CENERGI GROUP

EMPLOYMENT PERSONAL DETAILS

A. PERSONAL PARTICULARS
Full Name (as per IC):
Employee No.: Gender:
Residential Address: Race:
Marital Status:
Religion:
Nationality:
DOB (dd/mm/yyyy):
Contact (house): NRIC No./Passport:
Contact (mobile): Expiry date:

B. JOB DETAILS
Join date (dd/mm/yyy): Branch:
Position: Department:
Position Grade: Cost Centre:
Previous Employer Name:
Previous Employer Address:

C. FINANCIAL
Monthly Salary (RM):
RM /month Fixed/Not Fixed
Other Allowances (RM): 1)
2)
3)
Benefits in kind (if any): 1)
2)
3)
Bank Name: Branch:
Account No.: Address:

D. STATUTORY
Employee wish to voluntary contribute above statutory
1) (N1) EPF No.:
rate of 11%. Please state ____%
2) (N2) SOCSO: Please Indicate if you are a SOCSO member (YES / NO)
3) (N3) Income Tax No.: Branch:
4) Zakat: RM_____ Branch:
For zakat deduction, please indicate if offset PCB. If yes please state whether RM_____ or 100%
5) Tabung Haji No.:
6) ASB No.:

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 E. FAMILY
Spouse details
Name:
NRIC:
Occupation:
Income Tax No.: Branch:
(N4) Children Details (please state whether on full time study for children above 18 years old)
Name of Children Date of Birth Name of College/University Course
1)
2)
3)
4)
5)
**For married women only
Are you claiming child relief on PCB deduction? (YES / NO)
If yes, please state the no. of children you are claiming _________________

F. EMERGENCY CONTACT
Name: Contact No.:
Relationship: Home Address:

Explanatory Notes:

(N1) An employee earning RM3,000.00 or below is eligible to contribute to SOCSO. For those who
have been contributing to SOCSO, are required to continue with the contribution although
he/she is currently earning more than RM3,000.00.

(N2) For expatriate please provide the name of your tax agent and the contact number for record
purposes.

(N3) Remuneration means income in respect of the gains or profile from an employment other
than benefits in the kind under paragraphs 13(1)(b) and 13(1)(c) of the Income Tax Act.

(N4) If child above 18 years old and currently received full time education/further education in
Malaysia in respect of any award of diploma or higher (excluding matriculation/preparatory
course) / further education outside Malaysia in respect on an award of degree or higher,
please state clearly the college or university attended and course taken.

I hereby confirm that the information given above is correct and complete.

Employee Signature : _____________________________ Date : ___________________

Employee Name : _____________________________

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