Declaration

Application Source

Source of Application*

Important: Making a false declaration is an offence under the Penal Code and may result in prosecution and disqualification from assistance schemes.

Declaration Acceptance

I declare that the information I have provided is true, accurate and complete to the best of my knowledge.

Consent Acceptance

I consent to the agency verifying the information provided with other government agencies and third parties.

PDPA Consent

I consent to the collection, use and disclosure of my personal data in accordance with the Personal Data Protection Act.

Signature (type your full name)*