Borang Aduan Pelanggan

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BORANG CADANGAN / ADUAN BAHAGIAN K-EKONOMI, JABATAN KETUA MENTERI MELAKA

No Dokumen:Kualiti/BS/20 No Semakan Semula: 1 Tarikh Kuatkuasa/Semakan Semula : 1 Oktober 2008 Muka surat 1 dari 1

MAKLUMAT PELANGGAN NAMA SYARIKAT NO.TELEFON

NO.TELEFON BIMBIT

E-MAIL

TARIKH MAKLUMAT ADUAN /CADANGAN

KEGUNAAN PEJABAT SEMAKAN DAN PENENTUAN PUNCA KETIDAKPATUHAN

Tiket No:

PELAKSANAAN TINDAKAN SERTA-MERTA

TARIKH LAKSANA

DILAKSANA OLEH

TARIKH SAH

DISAHKAN OLEH

Nombor Borang LTTP, sekiranya perlu :

OLEH :

TARIKH:

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