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Member's Form

Please update your company profile and data in order to show to respective government department promptly. We hope to serve you better!

1. Company name * :
  Business Registration No * :
  Office Address * :
  Tel No * :
  Fax No * :
  Website :
 
  Company's representatives for contact
  Name of Representative :
  Gender :
  H/P No :
  Office Address :
  Tel. No. :
  Fax No. :
 
 
2. E-mail Address :
 
 
3. Nature of Business * :
 
 
4. Product brand (please specify if any) :
 
 
5. Export Countries (please specify if any) :
 
 
  Attachment : Please submit SSM, Form 9, Form 24 and others related to company in PDF format.
 
 
 
  • I hereby declare the above information is true to the best of my knowledge.
 
Name of Applicant :
Date :
Contact No. :
 
 
The information with * remark, will be shown in https://acci.my/, the rest will keep privacy.
 
 

 

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