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PT.

Sumisho E- Commerce Indonesia

B2B Customer Registration Form


x

New Customer

1. GENERAL DATA

Summitmas Building II, 19th floor


Jl. Jend. Sudirman Kav. 61-62, Jakarta 12190
Phone. +62 21 - 525 5280

Existed Customer (Change Points Only)

*Filled by Customer

1.1 Company Information


SMK Yaspia

Company Name*
Company Type*

Local Firm

International Firm

Company Address*

Jl. Benda Dalam Gg. H. Saenan II No. 12 Ciganjur Jagakarsa

Postal Code*

Telephone*

City*

Jakarta Selatan

021-78888977

Year Company Established *


No of Employee*

Sumitomo

2007
x

0 - 50 employees

Web Address:

50 - 100 employees

>100 employees

smkyaspia.sch.id

Order to Sukamart by: *

Website (http://office.sukamart.com)

Send PO by Email to our Sales team

1.2 Legal & Tax Data


Customer *

PKP

Non PKP

Required Documents: (Mohon dilampirkan)


Business Card PIC Contact *

NPWP*

SKT or SPPKP / BKPM*

* Mandatory Required for all the firms.

1.3 PIC Contact*

TDP/SIUP**
**Mandatory Required for all of the LOCAL firms.

Please fill out all 3 contact information


Purchasing Department PIC

Full Name (Nama Lengkap)

Finance PIC

Authorized Approver / Director

elmie nailul mishriyah

wisnu nugroho

bendahara

kepala sekolah

Department Name
Position (Jabatan)
Work Email

wis_nug@yahoo.com

Direct Phone Number

85691988272

*Untuk Local firm, 3 Kali order pertama wajib advanced payment (Bank Transfer only)
*Local firms are required in-advance payment (Bank Transfer) for the first 3 orders before applying for the post payment (TOP).
*Dengan ini menyatakan bahwa segala orderan yang dibuat oleh PIC ke PT Sumisho E-Commerce Indonesia (SECI) adalah mengikat perusahaan dan perusahaan setuju untuk menanggung segala sesuatu
yang timbul dari segala transaksi yang diwakili oleh PIC tersebut. Segala perubahan atas informasi di atas (termasuk PIC) wajib segera diberitahukan kepada SECI. Dalam hal tidak adanya pemberitahuan
maka SECI akan menganggap bahwa informasi di atas adalah tetap benar dan mengikat perusahaan.
* The company hereby declares that any order made by the PIC to PT Sumisho E-Commerce Indonesia (SECI) binds the company and the company agrees to be responsible for any matters arising from such
transaction Any changes to the information mentioned above must be notified to SECI. In case that the company fails to notifiy SECI, SECI will deem that any of the above information remains correct and
binding the company.

Authorized Signature for the Purcahse


Order:

Director or Purchasing Manager


Signature

Director or Finance / Accounting


Manager Signature

Full Name

Full Name

Full Name

Title

Title

Title

Date

Date

Company Stamp

donesia

9th floor
a 12190
25 5280

2. CONDITION & OTHER DATA

*Filled by Sukamart Team

2.1 Payment Condition*Filled by Sales PIC


Company Name*

Magento ID*
Payment & Terms*

Advanced Payment (Pay Before Delivery)

Post Payment

BANK TRANSFER / CREDIT CARD

BANK TRANSFER / CRE

*Fill out below if this is to request a change point only


Change Request

Reason to be changed:

(Please check)
*Filled by AR Team only for Local Company's change in Payment method
SO #

Order Date

Payment Date

AR PIC Name

1st

2nd

3rd

2.2.1. Payment Credit Limit*Filled by Sales PIC


Advanced Payment (Any Amount)

Local Firm(IDR 5 Mil)

JPN Firm/ Foreign Firm(IDR 5 Mil)

*Fill out below if this is to request a change point only


Change Request

AR team:

1) Current Pending PaymenIDR

Mil

AR team:

2) Latest Payment Info:

IDR

Mil

Date

AR team:

3) Next Payment Info:

IDR

Mil

Date:

IDR
4) Received New PO amoun

Mil

Sales PIC:

Sales PIC:

5) Request new Credit LimitIDR

Sales PIC:

6) Reason to be changed:

Mil

<--(add #1 + #4)

2.3 Zoho Update *


IsZoho Contactupdated with minimum 2 PIC from this company? (PIC order and Finance is a must)

2.3 Risk Management*


Anti-Social Group Check

Yes

NO (If YES, please explain the background)

Approved by :
Sales PIC

Assistant Manager

Acknowledged by :

President Director

Name :

Name : Masaaki Shimizu

Name :

Date :

Date :

Date :

Taketo Kokubo

Finance Manager

Name : Rahmawaty
Date :

ment

TOP

Days

ANSFER / CREDIT CARD

m(IDR 5 Mil)

Sumitomo Group (Unlimited)

edged by :

e Manager

aty