This document is an application for an ePerolehan access medium. It contains the applicant's personal details such as name, IC number, address, and contact information. It specifies that the applicant is requesting an ePXS access medium with 3 years validity to be delivered via courier. It provides instructions that the applicant must submit a photocopy of their IC along with payment to obtain the ePXS USB token. It also provides instructions for obtaining a digital certificate via smart card reader once MOF license approval and payment is received for a MyKad eP application. The applicant declares the information provided is true and agrees to the Terms and Conditions of ePerolehan service.

1. ePerolehan Access Medium Application
Ministry Of Finance (MOF) No. : NA
Company Name : WMY TRANSFORMATION CONSULTANCY & RESOURCES
User Name : WAHAB BIN RASIMON
Identification Card Number (IC) : 520320105899
Address Line 1 : NO.7, JALAN UMBUT 24/22,
Address Line 2 : SEKSYEN 24,
City : SHAH ALAM
Postcode : 40300
State : SELANGOR
Telephone : +603-55411336 Fax : +603-55412506
E-mail Address : wahab.wmy@gmail.om
ePerolehan Access Medium Type : ePXS (3 Years Validity)
Delivery Mode : Courier
Smart Card Reader : N/A
Please read the information below before proceeding to the next step. For further inquiry please contact our
Customer Service at 03-79857777 or e-mail to bantuan@commercedc.com.my
a) For MyeP card and ePXS USB Token Application
You must submit a photocopy of your Identification Card (IC) together with this form and payment to:
Commerce Dot Com Sdn. Bhd.
Level 2,
No 2, Wisma Amtek,
15, Jalan Tandang,
46050 Petaling Jaya,
Selangor.
b) For MyKad eP Application
Please go to ePerolehan website at https://SAS.commercedc.com.my/SAS/userlogin.asp to perform on-site
self injection of digital certificate using your smart card reader once your Company's MOF license application
is approved and payment for all fees has been made.
Declaration
I hereby confirm that I have submitted an online request for an ePerolehan Access Medium. I declare that all
the information given is true and accurate and have not withheld any information that would affect the
acceptance of my application. By signing this application form, I also agree to be bound by the Terms and
Conditions as stipulated in ePerolehan Standard Terms of Service, and any amendments made thereto from
time to time.
Signature: Date and Time: