Access Card Application Form

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APPENDIX 2: QMS-WIC-019 ACCESS CARD APPLICATION

BUILDING: Please tick (√) in below box, whichever is applicable. DATE:

WISMA CONSPLANT 1 EAST

WISMA CONSPLANT 2 WEST


*For those tenant office in Centre Wing, please tick (/) based on your office main door office
location.

CARD HOLDER DETAILS

To be completed by applicant

Name of Company:

Staff Name: I/C or Passport No:

Designation: Gender:

Contact No. (HP): Office Tel No:

Unit No / Floor: E-mail Address:

To be completed by Applicant Company’s authorized department (HR & Administration)

Authorized by:

Name: Nor Zaini Binti Samat @ Embong

Designation: Head, HR Department: HR

Signature & Stamp: Date: 19 December 2022

BUILDING MANAGEMENT OFFICE USE ONLY

Approved by:

Name: Designation:

Approved Date: Card Number:

Programmed By: Card Prepared On:

Signature: Delivered On:

Note: It is prohibited and may be unlawful to copy this form or disclose them to anyone unless you are authorized to do so.
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APPENDIX 2: QMS-WIC-019 ACCESS CARD APPLICATION

TERMS AND CONDITIONS FOR USE OF ACCESS CARD

The cardholder shall use the Access Card at all times for ingress and egress through the turnstile, lift, glass
door (Level G and Basement Parking) at Wisma Consplant 1 & 2.

The Building Management reserves the right to withdraw and terminate the Access Card without providing any
reasons.

The cardholder shall take reasonable care of the Access Card and shall not expose the card to extreme heat
nor strong magnetic force.

The cardholder shall not damage or tamper with the Access Card.

A replacement cost of RM 30.00 (excluding tax) will be charged to the card holder if the Access Card is
damaged or lost.

The Access Card is strictly non-transferable and the cardholder shall be held responsible for any misuse.

The respective company shall notify the Building Management of any cessation of employment so as to
terminate the usage of the Access Card.

The Building Management reserves the right to request for cardholders to show their Access Card for security
purpose. Cardholders who refuse to accede to the request may be denied entry to the building.

I acknowledge receipt of the card and agree to abide by the above terms and conditions.

Company: Pass No:


Name: Date:
Signature: I/C or Passport No:

Note: It is prohibited and may be unlawful to copy this form or disclose them to anyone unless you are authorized to do so.
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