Translation of Kartu Tanda Penduduk

(Indonesian Identity Card)

Province : Banten
City : Tangerang Selatan (South Tangerang)

NIK (Citizen Number) : xxxxxxxxxxxxxxxxxxxxx

Name : Zerosugar.
Place, Date of Birth : Jakarta, 09 June 1975
Sex : Male
Address : Jl. Peluru Blok E-35 / 26 Blood Type :
Neighborhood Ward : 005 / 007 Marital Status : Married
Village Administrative Unit : Benda Baru
District : Pamulang
City : South Tangerang
Religion : Moslem
Occupation : Civil Servant
Valid thru : 09 June 2015

On behalf of City Mayor

District Head

Signed
H. Abu Hurairah
 Translation of KARTU KELUARGA
(Family Registers)
No. 3603252505090022

Name of Head of Family : Zerosugar District : Pamulang

Address : Jl. Peluru Blok E-35 / 26 City : South Tangerang
Neighborhood Ward : 005 / 007 Postal Code : 15416
Village Administrative Unit : Benda Baru Province : Banten

Place of
No Full Name Citizen Number Sex Date of Birth Religion Education Occupation
Birth
1 2 3 4 5 6 7 8 9
1
2
3
4
5

Immigration Document Parents

No Marital Status Relation Nationality
Passport Number KITA/KITAP Father Mother
10 11 12 13 14 15 16 17
1
2
3
4
5

Issued on 25-05-2009 Head of Family District Head

Copy I. Head of Family
II. RT (Neighborhood Ward) signed signed
III. Sub District
IV. District Zerosugar. H. Abu Hurairah
 Translation of Kutipan Akta Nikah
(Marriage Certificate)

(Page 1) (Page 2)

Republic of Indonesia Day : Monday

Religion Affair Service Date, month, year : 05 September 2011
Hijri Calendar : 15 Jumadil Awal 1422
District : Cimahi Selatan (South Cimahi) Time : 08.00
City : Tangerang Selatan
Province : Jawa Barat (West Java) Hereby, is the marriage of

Page (3) 1. Name : Zerosugar

2. Father : H. Zerosin
Witnessed by wali nikah 3. Place, Date of Birth : Jakarta, 09 June 1975
4. Nationality : Indonesia
1. Name : Bapaknya Luna Maya 5. Religion : Islam
2. Place, Date of Birth : Zurich, 05 - 11 - 1966 6. Address : Jl. Cimanuk
3. Nationality : Indonesia 7. Marital Status : Not married
4. Religion : Islam 8. Occupation : Civil Servant
5. Address : Sukowati
6. Occupation : Businessman with a woman, namely

Act as a family representative, with the marriage gift of 27.9 grams of 1. Name : Luna Maya
gold, and praying accessories, in cash. 2. Father : Bapaknya
3. Place, Date of Birth : Bali, 07 Juni 1974
Bandung, 06 September 2010 4. Nationality : Indonesia
Religious Affairs Service Office of South Cimahi 5. Religion : Islam
6. Address : Sukowati
Signed 7. Marital Status : Not married
8. Occupation : Actress
I Gde Sekali