pant Kadir Timur, Bukit Pasir, 84300 Muar, Johor Darul Takzim
please fill in as follows
10. ALAMAT AHLI
MEMBER'S ADDRESS
PA
II
M|U
I
iS I U
[R
I
POSKOD
K
I
I [ M
I
[ P IA | S 1
I
L _J
__i
BANDAR
CITY
POSTCODE
NEGERI
STATE
[7
11.
O I R
Nombor Telefon Ahli

Member's Telephone Number
Isikan nombor telefon di ruangan yang disediakan di bawah
Contoh
Nombor Telefon Pejabat 07 9859450 dan Nombor Telefon Rumah/Bimbit 016-2070158
Please complete your telephone number (if any) as follows
For example Office Telephone Number 07 9859450 and Residence Telephone Number I Handphone 016 - 2070158

OFFICE TELEPHONE NUMBER
NO TELEFON RUMAH/BIMBIT
RESIDENCE TELEPHONE NUMBER /HANDPHONE
12.
Jenis Pembayaran
Type Of Payment
Jika tuan/puan memilih kaedah pembayaran kredit ke akaun bank, tanda ( / ) di ruang yang berkenaan seperti di bawah :
If you choose direct crediting, pleas$ tick ( ) as below:
TYPE OF PAYMENT
WARAN
ARAHAN BAYARAN
WARRANT
WARRANTLESS
DRAFBANKASING
KREDIT KE AKAUN
FOREIGN BANK
BANK
DRAFT
DIRECT CREDITING
13.
KalBank
Bqnl{ Code
Isikan nombor kod bank di ruangan yang disediakan seperti di bawah :
Please fill in the bank code number in the space below:
13. KOD BANK
BANK CODE
Nama Bank
Name of Bank
RHB Bank
Maybank
Bumiputra Commerce
Public Bank
Hong Leong Bank
Hong Leong Finance
Affin Bank
EON Bank
14.
Kod
Nama Bank
Kod
Code
Name of Bank
Code
01
02
03
04
05
06
07
08
Arab Malaysian Bank

Alliance Bank
Southern Bank
Utama Bank
Bank Muamalat
Bank Islam
09
10
11
12
13
14
15
Nombor Akaun Bank

Bank Account's Number
Jika nombor akaun bank adalah 1-23456 -789012-3, isikan ruangan berkenaan seperti di bawah:
If your bank account's number is 1-23456-789012-3, please fill in as below:
15.
Jenis Akaun
Type of Account
Jika akaun tuan/puan adalah jenis konvensional, tanda ( V ) di ruang yang berkenaan seperti di bawah:
Please tick (</) as below, if your type of account is conventional:
KONVENSIONAL
CONVENTIONAL
AL-WADIAH
AL-WADIAH
16.
Jenis Pengeluaran, Nombor Ahli, Nombor Kad Pengenalan dan Cap Ibu Jari
Type of Withdrawal. Membership Number. Identity Card Number and Thumb Impression
Isikan jenis pengeluaran, nombor ahli dan nombor kad pengenalan serta turunkan cap ibu jari kiri dan kanan tuan/puan dengan
terang dan penuh menggunakan Pad Cap Ibu Jari berwarna hitam.
Kindly fill in type of withdrawal, membership number, identity card number and left and right thumb impression. The impression
must be clear and fully affixed using black ink thumbprint pad.
17.
Afcuan Sakal
Witness Declaration
Senarai orang yang boleh menjadi saksi adalah seperti berikut:
The following persons may act as a Witness:
1.
2.
PegawaiKWSPterdiridaripada:
EPF Officer
Pegawai KWSP Gred 18 Ke atas

EPF Officer Grade 18 and above

EPF Counter Officer
Majikan Pemohon
Applicant's Employer
3.
Pegawai Kedutaan Malaysia

Malaysian Embassy Officer
4.
Notari Awam
Public Notary

ENT300 - Final Project - Fresh Chicken Farm

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ETR 300

FRESH CHICKEN FARM

MOHAMAD SHUKRY B. MAKSAH

EN MALIKI B IBRAHIM (FKE)

DIPLOMA IN ELECTRICAL AND ELECTRONIC ENGINEERING

FACULTY OF ELECTRICAL ENGINEERING

1.2 BUSINESS PLAN PURPOSE

1.3 BACKGROUND OF OWNERS

1.4 PARTNER'S PROFILE

2.0 INTRODUCTION TO THE ORGANIZATION

TYPES OF BUILDING AND INFRASTRUCTURE

2.1 ORGANIZATION CHART OF FRESH CHICKEN FARM

2.2 LIST OF ADMINISTRATION PERSONNELS

2.3 SCHEDULE OF TASK AND RESPONSIBLITIES

2.4 SCHEDULE OF REMUNERATION

2.5 LIST OF OFFICE EQUIPMENTS AND SUPPLIES

2.6 ADMINISTRATION BUDGET OF FRESH CHICKEN FARM

3.1 PRODUCT OR SERVICE DESCRIPTION

3.3 MARKET SIZE

STRENGTHS OF FRESH CHICKEN FARM

3.5 MARKET SHARE

3.8 MARKETING BUDGET

4.1 FLOW CHART OF OPERATION ACTIVITIES

FLOW CHART CONVENTIONAL SYMBOLS

PROCESS FLOW CHART

4.2 OPERATIONS SYSTEM

READY OF BOILER CLOSED HOUSE

INSTALL THE NECESSARY BROODING EQUIPMENT

c. PAD COOLING SYSTEM

DAILY CONTROL AND QUALITY CONTROL

b. FEED AND WATER

4.3 BUSINESS OPERATION TIME

4.5 TOTAL COST

4.6 MATERIAL REQUIREMENTS (INPUT)

4.8 SCHEDULE OF TASKS AND RESPONSIBILITIES

EQUIPMENT AND MACHINERY

4.11 OPERATIONS SPACE LAYOUT PLAN

4.12 OPERATION OVERHEAD

4.13 OPERATION BUDGET

5.1 PROJECT IMPLEMENTATION COST SCHEDULE

5.2 SOURCE OF FINANCE SCHEDULE

5.3 SUPPORTING SCHEDULES

LOAN OF AMORTIZATION SCHEDULE

FIXED ASSET DEPRECIATION SCHEDULE

5.4 PROFORMA FINANCIAL STATEMENTS

CASH FLOW PROFORMA (ANUALLY)

PROFORMA PROFIT AND LOSS ACCOUNT FRESH

PROFORMA BALANCE SHEET ACCOUNT FRESH

Diploma In Electrical and Electronic Engineering,

En. Husny B. Basir

2. Muhammad Fairuz B. Johari

3. Muhd. Nurfaiz B. Baharuddin

4. Ahmad Luqman B. Mohamed Shaihani

FRESH CHICKEN FARM

(Mohamad Shukry B. Maksah)

(Muhd. Nurfaiz B. Baharuddin)

lammad Fairuz B. Johari)

(Ahmad Luqman B. Mohamed Shaihani)

Mohamad Shukry B. Maksah

Muhd. Nurfaiz B. Baharuddin

41 Jin Sri Damak 50,

167 Jin. Tun Abdul Razak,

Taman Sri Andalas,