Application Form for Malaysia Semiconductor IC Design Park
Section 1: Applicant Details
Company Name
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Business Registration Number
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Date of Incorporation
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Business Address
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Email
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example@example.com
Office Number
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Company Website (if any)
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Type of Company (Please select one) **For more information, please refer to the Guideline/Handbook
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Startup
Small Medium Enterprise (SME)
Large Local Company
Foreign-owned Company
Other
Key Contact Persons: Name
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Key Contact Persons: Designation
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Key Contact Persons: Mobile Number
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Key Contact Persons: Email
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Shareholders Structure: Country of Origin
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Authorized Capital RM
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Paid-up Capital
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Section 2: Financial Information
Current Annual Revenue
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Accumulated Revenue
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Please describe your company's current funding status
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Self-funded
Venture Capital (VC) Backed
Personal Financing
Other
Financial performance of company (Prof
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Profit / (Loss) AFTER tax (RM) for YEAR 1, YEAR 2 and YEAR 3
Section 3: Business Information
Please (SELECT) the category of your company
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Design / IP
Electronic Design Automation (EDA)
Fabless Design
Outsourced Semiconductor Assembly and Test
Other
Please provide a brief overview of your company, product/services and target market (max 200 words)
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Number of FULL TIME Employees
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Number of PART TIME Employees
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Intellectual Property (IP) Status
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Patented
Trademarked
Patent Pending
No IP
Can you briefly describe your product or service, highlighting its unique value proposition and target market, existing and future customers etc. (max 300 words)
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Section 4: Declaration
Name
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Designation
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IC/Passport No
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Date
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Section 5: Submission Documents and Templates
Please ensure that this application form is submitted together with all supporting documents and the completed document checklist. All documents must be duly verified by the company’s authorised personnel or certified as true copies by an authorised party. Kindly upload all supporting materials, including the document checklist, into a single folder and share the folder link via a cloud storage platform such as Google Drive or OneDrive. Additionally, please make a copy of the required templates for submission - namely the NDA, Letter of Intent, and Business Proposal - which can be accessed here: https://terabox.com/s/1mpHewQBr4Xfx8v360DkF2g
Please SELECT the documents attached for this application
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Letter of Intent & Non-Disclosure Agreement
Business Proposal
Company registration forms (whichever is applicable) Certified true copy of Form 9, Form 24, Form 44, Form 49 (Bhd and Sdn Bhd) and Suruhanjaya Syarikat Malaysia (SSM) certificate for sole proprietorship and partnership .
Latest audited account for a company incorporated for more than one (1) year or latest management account, parent companies SSM search or equivalent to SSM search; and a copy of the latest audited account of the parent company (if any) for a company less than one (1) year.
Board of Director Resolution to be signed by the majority of directors on the appointment of authorised signatory
Company profile, including information on the organisation chart, profile of main team, products/services etc
List of award(s) and/or recognition(s) received in the past 5 years (if any)
Business plan / project proposal for the next three (3) years (can be included as part of the information in ppt)
If the Applicant/Recipient has previously received any grant from any other ministries or agencies under the government of Malaysia, the Applicant/Recipient must provide the necessary documentation to prove the completion of the project (Limited to five (5) years records from the date of approval of the Grant). If Applicant/Recipient has an on-going grant from any other ministries or agencies under the Government of Malaysia, the Applicant/Recipient must provide a letter from grant awarding entity or equivalent as the proof that the project is different (not overlap with the proposed project under InvestPenang) and has no non-compliance/breach issues occurred during the period of the funded project(s).
Document Checklist (Refer to Proposal template, Page 2)
Fully completed application form via Google Form (This Form)
Please provide a cloud folder (eg: OneDrive, Dropbox, Google Drive) link so we can review your supporting documents/document checklist
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Submit
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