Personal Bond 69721j

GOVERNMENT OF MALAYSIA Immigration Ordinance 1959 (F.M. 12 of 1969) Immigration Regulation, 1963 (P.L.N. 228/63) PERSONAL BOND (Regulation 18)

Stamp RM10.00

WHEREAS it is a condition of the issue of a Visit (Temporary Employment) to me / ...................................................of .................................................................. that (employee)

(address)

there be furnished by me / on behalf of said ............................................................. (employee) security in the sum of RM .......................... as a guarantee that I / the said ............. ................................................................ will comply with the provisions of the (employee)

Ordinance and of any Regulations made thereunder and with any conditions imposed in respect of or instructions endorsed on such . Now I ............................................ NRIC ................................................. of (employer)

........................................................................................................................... do (address)

hereby bind myself that I / the said ...................................................................... .... (employee)

will comply with the provisions imposed in respect of or instructions endorsed on such Visit (Temporary Employment) and in case of my / the said ............................. ... (employee)

making default therein, I hereby bind myself to forfeit to the Government of Malaysia the sum of RM.................... Dated this ........ day of .................................. 20 ......... at .................................... in the state of .................................................................. Signature of the above named

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Signed and executed by the above named .......................................... in my presence Signed of Witness

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Full name of witness

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Address of witness

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