PERMISSION TO WORK APPLICATION FORM

Company : ______________________________________________________

Person in Charge : ______________________________________________________

NRIC No : ______________________________________________________

Contact No. : ___________________(Office) _________________(H/P)

Date of Work : _____________________________________________________

Time In : __________________ Time Out:___________________

Purpose / Reason : _____________________________________________________

__________________________________________________________________________

Type of Vehicle : ___________________ (Car Reg. No):_______________

Details of workers:
No Name NRIC
1
2
3
4
5
6
7
8
9
10
NOTE :
• All contractor are required to report to SECURITY ON DUTY at the main entrance for verification of the approved
working permit and to obtain working pass.
• All working permits need to be submit to MAN TECHNICAL UNIT for approval in 3 working days prior to the
commencement of the day work carried out in the premises.

Requested By: Approved By:

________________________ ________________________
Co. Chop & Signature Co. Chop & Signature
Name : Name :
NRIC : Date :
Date :

c.c. : Security Dept

Maintenance Dept.