Company Name : Warung Bakmi Jawa Mbah Djojo

Business Address : Jalan Ki Hajar Dewantoro No. 104, Sawah Lama, Ciputat, Tangerang Selatan

Owner Identification Number

PIC's Name :

PIC's Number PIC's Email :

RESTAURANT INFORMATION
Restaurant Name :

Restaurant Address + Longitude Latitude Position from Google Maps

 more than one outlets

Restaurant Phone Number

Open and Close Time :

Menu and Price List Photos of Restaurant and/or Food

 attached  attached

BILLING INFORMATION
NPWP Registration Number  Attach Copy of NPWP Certificate
NPWP Address :

RestaurantTax 10% (PB1)  Included and Add 10%

Service Fee : % Not Applied  Applied
Finance PIC Name

Finance PIC Phone Number

Finance PIC Email

Finance Billing Address