area staples

WITHHOLDING TAX RECEIPT

ARTICLE 26 AND ARTICLE 4 SECTION (2) FOR
NON RESIDENT
FORMULIR BPNR
MINISTRY OF FINANCE OF H.1 Number : 2 0 0 0 0 0 0 7 0 5
REPUBLIC OF INDONESIA
DIRECTORATE GENERAL OF TAXES H.2 X 0 Amended Receipt H.3 Annulment

A. INCOME RECIPIENT

A.1 TIN : 31 47 66 58

A.2 Taxpayer's Name : Maersk Logistics & Services International A/S

A.3 Address : Esplanaden 50, 1263 Copenhagen K, Denmark

A.4 Country : Denmark A.5 Date of Birth : yyyy

dd mm
A.6 Birth City :

A.7 Passport Number : A.8 KITAS/KITAP Number :

B. INCOME TAX WITHHELD

Tax Period Code of Type of Taxable Gross Amount of Income (Rp) Deemed Net Income (%) Rate (%) Income Tax Withheld (Rp)
(mm-yyyy) Income
B.1 B.2 B.3 B.4 B.5 B.6
11-2022 27-104-01 21.201.775.240,00 100 0 0,00
Tax Object's Code Information : Imbalan Sehubungan dengan Jasa, Pekerjaan dan Kegiatan (PPh Pasal 26)
B.7 Reference Document: Document's Number Network Agreement

Document's Name Surat Perjanjian Date 3 0 dd 0 8 mm 2 0 1 7 yyyy

B.8 Reference Document for Tax Invoice :

Tax Invoice Number : Date yyyy
dd mm

B.9 X Income Tax is withheld at a rate stipulated in Double Tax Agreement. The reduced withholding tax rate is based on submitted Certificate of
Domicile with receipt number SKDWPLN-DNK/3/22-00000059 0 1 dd 0 1 mm 2 0 2 2 yyyy

B.10 Income Tax is borned by the Goverment based on reference document number:

B.11 Taxable income/tax subject/tax withheld is gived tax income based on

C. WITHHOLDING AGENT
C.1 TIN : 0 1 5 4 2 7 8 3 4 0 7 3 0 0 0
C.2 Taxpayer's Name : DAMCO INDONESIA
C.3 Date of Issuance : 1 1 dd 1 1 mm 2 0 2 2 yyyy
C.4 Signatory's Name : NICHOLAS BONGSOSARTONO
C.5 Taxpayer's Statement : I hereby declare that the unified withholding tax receipt has been correctly, completely and clearly filled and I also sign this electronically.

For any error in the filing of the unified withholding tax receipt, generating an excess of the income tax withheld, the party that will submit a
tax refund request for the overpaid amount is:

refund by Withholding Tax Agent

V book balance tranfer by Withholding Tax Agent

Under the prevailing tax law and regulation, Directorate General of Taxes stipulates that this Withholding Tax Receipt is valid and wet
signature is unrequired. This Withholding Tax Receipt has been electronically signed.
CL0W3XXN