Section 379

Putrajaya

PPBM 0408/08

B1-T12-UO3, Presint 16,

Jalan P16,

62150 Putrajaya 18.8.2008

P.U. (B) 599 40

Bil./

Nama Pertubuhan

Berdaftar/

Name of Registered

Youth Societies

No. Sijil

Pendaftaran/

Certificate of

Registration No.

Alamat/

Address

Tarikh

Pendaftaran/

Date of