Ryoichi Takeda - Fast Retailing Indonesia - Izin - Tinggal - Terbatas (31!03!2019)

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KEMENTERIAN HUKUM DAN HAK ASASI MANUSIA

REPUBLIK INDONESIA
KANTOR WILAYAH DKI JAKARTA
KANTOR IMIGRASI KLAS I KHUSUS JAKARTA SELATAN
JL. WARUNG BUNCIT RAYA NO 207

IB
IZIN TINGGAL TERBATAS ELEKTRONIK
ELECTRONIC LIMITED STAY PERMIT

NIORA : J1U1SADZ18456

Permit Number : 2C11JE4037-S

Stay/Multiple Entries Permit Expiry : 31-03-2019

Full Name : RYOICHI TAKEDA

Place / Date of Birth : SHIGA / 14-10-1984

Passport Number / Date of Expiry : TS0037312 / 01-02-2028

Nationality : JEPANG

Sex : MALE

Address : 1PARK AVENUE TOWER KING LT 22 UNIT D


JL KH M SYAFI'I HADZAMI RT 008 RW 05 KEBAYORAN LAMA

Occupation : MARKET RESEARCH MANAGER

Notice:
1. According to Article 71 Act Number 6 Year 2011 concerning Immigration, every changes of civil status, citizenship,
occupation, Guarantor, or change of address must be reported to Local Immigration Office in an immediate period of
time.
2. This Limited Stay Permit (Electronic) must be attach to the bearer’s Passport at all times
3. For further information please do not hesitate to contact Local Immigration Office or do visit our website
www.imigrasi.go.id.

Jakarta, 31-03-2018

Head of Klas I Khusus Jakarta Selatan Immigration Office.

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