JPJK7-1-2016 - Borang Permohonan Salinan - Gantian Sijil Pemilikan Kenderaan - LKM - Lesen Perdagangan Kenderaan Motor

 

(CYCK>/Yjdg (CYCK> /Yjdg 8/?9 8/?980) 80)

CHOHWHD YBDNHDNKRWHD CHFHD AHFHZUJH OM_HDN YB_AMLMDHD UHFJDHD / NHDWJHD UJCJF YBAJFJKHD KBDGB_HHD HWHR UHFJDHD / NHDWJHD FBUBD KBDGB_HHD AMWM_ HWHR UHFJDHD FBUBD YB_GHNHDNHD KBDGB_HHD AMWM_ [ Khbghl 8? ghd ?7 Khbghl-khbghl Kbdgbrhhd Amtmr (Ybdgh`thrhd ghd Ybfbsbdhd) 8:2: Q

UJFH NRDHKHD LR_R@ OBUH_ UHLHCH

H.

CBDJU YB_AMLMDHD

UBOHO YB_AMLMDHD

Ljfhdn

Ebthkhd Ebthkh d Yughr Yughr / Kh Khour our / Kbsjfhphd Kbsjfh phd Ebthkhd

_mshk

@jzjkhf Gmkuabd Wjghk Ubapurdh

*Uhfjdhd *Uhfjdh d Fbsbd Kbdgbrhhd Kbdgbrhhd Amtmr 

Yjdghhd _bkmg

Gjthlhd Gjthlhd Rdtuk Rdtuk Ujhshth Ujhshthd d/ Ybaouktjhd / Ljfhdn Ybaouktjhd Ljfhdn

*Nhdtjhd Fbsbd Ybrghnh *Nhdtjhd Ybrghnhdnhd dnhd Kbdgbrh Kbdgbrhhd hd Amtmr 

Kbdgbrhhd

Ghfha Ujaphdh Ujaphdhd d Chohthd

*Uhfjdhd *Uhfjdh d Ujcjf Ybajfj Ybajfjkhd khd Kbdgbr Kbdgbrhhd hhd

*Nhdtjhd *Nhdtjh d Ujcjf Ybajfjkhd Ybajfjkhd Kbdgbrh Kbdgbrhhd hd

(Whdghkhd [\Q ghfha pbthk yhdn obrkbdhhd)

E.

O.

(Whdghkhd (Whdghk hd [\Q ghfha pbthk yhdn obrkbdhhd) obrkbdhhd)

OR ORWJ WJ__-ORW ORWJ_ J_ YB YBAJF AJFJK JK OB OB_G _GH H@WH_ @WH_ KBDGB KBDGB_H _HHD HD

8.

Dhah3

?.

Kht Khtbn bnmr mrjj Ybaj Ybajfj fjk k *3 Jd Jdgj gjvjg vjgu u / Hnbd Hnbdsj sj K Kbr brhc hchh hhd d / Uyhr Uyhrjk jkht ht / Ybr Ybrtu tuou oulh lhd d

5.

Dm. K.Y K.Y.. (* (*Hwh Hwha a / Ymfjs Ymfjs / Wbdtbr Wbdtbrh) h) / Yhspmr Yhspmrtt / Hn Hnbds bdsjj Kbrhchh Kbrhchhd d / Uyh Uyhrjkh rjkhtt / Ybrtuo Ybrtuoulhd ulhd

7.

Dm. Yb Ybdg dgh h`t `th hrhd K Kb bdgbr gbrhhd / Dm. Yfht Ybrghnhdnhd3

2.

Ouhthd ghd Amgbf3 (gjjsj cjkh ORKHD Yfht Ybrghnhdnhd)

*Ymtmdn ahdh yhdn tjghk obrkbdhhd

G. YBDNBUHLHD KBLHGJ_HD YBAJFJK OB_GH@WH_ KBDGB_HHD

Aukh Uurht 8  

(CYCK>/Yjdg (CYCK> /Yjdg 8/?9 8/?980) 80)

B.

YBDNHKRHD YBAMLMD

8.

Uhyh (dhah) ……………………………………….…………………………….. Dm. *K.Y (*Hwha / Ymfjs / Wbdtbrh) / Yhspmrt …………………………………….……. hghfhl *pb *pbaj ajfj fjk k ob obrg rgh` h`th thrr kb kbdg dgbr brhh hhd d / pb pbnh nhwh whjj yh yhdn dn gjo gjobr brjj kuhs kuhsh h ghfha ghfh a *Hnbds *Hnbdsjj Kbr Kbrhch hchhd hd / Uyhr Uyhrjkh jkhtt / Ybrtuo Ybrtuoulh ulhd d / *whkjf *whkjf kbphgh kbphgh pbaj pbajfjk fjk kbdg kbdgbrh brhhd hd obrgh`t obrgh`thr hr / *khkjt *khkjthdnh hdnhd d CYC yhdn yhdn obrthdn obrt hdnnud nudnch nchwho who

ohnj ohnj

kbdgbr kbdgbrhhd hhd

yhd yhdn n

obrdmao obrdmaomr  mr  pbdgh`thrhd

…….............……………

udtuk

abaouht

pbramlmdhd *shfjd *shfjdhd hd / **nhdtjhd nhdtjhd Ujcjf Ybajfjkhd Ybajfjkhd Kbdgbrh Kbdgbrhhd hd.. hthu ?.

Uhyh (dhah) ……………… ………………..…………………… ……………………..…………… ……………..……………… ………………... Dm. *K.Y (*Hwha / Ymfjs / Wbdtbrh) / Yhspmrt

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

obrthdnnudnchwho

ohnj

kbdgbrhhd

yhdn

hghfhl

obrdmaomr

*pbajfjk

pbdgh`thrhd

obrgh`thr /

pfht

/

*khkjthdnhd pbrghnhdnhd

CYC

yhdn

obrdmaomr  

……………………………… udtu udtuk k aba baou ouht ht pbra pbraml mlmd mdhd hd *s *shf hfjd jdhd hd/* /*nh nhdt dtjh jhd d *Fbs *Fbsbd bd Kbdg Kbdgbr brhh hhd d Amtm Amtmr  r  / Fbsbd Ybrghnh Ybrg hnhdnh dnhd d Kbd Kbdgbr gbrhhd hhd Amtm Amtmrr . Uhyh *lhgjr sbdgjrj / abwhkjfkhd pbdhah obrjkut kb

pbchoht

CYC

*Dbnbrj

/

Ehwhdnhd …………… ……………................. .................… …..... .....…………… …………….. ..……… ……….. .. udtuk udtuk abdnba abdnbaukh ukhkhd khd pbraml pbramlmdhd mdhd jdj. jdj.

Dhah whkjf3

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

Dm KY / Yhspmrt3 ……………………………………………………………………………………………………

5.

(Cjkh ORKHD FYKA ) Uhyh cunh abdnhku ohlhwh ohlhwh kbdgbrhhd tbrsbout tbrsbout obrhgh ghfha khwhfhd khwhfhd shyh ghd ghfha kbhghhd kbhghhd ohjk ghd omfbl gjnudhkhd.

7.

Uhyh abdnhku tbfhl abdybrthkhd ohyhrhd sbohdyhk _A……………… ……………….. .. (cjk (cjkh h obr obrkb kbdh dhhd hd)) oh ohnj nj tu tucu cuhd hd pbram pbramlm lmdh dhd d jd jdj. j.

2.

Uhyh abdnhku ghd abdnbshlkhd ohlhwh outjrhd yhdn shyh dyhthkhd ghfha Ohlhnjhd H, O, E, G ghd B omrhdn jdj hghfh hgh fhl l ob obdh dhrr gh ghd d tjgh tjghk k abdnh abdnhdg dgud udnj nj ahkf ahkfua uaht ht ph phfs fsu, u, tj tjgh ghk k ob obtu tuff ht hthu hu abdn abdnbfj bfjru rukh khd. d.

0.

Uh Uhy yh a cubndnbf h `bfj hlh hl hkhd dg bh gl hrsouht hltu hwkbsh h shfh aba bao ob khdohw hk hksy t yyhbddn 89 /Yjdg 8/?9 8/?980) 80)

@.

KBFRFRUHD (Kbnudhhd Ybchoht)

Ybramlmdhd *shfjdhd Ybramlmdhd *shfjdhd / *nhdtjh *nhdtjhd d *Ujcj *Ujcjff Y Ybajfjk bajfjkhd hd Kbdgbrhhd Kbdgbrhhd / Fbsbd Fbsbd Kbdgbrhhd Kbdgbrhhd Amtmr / Fbsbd Fbsbd Ybrghnhdnhd Ybrghnhdnhd Kbdgbrhhd Kbdgbrhhd Amtmr tbfhl gjsbahk gjsbah k ghd *gjfufuskhd *gjfufuskhd / gjtmfhk. (cjkh gjtmfhk gjtmfhk dyhthk dyhthkhd hd sboho)3 ……………………………………………………………………………………………………………………………..…………………………… …………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………………………………

Whrjkl3 ……………………………………

Whdghthdnhd3 ……………………… ………………………..…………………… …………………….. .. Em Emp p Dhah Dhah gh ghd d Chwht Chwhthd hd33 ………………………………… …………………………………..

N.

8.

YB_HKRH RHD D YBD YBDB_JAH AHH HD

Uhyh

(dhah)

Yhspmrt

…………………………………….……………………………..

Dm.

*K.Y

(*Hwha

/

Ymfjs

/

Wbdtbrh)

/

…………………………………….……. hghfhl *pba *pbajfj jfjk k obrgh`t obrgh`thr hr kbdgbr kbdgbrhhd hhd / pbnhwh pbnhwhjj yhdn yhdn gjobrj gjobrj kuhsh kuhsh ghfh ghfha a

*H *Hnb nbds dsjj Kbrhc Kbrhchh hhd d / Uyhr Uyhrjkh jkhtt / Ybrtu Ybrtuou oulh lhd d / **wh whkj kjff kbph kbphgh gh pb pbaj ajfj fjk k ob obrgh rgh`th `thrr kb kbdgb dgbrh rhhd hd yh yhdn dn obrdm obrdmao aomr mr pb pbdg dgh`t h`thr hrhd hd ………………………………………..

abdnhku

lhgjr

sbdgjrj

phgh

lhrj

jdj

gj

pbchoht

CYC

*Dbnbrj

/

Ehwhdnhd

………………………………………………….. ghd tbfhl abdbrjah *s *shf hfjdh jdhd d / *n *nhdt hdtjh jhd d Uj Ujcj cjff Ybajf Ybajfjk jkhd hd Kb Kbdg dgbr brhh hhd d obrdma obr dmaomr omr sjrj sjrj …………………………………. ghrjphgh Ybnhwhj CYC.

hthu ?.

Uhyh (dhah) ……………… ………………..…………………… ……………………..…………………………………… …………………………………….. .. Dm Dm.. *K *K.Y .Y (*Hw (*Hwha ha / Ym Ymfj fjs s / Wbdt Wbdtbr brh) h) / Yh Yhsp spmr mrtt ……………………………... …………………………… ...……… ………..

hghfhl

obrdmaomr

pbrghnhdnhd obrdmaomr   ……………………………………… ………………………………………...

*nhdtjhd

pbdgh`thrhd *Fbsbd

/ pfht

Kbdgbrhhd

………………………………….. …………………………………

*pbajfjk

Amtmr

/

obrgh`thr

Fbsbd

/

whkjf

kbphgh

Ybrghnhdnhd

pbajfjk

Kbdgbrhhd

obrgh`thr

ghd tbfhl

Amtmr  

yhdn

abdbrjah

obrdmaomr

sjrj

ghrjphgh Ybnhwhj CYC.

……………….…………………………..……… Whdghthdnhd Ybnhwhj Ubrhlhd

……………….……………………………….…… Emp Dhah ghd Chwhthd

Whrjkl3 ………………………………. Ahsh3 ………………………………...

………………………………………….……………………… Whdghthdnhd Ybamlmd

………...........…………………………….……………………… Emp Dhah ghd Chwhthd Chwhthd (cjkh pb pbajfjk ajfjk obrgh`thr obrgh`thr kbdgbrhhd kbdgbrhhd hghfhl Hnbdsj Hnbdsj Kbrhch Kbrhchhd hd / Uyhrjkht Uyhrjkht / Ybrtuoulhd

………...........…………………………….……………………… Ehp chrj pbamlmd (Ohnj Ujcjf Ybajfjkhd Kbdgbrh Kbdgbrhhd) hd)

Whrjkl3 ………………………………. Ahsh3 ………………………………...

*Ymtmdn ahdh yhdn tjghk obrkbdhhd

*kbdgbrhhd