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COMPANIES COMMISSION OF MALAYSIA (AMENDMENT) ACT 2015

Section 20G(1)(a)

APPLICATION FOR COMPANY SECRETARYS LICENCE

SECTION A : PARTICULARS OF APPLICANT

Name (As per NRIC) VINOTHENI A/P KRISHNAN

Title / Salutation MISS

NRIC Number 891115-025788

Gender FEMALE

Race INDIAN

Date and place of birth 15/11/1989 and SUNGAI PETANI, KEDAH

Residential address NO. 115, LORONG BERANGAN 1/5, TAMAN BERANGAN, O8000,

SUNGAI PETANI, KEDAH.

City SUNGAI PETANI

Postcode 08000

State KEDAH

Mobile Phone Number 013-4689050/014-9454231

Residential Phone Number 013-4689050/014-9454231

Personal Email Address vnonispacky@yahoo.com

Office Name and Address

City

Postcode

State

Office Phone Number


Office Email Address

SECTION B : PARTICULARS OF ACADEMIC QUALIFICATION

Academic Qualification:

Please state and attach relevant certificate / e.g : Sijil Pelajaran Malaysia / Diploma in Business Administration / Degree in
document relating to: Accounting / Masters in Corporate Administration.

Sijil Pelajaran Malaysia (SPM) or equivalent;


and
Highest academic qualification (if any).

SECTION C : PARTICULARS OF EXPERIENCE IN SECRETARIAL PRACTICE

Total Years of Experiences in Secretarial 1 year in Moganaradha & Co plus with experience in incorporation and
Practice desolation of new company.

List of Work Experience Related to Please ensure the number of years accumulated in the tables below is the same as the
Secretarial Practice* above information.

(Please attach relevant document relating to the 1. Name of Entity MOGANARADHA & CO
experience) Entity No.
Occupation Sectary Assistance
Job Scope Managing new incorporation, changing of
director, key in minutes, new incorporation,
Duration From DD/MM/YY to DD/MM/YY
1 Years 00. Months

2. Name of Entity POR OOI & CO


Entity No.
Occupation Audit Assistant
Job Scope Preparing all types of audit work including
with statutory audit.
Duration From DD/MM/YY to DD/MM/YY
Years . Months

3. Name of Entity ABA Kemtar Trading


Entity No.
Occupation Accountant & Personal Sectary
Job Scope Preparing from incorporation of company
until dissolution of the company, all types of
company secretarial works, bookkeeping,
and accounting.
Duration From DD/MM/YY to DD/MM/YY
Years . Months

3. Name of Entity SC Top Clean


Entity No.
Occupation Accountant & Personal Sectary
Job Scope Preparing from incorporation of company
until dissolution of the company, all types of
company secretarial works, bookkeeping,
and accounting.
Duration From DD/MM/YY to DD/MM/YY
Years . Months

Note : Please insert table if required

SECTION D : PARTICULARS OF REFEREE

Name (As Per NRIC) RADHAKRISHNAN A/L MUTAIYA


NRIC Number 891115-02-5788

Address NO.115, LORONG BERANGAN 1/5, TAMAN BERANGAN, 08000 SUNGAI PETANI,
KEDAH.

City SUNGAI PETANI Postcode* 08000

State KEDAH Mobile / Office 013-4689050/014-9454231


Phone No.*
Occupation CHARTERED ACCOUNTANT

Note:

Referee must be a person with whom the applicant has had regular contact for the past five years of whom the Registrar may enquire
regarding the applicants character.
Please attach the referral letter.

SECTION E: DECLARATION OF APPLICANT

I VINOTHENI A/P KRISHNANNRIC Number 891115-02-5788 do


solemnly and sincerely declare that:

(a) I am not an undischarged bankrupt;


(b) I have not been convicted whether in or outside Malaysia of any offence referred to in section 198 of the Companies
Act 2016;
(c) I have not been convicted whether in or outside Malaysia of any offence involving fraud or dishonesty punishable on
conviction with imprisonment for three months or more;
(d) I do not have any pending legal actions against me under any provision of the Companies Act 2016 or the laws
specified in the First Schedule of the Companies Act 2016; and
(e) All information provided in this application and the documents attached is correct and true to my knowledge.

Signed by:

________________________
(Applicant)

Name : VINOTHENI A/P KRISHNAN

Date : 19.9.2017

Attention:

It is an offence under section 591 of the Companies Act 2016 to make or authorize the making of a statement that you know is
false or misleading and you may be liable, upon conviction, to imprisonment for a term not exceeding ten years or to a fine not
less than RM3 million or to both.

LODGER INFORMATION
Name : VINOTHENI A/P KRISHNAN

NRIC No : 891115 -02-5788

Address : NO 115, LORONG BERANGAN 1/5, TAMAN BERANGAN, 08000, SUNGAI PETANI, KEDAH.

Phone No : 013-4689050 / 014-9454231

Email : vnonispacky@yahoo.com

Note: Lodger information must be the same as the applicant

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