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Borang R3 Cidb

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Lembaga Pembangunan

Industri Pembinaan Malaysia


Construction Industry Development Board Malaysia
______________________________________________________________________________________

REGISTRATION
OF CONTRACTOR
Application for registration from
foreign contractor

CIDB R3/2013-SERIAL NO.:…………………..….

For Official Use

Application No.: ……………………………............


R3e
Date Received.: ……………………………….........

_______________________________________________________________________________________________________
Date :

Manager

Registration Department

Lembaga Pembangunan Industri Pembinaan Malaysia

Tingkat 10, Menara Dato’ Onn

Pusat Dagangan Dunia Putra

41 Jalan Tun Ismail

50480 Kuala Lumpur

I / We declare and confirm that the information given and photostated copies of documents

submitted as requested are authentic. I / We am /are aware and understand that any

information and documents are found to be false shall cause my/our application to be rejected.

I / We submit postal order/money order/bank draft/ banker’s cheque of RM4550 / RM5050* as

registration fee (inclusive of RM50.00 processing fee).

Signature …………………………………………………………………………………………….

Name of Applicant…………………………………………………………………………………

IC No./Passport No…………………………………………………………………………………

Designation………………………………………………………………………………………..…

Company’s chop………………………………………

____________________________________________________________________________________

* Delete where appropriate


Please note that fees payable are as follows :

(i) RM4550.00 if a certificate of provisional registration was issued.


(ii) RM5050.00 if no certificate of provisional registration was issued.
_______________________________________________________________________________________________________

A. Particular of Applicant B. Particular of Applicant


________________________________________ _______________________________________

1. Name of Firm ……………………………………….... 1. Project Awarded :

……………………………………………………………… 1.1. Title of Project……………………………………

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

2. Registered Address (in Malaysia)………………....... ……………………………………………………..

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

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

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

……………………………………………………………… 1.2 Date of Commencement………………………...

……………………………………………………………… 1.3 Date of Completion..………………………..…...

3. Correspondence Address (if different from (2) 1.4 Date of expiry of Defects Liability

…………………………………………………………….... Period …………………………………………....

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

………………………………………………………………. 1.5 Value of Contract :

………………………………………………………………. RM…….…………………………………………..

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

4. Telephone No :………………………………………... ………………………………………………………

5. Fax No :………………………………………………… ……………………………………………………..

6. Certificate of Registration (Companies Act 1965) SUBMIT A COPY OF LETTER OF AWARD OR


LETTER OF ACCEPTANCE.
SUMMIT COPY OF CERTIFICATE OF REGISTRATION

CERTIFIED BY REGISTRAR OF COMPANIES

7. Certificate of Provisional Registration No…………....

…………………………………………………………….

____________________________________________________________________________________________________
* If copy of certificates is not certificated, submit original certificate in person for verification.

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