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PT. Oriental Sheet Piling Sales Marketing Department Jl. Melawai VII No.

10 3rd Floor, Kenayoran Baru, Jakarta Salatan 12160 Indonesia


COMPANY NAME* YEAR ESTABLISHED* TEL NO.* BUSINESS ADDRESS* REGISTERED ADDRESS*
(IF DIFFERENT FROM ABOVE)

CREDIT APPLICATION FORM

REGISTERED NO.:* FAX NO.*

TYPE & NATURAL OF BUSINESS* PERSON TO CONTACT & EMAIL ADDRESS*

LEGAL CONSITUTION*
Sole Proprietor Limited Partnership Private Limited

Check here if formed less than 12 months

OWNERSHIP/ SHAREHOLDERS PARTICILARS*


Name(s) of Principal(s) Title NRIC No. Residence Address, City, State, Zip

KEY MANAGEMENT/PERSON INFORMATION*


Name Designation Direct Phone No Email Address

OTHER RELATED COMPANY & BUSINESS REGISTRATION*


Company Name Nature of Business Shareholding Business Address

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Version : 102012 - PTOSP 001 CLA

PT. Oriental Sheet Piling Sales Marketing Department Jl. Melawai VII No. 10 3rd Floor, Kenayoran Baru, Jakarta Salatan 12160 FINANCE* Indonesia
Name of Bank Branch of Bank Facilities Limit Utilization

TOP THREE SUPPLIER REFERENCES (TRADE)*


Name of Supplier Person to Contact Phone No. Credit Limit Granted Term

CREDIT LIMIT APPLICATION* Credit Limit (IDR) Credit Term (Days)

CURRENT YEAR FINANCIAL INFORMATION*


As of (Date)______for the______months then ended
These statements will be used for credit extension information only and will not be furnished or divulged to any other firm or agency, As an alternative, please attach current financial statement.

Annual Turnover Annual Gross Margin Annual Net Profit Assets: Cash in bank Account Receivables Other Receivables Inventory Current Assets Fixed Assets Non Current Assets Total Assets SUBMISSION CHECKLIST
1. Kindly fill up the form and the column with is COMPULSORY 2. To provide photocopy of Latest 2 Years Audited Accounts 3. To provide Company Profile & Certified Copy of Certification of Incorporation (Form 9) 4. To provide Project Details 5. Bank Guarantee/ Security Deposit with 20% on Material Value (Lease Order Only)

Liabilities: Account Payable Other Payable Current Liabilities Long Term Liabilities Net Worth Paid Up Capital

CREDIT TERMS AND CONDITIONS


1. PT. Oriental Sheet Piling reserves the right to charge the rate 1.5% per month or such rate on all overdue as PT. Oriental Sheet Piling shall from time to time notify us/me in writing: 2. Credit given herein is at PT. Oriental Sheet Piling sole discretion. PT. Oriental Sheet Piling reserves the right, without assigning any reason thereto, to stop the credit, revert to cash dealings and/ or withhold goods and services, suspend or terminate all present and future transactions with us/me. 3. We shall indemnify you against all legal fees and others expenses incurred by you in enforcing payment of outstanding balances, including any interests charged or chargeable on overdue balances. 4. Goods sold and delivered by us shall be further governed by terms and conditions specified in the Delivery Order and/or Invoices; 5. Acquiescence by PT. Oriental Sheet Piling or in any breach of any provisions herein or in the Delivery order/ Invoice shall not operate as or be deemed to be waiver of such provisions. 6. Credit terms: computed from delivery date; and 7. PT. Oriental Sheet Piling is hereby authorized to conduct searched with any service provider as it deems fit to obtain any information and data in us/me.

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Version : 102012 - PTOSP 001 CLA

PT. Oriental Sheet Piling Sales Marketing Department Jl. Melawai VII No. 10 3rd Floor, Kenayoran Baru, Jakarta Salatan 12160 DECLARATION Indonesia
The undersigned does hereby certify that he/she is authorized to sign this application on behalf of the applicant and further certifies that above credit information is correct and authorizes and directs the above indicated bank and business references to verify and said information and give additional requested information to PT. Oriental Sheet Piling and its assigns or designees upon request. The undersigned acknowledges that he/she has read and agrees to be bound to the terms on the reverse side of this agreement. A facsimile copy of the agreement shall be as binding as an original and shall include "Application For Credit and Credit Term Agreement" of PT. Oriental Sheet Piling

Authorized Signature
Name: NRIC No.: Designation: Date:

Company's Authorized Stamp

OFFICE USE ONLY FOR SALES DEPARTMENT Sales Person Full Name
Type of Order SALES LEASE
* Please tick any of the order (This section is exemption to Cash Before Delivery & Cash On Delivery terms)

Proposed Credit Limit Proposed Credit Term Justification (The below information is compulsory for salesperson to provide as accurate as possible)

Customer's Company Information

Project's Information

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Version : 102012 - PTOSP 001 CLA

PT. Oriental Sheet Piling Sales Marketing Department Jl. Melawai VII No. 10 3rd Floor, Kenayoran Baru, Jakarta Salatan 12160 Indonesia Key Management Person / Owner Information

Justification of Providing Credit Limit

Other Important Information

RECOMMENDATION BY CREDIT CONTROL


* This section is purely recommendation and does not conclude the approval of the credit evaluation and thus subject to circulation within the credit committee for final approval

SUPPORT Recommended Credit Limit (RM) Recommended Credit Term (Days) Approved by

REJECT

Name Date Remarks/ Recommendation:

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Version : 102012 - PTOSP 001 CLA

PT. Oriental Sheet Piling Sales Marketing Department Jl. Melawai VII No. 10 3rd Floor, Kenayoran Baru, Jakarta Salatan 12160 Indonesia

MANAGEMENT USE ONLY

APPROVAL BY CREDIT CONTROL COMMITTEE


* The final credit evaluation is only valid and taken into account after the approval are properly received by at least 2 committee and according to the matrix * If the approval is received via electronically, it is compulsory to attach the email correspondence. The validity of electronically approval will replace the signatory approval below.

Approved by:

Remarks:

Name: Designation: Approved by: Remarks:

Name: Designation: CREDIT CONTROL REMARKS AT FINAL APPROVAL STAGE

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Version : 102012 - PTOSP 001 CLA

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