Section 401

India Hulu Selangor

PPBM 0430/08

No. 15, Jalan Jejarum 1,

Bukit Sentosa,

48300 Rawang, Selangor 20.8.2008

P.U. (B) 599 42

Bil./

Nama Pertubuhan

Berdaftar/

Name of Registered

Youth Societies

No. Sijil

Pendaftaran/

Certificate of

Registration No.

Alamat/

Address

Tarikh

Pendaftaran/

Date of