LETTER OF INDEMNITY

To: Financial Controller

UNIVERSITI TENAGA NASIONAL SDN BHD [398494-K]
Jalan IKRAM-UNITEN
43000 Kajang, Selangor Darul Ehsan

IN CONSIDERATION of UNIVERSITI TENAGA NASIONAL SDN BHD [398494-K] (hereinafter referred to as

“UNITEN”), agreeing to admit me, ______________________________________________________________,
(Student’s name)
_____________________________________, of __________________________________________________
(Student’s NRIC No.) (Student’s address)
_________________________________________________________________________________________,
(Student’s address)
(hereinafter referred to as “the Student”) into UNITEN’s academic program as per letter of offer dated
_______________________, I hereby agree to indemnify UNITEN as follows:-

1. I will fully indemnify UNITEN against all liability claims, demands, actions, proceeding in respect of
personal injury (whether fatal or otherwise) to me if any during my study at UNITEN.

2. I shall not hold UNITEN in any way liable or claim or take any proceedings against UNITEN in respect of
any personal injury to me or loss or damage to my property which I may suffer in consequence of the
facilities afforded me to attend any of the departments at which I will be receiving education during my
study at UNITEN.

Dated this _______________ day of _______________________________________ 20_________.

Signature (Student’s):________________________________________

Signature of Witness:_________________________________________

Full Name of Witness:_________________________________________

NRIC No. of Witness:_________________________________________

__________________________________________________________________________________________
Notes:

1. Any one of the following shall be eligible to be a Witness to this document: Commissioner for Oaths / Head
of Village / ‘Tuai Rumah’ / ‘Ketua Kaum or Mukim Bertauliah’ / Lawyers / Judges / Government Officers at
Management or Professional level (formerly Class ‘A’) / Government School Headmasters / ‘Jaksa
Pendamai’ / State Government EXCO Members / TNB Officer. Please also ensure that you get your
witness to stamp their designation at the witness column of the Letter of Indemnity.
2. Students are required to, either have this document stamped at the nearest Stamp Duty Office, or purchase
a duty stamp for RM10 at any post office and submit it together with the Letter of Indemnity for our onward
endorsement at the stamp duty office. Please take note that, in order to avoid any possible future
misunderstanding, we do not receive cash for the duty stamp.
3. The completed document must be submitted to the Counter of Student Unit, Finance Department
within two weeks from the date of registration at the University.

LOI-Local Students