| * 1. |
Nama Perusahaan
Name of Institution |
|
| * 2. |
Karakteristik Insitusi
Type of Institution |
* Isi pilihan lain
|
| * 3. |
Bentuk Hukum
Legal Entity Form |
* Isi pilihan lain
|
| * 4. |
Kode Pajak
Tax ID |
|
| 5. |
% Kepemilikan Saham
Percentage of Shareholding |
% Lokal | Domestic shareholding percentage
% Asing | Foreign shareholding percentage
|
|
Alamat Perusahaan | Company Address
|
| * 6. |
Negara
Country |
|
| * 7. |
Provinsi
State |
|
| * 8. |
Kota
City |
|
| * 9. |
Jalan
Street |
|
| 10. |
Kode Pos
Zip Code |
|
| * 11. |
No. Telepon
Phone Number |
-
-
(Kode Negara | Country Code) - (Kode Area | Area Code) - (No. | Number)
Contoh | Example : 62-21-123456
|
| 12. |
No. Fax
Fax Number |
-
-
(Kode Negara | Country Code) - (Kode Area | Area Code) - (No. | Number)
Contoh | Example : 62-21-123456
|
| * 13. |
E-mail Perusahaan
Company E-mail |
|
| 14. |
E-mail Perusahaan 2
Company E-mail 2 |
|
| * 15. |
Bidang Usaha
Line of Business |
|
| * 16. |
Domisili
Domicile |
|
| 17. |
Status Domisili
Domicile Status |
* Isi pilihan lain
|
| 18. |
Lama Menempati
Length of Occupancy |
-
(Tahun | Years ) - (Bulan | Months)
|
