JPJL8 Borang Permohonan Pembaharuan Lesen GDL

(DZD N7)

D@A@U@L ZBLC@LCFRU@L D@N@L K@N@_YO@ AMQ@LC ZBQKMGML@L NBYBL XMF@YOML@N (o) Yon` a`i` p`leu`l p`leu`l eo eo kuf` sbabn`g sbabnuk kblcoso amrolc amrolc olo olo (oo) Cul`f`l Cul`f`l GRQRH ABY@Q ABY@Q (ooo) (ooo) *U`le *U`le`f` `f`l l e`n`k e`n`k pbt`f pbt`f abrfb abrfbl` l``l `l @

DBLOY ZBQKMGML@L

A

ARUOQ-ARUOQ ZB ZBKMGML

0

Lm. F.Z / Z`spmrt Zmnos / Ubltbr`

9.

L`k`

5.

@n`k @n`k`t `t

2.

Zmsfme

3.

Lbcb Lbcbro ro

7.

D`ltol D`ltol` `(N/Z)

1

F`tbcmro

8. A`le`r  

?.

U`rof U`rofg g N`gor  N`gor  G`ro

I

 

Aun`l

 

U`gul

ARUOQ-ARUOQ NBYBL

0.

1.

U`rof U`rofg g Nuput Nuput Nbsbl Kbk`leu

G`ro

 

Aun`l

 

U`gul

Qu`lc`l olo olo ultuf ultuf Zbrkmgml`l Zbrkmgml`l A`ru `t`u Zbl`ka`g` Zbl`ka`g`l l Fbn`s Nbsbl Nbsbl Xmf`soml`n Xmf`soml`n s`g`d` s`g`d` U`rofg Nuput Nbsbl Xmf`soml`n Xmf`soml`n (dof` `e`)

Lm. Nbli`l` (dof` `e`) G`ro

 

Aun`l

 

U`gul

Fbn`s Nbsbl Xmf`soml`n

E

Fme Fbcul``l (ultuf fbcul``l pbd`a`t)

ZBLC@FR@L Y`y` kblc`fu a`g`w` sbku` k`fnuk`t y`lc eoabrof`l eo `t`s `e`n`g abl`r. U`rofg4 ……………………………………..

B

…………………………………………. U`le`t`lc`l Zbkmgml

*@FR@L EMFUMQ (Rltuf Zbrkmgml`l A`ru `t`u Zbka`g`ru`l Nbsbl Xmf`soml`n s`g`d`) Y`y` s`gf`l p`e` g`ro olo tbn`g kbkbrofs`  …………………………………………………………………………………………………… pble`p`t s`y` abno`u ** sbsu`o / toe`f sbsu`o ultuf Lm. F.Z ………………………………………………………. e`l p`e` pble`p`t Kbk`leu Fblebr``l Zbrfgoek`t`l @w`k Kbk`leu Fblebr``l A`r`lc`l Abfbrd` sba`c`o Fmleuftmr a`co Fblebr``l Zbrfgoek`t`l @w`k U`rofg4 ……………………………………..

U`le`t`lc`l U`le`t`lc`l Emftmr  L`k`

**Zmtmlc y`lc k`l` toe`f abrfbl``l

YON@ YBQU@F@L YBQU@F@L EMFRKBL ABQOFRU4ABQOFRU4 0. 1. 9.

AMQ@LC ‗DZD N7‟ _@LC UBN@G EOOYO

QBYO QBYOU U A@_@ A@_@Q@ Q@L L ZBKBQ ZBKBQOFY OFY@@ @@L L EMFUM EMFUMQ Q YBFB YBFBZO ZOLC LC C@K C@KA@ A@Q Q ABQRF ABQRFRQ RQ@L @L NBY NBYBL BL (N@U@Q ABN@F@LC ZRUOG)

………………………………………….

 

 @n`k`t Fnolof / Gmspot`n Gmspot`n FBCRL@@L ZBD@A@U

ZBKA@G@QR@L NBYBL CEN E@L ZYX

 

………………………………………….  

………………………………………….