HR Department – Employee Personal Details Form

A. Employee Biodata
Name: Denny Helindar
KTP Card No.: 6503020512990001
Gender: Laki-laki
Birthdate: 05 Desember 1999
Age: 22 Tahun
Nationality:
Race:
Religion: Islam
Marital Status (Number of Child): Belum Menikah
Taxation No. (NPWP):
Social Security No. (BPJS):
Zakat No.:

B. Employee Contact Details

Address: Jl. Pasar Sentral
Postal Code: 777482
City: Nunukan Utara
State: Kabupaten Nunukan
Country: Kalimantan Utara
Telephone No. (Home): 085247406996
Mobile phone No.: 082296232912
Personal Email Address: dd255095@gmail.com

C. Banking Details
For BANK MANDIRI Only
Recipient Name:
Recipient Name (In English):
Bank Name:
Branch Code:
Swift Code:
Account No:
Bank Address (In English):
Bank Postal Code:

EASYBOOK.COM INC.
E: enquiry@easybook.com
 HR Department – Employee Personal Details Form

D. Family Information: NPWP deduction

• Only for dependent family members
No. Name Relationship
1
2
3

E. Emergency Contact Details

Reference 1
Name: Hajrah
Relationship: Ibu
Address: Jl. Pasar Sentral
Postal Code: 777482
City: Kab. Nunukan
State: Kalimantan Utara
Country: Indonesia
Telephone No. (Home):
Mobile phone No.: 085247406996

Reference 2
Name:
Relationship:
Address:
Postal Code:
City:
State:
Country:
Telephone No. (Home):
Mobile phone No.:

F. Declaration

I,Saya Denny Helindar with KTP No.654030205129990001 , hereby

declare all the above information is true, accurate and complete to the best of my knowledge. The
company will not be liable for any loss of any kind as a result of any information given found false or
incorrect.

EASYBOOK.COM INC.
E: enquiry@easybook.com
 HR Department – Employee Personal Details Form
For HR Use Only:

A. Section 1

Employee code: Position:

Hire Date: Salary:

Department: Location:

Employment Status: Recruitment Mode:

Official Email: Report to:

B. Section 2

No. Status Date Details

1 Confirmation

2 Promotion

3 Termination

EASYBOOK.COM INC.
E: enquiry@easybook.com