borang CP55D

CP55D [3/2020]

LEMBAGA HASIL DALAM NEGERI MALAYSIA
BORANG PERMOHONAN NOMBOR PIN e-FILING INDIVIDU

APPLICATION FORM FOR INDIVIDUAL e-FILING PIN NUMBER

1 Nama
Name

2 No. Pengenalan

Identification No
(Kad Pengenalan Baru / Polis /
Tentera / Pasport)
New IC / Police / Army / Passport

3 No. Cukai Pendapatan

Income Tax No.

4 Alamat Surat-Menyurat

Correspondence Address

Poskod Bandar
Postcode Town

Negeri
State

5 No. telefon

Telephone Number

6 e-Mel
e-mail

Tandatangan Pemohon / Wakil
Signature of Applicant / Representative

Nama Pemohon / Wakil
Name of Applicant / Representative

No. Pengenalan Pemohon / Wakil
Identification Number of Applicant / Representative

Tarikh
Date

Nota : Note :
Jika wakil membuat permohonan bagi pihak
pembayar cukai, sila kemukakan : If this application is made on behalf of the taxpayer,
a. Surat Kebenaran Pembayar Cukai
b. Salinan Pengenalan Diri Pembayar Cukai please enclose :
c. Salinan Pengenalan Diri Wakil
a. a written consent from the taxpayer
b. a copy of taxpayer’s identification document
c. a copy of representative’s identification document