SUBSIDI CLAIM PICARDO CAR SEAT

PICARDO PRODUCTS PURCHASE WITH MyCRS SUBSIDY

Note: please ensure you are entitled for the subsidy in MyCRS and never claim before proceed. We will verify your MyCRS Subsidy entitlement status before process your purchase request.
FULL NAME ( Nama Penuh )*

First NameMiddle NameLast Name
NRIC ( Nombor Kad Pengenalan ) *
ADDRESS( Alamat )*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TAKE PHOTO OF YOUR I/C (SILA AMBIL GAMBAR DEPAN KAD PENGENALAN ANDA )*
TAKE PHOTO OF YOUR I/C (SILA AMBIL GAMBAR BELAKANG KAD PENGENALAN ANDA )*
PHONE NUMBER ( NOMBOR TELEFON )*

Area CodePhone Number
DATE ( TARIKH )*

DayMonthYear
Date
OUTLET *
PICARDO SWIRL V2 (𝗥𝗠𝟯𝟵𝟵 - 𝗥𝗠𝟭𝟱𝟬 = 𝗥𝗠𝟮𝟰𝟵)PICARDO STRUNA (𝗥𝗠𝟮𝟰𝟵 - 𝗥𝗠𝟭𝟱𝟬 = 𝗥𝗠𝟵𝟵)PICARDO ASTON (𝗥𝗠𝟮𝟰𝟵 - 𝗥𝗠𝟭𝟱𝟬 = 𝗥𝗠𝟵𝟵)PICARDO MALTON (𝗥𝗠𝟭𝟵𝟵 - 𝗥𝗠𝟭𝟱𝟬 = 𝗥𝗠𝟰𝟵)PICARDO ZETA (𝗥𝗠𝟮𝟱𝟬 - 𝗥𝗠𝟭𝟱𝟬 = 𝗥𝗠𝟭𝟬𝟬)
SELF COLLECTDELIVERY ( 𝗖𝗛𝗔𝗥𝗚𝗘 𝗥𝗠 𝟮𝟱 )
SUBSIDI PRICE ( HARGA SUBSIDI )
ONLINE PAYMENT TRANSFER CIMB BANK

JITRON HEALTHCARE SDN BHD: 𝟴𝟲𝟬𝟬-𝟲𝟲-𝟯𝟵𝟴𝟮
PROOF OF PAYMENT ( BUKTI PEMBAYARAN)*

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PICARDO PRODUCTS PURCHASE WITH MyCRS SUBSIDY