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USER REGISTRATION FORM
FREE ZONE DEPARTMENT
Port Klang Authority
Mail Bag Service 202
Jalan Pelabuhan
42005 Port Klang, Malaysia

* Please complete the form before submit
* Please Fax ROB / ROC Certificate to 03-31688229
* Please Fax Copy Of Customs Agent Registration (If Applicable) to 03-31688229
       
1.
Date of Registration
:
dd mm yyyy
2.
Company Name
:
3.
ROB/ROC Code
:
4.
Company Address
:
5.
Company Category
( SA / FA / FF / DP / EXP / IMP / MFG )
:
       
6.
Telephone No. / Mobile No.
:
(e.g. 03-31688211, 012-8889999)
7. Fax No. : (e.g. 03-31688211)
8. Email :
9. Contact Person Name :
       
     
Lembaga Pelabuhan Kelang
Beg Berkunci 202, Jalan Pelabuhan Utara, 42005 Pelabuhan Klang, Selangor, Malaysia
Tel. : 03-3168 8211, Fax. : 03-3168 9117