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Category
Penduduk Tetap Malaysia
Orang Awam Malaysia
Anggota Polis
Anggota Tentera
Non Malaysian Resident
Identity Card No.
Name
Gender
MALE
FEMALE
Place of Birth
Date of Birth
Address 1
Address 2
Address 3
Post Code
State
JOHOR
KEDAH
KELANTAN
MELAKA
NEGERI SEMBILAN
PAHANG
P PINANG
PERAK
PERLIS
SELANGOR
TERENGGANU
SABAH
SARAWAK
W PERSEKUTUAN
W.P.LABUAN
SELANGOR DARUL EHSAN
W. PERSEKUTUAN(KL)
PULAU PINANG
W.PERSEKUTUAN(LABUAN)
KUALA TERENGGANU
PUTRAJAYA
City
Contact Number
E-mail
Mengikut Akta Perlindungan Data Peribadi 2010 (PDPA) Saya setuju memberi
maklumat individu kepada untuk
tujuan proses kursus lesen memandu mengikut keperluan Jabatan Pengangkutan Jalan Malaysia sahaja.
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