Rujukan
1. Borang A1 : Maklumat Pemohon (Individu) Borang A2 : Maklumat Pemohon (Syarikat)
2. Borang B : Maklumat Premis
3. Dokumen Sokongan : a) Gambar Premis (muka hadapan bangunan) b) Salinan SSM (jika pendaftaran syarikat)
c) Salinan Kad Pengenalan (jika pendaftaran individu) Nota
1. Borang A di isi oleh pemohon (individu / syarikat) 2. Borang B di isi mengikut bilangan unit yang ditawarkan References
1. Form A1 : Applicant Information (Individual) Form A2 : Applicant Information (Company)
2. Form B : Premise information
3. Supporting Documents : a) Images of the front of the building b) Copy of SSM (for company registration)
c) Copy of Identity Card (for individual registration) Note
1. Form A to be filled out by the applicant (individual / company) 2. Form B to be filled out according to the number of units offered
PENDAFTARAN SHORT TERM
ACCOMODATION (STA)
BORANG A1 FORM A1
1 2
3 4
Lelaki Male
5
Islam Islam
Buddha Buddhist 6
7 8
Kristian Christian
Lain-lain, sila nyatakan : Others (please state) Nama Pemohon :
Name of Applicant
Jantina : Gender
No. Kad Pengenalan / No. Passport : Identity Card No. / Passport No.
Premis Penginapan perlu berdaftar di bawah Kementerian Pelancongan, Seni dan Budaya Malaysia merangkumi seperti berikut :
a) Premis penginapan yang berdaftar atas talian seperti Airbnb.com, Traveloka.com, Agoda.com, Trivago.com, Booking.com, Mudah.com dan lain-lain atas talian; dan
b) Premis Penginapan yang BELUM berdaftar sama ada atas talian ataupun dengan kementerian.
BORANG PENDAFTARAN PREMIS PENGINAPAN ACCOMMODATION PREMISES REGISTRATION FORM
ACCOMMODATION PREMISES REGISTRATION :
Accommodation Premises that are required to be registered with the Ministry of Tourism, Arts and Culture of Malaysia are as follows :
Alamat Surat Menyurat : Mailing Address
Bangsa : Race
Melayu Malay PENDAFTARAN PREMIS PENGINAPAN :
Maklumat Pemohon (Individu) Applicant Information (Individual)
Agama : Religion
Bagi setiap item, sila tandakan (x) atau isi tempat kosong pada ruangan yang berkaitan For each item, please tick (x) or fill in the blank in the relevant space
Perempuan Female
E-mel : Email
India Indian
Lain-lain, sila nyatakan : Others (please state) Online registered accommodation premises such as Airbnb.com, Traveloka.com, Agoda.com, Trivago.com, Booking.com, Mudah.com and others; and
Cina Chinese
Nombor Telefon : Contact Number
Accommodation Premises that are not yet registered either online or with the ministry.
BORANG A2 FORM A2
1
Sdn. Bhd.
Limited
Enterprise Enterprise
Koperasi Cooperatives 2
3
4
5
6
Online registered accommodation premises such as Airbnb.com, Traveloka.com, Agoda.com, Trivago.com, Booking.com, Mudah.com and others; and
b) Premis Penginapan yang BELUM berdaftar sama ada atas talian ataupun dengan kementerian.
Accommodation Premises that are not yet registered either online or with the ministry.
Nombor Telefon : Contact Number
Emel Syarikat : Company Email Jenis Syarikat : Type of Company
Nama Syarikat : Company Name
Nombor SSM : SSM Number
BORANG PENDAFTARAN PREMIS PENGINAPAN ACCOMMODATION PREMISES REGISTRATION FORM
Alamat Surat Menyurat : Mailing Address
Maklumat Pemohon (Syarikat) Applicant Information (Company)
Bagi setiap item, sila tandakan (x) atau isi tempat kosong pada ruangan yang berkaitan For each item, please tick (x) or fill in the blank in the relevant space
PENDAFTARAN PREMIS PENGINAPAN :
ACCOMMODATION PREMISES REGISTRATION :
Premis Penginapan perlu berdaftar di bawah Kementerian Pelancongan, Seni dan Budaya Malaysia merangkumi seperti berikut :
Accommodation Premises that are required to be registered with the Ministry of Tourism, Arts and Culture of Malaysia are as follows :
a) Premis penginapan yang berdaftar atas talian seperti Airbnb.com, Traveloka.com, Agoda.com, Trivago.com, Booking.com, Mudah.com dan lain-lain atas talian; dan
9
10
11
12
Ada Yes
Tiada No
13
14 Pertanian
Agriculture
Komersial Commercial Persendirian
Private
15 Ada
Yes
Tiada No
16 Bandar
City Luar Bandar Rural
Pulau Island
17 Gimnasium
Gymnasium Kolam renang Swimming pool Mesin basuh Washing machine
18 Kemasan bilik
Housekeeping Perkhidmatan dobi Laundry service Pengangkutan Transportation Lokasi Premis Beroperasi :
Location of Premises Operated
Pinggir Bandar Suburbs Business License from
Local Authorities
Bangunan Strata / Kediaman Bertingkat Strata Building / Elevated Residential Bertanah [Teres / Rumah Berkembar]:
Landed [Terrace / Twin House]
Jenis Premis Kediaman : Residential Premises Type Alamat Premis : Premise Address Nama Premis : Premise Name
Lesen Perniagaan Daripada Pihak Berkuasa Tempatan : Jenis Hartanah :
Type of Property
(Sila lengkapkan maklumat : Lampiran 1) Please complete the attachment : Appendix 1 Bilangan Unit Yang Ditawarkan :
Number of units Offered
(Jika status premis kediaman strata)
(If the residential premises is residential strata properties )
Penyediaan sarapan pagi Breakfast
Perkhidmatan Yang Disediakan : Services Provided
Lain-lain, sila nyatakan : Others (please state)
Lain-lain, sila nyatakan : Others (please state) Pemandu Pelancong Tourist Guide Lain-lain, sila nyatakan :
Others (please state)
Kelulusan Joint Management Body (JMB) / Joint Management Corporation (JMC) : JMB / JMC approval
Tempat letak kenderan Parking
Peralatan memasak Cooking utensils Kemudahan Yang Disediakan :
Facilities Provided
Borang B diisi mengikut bilangan unit premis yang hendak didaftarkan.
Form B is filled in according to the number of premises units to be registered.
BORANG B FORM B
BORANG PENDAFTARAN PREMIS PENGINAPAN ACCOMMODATION PREMISES REGISTRATION FORM
Hendaklah diisi mengikut jumlah premis sama ada dalam milikan atau seliaan.
Must be filled in by the number of premises either in possession or supervision.
Maklumat Premis Premise information
BIL. UNIT
BIL NAMA PREMIS NO. UNIT DIDAFTARKAN BIL. BILIK
LAMPIRAN 1 APPENDIX 1
BORANG PENDAFTARAN PREMIS PENGINAPAN ACCOMMODATION PREMISES REGISTRATION FORM
Sila lengkapkan maklumat berikut. Sekiranya ruangan tidak mencukupi sila buat salinan tambahan.
Please complete the following information. Please make additional copies for further information.
JUMLAH
(i)
(ii)
(iii)
(iv)
(v)
(vi)
Tarikh : Date
PENGAKUAN PEMOHON : DECLARATION OF APPLICANT
3. Saya mengaku bahawa semua keterangan di atas adalah benar dan permohonan pendaftaran ini adalah lengkap. Sekiranya maklumat yang diberikan adalah tidak benar atau permohonan tidak lengkap kementerian berhak membatalkan permohonan ini.
I acknowledged that all of the above statements are true and complete. If the information provided is not true or incomplete, the ministry reserves the right to cancel the application.
Tandatangan pemohon : Applicant signature
* BORANG YANG TELAH LENGKAP DI ISI BOLEHLAH DIHANTAR MELALUI : COMPLETED FORMS CAN BE SENT THROUGH
** BAGI MAKLUMAT LANJUT, SILA BERHUBUNG TERUS DENGAN IBU PEJABAT BAHAGIAN PELESENAN PELANCONGAN, KEMENTERIAN PELANCONGAN, SENI DAN BUDAYA
FOR MORE INFORMATION, PLEASE CONTACT TOURISM LICENSING DIVISION, MINISTRY OF TOURISM, ART AND CULTURE
EMAIL : [email protected] ; ATAU EMEL
ALAMAT : BAHAGIAN PELESENAN PELANCONGAN (PLN)
ADDRESS KEMENTERIAN PELANCONGAN, SENI DAN BUDAYA MALAYSIA ARAS 1, NO.2 MENARA 1 JALAN P5/6
PRESINT 5, 62200 PUTRAJAYA
1. Saya telah melengkapkan borang pendaftaran.
I have completed the registration form.
2. Bersama-sama ini disertakan dokumen-dokumen seperti berikut : Accompanied by the following documents:
Salinan Suruhanjaya Syarikat Malaysia (jika berkaitan) Copy of Companies Commission of Malaysia (if applicable)
Salinan Pembuktian Milikan Premis Penginapan Copies of Acquisition of Accommodation Premises Borang A1 : Maklumat Pemohon Individu (jika berkaitan) Form A1: Individual Applicant Information (if applicable)
Borang A2 : Maklumat Pemohon Syarikat (jika berkaitan) Form A2: Company Applicant Information (if applicable)
Borang B : Maklumat Premis Form B: Premise Information
Salinan Kad Pengenalan (jika berkaitan) Copy of Identity Card (if applicable)
