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UMA-4(Pin. 1/2002)

Akta Wang Tak Dituntut 1965( Pindaan 2002 ) SERAHAN WANG TAK DITUNTUT DENGAN BORANG UMA-3

( Ditaip dalam dua salinan ) Pendaftar Wang Tak Dituntut, Jabatan Akauntan Negara Malaysia Tingkat 42, Menara Maybank 100, Jalan Tun Perak 50050 Kuala Lumpur Saya sertakan cek bernombor ........................................ bertarikh ..............................................berjumlah RM .................................bersama-sama dengan Daftar Wang Tak Dituntut (Borang UMA-3) bagi tahun berakhir 31 Disember.....................dari muka surat.........................hingga muka surat...........................

Nama Syarikat / Firma Cawangan ( jika berkaitan ) Alamat

: ................................................................................................................... : .................................................................................................................................... : ......................................................................................................................... ........................................................................................................................... ........................................................................................................ ........................................................................................................

No. Telefon No. Fax

: ............................................................................................................. : ..............................................................................................................

Tarikh.................................... Untuk Kegunaan Pejabat Sahaja

Maklumat Resit No. Resit : Tarikh Resit :

.................................................... Tandatangan

Nama Pegawai : Jawatan : Cap Syarikat / Firma :

-----------------------------------------------------------------------------------------------------------------------------------SERAHAN WANG TAK DITUNTUT DENGAN BORANG UMA-3

Maklumat Resit

Diakui terima bayaran Nama Syarikat/Firma : Amaun RM No. Resit Tarikh Resit : : :

Alamat

:

.....................................................

b.p. Pendaftar Wang Tak Dituntut Cap pejabat:

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Microsoft Word - Borang UMA-4.doc

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Microsoft Word - Borang UMA-4.doc