SUPPLIER CREATE / AMEND REQUEST FORM for Indonesia Vendors

Type of request: Create (Create Vs Amend Vs Inactivate Vs Reactivate) Vendor Amendments

Vendor Persistence:
Amendment Requests Type
Regular (One Time Vs Regular) (Provide reasons /
documentation details in
Supplier Audit Section)
PS Vendor Id to be amended

Circulation Flow:

Requestor completes due Procurement Review and JBS Vendor Admin JBS Vendor Approver
dilligence Reqestor completes and submits request form key in PS systerm approves in PS systerm
Approval

General Data Related Vendor Information (For Corporate Vendor Reporting)

Name* (40 Charecters) Specify Parent Vendor Id

Additional Name

Supplier Address and Location

Address Sequence: Single Address, Single Location

Address Sequence 1 Address Sequence 2

Address Line 1* Address Line 1

Address Line 2* Address Line 2

Address Line 3* Address Line 3

City/Town* City/Town*

Province Province

Country Indonesia Country Indonesia

Postal Code (zip code) Postal Code

Email Address Email Address

Contact Person Contact Perso

Mobile Phone Mobile Phone

Busines Phone No/ Extension Busines Phone

Capital Amount Capital Amoun

Terms of Payment Terms of Payment

Bank Data (Mandatory if Payment Method is EFT)

Note: It is the responisbility of the vendor to check and confirm with their bank for the correct banking details
Bank
Beneficiary
Name
Vendor's Payment Method

Vendor's
BSB/IBAN/IFSC No Bank Name

Vendor's
Banking Info 2 Bank A/c No.

Banking Info 3 Currency IDR

SWIFT Code

Tax Registration Details

Tax Identification Nos Witholding Rate

VAT Applicability

Additional Notes

Specific Instruction not captured

Preappoved Vendors, Vendor Payment to be put on Hold etc.
above

Supplier Audit Documentation

If Vendor Amendment (Please

provide reasons with
documentation for specific
changes)