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ARAHAN UNTUK KEGUNAAN PEJABAT
MAKLUMAT ASAS BAKAL PESARA
1. Sila isikan borang ini dengan menggunakan dakwat
HITAM/BIRU.
2. Sila gunakan “ HURUF BESAR”.
3. Sila tandakan pada yang bertanda *.
MAKLUMAT PEGAWAIA
Tarikh Terima :
Hari Bulan Tahun
/ /
3. Nama
JPA.BP.SPPP.B07a
6. Jawatan
8. Gred gaji 9. Tanggagaji 10. Gaji
Hari Bulan Tahun
/ /
4. Jantina*
L PLelaki Perempuan
11. No. Keahlian KWSP
5. Tarikh lahir (Mengikut rekod perkhidmatan)
5. Tarikh pemberian taraf berpencen/
disifatkan bepencen
.
/ /
Hari Bulan Tahun
3a. Tarikh lantikan pertama
/ /
Hari Bulan Tahun
3b. Tarikh disahkan dalam jawatan pertama
/ /
Hari Bulan Tahun
4a. Tarikh lantikan jawatan sekarang
/ /
Hari Bulan Tahun
4b. Tarikh disahkan dalam jawatan sekarang
1. Jenis Perkhidmatan*
MAKLUMAT PERKHIDMATANB
10
11 Perkhidmatan Polis
Perkhidmatan Awam Negeri20
Perkhidmatan Awam Persekutuan 30
40 Badan Berkanun Negeri
Kuasa Tempatan
Badan Berkanun Persekutuan
/ /
Hari Bulan Tahun
1a. No. Kad Pengenalan semasa
2a. No. Kad Pengenalan dahulu
1b. Kategori Kad Pengenalan semasa *
01 02Baru Lama Polis
2b. Kategori Kad Pengenalan dahulu *
01 02Baru Lama 04
04
7. Skim Gaji
12. Pilihan umur persaraan (tahun)*
55 56 Lain-lain, nyatakan……………
- 1 -
Polis
50
2. Nama Jabatan/Agensi
UNTUK KEGUNAAN
PEJABAT
Kod Jabatan / Agensi
JABATAN PERKHIDMATAN AWAM MALAYSIA
BAHAGIAN PENCEN
-2-
JPA.BP.SPPP.B07aPENGESAHAN KETUA JABATANC
Saya mengakui dan mengesahkan bahawa segala maklumat yang dicatatkan adalah betul.
______________________________________
(Tandatangan Ketua Jabatan)
Cop rasmi jabatan :
Tarikh :

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Jpa.bp.sppp.b07a

  • 1. ARAHAN UNTUK KEGUNAAN PEJABAT MAKLUMAT ASAS BAKAL PESARA 1. Sila isikan borang ini dengan menggunakan dakwat HITAM/BIRU. 2. Sila gunakan “ HURUF BESAR”. 3. Sila tandakan pada yang bertanda *. MAKLUMAT PEGAWAIA Tarikh Terima : Hari Bulan Tahun / / 3. Nama JPA.BP.SPPP.B07a 6. Jawatan 8. Gred gaji 9. Tanggagaji 10. Gaji Hari Bulan Tahun / / 4. Jantina* L PLelaki Perempuan 11. No. Keahlian KWSP 5. Tarikh lahir (Mengikut rekod perkhidmatan) 5. Tarikh pemberian taraf berpencen/ disifatkan bepencen . / / Hari Bulan Tahun 3a. Tarikh lantikan pertama / / Hari Bulan Tahun 3b. Tarikh disahkan dalam jawatan pertama / / Hari Bulan Tahun 4a. Tarikh lantikan jawatan sekarang / / Hari Bulan Tahun 4b. Tarikh disahkan dalam jawatan sekarang 1. Jenis Perkhidmatan* MAKLUMAT PERKHIDMATANB 10 11 Perkhidmatan Polis Perkhidmatan Awam Negeri20 Perkhidmatan Awam Persekutuan 30 40 Badan Berkanun Negeri Kuasa Tempatan Badan Berkanun Persekutuan / / Hari Bulan Tahun 1a. No. Kad Pengenalan semasa 2a. No. Kad Pengenalan dahulu 1b. Kategori Kad Pengenalan semasa * 01 02Baru Lama Polis 2b. Kategori Kad Pengenalan dahulu * 01 02Baru Lama 04 04 7. Skim Gaji 12. Pilihan umur persaraan (tahun)* 55 56 Lain-lain, nyatakan…………… - 1 - Polis 50 2. Nama Jabatan/Agensi UNTUK KEGUNAAN PEJABAT Kod Jabatan / Agensi JABATAN PERKHIDMATAN AWAM MALAYSIA BAHAGIAN PENCEN
  • 2. -2- JPA.BP.SPPP.B07aPENGESAHAN KETUA JABATANC Saya mengakui dan mengesahkan bahawa segala maklumat yang dicatatkan adalah betul. ______________________________________ (Tandatangan Ketua Jabatan) Cop rasmi jabatan : Tarikh :