PEJABAT SETIAUSAHA KERAJAAN PAHANG
BORANG PERMOHONAN PERALATAN ICT
BORANG E
  (A). Maklumat Pemohon
Nama : ________________________________________________________________
Kad Pengenalan : ________________________________________________________________
Jawatan : ________________________________________________________________
Gred : ________________________________________________________________
Bahagian/Unit : ________________________________________________________________
Emel : ________________________________ No.Telefon : __________________
  (B). Maklumat Jabatan
Nama Jabatan : _____________________________________________________________
No Telefon Jabatan : _____________________________________________________________
No.Faks : _____________________________________________________________
  (C). Maklumat Peralatan ICT

  PERALATAN ICT
  TUJUAN
JUMLAH (UNIT)
PERSONAL COMPUTER    
NOTEBOOK    
LCD PROJECTOR    
PRINTER BLACK & WHITE (PERSONAL)    
PRINTER COLOR    
PRINTER BLACK & WHITE (NETWORK)    
PRINTER BLACK & WHITE (HEAVY DUTY)    
SCANNER    
SCANNER (AUTOFEED)    
LCD PROJECTOR    
NOTEBOOK    
PERSONAL COMPUTER    
PRINTER BLACK & WHITE (HEAVY DUTY)    
PRINTER BLACK & WHITE (NETWORK)    
PRINTER BLACK & WHITE (PERSONAL)    
PRINTER COLOR    
SCANNER    
SCANNER (AUTOFEED)    
LCD PROJECTOR    
NOTEBOOK    
PERSONAL COMPUTER    
PRINTER BLACK & WHITE (HEAVY DUTY)    
PRINTER BLACK & WHITE (NETWORK)    
PRINTER BLACK & WHITE (PERSONAL)    
PRINTER COLOR    
SCANNER    
SCANNER (AUTOFEED)    
PRINTER( SLIP PRINTER)    
LAIN-LAIN    

  (D). Pengesahan Pemohon
 
 
Tandatangan : _________________________________________
Tarikh : _________________________________________
  (E). Kelulusan Ketua Jabatan
Saya mengesahkan bahawa maklumat yang dinyatakan adalah sah dan benar serta mematuhi Peraturan Am Pengisian Borang Permohonan Peralatan ICT.
 
 
Tandatangan : _________________________________________
Nama : _________________________________________
Jawatan : _________________________________________
Tarikh : _________________________________________
 
 
Cetakan Sistem Permohonan Peralatan ICT Pejabat Setiausaha Kerajaan Pahang 2017