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1. Declaration Header: Official letterhead, form number, and police station details
2. Declarant's Personal Information: Full name, IC/Passport number, address, contact details, and other identifying information of the person making the declaration
3. Time and Location Details: Date and time of making the declaration, location of the police station
4. Incident Details: Comprehensive description of the incident including date, time, location, and sequence of events
5. Verification Statement: Standard text confirming that the declaration is true and made voluntarily
6. Acknowledgment of Legal Implications: Statement warning about consequences of false declarations under Malaysian law
7. Signatures: Space for declarant's signature, witness signature, and receiving officer's details
1. Translator Declaration: Required when the declarant needs a translator, including translator's details and confirmation of accurate translation
2. Property List: Detailed list of items when declaration involves lost/stolen property or recovered items
3. Witness Information: Details of witnesses to the incident being reported, if any
4. Vehicle Information: Specific section for vehicle-related incidents including registration numbers, makes, and models
5. Medical Information: Required for incidents involving injuries or medical emergencies
1. Attachment A - Supporting Documents: List and copies of supporting documents provided (ID cards, photos, receipts, etc.)
2. Attachment B - Sketch/Map: Diagrams or maps related to the incident location or scene
3. Attachment C - Photographs: Referenced photographs of damage, injuries, or relevant scenes
4. Attachment D - Additional Statements: Any supplementary statements or clarifications to the main declaration
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