IMM 16A FORM 16A MALAYSIA IMMIGRATION …

1 IMM 16A. form 16A. MALAYSIA . IMMIGRATION REGULATIONS 1963. APPLICATION FOR RESIDENCE PASS Photo [Regulation 16A] (Pasport Size). PERSONAL DETAILS. 1. Full name : (In block letter). 2. Other name (if any) : (In block letter). 3. Gender : Male 4. Date of Birth : (DD/MM/YY). Female 5. Place of Birth : 6. Religion : 7. Current Address in MALAYSIA : 8. Contact Number : 9. Academic qualification : 10. Email Address : 11. PARTICULARS OF TRAVEL DOCUMENT HELD. (a) Travel Document's Number : (b) Expiry Date : (DD/MM/YY). (c) Issuance Country : (d) MALAYSIA Identity Card : Number (if any). 12. If Visa granted before arrival, state (a) Reference Number : (b) Place of Issue : (c) Expiry Date : (DD/MM/YY). 13. Date of current entry : 14. Date up to which : (DD/MM/YY) current pass in valid (DD/MM/YY). 15. Reason for application : 16. Date : 17. Signature of applicant.

2 (DD/MM/YY). Left Index Finger Right Index Finger IMM 16A. DECLARATION BY LOCAL SPONSOR IN SUPPORT OF AN ALLPICATION FOR A. RESIDENCE PASS. I, the undersigned, wish to sponsor the above application: Particular of myself are as follows : Full name : Gender : Male Date of Birth : (DD/MM/YY). Female Place of Birth : Identity Card Number : Profession / Occupation : Company's Correspondence : Address Current Address : Contact Number : Email address : Relationship : Hereby certify that ;- (a) I have known personally for a period of .years ;. (b) He / She is not the best of my knowledge and belief within the category of persons prohibited to enter into MALAYSIA ;. (c) The statement made by him / her in the application are true. Further certify that the attached photographs, one of which I have endorsed accordingly on the back, are true hereness of the applicant.

3 Dated this day of .. 20 .. Signature of sponsor