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