LETTER OF GUARANTEE

To : Embassy of the Republic of Indonesia in USA

Subject : e-Visa Application

Through this letter, we the undersigned, hereby declare that if the below mentioned applicants
enters Indonesia :
APPLICANT (Foreign Citizens)

Full Name : Charles Robert Couch Arielle Kristina Baune

Nationality : USA USA
Place and Date of Birth : Oregon, 15 Nov 1957
th
Illinois, 21st Aug 1983
Passport No. : 566036296 670360442
Passport Expiration Date : 21st June 2028 10th Aug 2031
Sex : Male Female
Purpose of Visit : Business Trip (Checking production result of their order)

We shall guarantee thefollowings:

1. We shall provide the necessary supervision to ensure that the applicant does not engage in
activities other than those permitted for the purpose of entry into Indonesia and abides
byIndonesian laws and regulations.
2. We shall shoulder the cost of the applicant’s living expenses and return travel expenses if the
applicant is unable to pay them.
3. We shall serve as the applicant’s guarantor if the applicant in any way becomes involved in
Indonesian legal proceedings.
4. We shall be responsible to make sure that the above named person will return back to
His/HerHome Country before the limit of His/Her Visa expires.

Temanggung, 17th March 2022

PT Tanjung Kreasi Parquet Industry

Muhammad Hamdani
Director

Tel. +62 298 592301

Jl. Raya Ambarawa – Magelang, Km.13
+62 298 592302
Pringsurat - Temanggung 56272
Fax. +62 298 592303
Jawa Tengah
Indonesia
www.dsn.co.id