CLAIM FORM ATP No:
REN (Lister) % REN(Closer) %
TM TM
Acct No Acct No
Bank Name Bank Name
Vendor Tel :
Purchaser Tel :
Property Identification
(Type & Full Address)
Selling Price RM
Mark-up Price RM REN Commission RM (%)
Total Collected RM (%) for Internal CoA
GST RM (%) REN Commission RM (%)
Commission RM (%)
Consent Required YES / NO
Payment Received by: CASH / CDM / BANKER'S CHEQUE / CHEQUE Bank: Bank In Date : Cheque No:
Vendor's Lawyer Person In Charge Tel Date Sent
Purchaser's Lawyer Person In Charge Tel Date Sent
Bank/Branch Person In Charge Tel Date Sent
EXTERNAL CoA
Co-Agency Firm Tel Fax Email
REN(Co-A) Tel Fax Email
Invoice Date Bank Account No
REFUND (Applicable for excess amount from ED collected Only)
Vendor/Purchaser/ NRIC Fee RM (%)
Panel Lawyer
Bank Account No. Email
Decline Letter Bank (1) Date Bank (2) Date
Check List Yes No
REMARKS 1. ATP
2. ATS
3. Copy of Cheque
Submitted by Date 4. Copy of Bank Slip
5. Copy of 'Stamped' SPA
Checked (TM) Date 6. Authorisation Letter (payment to 3rd Party/
other than registered Vendor/Purchaser)
Approved (GTM) Date
7. Written Instruction/permission/to forfeit
Approved (Admin) Date from Vendor
Claim Form REV : 05