KEPOLISIAN NEGARA REPUBLIK INDONESIA, : - RESOR KOTA DELI SERDANG Nomor:02-006074 9 SEKTOR TANJUNG MORAWA TI POLICE RECORD. Nomor : SKCK/YANMAS/2007 XIIWVAN 2.2/2022/INTELKAM This is (0 certify thet Nama : HERIADI MANURUNG Name . : LAKELAKI Sex + INDONESIA Nationality Agama : KRISTEN PROTESTAN Religion ‘Tempat dant ahir : MEDAN, 6 APRIL 1980 Place and date of bith ; JLN LUNG SERDANG PERUMAHAN PUTRI TRAMEDANG RESIDENCE Current address RT 001, RW.00{: DESA UJUNG SERDANG, KEC. TANJUNG MORAWA, KAB, DELI SERDANG, PROV. SUMATERAUTARA Pekerigan : Coataten peunyoaeeen ‘Nomor Kerty Tanda Penduduls snl Ne Gitizen card number Nomor Paspor/ KITAS/ KITAP* Gy Passpor/ KITAS/KITAP number aay ‘Bumus sidik iar} wy Fingerprints Formula As of screening through the i Existing Police record bahwa nz ssolama la berada di Indonesia dart =, ‘dunng histher stay in Indonesia from ae a SS +29 DESEMBER 2022 unt ™ This certificate is issued at the request fo the epplicant apy : MELAMAR PEKERJAAN SWASTA, Valid from ‘Sampal dengan : a : 29 JUNI 2023 29 DESEMBER 2022