NR/R/PS1/Pin.Rev.1/2011 Baru New Lanjutan Extension LEMBAGA HASIL DALAM NEGERI MALAYSIA INLAND REVENUE BOARD OF MALAYSIA PELAWAT SEMENTARA – PAS LAWATAN PROFESIONAL FOREIGN VISITORS – PROFESSIONAL VISIT PASS A. MAKLUMAT PELAWAT SEMENTARA / DETAIL OF FOREIGN VISITORS A1. Nama penuh seperti dalam pasport: A2. Warganegara: Full Name as in passport: Citizenship: Mr./Mrs./Ms................................................................................... ..…….......................................................... DD MM YYYY A3. No. pasport: A4. Tarikh Lahir: Passport No.: Date of Birth: A5. No. Fail Cukai Pendapatan Malaysia, jika ada: SG/OG Income Tax File No., if any: A6. Alamat Address: ....................................................................................................................................................................................... ....................................................................................................................................................................................... ....................................................................................................................................................................................... ....................................................................................................................................................................................... DD MM YYYY DD MM YYYY A7. Tempoh lawatan: Duration of stay: A8. Tujuan lawatan: Purpose of stay: ....................................................................................................................................................................................... ....................................................................................................................................................................................... ....................................................................................................................................................................................... ....................................................................................................................................................................................... B. MAKLUMAT KONTRAK / CONTRACT DETAILS DD MM YYYY DD MM YYYY B1. Tempoh kontrak: dari from Duration of contract: B2. Nilai kontrak: RM ................................ contract value: B3. Manfaat berbentuk barangan: Benefit in kind: Nilai tempat kediaman: @ RM ............................ X ............................ hari = RM ................................ Value of accommodation: day Nilai tiket kapal terbang / pengangkutan: RM ................................ Value of airfare/transport: Nilai makanan: @ RM ............................ X ............................ hari = RM ................................ Value of food: day Nilai manfaat-manfaat lain yang disediakan, nyatakan jenis manfaat: Value of other benefits in kind provided, state the type of such service or facility: ....................................................................................................................................................... ....................................................................................................................................... RM ................................ JUMLAH TOTAL RM ............................... 4. Nyatakan nama dan alamat individu/syarikat yang berhak menerima bayaran (B2), jika, lain dari penama di atas (A1): State name and address of the individual / company who is entitled to the contract payment (B2), if, other than the above named person (A1): ....................................................................................................................................................... ....................................................................................................................................................... ....................................................................................................................................................... No. Fail cukai pendapatan Malaysia, jika ada: Income Tax File No., if any: Sila lihat sebelah [PTO] BORANG NR/R/PS1 dari from hingga to hingga to