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Security Bond Form

This document is a security bond issued by the Government of Malaysia's Immigration Ordinance and Regulations. It binds an individual to comply with immigration laws and any conditions of their visa or pass. If the individual fails to comply, they will forfeit the security deposit of RM10,000 that was provided upfront. The document records the individual's personal details, signature, witness signature and details, and the receipt number for the security deposit paid.

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746 views1 page

Security Bond Form

This document is a security bond issued by the Government of Malaysia's Immigration Ordinance and Regulations. It binds an individual to comply with immigration laws and any conditions of their visa or pass. If the individual fails to comply, they will forfeit the security deposit of RM10,000 that was provided upfront. The document records the individual's personal details, signature, witness signature and details, and the receipt number for the security deposit paid.

Uploaded by

Shah Echa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Appendix 12

GOVERNMENT OF MALAYSIA
Stamp
Immigration Ordinance, 1959
(F.P.M. 12 of 1969) RM10.00
Immigration of Malaysia Regulation, 1963 By the stamping
(F.L.W. 228/63) office in Inland
Revenue Board
SECURITY BOND of Malaysia
(Regulations 18)

Where’s it is a condition of the issue of a to me / the said


of
that there furnished by me / on behalf of the
said security in the sum of as
a guarantee that I / the said will comply with the provisions of the above Ordinance and of
any regulations made there under and with any conditions imposed in respect of, or
instructions endorsed on such pass.
Now I, NRIC
of
do hereby bind myself that I / the said
will comply with the provisions of the above Act and of any regulations made
there under and with any special conditions imposed in respect of, or instructions endorsed
on such pass.
And in case of my / the said
making default therein, I hereby bind myself to forfeit to the Government of Malaysia the sum
of which I hereby deposited with the Government of Malaysia vide
Receipt No. .

Dated this day of at in


the state of .

Signature of the abovenamed

Signed and executed by the abovenamed


In my presence
Signature of Witness :
Fullname of Witness :
Address of Witness :

FILE REF :
Note : The amount chargeable is according to country of origin of the participant : refer to Rate of
Security Bond by country

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