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    The document is an application form for appealing a fine under Acts 133/171. It requests the applicant's name, ID number, address, phone number, occupation, fine number, date of fine, fine amount, offense type, purpose and reason for appeal.

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    The document is an application form for appealing a fine under Acts 133/171. It requests the applicant's name, ID number, address, phone number, occupation, fine number, date of fine, fine amount, offense type, purpose and reason for appeal.

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    The document is an application form for appealing a fine under Acts 133/171. It requests the applicant's name, ID number, address, phone number, occupation, fine number, date of fine, fine amount, offense type, purpose and reason for appeal.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    6 views1 page

    Undang-Undang 0

    Uploaded by

    lawassarawak2023
    The document is an application form for appealing a fine under Acts 133/171. It requests the applicant's name, ID number, address, phone number, occupation, fine number, date of fine, fine amount, offense type, purpose and reason for appeal.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Majlis Perbandaran Kuala Kangsar Cawangan Sg.

    Siput Tel : 05-7763199 (KK)


    Jalan Taiping 311000 Sg. Siput (U) : 05-7768199 (KK)
    33000 Kuala Kangsar, Perak Darul ridzuan Perak Darul ridzuan : 05- 5981520 (SS)
    Fax: 0 Fax No 05- 7761004 Email: [email protected]

    RAYUAN KOMPAUN AKTA 133 / 171

    Nama Pemohon: ……………………………………………………………………. No. K / P : ………………………………...

    Alamat : ………………………………………………………………………………………………………………………………..

    …………………………………………………………………………………………………………………………………………..

    No Telefon…………………………… …Pekerjaan………………………………………………………………………………..

    No. Kompaun : ………………………… Tarikh Kompaun:……………………Jumlah Kompaun : RM…..............................

    Jenis Kesalahan : …………………………………………………………………………………………………………………….

    …………………………………………………………………………………………………………………………………………..

    Tujuan Rayuan : ……………………………………………………………………………………………………………………...

    …………………………………………………………………………………………………………………………………………..

    Alasan Permohonan : ………………………………………………………………………………………………………………..

    …………………………………………………………………………………………………………………………………………..

    …………………………………………………………………………………………………………………………………………..

    …………………………………………………………………………………………………………………………………………..

    Tarikh : ……………………………………………… Tandatangan Pemohon : ………………………………………………….

    (UNTUK KEGUNAAN PEJABAT)

    Tarikh permohonan diterima : …………………………………………………….

    Ulasan Pegawai Kompaun / Pegawai yang mengeluarkan kompaun.

    …………………………………………………………………………………………………………………………………………

    …………………………………………………………………………………………………………………………………………

    …………………………………………………………………………………………………………………………………………

    …………………………………………………………………………………………………………………………………………

    Tarikh : ……………………………………….. Tandatangan Pegawai : ……………………………………………….

    (KEPUTUSAN YDP / SU)

    Batal Tolak

    Kurang Tangguh

    Jumlah bayaran yang perlu dibayar : RM…………………………………………………………………………………………

    Tarikh : ………………………………………….. Tandatangan : ………………………………………………….…….

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