BORANG PENGADUAN UNTUK SISTEM DAN PROSES KERJA

1
B
BORANG PENGADUAN UNTUK SISTEM DAN PROSES
KERJA COMPLAINT FORM FOR THE SYSTEM AND WORK
PROCESS
1.0 Butir-butir aduan / Details of complaint 1.1
Tarikh / Date _______________________________
______ 1.2 Waktu / Time ______________________
_______________ 1.3 Tempat kejadian / Location of
event _____________________________________ 1.4
Jenis aduan / Category of complaint
_____________________________________ Contoh
Kelewatan / Kesilapan / Penangguhan / Kehilangan
Example Delay / Error / Postponement /
Misplace 1.5 Keterangan / Explanation
_________________________________________________
__________________ _______________________________
____________________________________ _____________
__________________________________________________
____ _____________________________________________
______________________ ___________________________
________________________________________ _________
__________________________________________________
________ _________________________________________
__________________________ 2. Dokumen maklumat
sokongan / Supporting document
evidence 2.1 Dokumen sokongan yang disertakan
(sekiranya ada) / Supporting documents attached
(if any) i. ______________________________________
_______________ ii. ______________________________
_______________________ iii. _____________________
________________________________ iv. _____________
________________________________________ (Sila
sertakan lampiran keterangan jika ruang tidak
mencukupi/ Please use additional paper should
the space provided is insufficient )
2
2.2 Nama dan jabatan pegawai yang bertanggugjawab
(sekiranya ada) / Name and
department of the personnel in charge (if
any) i. __________________________________________
____________________ ii. _________________________
_____________________________________ 3 Butir-but
ir pelapur / Details of complainant 3.1 Name /
Name _____________________________________
_________ 3.2 NRIC no./ Passport no.
______________________________________________ 3.3
Jawatan/Designation _______________________
_______________________ 3.4 Alamat/Address
____________________________________________
__ _______________________________________________
___________________ ______________________________
____________________________________ 3.5 Tel
________________________________ Saya mengaku
bahawa segala keterangan di atas adalah benar./ I
certify that all details given above are true.
Tandatangan / Signature
____________________ Tarikh / Date
____________________________________________
_______________________________ Hantarkan aduan
anda kepada/ Address your complaint to The
Chairman Remedial Grievance System c/o Deputy
Rector (Student and Alumni Affairs) Level 4,
Administration Block International Islamic
University Malaysia Jalan Gombak, 53100 Kuala
Lumpur
UNTUK KEGUNAAN PEJABAT / FOR OFFICE USE No
rujukan kes / Case reference No Tarikh terima /
Date received