MyKad Recycle Rewards

BI-QMP-MAR-F01(O)

1. Company Information

* Company Name:

* Registered Address:

* Company Registration Number:

	-	This will be your login Id.
Company Registration Number		Branch Code

* Email Address:

* Office Number

(1):

Country

Area

Number

(2):

Country

Area

Number

Office Fax:

Country		Area		Number
Example:	60		5		xxxxxxx

For area code, where applicable, please exclude the initial dialling prefix (usually '0' when calling from within your own country).

2. Contact Person Information

* Contact Person:

Department:

*Designation:

* Contact No / Ext:

Contact Person:

Department:

Designation:

Contact No / Ext:

Contact Person:

Department:

Designation:

Contact No / Ext:

3. Nature of Business
* 1. Nature of Business
* 2. Any branch in Malaysia?	Yes No If Yes, please fill up the number of branches.
* 3. Is your company registered under ISO 9000?	Yes No
* 4. Is your company registered under ISO 14000?	Yes No

4. Payment Method

Request of Cash Conversion: (If tick please fill up payment detail at below.)

Payment made to:

Bank Name:

Bank Account Number:

Payment Method:

Monthly

Quaterly

Semi-Anually

Anuallly

Other

5. Login Information
Login Id:	Company Registration Number is your Login Id.
* Password:
* Confirm Password:

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