Provisional Member Application | Chartered Tax Institute Of Malaysia

Name*

Passport / IC Number*

*Insert IC Number without '-' symbol

Nationality*

Date of Birth*

Gender*

Male
Female

Mailing Address

Mailing Address*

Mailing Address 2*

Mailing Address State*

Mailing Address Postcode*

Email Address*

Home Tel No.*

Office Tel No.*

Mobile Tel No.*

Company Address*

Company Address 2*

Company Address State*

Company Address Postcode*

Current Employment Details

Company Name*

Designation*

Employment Category*

Employment History

*

Organisation	From	To	Position	Nature / Scope of Work

Professional Qualifications (Check those applicable)

Professional Qualification 1

Chartered Accountant of Malaysian Institute of Accountants (with practising certificate and audit license)

Professional Qualification 2

Chartered Accountant of Malaysian Institute of Accountants (with practising certificate)

Professional Qualification 3

Chartered Accountant of Malaysian Institute of Accountants (without practising certificate)

Professional Qualification 4

Licensed Accountant of Malaysian Institute of Accountants

Professional Qualification 5

Advanced Courses examination conducted by the Inland Revenue Board

Professional Qualification 6

Approved Tax Agent under section 153 of the Income Tax Act, 1967 (without restricition)

Professional Qualification 7

In practice or employment as an advocate or solicitor of High Court of Malaya, Sabah and Sarawak

Professional Qualification 8

Successfully completed the final examinations of the Chartered Tax Institute of Malaysia

Professional Qualification 9

Custom Officers at Superintendent Level (Grade 41) with 5 years experience

Professional Qualification 10

Full member of ACCA, CIMA, CPA (with 5 years practical experience in taxation matters)

Other (Please specify)

MIA membership / Treasury Authority Ref / Practising Certificate / Student Registration

Date Awarded

Academic Qualifications

Academic Qualification*

Name of institution	Date Awarded	Qualifications

Declaration*

I undertake that, if admitted as a member of the Institute, I shall be bound by the provisions of the Memorandum & Articles of the Chartered Tax Institute of Malaysia, the rules and by-laws made thereunder, and that I shall conduct myself at all times in a manner compatible with my membership of the Institute and of the profession of accountancy, or the legal profession as the case may be.

Please upload the the following documents (must be certified true copy) to complete your application

Identity Card Front*

Identity Card Back*

Academic and Professional Qualifications*

Testimonials*

Submit Your Photograph*

CTIM

CTIM

CTIM

Mailing Address

Current Employment Details

Employment History

Professional Qualifications (Check those applicable)

Academic Qualifications

Please upload the the following documents (must be certified true copy) to complete your application

CTIM