Nama Direktur/Owner Name :

Nama Perusahaan/Company Name :

No. NPWP Perusahaan/Tax Registration No. :
Alamat Perusahaan/Company Address :
Telp. Kantor/Office Phone Number ;
Kelurahan :
Kecamatan :
RT :
RW :

Nama Purchasing/Purchasing Name :

Telp. Purchasing/Purchasing Phone :
Email Purchasing/Purchasing Email :

Alamat Kirim/Delivery Address :

Nama Receiving/Receiving Name :
Telp. Receiving/Receiving Phone :
Telp. Receiving/Receiving Phone :

Cara Pembayaran/Payment Method : Cash Giro Transfer

Nama Bank/Bank Name

Nama Cabang Bank/Bank Branch Name
No. Rekening/Account Number
Nama Pemilik Rekening/Beneficiary Name

Nama Finance/Finance Name

Telp. Finance/Finance Phone
Email Finance/Finance Email

Mohon sertakan softcopy/Please attach softcopy of Jakarta,

1 NPWP Perusahaan
2 KTP Direktur
3 SIUP/NIB Perusahaan
4 TDP Perusahaan
5 Domisili Perusahaan
tanda tangan dan nama penanggung jawab sign
and name of person in charge
Nama Direktur/Owner Name : Nama
Perusahaan/Company Name : No. NPWP
Perusahaan/Tax Registration No. : Alamat Perusahaan/Company
Address : Telp. Kantor/Office Phone
Number :
Kelurahan :
Kecamatan :
RT :
RW :

Nama Direktur/Owner Name

Nama Purchasing/Purchasing Name :
Telp. Purchasing/Purchasing Phone : Email
Purchasing/Purchasing Email :
Alamat Kirim/Delivery Address : Nama
Receiving/Receiving Name : Telp.
Receiving/Receiving Phone :
Email Receiving/Receiving Email :
Cara Pembayaran/Payment Method
Cash Giro Transfer
Nama Bank/Bank Name : Nama Cabang
Bank/Bank Branch Name : No. Rekening/Account Number
:
Nama Pemilik Rekening/Beneficiary Name :
Nama Finance/Finance Name :
Telp. Finance/Finance Phone : Email
Finance/Finance Email :
Mohon sertakan softcopy/Please attach softcopy of Jakarta,
1. NPWP Perusahaan
2. KTP Direktur
3. SIUP/NIB Perusahaan
4. TDP Perusahaan
5. Domisili Perusahaan
tanda tangan dan nama penanggung jawab
sign and name of person in charge
OLIVA(PT. GELMAX INDONESIA SENTOSA)Jl. Jembatan Dua, Komplek Harmoni Mas D6, Jakarta Utara 14450T : +62 21 667 0011 |