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| Question | Answer |
|---|---|
| Form Name | Uma 7 Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | akta dituntut, uma 7 form, borang permohonan wang tidak dituntut, akta dituntut online |
Akta Wang Tak Dituntut 1965( Pindaan 2002 )
Seksyen 13(1)
PERMOHONAN BAYARAN BALIK WANG TAK DITUNTUT
Application For Refund of Unclaimed Moneys
[PENTING : SILA RUJUK KEPADA PANDUAN TUNTUTAN BAYARAN BALIK WANG TAK DITUNTUT SEMASA MENGISI BORANG INI ]
[IMPORTANT : PLEASE REFER TO GUIDELINES FOR CLAIMS ON REFUND OF UNCLAIMED MONEYS IN FILLING UP THIS FORM ]
Perihal Empunya Asal Wang Tak Dituntut Particulars of Original Owner of Unclaimed Moneys
Nama :…...............................…........................………………………………………………………….
Name
Nombor kad pengenalan / pasport / syarikat / firma : ….............…..................…………………………
Identity card / passport / company / firm number
Amaun RM:…...............…..………………………………………………………………….…………………….
Amount
Jenis :….........................................................................................................................…...………
Type
Perihal Pemohon Particulars of Applicant
Nama :….......................................................................….............................…………………………….
Name
Nombor kad pengenalan / pasport : ….................................................................….......................……...
Identity card / passport number(Sila sertakan /please attach copy)
Alamat surat menyurat terkini :….............................…...............................................…………..............
Present Correspondence Address
|
…........................ …...……………………………………………… |
|
…........................................……...........……………………………….... |
No. Telefon |
: …...................…………………………………………………………... |
Telephone Number |
|
No. Faks / |
:…............................... …………………………………………………... |
Fax Number / |
(Makluman bayaran akan dibuat melalui |
mail) |
|
Perihal akaun bank pemohon yang masih aktif (Bayaran akan dikreditkan terus ke dalam akaun pemohon)
Particulars of claimant’s bank account (Payment will be credited into claimant’s acount)
Nama dan alamat bank : …............................................................................................................…
Bank’s name and address
Nombor akaun bank : …..........................……..............................................................................
Bank account number
(Sila sertakan salinan muka hadapan akaun bank / penyata bank)
(Please attach a copy of bank statement / bank account)
Saya sertakan
I attach herewith supporting documents showing proof of ownership right to the unclaimed moneys.
1…...............................................….........….. |
3 |
2…..............................................……......…. |
4 |
.………………………………………..
Tandatangan Pemohon / Cap Syarikat
Signature of Applicant / Company’s Stamp
Tarikh :…………………….
Date
Untuk Kegunaan Pejabat Sahaja (For Office Use Only )
tarikh terima permohonan