MEMBERSHIP APPLICATION FORM

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APPLICATION NO: MEMBERSHIP APPLICATION FORM MEMBERSHIP NO: FOR OFFICE USE ONLY Qualification Certificate Testimonial / RPE Experience Years/Months Payment Recorded by Review 1 Review 2 Approval Date CATEGORY APPLIED FOR (PLEASE ) Chartered Accountant Licensed Accountant Associate Member PERSONAL DETAILS Title: (Dr / Mr / Ms / Mdm / Others) Full Name: (As per NRIC/Passport) Date of Birth: (DD/MM/YY) Age: Sex: (F / M) Attach one Passport Sized Photo I/C No: (New) Passport No: (Applicable for Foreigners only) Nationality: I/C No: (Old) Race: *Residential Address: Phone No: (Residential) (Postcode) (Country) (State) (Mobile) E-mail: CURRENT EMPLOYMENT DETAILS (This section must be completed) Job Title: Firm / Company: *Business Address: (Postcode) (Country) Office No: E-mail: Employment Category: (Tick one only) Commerce/Industry Public Practice Job Level: (Tick one only) (State) (Fax) Public Sector Academia Size of Organization (Number of employees in the group) Less than 50 Between 50-250 Between 251-2000 Over 2000 Entry Level Middle Management Senior Management Business Category: (Tick one only) Agro Based Plantations Construction Electronics Government/Statutory Body Insurance/Banking/Finance Logistics Manufacturing Oil & Gas Trading/Services Job Category: (Tick one only) Administration Corporate Finance Company Secretarial Financial Management General Management Management Accounting Strategic Planning Type of Organization: (Tick one only) Small Medium Enterprise (SME) Non-SME Multinational Accountancy Practising Services Education/Training Food/Drink/Tobacco Hotel/Catering/Leisure IT & Telecommunication Management Consultancy/Advertising Mechanical/Automotive/Engineering Property/Development - Investment Others (Please specify) Auditing & Assurance Corporate Governance Financial Accounting Financial Planning Information Technology Management Risk Management Taxation Others (Please specify) * Please tick ( ) your preferred mailing address Malaysian Institute of Accountants Dewan Akauntan, Unit 33-01, Level 33, Tower A, The Vertical, Avenue 3 Bangsar South City, No. 8, Jalan Kerinchi, 59200 Kuala Lumpur, Malaysia [Web] http://www.mia.org.my [Phone] + 603-2722 9000 [Fax] + 603-2722 9100

APPLICATION FOR MEMBERSHIP AS A CHARTERED ACCOUNTANT Please tick ( ) where applicable. I have passed the Final Examination of Part I of the First Schedule of the Accountants Act, 1967: AND / OR Diploma in Accounting, University of Malaya (up to examination session 1981/82) Bachelor of Accounting, University of Malaya Bachelor of Accounting (Honours), Universiti Kebangsaan Malaysia Advanced Diploma in Accountancy, MARA Institute of Technology Bachelor of Accounting, Universiti Teknologi MARA Bachelor of Accounting (Honours), Universiti Utara Malaysia Bachelor of Accounting (Honours), Universiti Putra Malaysia (formerly known as Universiti Pertanian Malaysia) Bachelor of Accounting (Honours), Universiti Islam Antarabangsa Bachelor of Accounting (Honours), Universiti Sains Malaysia Bachelor of Accounting (Honours), (Information System), Universiti Utara Malaysia Bachelor of Accounting (Honours), Universiti Tenaga Nasional (the academic programme for which first commenced from the academic year 2002/2003 onwards) Bachelor of Accounting (Honours), Universiti Multimedia (the academic programme for which first commenced from the academic year 2002/2003 onwards) Bachelor of Accounting (Honours), Universiti Malaysia Terengganu (formerly known as Kolej Universiti Sains dan Teknologi Malaysia) Bachelor of Accounting (Honours), Universiti Malaysia Sabah Bachelor of Accounting (Honours), Universiti Selangor (formerly known as Universiti Industri Selangor) Bachelor of Accounting (Honours), Universiti Sultan Zainal Abidin Bachelor of Accounting (Honours), Universiti Sains Islam Malaysia Bachelor of Accounting (Honours), Universiti Tunku Abdul Rahman Bachelor of Accounting (Honours), INTI International University Bachelor in Accountancy (Honours), Management and Science University (the academic programme for which first commenced with the academic session November 2010 onwards) (Enclose certified photocopy of university degree certificate and final examination transcript) I am a full member of one of the recognized bodies listed in Part II of the First Schedule of the Accountant Act, 1967: Malaysian Institute of Certified Public Accountants Institute of Chartered Accountants of Scotland Institute of Chartered Accountants in England & Wales Institute of Chartered Accountants in Ireland Association of Chartered Certified Accountants (United Kingdom) Institute of Chartered Accountants in Australia CPA Australia (formerly known as Australian Society of Certified Practising Accountants) New Zealand Institute of Chartered Accountants (formerly known as Institute of Chartered Accountants of New Zealand) Canadian Institute of Chartered Accountants Institute of Chartered Accountants of India Chartered Institute of Management Accountants (United Kingdom) (Enclose certified photocopy of Certificate of Membership)

APPLICATION FOR MEMBERSHIP AS A CHARTERED ACCOUNTANT AND / OR I have passed the Qualifying Examination of the Malaysian Institute of Accountants (Enclose certified photocopy of certificate of successful completion of Qualifying Examination) APPLICATION FOR MEMBERSHIP AS A LICENSED ACCOUNTANT I am a member of the Malaysian Society of Accountants and have passed one of the final examinations of that body last held in December 1992 (Enclose certified photocopy of Certificate of Membership and final examination transcript) APPLICATION AS AN ASSOCIATE MEMBER I am a holder of a Degree or/and Master Degree issued by: (i) University/Institution of higher learning: Majoring In: (ii) University/ Institution of higher learning: (Enclose certified photocopy of university degree certificate/s and final examination transcript/s ) Majoring In: (Enclose certified photocopy of university degree certificate/s and final examination transcript/s ) WORKING EXPERIENCE Please list according to chronological order. Please attach separate sheet if necessary. From Date To Name and Address of Firm / Employer Nature of Business of Firm / Employer Position held Applicants possessing a qualification under PART I OF THE FIRST SCHEDULE OF THE ACCOUNTANT ACT, 1967 and MIA QE Graduate are required to undergo the CARE Programme. Please submit Record of Practical Experience through online registration at http://care.mia.org.my or using hardcopy form which may be downloaded from the Institute s website http://www.mia.org.my. In the case of ALL APPLICANTS, experience of less than 6 months in one employment would not be accepted.

FEES I enclose RM in payment of the admission fee and current annual membership subscription via: Cash Cheque/Bank Draft (Bank and No.) Chartered Accountant Admission Fee RM 500.00 Annual Membership Subscription RM 350.00 Credit Card No. - - - Visa Master Licensed Accountant RM 500.00 RM 350.00 Expiry date : (mm)/ (yyyy) For cash payment, applicants must submit the application form personally. All Cheques and Bank Draft should be crossed A/c Payee Only and made payable to the MALAYSIAN INSTITUTE OF ACCOUNTANTS. Please note that the Institute s financial year is 1 July to 30 June. Applications which are received after 30 April each year will be processed for the next financial year. However, if you wish to have your application processed immediately, please notify in writing. Associate Member RM 500.00 RM 200.00 DECLARATION I, Identity Card No: declare that: The above information is true and complete to the best of my knowledge and belief. I have not been adjudged a bankrupt. I have had no conviction involving fraud, dishonesty or professional misconduct locally or overseas, and I undertake to notify the Registrar of any such future conviction as soon as practicable. I undertake that, if admitted as a member of the Institute, I shall be bound by the provisions of the Accountants Act 1967, the rules and by-laws made there under, and that I shall conduct myself at all times in a manner compatible with my membership of the Institute and of the profession of accountancy. I understand and agree with the Institute s Database Information Privacy Policy as provided in the Institute s website. that any collection or disclosure of information which is deemed necessary for the benefit of MIA and/ or the profession, or in the discharge of the duty thereof is protected and properly authorised by the Institute s Management. Please send the completed form, documents and payment to: Signature Date: (dd)/ (mm)/ (yyyy) The Registrar Malaysian Institute of Accountants Dewan Akauntan Unit 33-01, Level 33 Tower A, The Vertical Avenue 3, Bangsar South City No. 8, Jalan Kerinchi 59200 Kuala Lumpur Malaysia For Office Use Date application received: Received by : Receipt (Admission fee) : Receipt (Annual subscription) :

ELIGIBILITY & GUIDELINES FOR REGISTERING WITH THE MALAYSIAN INSTITUTE OF ACCOUNTANTS APPLICANTS UNDER THE CHARTERED ACCOUNTANT CATEGORY MUST POSSESS ONE OF THE FOLLOWING: Passed any of the final examination specified in *Part I of the First Schedule of the Accountants Act, 1967 and gained not less than of 3 years of working experience in the service of a Chartered Accountant or in a Government department, bank, insurance company, local authority or other commercial, financial, industrial or professional organisation or other undertaking approved by the Council; and/or Member of any of the recognised bodies specified in **Part II of the First Schedule of the Accountants Act, 1967; and/or Passed the MIA Qualifying Examination (QE) and gain 3 years of working experience in the service of a Chartered Accountant or in a Government department, bank, insurance company, local authority or other commercial, financial, industrial or professional organisation or other undertaking approved by the Council. APPLICANTS UNDER THE LICENSED ACCOUNTANT CATEGORY MUST BE A: Member of the Malaysian Society of Accountants and passed any of the final examinations of that body last held in December 1992 and gained not less than 3 years working experience in the service of a Chartered Accountant or in a Government department, bank, insurance company, local authority or other commercial, financial, industrial or professional organisation or other undertaking approved by the Council. APPLICANTS UNDER THE ASSOCIATE MEMBER CATEGORY MUST: Possess a first degree or a Masters degree or higher, in which he must have a major in accounting for either his first degree or Masters degree or higher; and He has not less than 3 years experience in teaching accountancy or accountancy related subjects at an institution of higher learning or equivalent. NOTE ON MEMBER INDUCTION COURSE The Institute s By-Laws provides that all newly admitted members would be required to attend the Member Induction Course (e-mic) which is conducted via e-learning within 6 months from the date of admission. Please note that there will be a fee to enroll for the e-mic. Please visit MIA website (www.mia.org.my) for more information. INSTRUCTION TO COMPLETE APPLICATION FORM All photocopied documents must be certified true by either a member of MIA, member of Parliament, Magistrate, Justice of Peace, Notary of Public or any other persons authorised under the provisions of the Statutory Declaration Act 1960. A statutory declaration signed by the owner of the documents which acknowledges that copies of the documents are true originals may be performed before and attested by a Commissioner for Oaths. If you have previously resigned or been removed from membership, this form is not applicable to you. Kindly fill in the Readmission Form which can be obtained from the Institute or it can be downloaded from the Institute s website under Members Area/Membership Area/Forms/Readmission. Applications which are received after 30 April each year will be processed for the next financial year. However if you wish to have your application processed immediately (current financial year), please inform us in writing. An applicant may apply for only ONE category of membership, namely Chartered Accountant, Licensed Accountant or Associate Member. Please complete only the category applied for. E.g. If you are applying under the Chartered Accountant category, complete the Chartered Accountant section only. Do not complete the Licensed Accountant/Associate Member sections. The following sections must be completed by all applicants. 1. Personal Details 2. Employment Details 3. Application Category 4. Working Experience 5. Fees The Institute s Financial Year is from 1 July to 30 June and is payable on 1 July annually (there is no provision for prorated annual subscription). The Institute accepts payment by cash/cheque/bank draft/credit card. Payment must be made in full upon submission of application and made payable to MALAYSIAN INSTITUTE OF ACCOUNTANTS. Please issue separate cheques for each individual application. Please do not send post-dated cheques. Any payment which is rejected by the bank may result in your approval being withdrawn. Upon applying, applicants must enclosed payment for admission fees and annual subscription.

CHECKLIST Please ensure you have enclosed all copies of relevant documents when submitting your application All Applicants: One (1) Passport sized photograph; Appropriate fees; and Certified photocopy of identity card / passport. Application as a Chartered Accountant: For Graduates of Recognised Universities under Part I of the First Schedule of the Accountants Act 1967 Certified photocopies of University Degree Certificate, Full Examination Transcripts and fulfills *MIA CARE Programme requirements. For Members of Recognised Bodies under Part II of the First Schedule of the Accountants Act 1967 Certified photocopy of Certificate of Membership and latest receipt of annual subscription payment to the said body. For MIA Qualifying Examination Graduates Certified photocopy of Certificate of Successful Completion of Qualifying Examination and fulfills *MIA CARE Programme requirements. Application as a Licensed Accountant: Certified photocopies of Certificate of Membership of the Malaysian Society of Accountants (MSA), Final Examination Transcript of the MSA examination, latest receipt of annual subscription payment to MSA and Record of Practical Experience. Application as an Associate Member: Certified photocopies of University Degree or a Masters degree Certificate/s or higher and Final Examination Transcript/s; and **Record of Teaching Experience. NOTES: All photocopy of documents must be certified true copy by either a MIA member (state name, membership number and signature), Justice of Peace, Magistrate, Notary of Public or Member of Parliament or a statutory declaration signed by the owner of the documents which acknowledges that copies of the documents are true originals may be performed before and attested by a Commissioner for Oaths. *MIA Chartered Accountant s Relevant Experience (CARE) Programme MIA CARE Programme is applicable to accounting graduates listed in Part I of the First Schedule to the Accountants Act, 1967 and MIA Qualifying Examination (QE) graduates. Graduates are required to submit Record of Practical Experience through online at http://care.mia.org.my or download the hardcopy which is available at the Institute s website http://www.mia.org.my and submit together with the MIA membership application form. **Record of Teaching Experience (RTE) RTE is applicable to academicians who wish to apply for MIA membership as Associate members, which is to be submitted together with the MIA membership application form. RTE form can be downloaded from the MIA website (www.mia.org.my) REMINDER: Employment of less than 6 months or experience obtained from practical experience for the purpose of obtaining the degree in accounting will be not considered as part of the 3 years. Application by Non-Malaysians A non-malaysian who wishes to apply for MIA membership would be required to comply with the residency requirements as follows: The applicant is required to provide evidence that he/she has been in Malaysia for at least 182 days within a period of one year at the point of application; and He/she has a permanent address in Malaysia. However, a non-malaysian who is a member of a recognized professional accounting body under Part II of the First Schedule of the Accountant Act, 1967, and being offered employment in Malaysia with a valid work permit issued by the Government authorities may be considered for admission as a member even though he may not fulfill the residency requirement. Amended 04/01/2018