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CONFIDENTIAL
Malaysian Biotechnology Corporation Sdn Bhd
510-BNX-FRM-BioNexus Variation Request Form V1.0 (BNX-VRF-V1.0)
BIONEXUS VARIATION REQUEST /
NOTIFICATION FORM
SECTION A : VARIATION REQUEST
1.0 : Request for additional qualifying activities
2.0 : Amendment of BioNexus Special Conditions :
2.1 : Request to reduce minimum knowledge workers percentage requirement
2.2 : Request to extend the commencement date of the Qualifying Activities
2.3 : Request to amend other BioNexus Special Conditions
3.0 : Request to conduct/generate revenue from non-qualifying activities
4.0 : Other variation request
SECTION B : NOTIFICATION
1.0 : Changes of company information
2.0 Other notification
· Applicant is required to complete ONLY the respective part of this form according to the variation request.
· This variation request form must be TYPE-WRITTEN.
· Application fee (applicable ONLY for Section A: Variation request) – Bank draft of Ringgit Malaysia five hundred thirty only (RM 530 – inclusive of 6% GST) made payable to MALAYSIAN BIOTECHNOLOGY CORPORATION SDN BHD.
Reference 1
:
Definition of knowledge and general workers
PARTICULARS OF COMPANY
1.1
Company name :
1.2
BioNexus number :
1.3
Correspondence address:
Contact person:
Designation:
Telephone no.:
Fax no.:
E-mail:
Website:
SECTION A : VARIATION REQUEST
1.0 : Request for additional qualifying activities
i.
Current approved qualifying activities :
ii.
Existing products/services :
Products/Services
Description
iii.
Additional qualifying activities requested :
iv.
Reason for the request to add in qualifying activities :
v.
Summary of technology used to undertake the new activity:
vi.
Is the technology patented?
Yes
No
If “Yes” please attach:
Appendix 1
If “Yes” please provide the following information :
i. Title :
(If more than one, please attach as an appendix)
ii. Patent number :
iii. Application filing date :
iv. Applicant’s name :
v. Status :
Filed
Granted
vii.
Legal rights to the technology :
Please attach:
Appendix 2
i. Was the technology developed in-house?
Yes
No
ii. If “NO” who is the technology owner?
iii. What is the arrangement between the applicant and owner of the technology?
Technology licensing/transfer agreement
Technology acquisition agreement
Others (please provide details) :
MALAYSIAN BIOTECHNOLOGY CORPORATION SDN BHD
http://www.biotechcorp.com.my
\
CONFIDENTIAL
Malaysian Biotechnology Corporation Sdn Bhd
510-BNX-FRM-BioNexus Variation Request Form V1.0 (BNX-VRF-V1.0)
2
1 viii. Project Implementation Schedule for the new activity :
Activities/Milestones
Year :
Year :
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
7
8
9
10
11
12
ix.
Financial performance :
Please attach:
Appendix 3
· Year of first revenue generated
:
· Please provide revenue generated for past 3 years.
:
Products/Services
RM
Year
Year
Year
x.
Any additional investment for undertaking the new activity?
If “Yes”, please complete the folloiwng table:
Yes
No
Item
Unit cost (RM)
Unit
Total (RM)
· Breakdown of capital expenditure (CAPEX)
· Breakdown of operational expenditure (OPEX)
TOTAL
CONFIDENTIAL
Malaysian Biotechnology Corporation Sdn Bhd
510-BNX-FRM-BioNexus Variation Request Form V1.0 (BNX-VRF-V1.0)
xi.
Projection of additional human resources to undertake the new activity:
Please identify and label the knowledge and general workers as follows:
* = knowledge worker
# = general worker
Reference 1 : Definition of knowledge and general workers
Designation
Year
Total additional staff
Total knowledge workers
xii.
Projection of revenue to be generated from the new activity:
Products/Services
Annual revenue projection (RM)
2017
2018
2019
2020
2021
SUB TOTAL
TOTAL
2.0 : Amendment of BioNexus Special Conditions
2.1 : Request to reduce minimum knowledge workers percentage requirement
i.
Current approved percentage :
ii.
New percentage request :
iii.
Reason to reduce the percentage :
iv.
Current human resource employment :
Please attach:
Appendix 4
Please identify and label the knowledge and general workers as follows:
* = knowledge worker
# = general worker
Reference 1 : Definition of knowledge and general worker
Designation
Year
Total staff (a)
No. general workers (b)
No. knowledge workers (c)
% of knowledge workers : (c)/(a-b)
iv.
New human resource projection :
Please identify and label the knowledge and general workers as follows:
* = knowledge worker
# = general worker
Reference 1 : Definition of knowledge and general worker
Designation
Year
Total staff (a)
No. general workers (b)
No. knowledge workers (c)
% of knowledge workers : (c)/(a-b)
CONFIDENTIAL
Malaysian Biotechnology Corporation Sdn Bhd
510-BNX-FRM-BioNexus Variation Request Form V1.0 (BNX-VRF-V1.0)
17
2.2 : Request to extend the commencement date of the Qualifying Activities
i.
Reason to extend the commencement date :
ii.
New project implementation schedule :
Activities/Milestones
Year :
Year :
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
7
8
9
10
11
12
CONFIDENTIAL
Malaysian Biotechnology Corporation Sdn Bhd
510-BNX-FRM-BioNexus Variation Request Form V1.0 (BNX-VRF-V1.0)
2.3 : Request to amend other BioNexus Special Conditions
i.
Please state your variation request :
Please attach:
Appendix 5
ii.
Please provide reason for the variation request :
3.0 : Request to conduct/generate revenue from non-qualifying activities
i.
Please provide information on the non-qualifying activities to be undertaken :
ii.
Please provide reason for the request to undertake the non-qualifying activity :
xii.
Projection of revenue to be generated from the non-qualifying activity:
Products/Services
Annual revenue projection (RM)
2017
2018
2019
2020
2021
SUB TOTAL
TOTAL
4.0 : Other variation request
i.
Please state your variation request :
Please attach:
Appendix 6
ii.
Please provide reason for the variation request :
SECTION B : NOTIFICATION
1.0 : Changes of company information
i.
Please choose :
Change of company name
Please attach:
Appendix 7
Change of the company shareholding structure
Please attach:
Appendix 8
Please provide Board of Resolution indicating that the change in the shareholding structure (acquisition, merger, etc.) of the company will not affect the business activity and will remained in compliance to BioNexus Terms & Conditions.
Change of location of operation
Others
ii.
Please provide reason for the change :
2.0 : Other notification
i.
The notification summary :
ii.
Please provide the details :
Please attach:
Appendix 9
DECLARATION
I/We, the undersigned authorise representative/representatives of the company, hereby certify that all information provided in this variation request are, to the best of my/our knowledge, true and accurate. I/We further undertake to promptly notify Malaysian Biotechnology Corporation Sdn Bhd (“BiotechCorp”) of any change in the information.
I/We understand that BiotechCorp may require further information to evaluate this variation request/notification, and that the authorised representative identified herein may be contacted if additional information is required.
I/We further confirm that this variation/notification request is made on the basis that if successful, the company will be bound by the revised terms and conditions of the BioNexus Status.
Name
:
Designation
:
Date
(Signature)
(Company stamp or Seal)
To be submitted to :
Malaysian Biotechnology Corporation Sdn Bhd
Level 16, Menara Atlan
161B, Jalan Ampang
50450 Kuala Lumpur
Attention: Vice President, Monitoring & Compliance Department
Tel : 603-2116 5588
Fax : 603-2116 5528
Appendices Checklist :
Check
Appendix 1
Copy of Intellectual Property
(e.g Patent / Trademarks / Copyrights / Industrial Design )
Not
applicable
Appendix 2
Copy of technology licensing agreement
Not
applicable
Appendix 3
Audited financial statement (past 3 years)
Appendix 4
Employees Provident Fund (KWSP) – Employer’s Contribution Statement
Appendix 5 & 6
Other related supporting documents
Not
applicable
Appendix 7 & 8
Statutory documents certified by Companies Commission of Malaysia (CCM) :
· Form 13 : Change of name (if applicable)
· Form 20: Return on change of private limited to public limited (if applicable)
· Form 32A : Transfer of shares (if applicable)
Form 24 : Particulars of allotment of shares
Form 49 : Particulars in register of directors, managers and secretaries and changes of particulars
Appendix 9
Other related supporting documents
Not
applicable
REFERENCE 1 : Definition of knowledge and general workers
1.1 Knowledge Workers
Upon the approval as BioNexus company, a compulsory requirement on the employment of knowledge workers will be imposed. To qualify as knowledge workers, the employee must possess either one of the following:
a. Master’s Degree or higher:
i.Master’s degree or higher qualification in life sciences or biotechnology-related field; or
ii.Master’s degree or higher qualification in non-life sciences or non-biotechnology-related fields but relevant to the biotechnology business; OR
b. Bachelor’s Degree:
i.Degree in life sciences or biotechnology-related field with 1 year relevant working experience in the biotechnology or biotechnology-related industry; or
ii.Degree in non-life sciences or non-biotechnology-related field but relevant to the biotechnology business with 3 years relevant working experience; OR
c. Diploma:
i.Diploma in life sciences or biotechnology-related field with 3 years relevant working experience in the biotechnology or biotechnology-related industry;
ii.Diploma in non-life sciences or non-biotechnology-related field but relevant to the biotechnology business with 5 years relevant working experience; OR
d. Others qualifications:
i.Individuals with 10 years relevant working experience in the biotechnology industry; or
ii.Graduate of the Biotechnology Entrepreneurship Special Training (BeST) Programme organised by BiotechCorp or its affiliates; or
iii.Other knowledge workers certified by BiotechCorp.
1.2 General Workers
The calculation on percentage of knowledge workers from the total employees will exclude the number of general workers. General workers are defined as those employees who perform general and miscellaneous functions. This category includes drivers, conductors, telephone operators, clerks, despatch and security guards.
Example :
a. Total employees
:
60
b. Total general workers
:
25
c. Total knowledge workers
:
11
d. Total employees calculated for knowledge workers percentage (a – b)
:
35
Percentage of knowledge workers (c/d x 100)
:
(11/35) x 100 = 31%