EmailMe Form - Application Form for Telephone Line

Application For: *
Home
Business
Company Name :
For Business ONLY
Company Registration No :
For Business ONLY
Name of Applicant : *
* must same with NRIC. For BIZ, business owner name
Applicant IC No: *
(Example: 721010145243)
Applicant Old IC No:
(This is required if applicant born in 1977 or before 1977)
Mobile Number *
Contact Email : *
Address for installation: Please fill (-) for empty space. Must same with TNB address bill. *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Please upload your document requirement below: in .jpg or .pdf . Only for 1MB size.
For HOME - must upload no 1.
FoR BUSINESS - must upload no 1 and 2.
1. Copy of Applicant NRIC : *
2. Copy of Companies Commision Malaysia (SSM) - business registration