GS1 GLN Membership Registration

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Important Notification

Please ensure that full payment has been made prior to submitting the application form.

For the breakdown of the fees, Click Here.

If you require an invoice before making payment, please send an email to payment@gs1my.org, titled "Request Proforma Invoice for New Application".

Complete applications (full payment and necessary documentation provided) will be approved and emailed within 5 working days.

Company Name *

Registration No.

Nature of Constitution *

Date of Formation *

Month

Day

Year

Name(s) of Sole-proprietor/Partners/Directors *

Present Issued Capital * RM

Nature of Business

	Main Business	Secondary Business
Manufacturer	Manufacturer - Main Business	Manufacturer - Secondary Business
Wholesaler	Wholesaler - Main Business	Wholesaler - Secondary Business
Retailer	Retailer - Main Business	Retailer - Secondary Business
Others	Others - Main Business	Others - Secondary Business
Others (Please specify)	Others (Please specify)

Product(s) Manufactured/Traded *

(Please provide details and breakdown, eg. Biscuits, Shoes, Blouses)

Brand Names *

e.g. Coca-Cola, Nike, Abba, Onwards, etc. Please key in "Nil" if your company do not own any brand name.

Are You the Brand Owner? *

Yes

Number of Employees *

Contact Personnel in Your Company

(*Email must be provided as the GS1 approval letter will be emailed to you. **Mandatory fields)
Title*	Salutation*	Name*	Position*	Department / Division*	Mobile Phone*	Personal Email
Title **Person in Charge of GLN	Salutation *	Name *	Position *	Department / Division *	Mobile Phone *	Personal Email
Title **Person-in-Charge of QA or Compliance	Salutation	Name	Position	Department / Division	Mobile Phone	*Personal Email
Title **Billing Contact / Accounts	Salutation	Name	Position	Department / Division	Mobile Phone	*Personal Email
Title **CEO or Director or President	Salutation	Name	Position	Department / Division	Mobile Phone	*Personal Email

Office Contact

(*Email must be provided as the GS1 approval letter will be email to you. If no group office email, please provide individual email.)

Address Line 1 *

Address Line 2

Address Line 3

Postcode *

State *

Telephone

Fax

Group Office Email *

Website / Facebook / LinkedIn

I wish to apply for GLN Identifier Numbers:

Category *

I acknowledge that the GLN Membership License is only meant for the identification of entities, locations and assets. They cannot be used to identify products or cartons.

Join Month :
Annual Fee :

Registration Fee (One-off, Fixed)	Annual Fee (Pro-Rated)	Fees paid in Advance (2-years)	VbG-PDSS Support Package (Optional)	Security Deposit (1 & 1/2 Years)	Grand Total of Fees
Registration Fee (One-off, Fixed) 1050.00	Annual Fee (Pro-Rated)	Fees paid in Advance (2-years) 780.00	VbG-PDSS Support Package (Optional) 380.00	Security Deposit (1 & 1/2 Years) 585.00	Grand Total of Fees

Important Notes: 1. Refer to the GLN Membership fee breakdown for Pro-Rate. 2. Security Deposit is equivalent to one and a half years annual fee. 3. Verified by GS1 - Product Databank Support & Services (VbG-PDSS) is optional. 4. VbG-PDSS for GLN Membership : RM 380.00

The following are the different types of items that GLNs can be allocated to:
GLN Type	Examples
GLN Type Legal Entity	Examples ABC Sdn Bhd, BCD Limited
GLN Type Fixed Physical Location	Examples Head Office, Branch, Factory, delivery shelf, dry foods shelves
GLN Type Mobile Physical Location	Examples Forklift, Logistic Truck, Defibrillator, Oxygen Tank, Air sensor
GLN Type Digital Location	Examples www.gs1my.org, 192.168.0.0
GLN Type Function	Examples Accounts Department, Marketing, Operations, Pantry
GLN Type Area or Section	Examples Production floor, Packaging Area, Delivery Area, Dangerous goods section, storage section, processing section

Listing for GLN assignment
Type of Entity, Location, Function or Asset*	Name*	Full Address (Physical or Digital)*	Postcode*	Email Address*	Phone No.*
Type of Entity, Location, Function or Asset *	Name *	Full Address (Physical or Digital) *	Postcode *	Email Address *	Phone No. *
Type of Entity, Location, Function or Asset	Name	Full Address (Physical or Digital)	Postcode	Email Address	Phone No.
Type of Entity, Location, Function or Asset	Name	Full Address (Physical or Digital)	Postcode	Email Address	Phone No.
Type of Entity, Location, Function or Asset	Name	Full Address (Physical or Digital)	Postcode	Email Address	Phone No.
Type of Entity, Location, Function or Asset	Name	Full Address (Physical or Digital)	Postcode	Email Address	Phone No.
Type of Entity, Location, Function or Asset	Name	Full Address (Physical or Digital)	Postcode	Email Address	Phone No.
Type of Entity, Location, Function or Asset	Name	Full Address (Physical or Digital)	Postcode	Email Address	Phone No.
Type of Entity, Location, Function or Asset	Name	Full Address (Physical or Digital)	Postcode	Email Address	Phone No.
Type of Entity, Location, Function or Asset	Name	Full Address (Physical or Digital)	Postcode	Email Address	Phone No.

Payment Method (All appropriate fees should made in favour of "GS1 MALAYSIA BERHAD", Maybank: 5-14208-626-707)
Select Method *

Transfer/Bank-In Slip *

Files must be less than 4 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.

Cheque Number

GS1 Malaysia Berhad Bank Account Details
Account Name : GS1 Malaysia Berhad
Account No. : 5-14208-626-707 (GIRO or IBG only, Do not choose DUITNOW or Instant Transfer)
Bank Name : Maybank Berhad
Bank Address : No. 8-10, Jalan 53, Desa Jaya, Kepong, 52100 Kuala Lumpur.
Swift Code : MBBEMYKL

Payment via JomPAY
Biller Code:12013
Ref 1:Company Name

Also enclosed are certified copies of the following documents of the company:
Business Registration Certificate / Certificate of Incorporation / Latest Annual Return (LAR) / Referral Letter *

If you are a Sdn Bhd / or Bhd (Private Limited or Limited Company), it is COMPULSORY for you to submit your Form 9 or Section 14 document when you apply for a GS1 membership.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx xls xlsx zip.

Acknowledgement *
Yes, I hereby certify the above are true and agree to the conditions

I certify that the above information is true to the best of my knowledge. I have read the GLN Rules and Regulations governing GS1 Malaysia subscribers to the GS1 System and on behalf of my company agree to abide by the said Terms and Conditions. We hereby agree to provide GS1 Malaysia with full access to, and allow GS1 Malaysia the use of and to share all company and GLN information provided by our company as GS1 Malaysia deems necessary as a trusted source of product information for retailers, international buyers, trading partners and any other marketing and promotion activities.

Disclaimer and Personal Data Protection Act Notice: This Application Form and any attachment/s are confidential and for viewing only by the GS1 Malaysia. Any unauthorized access to review, reproduce, or disseminate the information contained herein is strictly prohibited. GS1 Malaysia Berhad does not guarantee the security of any information electronically transmitted. This Application Form may contain personal and sensitive personal information and will be subject to the Personal Data Protection Act 2010, its implementing rules, regulations, and issuances of the Personal Data Protection Commissioner (“PDPA Laws”). By viewing, using, storing, sharing, and disposing (collectively “Processing”) this Application Form, you agree to comply with the PDPA Laws. By submitting this Application Form, you consent to the Processing by GS1 Malaysia Berhad of the Personal Data contained within. GS1 Malaysia Berhad is not responsible for the proper and complete transmission of the information contained in this Application Form nor for any delay in its receipt. The use of this Application Form for any unlawful purpose or for any purpose other than as permitted by GS1 Malaysia Berhad is strictly prohibited.
Disclaimer *
Yes, I understand, accept and agree to the statement above.

Verified by GS1 - Product Databank Support & Services (VbG-PDSS) *
Yes, I understand the conditions

The Verified by GS1 - Product Databank Support & Services (VbG-PDSS) is an optional package of GS1 Malaysia Services, Platforms and Capacity Building Sessions. It will automatically renew every 3 years. If I do not wish to continue to renew the VbG-PDSS, I must inform GS1 Malaysia a minimum of 3 months before the next annual billing cycle, otherwise, the package will continue to be renewed and charges will be billed to my company.

Name *

Designation *
(CEO, MD, COO, GM, Director, Manager, Owner)

Date *
Month

Day

Year

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GS1 GLN Membership Registration