EmailMe Form - Unifi Application Form Business

Type of Application *
Package *
Preferred Service ID *
If more than 1 option please separate with ";"
Web Domain
Choose: .com/.com.my/.net/.net.my/.org/.org.my
Company / Firm Name *
Company Number / Business Registration Number *
Property Type *
Landed
High Rise (5 Storey or more)
Installation Address *
Office Tel. No.
Fax No.
Contact Person (as per NRIC / passport) *
NRIC / Passport No. *
Photostat IC *
Upload your photostat IC front and back (Cross for Unifi Application Only)
Mobile No. *
Other Contact E-mail *

Confirm
Preferred Communication *
Mail
E-mail
Office Phone
Mobile
Billing Information *
E-mail (FREE)
Hard Copy Paper Bill (RM8/month)
Billing Address
Photostat Form 24
For Sendirian Berhad only
Photostat Form 49
For Sendirian Berhad only
Photostat Borang 9 / SSM (Suruhanjaya Syarikat Malaysia) *
*
I Agree
I hereby Agree to enclose above particulars to UniFiHSBB.biz for the Unifi Registration Process.