APPLICATION FORM

LININDO PACIFIC INTERNATIONAL

(group of companies)

POSITION Management Trainee Sales

SOURCES Instagram
A. PERSONAL DATA
FULL NAME Yehezkiel Bayu Manggala Saputra IDENTITY CARD Jl. K.s . Tubun gg.3 No. 57 Kec. Samarinda
GENDER Male ADDRESS Ulu Kel. Dadimulya 75123
EMAIL yehezkielbayu@gmail.com CITY/ REGENCY Samarinda
RELIGION Christian PROVINCE Kalimantan Timur
STATUS Single POSTAL CODE 75123
PLACE OF BIRTH Samarinda
Jl. Wonocatur No. 1 RT. 01 RW. 23
DATE OF BIRTH 29-03-1993 DOMICILE ADDRESS
Banguntapan, Bantul 55198
HEIGHT (CM) 173
DOMICILE CITY/
WEIGHT (KG) 70 Bantul
REGENCY
NATIONALITY Indonesian DOMICILE PROVINCE Daerah Istimewa Yogyakarta
ETHNIC GROUP Jawa DOMICILE POSTAL CODE 55198
CONTACT NO. 1 082243809962 DRIVER LICENSE A
CONTACT NO. 2 - DRIVER LICENSE NO 930317151921
HOME PHONE NO - VALIDITY PERIOD 2022-03-29
IDENTITY CARD NO 6472032903930004 GLASSES #
B. FAMILY INFORMATION
DATE OF BIRTH
NAME RELATION OCCUPATION
(DD/MM/YYYY)
Totok Marnata 1962-10-23 Father PNS
Retno Murwanti Kadarini 1965-09-18 Mother Ibu Rumah Tangga
- 0000-00-00 # -
- 0000-00-00 # -
- 0000-00-00 # -
- 0000-00-00 # -
- 0000-00-00 # -
- 0000-00-00 HUSBAND/ WIFE -
- 0000-00-00 CHILDREN 1 -
0000-00-00 CHILDREN 2
- 0000-00-00 CHILDREN 3 -
C. EDUCATION
HIGH/ VOCATIONAL
SMA Negeri 1 Samarinda
SCHOOL
MAJOR IPA
ENTRY YEAR 2008 STATUS Graduate
GRADUATION YEAR 2011
FINAL SCORE 8.2 DIPLOMA NUMBER -
DIPLOMAT -
FACULTY - STUDY PROGRAM -
ENTRY YEAR # STATUS #
GRADUATION YEAR #
GPA - DIPLOMA NUMBER -
SARJANA(S1)
FACULTY Hukum STUDY PROGRAM Hukum
ENTRY YEAR 2013 STATUS Graduate
GRADUATION YEAR 2019
GPA 2.83 DIPLOMA NUMBER -
MAGISTER(S2)
FACULTY - STUDY PROGRAM -
ENTRY YEAR # STATUS #
GRADUATION YEAR #
GPA - DIPLOMA NUMBER -
D. NON FORMAL EDUCATION (INCLUDING COURSE, TRAINING, SEMINAR, ETC)
COURSE/ TRAINING/ SEMINAR ORGANIZER PERIOD(MM/YYYY) CERTIFIED
- - 0000-00-00 -
- - 0000-00-00 -
- - 0000-00-00 -
 - - 0000-00-00 -
- - 0000-00-00 -
E. ORGANIZATION EXPERIENCE AND ACHIEVEMENT (INCLUDING CLUB, PROFESSIONAL MEMBERSHIP, ETC)
ORGANIZATION NAME JOIN PERIOD OCCUPATION ACHIEVEMENT
- - - -
- - - -
- - - -
- - - -
- - - -
F. EXPERIENCE (STARTING FORM THE LAST, INCLUDING INTERNSHIP, FREE LANCE, PART TIME)
COMPANY NAME Bank BRI Kanwil Jogja
ENTRY POSITION Quality Assurance Officer IN ( MM/YYYY ) 08/2019
CURRENT/ LAST
Quality Assurance Officer OUT ( MM/YYYY ) 11/2019
POSITION
TAKE HOME PAY (THP) 2400000 OFFICE NO -
EMPLOYEE STATUS Contract

JOB RESPONSIBILITIES Memastikan produktifitas penggunaan mesin EDC BRI di setiap Merchant BRI.

ACTIVE Yes

REASON OF RESIGN Kontrak Habis

COMPANY NAME -
ENTRY POSITION - IN ( MM/YYYY ) -
CURRENT/ LAST
- OUT ( MM/YYYY ) -
POSITION
TAKE HOME PAY (THP) - OFFICE NO -
EMPLOYEE STATUS -

JOB RESPONSIBILITIES -

ACTIVE

REASON OF RESIGN -

COMPANY NAME -
ENTRY POSITION - IN ( MM/YYYY ) -
CURRENT/ LAST
- OUT ( MM/YYYY ) -
POSITION
TAKE HOME PAY (THP) - OFFICE NO -
EMPLOYEE STATUS

JOB RESPONSIBILITIES -

ACTIVE

REASON OF RESIGN -

G. COMPENSATION AND BENEFIT

SALARY CURRENT/ LAST EXPECTATION
TAKE HOME PAY (THP) - -

SALARY COMPONENTS - -

BONUS - -
ETC - -
H. FOREIGN LANGUAGES AND LOCAL LANGUAGES SKILLS
LANGUAGES READ WRITTEN SPOKEN
Inggris Good Fair Fair
Indonesia Very Good Very Good Very Good
-
I. WORK REFERENCE
NAME RELATION CONTACT NO ADDRESS
- - - -
- - - -
- - - -
J. EMERGENCY CONTACT
NAME RELATION CONTACT NO ADDRESS
 - - - -
- - - -
- - - -
K. IN THE ORGANIZATIONAL STRUCTURE, TO WHO ARE YOU REPORTING AND HOW MUCH PEOPLE YOU LEAD IN THE LAST
COMPANY/ NOW? (AND IT'S POSITION NAME)

L. EXPLAIN THE INNOVATIONS/ ACHIEVEMENTS YOU HAVE EVER DONE DURING WORK/ SCHOOL/ ORGANIZATION

M. EXPLAIN YOUR WORK SKILLS (INCLUDING OTHER MACHINES, TOOLS, APPLICATIONS, CAPABILITIES)

N. HOBBY

O. STATEMENT
1. The time you need to resign from the company now? -
2. Have you ever applied to this group of companies before?* (If yes, when and what
-
position)
3. Have you ever been involved with the Police?* (in connection with criminal offenses/
-
judiciary/ civil violations)
4. Have you ever suffered from a serious illness and/ or an infectious disease? If yes, please
-
explain
5. Have you ever been hospitalized or surgery? If yes, please explain -
6. (Sales position only) Are you willing to be placed in Kalimantan at least 1 year? -
7. Are there brothers/ friends who work in this company? If yes, please explain -
8. (For women) Are you willing to not get pregnant during the first 1 year of work? -
9. Do you have a side job? If yes, please explain -
10. Do you have ownership/ attachments with other companies? If yes, please explain -
11. If you are accepted, when can you start work? 01-01-1970
CONFIRMATION Yes
DATE 11-05-2020