CLAIM FORM ATP No:

REN (Lister) % REN(Closer) %

TM TM

Acct No Acct No

Bank Name Bank Name

Vendor Tel :

Purchaser Tel :

Property Identification
(Type & Full Address)

Selling Price RM

Mark-up Price RM REN Commission RM (%)

Total Collected RM (%) for Internal CoA

GST RM (%) REN Commission RM (%)

Commission RM (%)

Consent Required YES / NO

Payment Received by: CASH / CDM / BANKER'S CHEQUE / CHEQUE Bank: Bank In Date : Cheque No:

Vendor's Lawyer Person In Charge Tel Date Sent

Purchaser's Lawyer Person In Charge Tel Date Sent

Bank/Branch Person In Charge Tel Date Sent

EXTERNAL CoA

Co-Agency Firm Tel Fax Email

REN(Co-A) Tel Fax Email

Invoice Date Bank Account No

REFUND (Applicable for excess amount from ED collected Only)

Vendor/Purchaser/ NRIC Fee RM (%)

Panel Lawyer
Bank Account No. Email

Decline Letter Bank (1) Date Bank (2) Date

Check List Yes No

REMARKS 1. ATP
2. ATS
3. Copy of Cheque
Submitted by Date 4. Copy of Bank Slip
5. Copy of 'Stamped' SPA
Checked (TM) Date 6. Authorisation Letter (payment to 3rd Party/
other than registered Vendor/Purchaser)
Approved (GTM) Date
7. Written Instruction/permission/to forfeit
Approved (Admin) Date from Vendor

Claim Form REV : 05