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Borang Pengisytiharan Kementerian Kewangan

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DECLARATION FORM FOR REGISTRATION OF COMPANY/CONSULTING FIRM WITH

THE MINISTRY OF FINANCE MALAYSIA

PU/UPS/1 -V.1 /1 0 (BI)

:

: Application Reference No

Application Type

Declaration For Application To Register With The Ministry Of Finance Malaysia

: : :

:

: 1.

2.

3.

5.

I/We declare that submission of all information in this declaration form, application form and supporting documents is correct and valid. I/We hereby allow the Ministry of Finance to verify any information in this declaration form, application form and supporting documents with the company/consulting firm or any other third party. I/We agree that I/we am/are responsible to update any changes in the company's information if any, after registration within twenty-one (21) days from the date the changes occur. If I/we fail to do so, the Ministry of Finance Malaysia may cancel the registration or take other actions.

I/We consent to the Ministry of Finance Malaysia representative to visit the company/consulting firm premises for the inspection/audit purposes and to verify the documents and related information.

I/We declare that the company/consulting firm does not have Owners, Board of Directors/Directors, Managers and Employees in any company/consulting firm who have been registered with the Ministry of Finance in the same category/categories. I/We agree that only personnel authorized by the company/consulting firm and the names stated in the Company/Consulting Firm Registration Certificate are allowed to do any transaction in Government procurement on behalf of the company/consulting firm.

I/We allow the Ministry of Finance Malaysia to provide information of the company/consulting firm to other Agency/Agencies for the purpose of Government procurement and to third party/parties for the purpose of improving the Government delivery system.

Applicant's Name*

Designation Signature

Name of Company/Consulting Firm

Date

4. I/We agree that the company/consulting firm after being newly registered is not allowed to make any changes to Equity Ownership and Board of Directors/Managers within six (6) months from the date of registration.

I/We understand that failure to comply with any of the above conditions, the Ministry of Finance Malaysia has the right to reject the company/consulting firm's application. If the application is rejected, the documents submitted will be returned by post/courier except when requested by the company/consulting firms, the documents will be held temporarily for fourteen (14) days from the date of rejection. The document will return by mail if they remain unclaimed within this period.

6.

I/We understand that whatever documents submitted for registration will become the Government property for any applications that have been approved or rejected after the visit/audit.

7.

I/We agree to give permission to the Ministry of Finance Malaysia to cancel the registration and delete all records/data automatically from the ePerolehan system if I/we do not renew the company/consulting firm registration within one (1) year from the expiry date of specify registration. I/We may make a new application if still interested to register with the Ministry of Finance Malaysia after the period. 8.

I/We understand that the Government and the Ministry of Finance Malaysia is not responsible for any loss(es) or damage(s) on the company /consulting firm that have been registered with the Ministry of Finance Malaysia and/or use any information obtained from this website: www.eperolehan.gov.my. I/We also agree that the approval of registration will not in any way bind the Government to offer any Government procurement to the company/consulting firm.

9.

I/We understand that any act or attempt to corruptly offer or give, solicit or receive any gratification to and from any person relating to Government procurement is a criminal offence under the Malaysian Anti-Corruption Commission Act 2009 [Act 694]. If any individual attempts to seek bribe from the company/consulting firm as an offer/or gratification pertaining to Government procurement, I/we will immediately lodge a report at the nearest office of the Malaysian Anti-Corruption Commission (MACC) or police station.

10.

NRIC/Passport No. :

Official Seal Of Company/Consulting

Firm

Referensi

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