perkhidmatan utama putra international ??putra international (pusat antarabangsa) universiti putra...

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  • PERKHIDMATAN UTAMA

    PUTRA INTERNATIONAL (PUSAT ANTARABANGSA)

    UNIVERSITI PUTRA MALAYSIA 43400 UPM Serdang, Selangor, Malaysia

    Tel: 603-8946 6048 / 6198 E-mail: intl@upm.edu.my

    Kod Dokumen: SOK/PIC/SS08 CHECKLIST FOR SPECIAL PASS APPLICATION

    PLEASE USE CAPITAL LETTERS

    Name:

    Passport No:

    Expiry Date of passport:

    d

    d

    /

    m

    m / y y y y

    NO. SEMAKAN : 02 NO. ISU : 02 TARIKH KUATKUASA : 25/05/2017 1 drp. 1

    No. Required Documents (Please arrange the document according to the sequence given)

    No of

    Copy

    Tick (If Complete) Office Use

    Applicant Help Desk

    Counter Staff

    1 Checklist for Special Pass Application (SOK/PIC/SS08) 1 2 Visa & Pass Application Form (UPM/PIC/BR01/APPLICATION FORM)

    (If you have more than 1 dependent, fill up this form once only) 1

    3 Format A Form - PK(O)IM,G.04/ FQ-01 2 4 TYPED Letter address to Immigration Director Malaysia, Kuala Lumpur

    explain the reason to apply for special pass 2

    5 COPY of Registration Slip/ Deferment Letter/ Withdrawal Letter/ Terminate Letter

    2

    6 a. LATEST of Family Letter from Embassy (ORIGINAL/ COPY must endorsed by Embassy) b. Translated Marriage Certificate (Endorsed by Embassy)

    c. Translated Birth Certificate (Endorsed by Embassy)

    2

    7 COPY of new offer letter/ flight ticket *Date of flight ticket must be within 30 days from the application submission

    2

    8 A4 sized COPY of passport (All pages of the passport) (If latest date entry in old passport, please provide all the pages) *Please write number on each of the pages

    1

    9 A4 sized COPY of passport (Details & Pass page) *Application for dependant please attached together student details & pass page

    1

    10 Receipt of Payment to EMGS (Refer Page 4 for fee information) 2 11 Receipt of Payment to UPM (Refer Page 4 for fee information) 2

    Note

    1. This checklist is for ONE application. ADDITIONAL of other dependent application will require the same number of copies.

    2. Documents which DO NOT follow the specifications are deemed incomplete and shall be rejected.

    3. Please DO NOT staple your documents and photo. 4. Use a paper clip instead. 5. DO NOT make any travel plans until all application process have been completed. (Any

    request to expedite application processing will not be entertained by PIC)

    Checked by

    Date

  • SOKONGAN

    PENGURUSANPELAJARDANSTAFANTARABANGSA

    PUTRAINTERNATIONALCENTRE

    (PUSATANTARABANGSA)

    KodDokumen:SOK/INT/BR01/VP

    VISA&PASSAPPLICATIONFORM

    NO.SEMAKAN : 00

    NO.ISU : 01

    TARIKHKUATKUASA : 24/3/2017 1drp.2

    TYPEOFAPPLICATION

    PLEASETICK(/)

    NEWSTUDENT STUDENTRENEWAL

    SPECIALPASS INVITATION/RELEASE/CLAIM

    LETTER

    VAL DEPENDENTRENEWAL TRANSFERSTICKER CANCELLATION/SHORTENING

    NEWDEPENDENT IKHTISAS/RESEARCH

    ATTACHMENT

    STAFF STAFFDEPENDENT

    STUDENTS/STAFFSPARTICULARS:

    1.NAME

    :

    _______________________________________________________________________

    2.MATRIC/STAFFNO

    :

    _________________

    GENDER

    :

    Male

    Female

    3.NATIONALITY

    4.PROGRAMME

    (ForStudentOnly)

    :

    BachelorMasterPhD

    5.PASSPORTNO.

    :

    ________________________________

    7.PASSEXPIRYDATE

    :

    (DD/MM/YYYY)

    (DD/MM/YYYY)

    8.MOBILENO.

    :

    ________________________

    9.EMAIL

    :

    ________________________

    10.NEARESTMALAYSIAEMBASSY:____________________________________________________

    (ForVALapplicationonly)

    6.EXPIRYDATE:

    : _____________________

  • NO.SEMAKAN : 00

    NO.ISU : 01

    TARIKHKUATKUASA : 24/3/2017 2drp.2

    DEPENDENTSPARTICULARS:

    NAME PASSPORTNO.PASSPORT

    EXPIRYDATE

    SOCIALPASS

    EXPIRYDATERELATION

    IcertifythatallinformationgiveninthisapplicationistrueandIhavealsosubmittedapplicationformeormy

    dependents:student/workingpass/visitpass(New/Renewal/SpecialPass/Shortening/Endorsement)

    ....... ....

    Student/StaffsSignature Date

    FOROFFICEUSEONLY

    PAYMENTCHECKLIST:(Note:PleasepresenttheoriginalreceiptfromtheBursarCounterandthecopyoftheReceiptuponsubmissionofyourapplicationtotheCounterofVisa&Pass.)

    TYPEOFPAYMENT Student/

    Staff

    Dependent

    1

    Dependent

    2

    Dependent

    3

    Dependent

    4

    Dependent

    5

    Dependent

    6

    NEWAPPLICATION:

    RENEWAL

    SPECIALPASS

    TRANSFERSTICKER

    SHORTENING/

    CANCELLATION

    INVITATIONLETTER/

    RELEASELETTER/

    CLAIMLETTER

    LATESUBMISSION

    OTHERS:

    TOTALAMOUNT(RM):

    OfficersSignatureandStamp Date

    PUTRAINTERNATIONALCENTRE

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