Pts - New Passenger Data Entry Form: Lifting - Balikpapan@bpmigas - Go.id

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PTS - NEW PASSENGER DATA ENTRY FORM

Entity *: MSA/SPS/PRS

Employee/ Employee No.


No Contractor/
/
Guest *
GGI No.
1

Guest

Sex * Marita
Contact Information *
Birthdate *
Nationality Expired of Certificates (dd/mmm/yyyy) *
l
(dd/mmm/yyyy)
*
Status
Last
(M/F)
Company
Position
Phone
E-mail
HUET
Sea Survival
MCU*
BACHTERA
Singl
BP
Pengawas 08133471
INDONESI
lifting_balikpapan@bpmigas.go.id
M
17-MEI-1984
WAN
e
MIGAS
Lifting
5178
A

Name (ID Card) *


First

Middle

ICHSANDI

2
3
4
5
6
7
8
9
###
Comments/Remark : TANKER LIFTING ACTIVITY

* Must be filled in
GGI
: For All TEPI Users
MCU
: For site personnel or people going to site as site requirement
HUET
: For those who using helicopter transportation more than
5 trips and forth (10 times) / year
SEASVAL
: For those who using sea transportation more than 10 trips
and forth (20 times) / year

Created By

Name
: ANTONIAGA
42763Date
: -409dd-mmmm-yyyy

Approved by (Min. Head of Service)

Name
: CHAIRUL
42763Date
: -409dd-mmmm-yyyy

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