TUNTUTAN TUNAI (CASH CLAIM) (POS M.0. 6) 229990-M
KIRIMAN WANG (MONEY ORDER)
RM
Matawang Asing (Foreign Curency)
Sen
atau (or)
Amaun Kiriman Wang (Money Order Amount)
Tandakan (√ ) Di Ruang Berkenaan (Please Tick (√) The Appropriate Column) Jenis Dalam Negeri Luar Negeri (Type) (Domestic) (Foreign) ____________________________________________________________ KW Biasa (Ordinary MO) KW Telegraf (Telegraphic MO)
Untuk Kiriman Wang Ekspres / Telegraf (For Express / Telegraphic Money Order)
KW Ekspres (Express MO)
Mesej: ______________________________________________________________ (Message) ____________________________________________________________
Pejabat Pembayar (Payment Office)
_________________________________________
No. Tel. Penerima: _____________________________________________________ (Payee’s Tel. No)
UNTUK KEGUNAAN PEJABAT (For Office Use)
Nama Penerima: _______________________________________________________ (Payee’s Name) _______________________________________________________
RM
Alamat (Address): ______________________________________________________
_____________________________________________________________________
Amaun Komisen B Tambahan B Telegraf B T Telegraf
Nama Pengirim: _______________________________________________________
Jumlah
_____________________________________________________________________
Sen
(Sender’s Name) ______________________________________________________ No. Kad Pengenalan: ___________________________________________________ (I.C Number) No. Kenderaan: _______________________________________________________ ____________________________________ No Tel: _________________________ T.T. / C.I.J Pengirim: (Sender’s Signature / Thumbprint)
Jenis
Cap Tarikh
Pejabat Pengeluar
Tarikh Keluaran
Nombor Stok
_____________________________ T/tangan Pegawai Pengeluar
Resit Permohonan Kiriman Wang (Money Order Application Receipt)
TUNTUTAN TUNAI (CASH CLAIM)
Nama Penerima: (Sender’s Name) No. K/P Penerima: (Sender’s IC No) 229990 - M
No Kenderaan: Nama Pejabat Pos:
………………………….. Pegawai Pengeluar Issuing Officer
Jumlah Bayaran: Tarikh: Cap Tarikh
(UNTUK SIMPANAN PENGIRIM) (TO BE KEPT BY REMITTER)