APPLICATION FORM
MANAGEMENT SYSTEM CERTIFICATION
A. APPLICATION GUIDE
  The following documents will have to be submitted prior to the Stage 1 / Stage 2 audit:
  • Quality/Environmental/OHSMS/TS/TL/ISMS/ITSMS/BC-DR Manual and Procedures/etc
  • Process flow charts
  • Site layout plan (for BC-DR application)
All documents submitted will be held in strict confidence.

Please return the completed form and accompanying documents to:

 TÜV SÜD PSB (M) Sdn Bhd
Unit 842 & 846, Block A, Kelana Centre Point
Jalan SS7/19, Kelana Jaya
47301 Petaling Jaya
Tel: (60) 3 7880 1995 Fax: (60) 3 7880 1994
Email: enquiries@tuv-sud-psb.com.my
Website: www.tuv-sud-psb.com.my  
  B. ORGANISATION DETAILS
 
Name of Organisation:  
Address:  
Telephone:   Fax:   Website:  
Business Registration No.:   Ownership:  
Year of Establishment:   Annual turnover:   Total Staff Strength:  
Shift
Working Hours
No of Employees
(Full Time)
No of Contractor Staff
No of Employees
(Part Time)
Normal        
First        
Second        
Third        

Name of CEO/MD/GM:  
Telephone:   Fax:   Email:  
Name of Management Representative:   Designation:  
Telephone:   Fax:   Email:  

Indicate whether the unit is a part of some larger organisation; if so provide the name and address of the holding organization.

Name of Holding Organisation:  
Address:  

If your organization already has third party certification, please provide details.
Name of Certification Body:   Standard(s):  
Scope of Certification:    
Date of Certification:   Certificate Expiry Date:  

Standard(s) of Certification: 
    ISO 9001:2000   ISO/IEC 20000:2005
    ISO/IEC 27001:2005   SS 507:2004
    ISO 14001:2004   OHSAS 18001: 1999/2007
    ISO/TS 16949:2002   SS 506:Pt 1: 2004/Pt3:2006
        Others:   (please specify)

Type of Request:
Initial Certification  
Renewal of Existing Certification
   Extension  
Scope of Certification:

 

Address of Alternate Site(s) (Please attach list if more than 1 site) 
  
Target Date for:
Stage 1 Audit:   Stage 2 Audit:  
Note: The organization is required to carry out an internal audit and management review prior to the conduct of the Stage 1 audit.
C. BUSINESS DETAILS
a.

Brief description on the organisation, nature of business and the business organizational structure:
b.

Brief description on the main business processes or activities (e.g. Sales, Marketing, Provision of Services, etc.).
Please attach the process map or process flow chart to provide a clear description of the main business processes or activities, including outsourced activities.
c.

Brief Description on the Organization's IT Infrastructure (for ISMS, ITSMS & BC-DR application only)
d. Please indicate whether consultancy used for Management System:
  Yes, please indicate name of consultant 
  No

 
D. ISO 27000 CERTIFICATION RELATED INFORMATION
a. Please provide the number of application development and maintenance staff (applicable under the scope of certification): 

No of Users   No of Servers  
Number of Sites
(please attach a list
of sites)		   Number of
workstations + PC+
laptops		  
b. Any use of Network & Encryption Technology for both Internal and External connection?
  Yes,   No
If Yes, please indicate if "digital signature and/or PKI technologies" is used:
 
c. Does the organization need to comply with any legal, statutory and regulatory requirements?
  Yes,   No

If Yes, please indicate the "significance in legal compliance"
  Incompliance leads to possible prosecution
  Incompliance leads to significant financial penalty or goodwill damage
  Incompliance leads to insignificant financial penalty or goodwill damage
d. Please indicate the applicability of sector-specific risk.
  Sector-specific law and regulation applies
  No applicable sector-specific law and regulation but significant sector specific risk applies e.g. aerospace, telecoms, etc.
  No applicable sector-specific law and regulation and no applicable sector-specific risk applies
Any other comments (if applicable):
 
e. Please indicate the status of your organization's ISMS implementation
  Yes No
Has the risk assessment on the organization been carried out?
Is the Statement of Applicability (SOA) available for review?
Have the controls identified in the risk assessment been implemented?
Does your organization engage an external consultant for the implementation of the ISO/IEC 27001?

E. ISO 20000 CERTIFICATION RELATED INFORMATION
a. Are the Service Delivery and the Service Support processes implemented across the scope of
certified services or products? YES NO
i. If Yes, please state the relevant procedural documentation
ii. If No, state the different processes implemented for each certified services or products
b. Do you outsource any of the service delivery or service support process? YES NO
i. If yes, state the process outsourced:
  Number of contract staff:
 
Location(s) (1)
  (2)
  (3)
ii. If No, please state the relevant procedural documentation
c. Please state the locations of Data Centres if different from main address, if any.
i. Main Data Centre:
ii. Disaster Recovery Data Centre:
F. BUSINESS CONTINUITY & DISASTER RECOVERY (BC-DR) CERTIFICATION RELATED INFORMATION
a. Certification applying for
Disaster Recovery Services Only (exclusion of clause 5 of Singapore Standard of BC/DR Industry)
Both Disaster Recovery & Business Continuity Services
b.

Number of sites with DR Services within scope :
(Please complete the details of individual site)

Address Floor Area Capcity Used Staff Strength
c.

No. of sites with BC Services within scope :
(Please complete the details of individual site)

Address Service Provided Staff Strength
d. Do you outsource any of the Service Delivery or Service Support process?
YES NO
If yes, state the process outsourced:
G. ISO 14000 CERTIFICATION SCHEME
  Details of your Environmental Management System (Please fill separately for each location, if applicable)
i. Please provide details of significant environmental aspects and impacts. (Please use extra sheets if necessary)
ii. Please provide a list of the environmental legal and other requirements applicable to our company. (Please use extra sheets if necessary)
iii. Is your site or part of your site classified as Scheduled Premises under the Environmental Pollution Control Act?
YES NO

If "Yes" have you obtained written permission from PCD?
iv. Do you operate disposal facilities for toxic industrial wastes as listed in the schedule of the Environmental Public Health (Toxic Industrial Waste) Regulations?
YES NO
If "Yes" have you obtained written permission from PCD?
v. Is your site discharging trade effluent into public sewer?
YES NO
Watercourse?
YES NO
Controlled watercourse?
YES NO
If "Yes" have you obtained written permission from PCD?
vi. Do you collect or accept any toxi industrial waste for storage, processing, use, treatment or disposal?
YES NO

If "Yes" have you obtained the corresponding licence?
vii. Do you import, sell or export hazardous substances’ that are listed under the Environmental Public Health Act (Hazardous Substances) regulators?
YES NO
If "Yes" have you obtained the corresponding licence?
viii. Do you store, purchase or use any hazardous substances’ that are listed under the Environmental Pollution Control Act (Hazardous Substances) regulators?
YES NO
If "Yes" have you obtained the corresponding licence?
ix. Details of raw materials, oil (including lubricating, gear and hydraulic oil, etc), gases and chemicals used in the process / trade / service:
Raw materials / Oils / Chemicals Physical State Means of Storage Type & Capacity of Containers Quantity Used / Month Maximum Stock
x.

Approximate quantity of water consumption for premises:
PUB water: m3/month
Industrial water: m3/month

xi. Type of waste treatment facilities
Wastewater treatment plant
Solvent Recovery Unit
Waste Incinerator
Others (to specify):
xii. Details of wastes whether gaseous, liquid or solid to be treated:
Waste Nature Chemical found in Waste Industrial Process / Source Estimated Quantity per Month
xiii. Details of residue such as treated effluent, sludge and ashes produced from waste disposal facilities and other process wastes (including waste oil, coolants, solvents and chemicals) generated:
 
Type of Waste Quantity / Month Means of Storage & Disposal
xiv.

Type of air pollution control equipment used:

Scrubber   Electrostatic Precipitator
Bag Filter   Activated Carbon absorber
Cyclone   Others:
xv.

Type of fuel burning equipment used:

Boiler   Dryer
Furnace   Generator
Heater   Others


H. OHSMS CERTIFICATION SCHEME
 

Details of your Management System (Please fill separately for each location, if applicable)

i) Please provide details of significant OHS risk assessment. (Please use extra sheets if
necessary)
ii) Please provide a list of the OHS laws and regulations applicable to your company.
iii) Did your company receive any fine in the past 3 years?
YES NO
iv) Does your company currently have any safety programmes in place? Please elaborate.
v) Does your company have any features in place to safeguard its staff occupational health
safety?
vi) Please complete section G(iii) to G(xv) if your company has not already been certified to SS
ISO 14000.
J. TL 9000 CERTIFICATION SCHEME
i. Standard applying for:
  Full TL 9000
  Top-up TL 9000 from existing ISO 9001
  ISO 9001 and then upgrade to TL 9000
 
ii. Please indicate the distinct certifications to any of the following specialty areas or any combination there of:
a) TL 9000-HW (Hardware) Yes   No  
b) TL 9000-SW (Software) Yes   No  
c) TL 9000-SC (Service) Yes   No  
iii.

Indicate whether you are first or lower tier supplier to Telecommunications service providers
subscribing TL 9000. Indicate your Telecommunication customer:

Note:
Please note that TL 9000 certification assessment will not proceed until at least one data point (3months data) of the appropriate metrics has been submitted to the QUEST Forum Administrator, and written confirmation of the acceptability of the data has been received.
This requirement will also be included in all quotations to TL 9000 applicants.
K. ISO/TS 16949 CERTIFICATION SCHEME
 
i. Standard applying for:
  Full ISO/TS 16949:2002
  Upgrade from ISO 9001:2000
Is existing certification obtained from TÜV SÜD PSB?
Yes No , please list
ii.. Is your organization considered as “Product Design Responsible”?
Yes   No  
 
iii. Who are your automotive customers? Please list them down.
 
iv. Please indicate your organization remote activities (if applicable) and the number of supporting staffs. Eg. Purchasing / design center location in another country / city / street.

  Note:
i. The following documents will have to be submitted prior to the preliminary assessment:
- Quality manual
- Internal audit and management review planning and results from previous 12 months
- List of qualified internal auditors
- List of customer specific requirements
- Customer complaint status
- Operational performance trends for the previous 12 months, minimum.
ii. The certification assessment shall be completed within 3-month period from the
document review, i.e. upon submission of item (i)
iii. Company is required to carry out an internal audit and management review prior to the
assessment by TÜV SÜD PSB.


I hereby declare that the information given herein and in any supporting documents is true,
complete and accurate to the best of my knowledge and belief.



"The management understands the importance of impartiality in our certification of management systems. We will use all reasonable efforts to manage all possible conflicts of interest and ensure objectivity of our certification services".