Section 505

Kg. Pasir Garam

PPBM 0532/08

Lot 5169, Teratak

Di Tebing,

36800 Kampung Gajah,

Perak 11.9.2008

P.U. (B) 599 51

Bil./

Nama Pertubuhan

Berdaftar/

Name of Registered

Youth Societies

No. Sijil

Pendaftaran/

Certificate of

Registration No.

Alamat/

Address

Tarikh

Pendaftaran/

Date of