MITISA HOLDINGS SDN. BHD.

(510994-M) MHSB-Std-TQS03
REV:00 15/1/09
Technical Query Sheet

Project :

Attention : Date : ..

Conformation Required:

Drawing Number /Attachments: Date Required:

Requested By :
Signature : ...
Name : ..
Designation : ..

Contact no./Fax :

Response :

Attachment : Date:

Responded By : .
Signature :
Name :
Designation / Co : .
MITISA HOLDINGS SDN. BHD. (510994-M) MHSB-Std-TQS03
REV:00 15/1/09
Technical Query Sheet