Professional Documents
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(Hiams) As-Ib Personal Data Form
(Hiams) As-Ib Personal Data Form
(Hiams) As-Ib Personal Data Form
(3 X 4)
Name
(Full Name)
Nick Name Supri
Sex (Male/ Female): Male Place and Date of Birth :Tegal, 07 April 1985
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Page 1
(HIAMS)AS-IB Recruitment & Selection Systems & Procedures
(HIAMS)AS-IB CANDIDATE APPLICATION FORM
Format Number : __/HR/__/__
PT Hitachi Automotive Systems Indonesia Human Resources Department
Driving License
SIM A Number & Plat Number: SIM A Date of Issued: SIM A Valid Date Until:
SIM B Forklift N
umber & Plat SIM B Forklift Date of Issued: SIM B Forklift Valid Date Until:
Number:
SIM C Number & Plat Number: SIM C Date of Issued: SIM C Valid Date Until:
SIM C Plat no B 3829 UCN 16 August 2013 07 April 2018
Banking Details
Bank Account No: Bank Name & Code Bank Number: Branch Name & Address:
120-00-0975997-3 Mandiri Jl. Budi mulia 05 rt/rw 012/008
Pademangan barat Jakarta utara
2ND SISTER/ BROTHER Hartono 36 Captain Nakhoda Jl. Laban Jatibogor Tegal
3RD SISTER/ BROTHER Komari 32 Entrepreneur Jl. Laban Jatibogor Tegal
TH
4 SISTER/ BROTHER Muyati 29 Housiwife Jl. Laban Jatibogor Tegal
WIFE/ HUSBAND Dewi maryam 28 Housiwife Jl. Budi mulia 05
Pademanagan Jakarta utara
1ST CHILD M. Ikhsan alfatih 1 -
supriyanto
2ND CHILD
3RD CHILD
4TH CHILD
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Page 2
(HIAMS)AS-IB Recruitment & Selection Systems & Procedures
(HIAMS)AS-IB CANDIDATE APPLICATION FORM
Format Number : __/HR/__/__
PT Hitachi Automotive Systems Indonesia Human Resources Department
Total Allowances
(Named Transport Transport, Meals Meals, Home/Villa
Allowance, Meals
Allowances)
Others Benefits (e.g Bonus, THR, BPJS Bonus, Assurance, Ticket
Bonus/ THR/ BPJS, (assurance)
etc)
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Page 3
(HIAMS)AS-IB Recruitment & Selection Systems & Procedures
(HIAMS)AS-IB CANDIDATE APPLICATION FORM
Format Number : __/HR/__/__
PT Hitachi Automotive Systems Indonesia Human Resources Department
EDUCATION QUALIFICATION :
QUALIFICATION NAME OF SCHOOL/ UNV PASSING PERIOD MAJOR & IPK ACHIEVEMENT
GRADE
FROM TO
Master Degree
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Page 4
(HIAMS)AS-IB Recruitment & Selection Systems & Procedures
(HIAMS)AS-IB CANDIDATE APPLICATION FORM
Format Number : __/HR/__/__
PT Hitachi Automotive Systems Indonesia Human Resources Department
KNOWLEDGE
SCM Management, warehouse
management, inventory management,
production management
ATTITUDE
Aggressive, passionate, disciplin
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Page 5
(HIAMS)AS-IB Recruitment & Selection Systems & Procedures
(HIAMS)AS-IB CANDIDATE APPLICATION FORM
Format Number : __/HR/__/__
PT Hitachi Automotive Systems Indonesia Human Resources Department
2. Are you preferred to join our Study Aboard or Overseas Training Program? (Sometime these programs will
take long term period of more than 14 days). I prefer both of them.
3. Are you preferred to be place in different Department (from your previous experience), or different
position that you are applying ? And are you accepted for Shift or Overtime working hours?
I will accept all position even different departments as challenge, opportunity and develop my carrier.
I, declare that the particulars given above are correct and true to the best of my knowledge
and belief and no attempt has been made by me to Conceal or withhold pertinent
information, which you are at liberty to verify at any time. I also understand that any
misrepresentation of facts in the application is sufficient cause for termination of my
services/ employment in PT Hitachi Automotive Systems Indonesia ((HIAMS)AS-IB), if
appointed.
Place: Cikarang, Date:3 November 2015, Applicant’s Signature: Supriyanto
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(HIAMS)AS-IB Recruitment & Selection Systems & Procedures