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CERTVICATE OF DOMICILE

Number : 346/IX / 2016


The undersigned below, Headman of Mangunweni Village Ayah
subdistrict, Kebumen District; explained;
Name

: Sugiarto

Identity Number

: 3305012908640002

Place of Birth

: Kebumen

Date of Birth

: Augs 29th, 1964

Religion

: Islam

Job

: Employment

Address

: Mangunweni Village RT 02 RW 01 Ayah


Kebumen.

The person above is a resident of RT 02 RW 01 Mangunweni


Village - Ayah Kebumen is near Yogyakarta.
This certificate is made to be used as it should be.
Mangunweni; Sept 29-2016
Headman of Mangunweni Village

MUKH FAOJIl

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