CPA Tax & Investment Review 2003

Appendix 6-2: Form ICA 1 (97) ICA 1 (97)

PERMOHONAN BAGI LESEN PENGILANG DI BAWAH AKTA PENYELARASAN PERINDUSTRIAN, 1975 DAN / ATAU GALAKAN DI BAWAH AKTA PENGGALAKAN PELABURAN, 1986 UNTUK PROJEK PENGILANGAN BARU APPLICATION FOR MANUFACTURING LICENCE UNDER THE INDUSTRIAL COORDINATION ACT, 1975 AND / OR INCENTIVE UNDER THE PROMOTION OF INVESTMENTS ACT, 1986 FOR A NEW MANUFACTURING PROJECT Permohonan untuk: [ tandakan (√) di ruang yang berkenaan ] Application for: {tick (√) whichever is relevant} (i)

Lesen Pengilang Manufacturing Licence

(ii) (a) Taraf Perintis Pioneer Status (b) Elaun Cukai Pelaburan Investment Tax Allowance Keluaran/aktiviti dicadangkan Proposed products/activities

330

❒ ❒ ❒

No. kod tarif Tariff code no.

Appendix 6-2 ICA 1 (97)

A.

BUTIR-BUTIR PEMOHON/SYARIKAT PARTICULARS OF APPLICANT COMPANY

1.

Nama pemohon/syarikat dan alamat surat-menyurat Name of applicant/company and correspondence address

Telefon Telephone

Faks Fax

Pegawai dihubungi Contact person Jawatan Designation

2.

(a) Nama syarikat yang akan mengusahakan projek pengilangan Name of company which will undertake the manufacturing project

(b) Tarikh diperbadankan Date of incorporation (c) Alamat pejabat berdaftar Address of registered office

No. Telefon Telephone No.

3.

No. Faks Fax No.

Tapak kilang yang dicadangkan Proposed factory location

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4.

Butir-butir pengarah Particulars of directors

Nama dan alamat kediaman Warganegara Name and residential address Nationality

332

% saham dipegang dalam syarikat % shares held in the company

ICA 1 (97)

B.

1.

KOS PROJEK PROJECT COST

Harta tetap Fixed assets Tanah (nyatakan keluasan) Land (specify area)

b.

Bangunan kilang (nyatakan keluasan kawasan binaan) Factory building (specify built-up area)

c.

Loji dan jentera Plant and machinery Kelengkapan lain Other equipment Jumlah harta tetap Total fixed assets

d.

Fasa 2 Phase 2 RM

Jumlah Total RM

333

Appendix 6-2

a.

Fasa 1 Phase 1 RM

Nota: Jika tanah, bangunan kilang, loji atau jentera disewa/dipajak, nyatakan kos sewaan/pajakan tahunan. Note: If the land, factory building, plant or machinery is rented/leased, specify the annual cost of rental/lease. Fasa 1 Phase 1 RM 2.

Perbelanjaan sebelum pengendalian Pre-operational expenditure

3.

Modal kerja Working capital Jumlah Total

Fasa 2 Phase 2 RM

Jumlah Total RM

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334

ICA 1 (97)

Appendix 6-2 ICA 1 (97)

C.

SUMBER KEWANGAN FINANCING RM

1.

Modal dibenarkan Authorised capital

2.

Modal dibayar Paid-up capital

%

(a) Individu rakyat Malaysia Malaysian individuals Bumiputera Bumiputera Bukan Bumiputera Non-Bumiputera (b) Syarikat yang diperbadankan di Malaysia* Companies incorporated in Malaysia*

(c) Rakyat asing (nyatakan negara) Foreign nationals (specify country)

Jumlah (a), (b) dan (c) Total (a), (b) and (c)

100%

* Bagi 2(b), nyatakan struktur ekuiti seperti berikut: * For 2(b), provide equity structure as follows: Nama syarikat Name of company

Nama syarikat Name of company

Bumiputera Bumiputera

Bumiputera % Bumiputera

%

Bukan Bumiputera Non-Bumiputera

Bukan Bumiputera % Non-Bumiputera

%

Rakyat asing Foreign nationals

Rakyat asing % Foreign nationals

%

335

CPA Tax & Investment Review 2003 ICA 1 (97)

RM 3.

Pinjaman Loan Tempatan Domestic Asing Foreign Jumlah Total

4.

Sumber lain Other sources

Jumlah Total Jumlah 2, 3 dan 4 Total of 2, 3 and 4 5.

336

Berikan nama mana-mana syarikat lain yang mengilangkan keluaran yang sama/seumpamanya yang dalam mana-mana pemegang saham syarikat pemohon atau syarikat pemohon mempunyai penyertaan ekuiti. State the names of any other company manufacturing the same/similar products in which any shareholders of the applicant company or the applicant company has equity participation.

Appendix 6-2 ICA 1 (97)

D. GUNATENAGA MANPOWER Pekerjaan sepenuh masa Full-time employment Golongan Category

1.

2.

Rakyat Malaysia Malaysian national

Rakyat asing Jumlah Foreign Total national

Kakitangan pengurusan dengan Managerial staff with a.

Kelulusan teknikal Technical qualifications

b.

Kelulusan sains Science qualifications

c.

Kelulusan/pengalaman lain Other qualifications/experience

Kakitangan teknikal dan penyeliaan dengan Technical and supervisory staff with a.

Kelulusan teknikal Technical qualifications

b.

Kelulusan sains Science qualifications

c.

Kelulusan/pengalaman lain Other qualifications/experience

3.

Pekerja jualan, perkeranian dan pekerja lain Sales, clerical and other workers

4.

Pekerja kilang Factory workers a.

Mahir Skilled

b.

Tak mahir Unskilled Jumlah Total 337

CPA Tax & Investment Review 2003 ICA 1 (97)

E.

PROSES PENGILANGAN DAN KAWALAN PENCEMARAN MANUFACTURING PROCESS AND POLLUTION CONTROL

1.

Berikan carta aliran proses pengilangan dan terangkan prosesproses utama. Tandakan proses-proses mengikut jenis jentera yang digunakan seperti berikut: Provide the manufacturing process flow chart and explain the major processes. Indicate processes according to type of machinery used as follows:

2.

R

bagi jentera robotik for robotic machinery

A

bagi jentera automatik for automatic machinery

S

bagi jentera separa automatik for semi-automatic machinery

M

bagi pengendalian tangan for manual operation

Daripada carta aliran proses pengilangan, berikan butir-butir mengenai pengeluaran bahan cemar. From the manufacturing process flow chart, provide details on emission pollutants. (a) Tempat pengeluaran (b) Jenis bahan cemar Type of pollutants Point of emission

338

(c) Kuantiti Quantity

Appendix 6-2 ICA 1 (97)

F.

JENTERA DAN KELENGKAPAN KAWALAN PENCEMARAN UTAMA MAIN POLLUTION CONTROL MACHINERY AND EQUIPMENT

1.

Jentera dan kelengkapan Machinery and equipment

Perihalan Description

Jenis* Unit Baru atau Type* Unit terpakai New or used

Fungsi Function

Negara asal Country of origin

Kos Cost RM

* Catatkan Indicate R

bagi jentera robotik for robotic machinery

A

bagi jentera automatik for automatic machinery

S

bagi jentera separa automatik for semi-automatic machinery

M

bagi pengendalian tangan for manual operation

339

CPA Tax & Investment Review 2003 ICA 1 (97)

2.

Kelengkapan kawalan pencemaran Pollution control equipment Perihalan Description

Unit Baru atau Unit terpakai New or used

Fungsi Function

Negara asal Kos Country Cost of origin RM

G. SUMBER PENGETAHUAN TEKNIKAL SOURCES OF TECHNICAL KNOW-HOW Nama dan alamat pembekal Name and address of supplier

340

Tempoh pengalaman Year of experience

Hubungan dengan pemohon (contohnya pembekal jentera, syarikat induk/bersekutu) Relationship with applicant (e.g. machinery supplier, parent/associate company)

ICA 1 (97)

H.

JADUAL PENGELUARAN PRODUCT SCHEDULE Tahun 1 Year 1

Keluaran Products

Tahun 2 Year 2

Tahun 3 Year 3

Keupayaan pengeluaran tahunan maksimum bagi setiap giliran 8 jam Kuantiti* Nilai di kilang Kuantiti* Nilai di kilang Kuantiti* Nilai di kilang Maximum annual production Quantity* Ex-factory value Quantity* Ex-factory value Quantity* Ex-factory value capacity per 8 hour shift RM RM RM

Jumlah Total

341

Unit seperti yang dinyatakan dalam “Malaysian Trade Classification and Customs Duties Order”. Units as specified in the “Malaysian Trade Classification and Customs Duties Order”.

Appendix 6-2

*

CPA Tax & Investment Review 2003 ICA 1 (97)

I.

PASARAN MARKET

Keluaran Products

% pasaran % of market Tahun 1 Tahun 2 Tahun 3 Year 1 Year 2 Year 3

Untuk pasaran tempatan For domestic market

Untuk pasaran ZB/GPB* For FZ/LMW* market

Untuk pasaran eksport For export market

* *

342

Zon Bebas/Gudang Pengilangan Berlesen Free Zone/Licensed Manufacturing Warehouse

Pengguna dan tempat tujuan eksport utama Principal consumers and export destinations

Appendix 6-2 ICA 1 (97) J.

BAHAN MENTAH DAN KOMPONEN UTAMA MAIN RAW MATERIALS AND COMPONENTS

Bahan mentah dan Kuantiti* Nilai komponen setahun setahun Raw materials and Quantity Value components per annum per annum RM

Sumber Source Pengilang tempatan Local manufacturer

Import Import

% nilai Nama dan alamat % nilai % of value Name and address % of value

* Unit seperti yang dinyatakan dalam “Malaysian Trade Classification and Customs Duties Order”. Units as specified in the “Malaysian Trade Classification and Customs Duties Order”. 343

CPA Tax & Investment Review 2003 ICA 1 (97)

K.

PENENTUAN HARGA KELUARAN PRODUCT PRICING

Perkara Item

% harga di kilang untuk setiap keluaran % of ex-factory price for each product Keluaran Product

(a) Kos bahan mentah/komponen yang diimport Cost of imported raw materials/components (b) Kos bahan mentah/komponen tempatan Cost of local raw materials/components (c) Kos tenaga dan bahan api Cost of energy and fuel (d) Kos buruh Cost of labour (e) Susutnilai Depreciation (f) Bayaran faedah, cukai tak langsung, cukai tanah, dsb. Interest payments, indirect taxes, quit rent, etc. (g) Kos pentadbiran dan pemasaran Administrative and marketing costs (h) Kos teknologi (termasuk kos royalti, kos perkhidmatan pengurusan dan kos lain yang berhubungan Cost of technology (including royalty, management services and other related costs) (i) Keuntungan pengilangan Manufacturing profit Jumlah Total

344

100%

Appendix 6-2 ICA 1 (97)

L.

PENGAKUAN DECLARATION

Saya, , mengaku bahawa sebaik-baik yang saya tahu dan percaya butir-butir yang diberikan dalam permohonan ini adalah benar.

I, , hereby declare that to the best of my knowledge and belief the particulars furnished in this application are true.

Tarikh: Date:

................................................... (Tandatangan pemohon) (Signature of applicant)

(Jawatan) (Designation)

345