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FORM DEKLARAS! ENTERTAINMENT ary Case ae cae caer Nama Tamu Bapak Valerian, Bapak Edwin 5 - | = Sisue ~ “Tebing Tinga, 3 Novernver 2023 Pemohon, Mengetahui, Menyetuju, ‘Beoery rake 6. Branéh Operation Area Manager(HO) Division Head SBO_—_ Account Owner Head Entertainment ASME ep. 8 ate Suto 9. 28 etan 2094 Iasiee : SIDS rack ib est: a8 2 ST Tailed an oy Heh a 2/1/20 19.13.33 Cle by Sth at 2/1178 2337.98 ry ras) ‘owt 8) Sw Tek so. 2 ofr Ue wea. 1 cAUKDY nse Ta suc 00.08 2 been mo.00.08 2 Simin OFF sc. 1 var re 1.00, sibel Ite. St 31.40.00 1.50.00 woes Saat 6-30.08 Total tow Du 6. 590,00 fy CRONE chiomacar (ss Date & crasie 416.986, 00 tard! Tat 4 a ath tar CU Aware Ce: 26641 oll A ash: TR Jala $10 2, 3 etan 2284 ee) Pats Sst: UTED TACT able ts aT a Ahan by nt at 02713 19.050 Chg Oy Hah at 2/1/25 2.0.14 av res) mi (8) Tem 6 A000 Stata Le. St 1.a.0n.60 os trust aa. Tota! sar tse 1.0. 00,00 yD caesar / ion Tit A rest 1.0.0000 Card! Test sites ate mer: O88; fear Coe: 28064) (vest Sigmture: —___ Faptoree Staroture:

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