Customer Application

Customer Details
Customer Company
Name :
NPWP No :

Customer Address :
State: Postcode:

Phone: Facsimile:

Name:
Account Payable
Phone: Mobile:
Contact Details :
Email:

Address for Invoice

Address: Facsimile:
to be sent :

Term Payment : ….. days net

Declaration

All data mention above are correctly presented by the Company Authorised Person:

Name : Company Stamp :

Signatures :

X
Document attached :
Attachment for legal and tax matter

No. Document

1 Tax Payer Number (Nomor Pokok Wajib Pajak (NPWP)

2 Taxable Entrepreneur Principal Number (Nomor Pokok Pengusaha Kena Pajak (NPPKP)

4 Photocopy of ID of The Owner / Management of The Company (Fotokopi KTP Pemilik,

Pengurus/ Direksi Perusahaan)

5 Deed of Establishment of the Company & Last Amendment

(Akta Pendirian Perusahaan & SK dan Akta Perubahan Terakhir & SK)

6 Deed of Branch Establishment of the Company / Akta Pendirian Cabang & SK (Jika Ada)
7 Business Identification Number (Nomor Induk Berusaha (NIB)

8 Business License (Izin Usaha / Surat Izin Usaha Perdagangan (SIUP)

9 Certificate of Domicile / Surat Keterangan Domisili