NEW HIRE PROFILE FORM R C 0 1

TO BE COMPLETED BY HR:

1. Please complete "Requestor Staff No.", "Request Date", "Requestor Name", "Department" and "Company".

D D M M Y Y

Requestor Staff No. Request Date

Requestor Name

Department

Company

TO BE COMPLETED BY EMPLOYEE:

Instructions :

4. Please attach passport-sized photo within the designated area.

PID

Mr. Mrs. Ms. Encik Puan Cik

Title (1) E.g. Dr., Ir., YM. Etc

Title (2) E.g. Tan Sri, Puan Sri, Dato', Datuk, etc.

N A N A N G

Child Of

A R I E S C A H Y O N O

Sex X Male Female

Birth Date 0 5 0 6 9 1 DDMMYY Ethnicity X Bumiputera Non Bumiputera Mark "X" where applicable

Religion I S L A M Race

Marital Status S I N G L E E.g. Single , Married , Widow , Divorced, Separated

Marital Status Since DDMMYY (Please leave vacant if marital status is Single)

Education Sponsorship

Personal Email

N N _ S E

A. Bank Details

Bank Name

Account No.

Savings Current Mark "X" where applicable

Bank Branch

City Postcode

B. Personal IDs

Birth Certificate No.

NRIC No. Old IC No.

Passport No.

Passport Issuing Authority

Passport Issuing Date DDMMYY Passport Expiry Date DDMMYY

Passport Type (Nationality)

EPF No.

Contribute to SOCSO? Yes No SOCSO No.

C. Additional Tax Deduction

Income Tax Number

Tax Office

2. Please scan this form (on first page) to SSC HR together with the printed Application Form, Signed Acceptance of Offer Letter, Approved Recommendation for Offer Form, Festive Advance Form (if applicable) , MEDEX002 Form , GTLA Beneficiary Form, Employee Profile’s supporting documents and other company & government statutory specific documentation.

1. Please fill in the forms in UPPER CASE.

Please attach passport-sizedphoto here

2. Please ensure that all information filled are complete and accurate before submitting to HR. 3. Please attach supporting documents where applicable and required.

Offer Letter Ref. No

Title (Mark "X" where applicable)

First Name (as per IC)

Enter first name (Enter family surname for Chinese)

Bin , Binti , Bte, A/L , A/P , A/K etc

Last Name(as per IC)

Enter last/father's name

E.g. PETRONAS , JPA , MARA , UTM , USM etc

Please include proof of bankslip

Type of Account

Malaysian, Singaporean, Japanese etc

Kuala Lumpur, Ipoh , Kuantan etc

NEW HIRE PROFILE FORM R C 0 1

D. Married Spouse Particulars

Child Of Bin , Binti , Bte, A/L , A/P , A/K etc

NRIC No.

Passport No.

Sex Male Female Birth Date DDMMYY

Location of Birth

Country of Birth

Nationality

Spouse Employed? Yes No

E. Dependents Children Particulars

Dependent (1)

First Name

Child Of Bin , Binti , Bte, A/L , A/P , A/K etc

Last Name

NRIC No. Please complete either NRIC No. or Birth Certificate No.

Birth Certificate No. Birth Certificate (For children below 12 years of age)

Passport No.

Sex Male Female Birth Date DDMMYY

Location of Birth

Country of Birth

Nationality

Step Child? Yes No Child Custody? Yes No Mark "X" if applicable.

Child Type Legitimate Adopted Others Mark "X" if applicable and include supporting documents

Is dependent handicapped? Yes No Married? Yes No Yes No

Primary School Professional Bodies Mark "X" for highest education received

Dependent (2)

First Name

Child Of Bin , Binti , Bte, A/L , A/P , A/K etc

Last Name

NRIC No. Please complete either NRIC No. or Birth Certificate No.

Birth Certificate No. Birth Certificate (For children below 12 years of age)

Passport No.

Sex Male Female Birth Date DDMMYY

Location of Birth

Country of Birth

Nationality

Step Child? Yes No Child Custody? Yes No Mark "X" if applicable.

Child Type Legitimate Adopted Others Mark "X" if applicable and include supporting documents

Is dependent handicapped? Yes No Married? Yes No Yes No

Primary School Professional Bodies Mark "X" for highest education received

First Name(as per IC)

Last Name(as per IC)

Town of birth as in birth certificate

Country of birth as in birth certificate

Malaysian, Singaporean, Japanese etc

Town of birth as in birth certificate

Country of birth as in birth certificate

Malaysian, Singaporean, Japanese etc

Dependent Employed?

Education Level Secondary School

Institute of Higher Learning

Town of birth as in birth certificate

Country of birth as in birth certificate

Malaysian, Singaporean, Japanese etc

Dependent Employed?

Education Level Secondary School

Institute of Higher Learning

NEW HIRE PROFILE FORM R C 0 1

E. Dependents Particulars (cont'd)

Dependent (3)

First Name

Child Of Bin , Binti , Bte, A/L , A/P , A/K etc

Last Name

NRIC No. Please complete either NRIC No. or Birth Certificate No.

Birth Certificate No. Birth Certificate (For children below 12 years of age)

Passport No.

Sex Male Female Birth Date DDMMYY

Location of Birth

Country of Birth

Nationality

Step Child? Yes No Child Custody? Yes No Mark "X" if applicable.

Child Type Legitimate Adopted Others Mark "X" if applicable and include supporting documents

Is dependent handicapped? Yes No Married? Yes No Yes No

Primary School Professional Bodies Mark "X" for highest education received

Dependent (4)

First Name

Child Of Bin , Binti , Bte, A/L , A/P , A/K etc

Last Name

NRIC No. Please complete either NRIC No. or Birth Certificate No.

Birth Certificate No. Birth Certificate (For children below 12 years of age)

Passport No.

Sex Male Female Birth Date DDMMYY

Location of Birth

Country of Birth

Nationality

Step Child? Yes No Child Custody? Yes No Mark "X" if applicable.

Child Type Legitimate Adopted Others Mark "X" if applicable and include supporting documents

Is dependent handicapped? Yes No Married? Yes No Yes No

Primary School Professional Bodies Mark "X" for highest education received

Dependent (5)

First Name

Child Of Bin , Binti , Bte, A/L , A/P , A/K etc

Last Name

NRIC No. Please complete either NRIC No. or Birth Certificate No.

Birth Certificate No. Birth Certificate (For children below 12 years of age)

Passport No.

Sex Male Female Birth Date DDMMYY

Location of Birth

Country of Birth

Nationality

Step Child? Yes No Child Custody? Yes No Mark "X" if applicable.

Child Type Legitimate Adopted Others Mark "X" if applicable and include supporting documents

Is dependent handicapped? Yes No Married? Yes No Yes No

Primary School Professional Bodies Mark "X" for highest education received

Town of birth as in birth certificate

Country of birth as in birth certificate

Malaysian, Singaporean, Japanese etc

Dependent Employed?

Education Level Secondary School

Institute of Higher Learning

Town of birth as in birth certificate

Country of birth as in birth certificate

Malaysian, Singaporean, Japanese etc

Dependent Employed?

Education Level Secondary School

Institute of Higher Learning

Town of birth as in birth certificate

Country of birth as in birth certificate

Malaysian, Singaporean, Japanese etc

Dependent Employed?

Education Level Secondary School

Institute of Higher Learning

NEW HIRE PROFILE FORM R C 0 1

F. Emergency Contacts

First Name

Child Of Bin , Binti , Bte, A/L , A/P , A/K etc

Last Name

Unit No & Street

Town/City Postal Code

State

Country

Contact Number Area Code | Phone No.

STATEMENT OF DECLARATION:

Signature of Applicant Date (DD.MM.YY)

I hereby declare that all information that I have provided above and the sheets attached hereto are true and correct. I understand that any false statement(s) may cause disciplinary action to be taken against me. By signing this declaration, I agree to authorize PETRONAS to investigate and verify my statement(s) and all information that I have provided.

TAMBAHAN FORMULIR DATA KARYAWAN

Tempat Lahir :

No. Jamsostek :

No. NPWP :

Alamat NPWP :

Nama Pemilik Rekening :

Bank

Penerima Santunan / Ahli Waris

N a m a Alamat Lengkap Hubungan

PENDIDIKANDimulai dari yang paling baru

No Sekolah/Universitas Jurusan Mulai Selesai IPK Strata

PEKERJAANDimulai dari yang paling baru

No Perusahaan Jabatan Uraian Tugas Mulai Selesai

TRAINING

No Nama Training/Workshop/Seminar Penyelenggara Tempat Tahun

Harap melampirkan :

- Photo copy Kartu Keluarga

- Photo copy K.T.P.

- Photo copy Surat Nikah

- Photo copy Surat Kelahiran (untuk semua anggota keluarga)

- Photo copy Kartu Jamsostek lama, jika ada Baru Lanjutkan- Photo copy Ijazah/sertifikat training

Dibuat oleh : Diperiksa oleh :

Tanggal : Tanggal :

*) soft copy dari dokumen ini harus dikirmkan kepada bagianHR

TAMBAHAN FORMULIR DATA KARYAWAN

PENDIDIKAN

Strata

PEKERJAAN

Selesai

TRAINING

Tahun