PTS - NEW PASSENGER DATA ENTRY FORM

Entity *: __________________

Employee/ Employee No. Name (ID Card) * Sex * Marita Contact Information * Expired of Certificates (dd/mmm/yyyy) *
Birthdate *
No Contractor/ / l Nationality *
(dd/mmm/yyyy)
Guest * GGI No. First Middle Last (M/F) Status Company Position Phone E-mail HUET Sea Survival MCU*
1 Contractor Erwin Nugraha M Married PT ISP Asst
Inspector
0812537983
83 nugraha_erwin18@yahoo.co.id
18-Sep-1979 Indonesia 12-Apr-2021 31-Mar-2020

Asst 0821583928
2 Contractor Nico Achmad Zulfiansyah M Single PT ISP
Inspector 11 nicoachmad11@gmail.com 14-May-1995 Indonesia 1-Mar-2021 15-May-2020

10

Comments/Remark :

* Must be filled in Created By Approved by (Min. Head of Service)

GGI : For All PHM 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 Erwin Nugraha Name :
SEASVAL : For offshore passenger or passenger on mission with a cumulated Date : 30 Maret 2019 Date :
duration of 15 days or more per year
 PTS ID Creation Guidelines
1 Prior filling in this form, please check whether the name(s) to be registered has already been
This is to avoid double registration.
2 The form is designed for registration of multiple personnel under similar entity of responsibili
The form shall be downloaded, filled, signed, scanned and e-mailed back to PTS administra
EP-ID.PTS-INDONESIA@pertamina.com
Please put the subject [ptsreg-your entity].
3 “Entity” refers to TEPI entity to which the person to be registered is related.
It applies the same manner like the current practices for bookings.
4 For non-TEPI personnel, the GGI information shall be left blank.
5 Until different policy is put in place, for personnel not having the certificates required, the cel
It is strongly recommended for those who have already obtained the certificates, to have the
Reliability of personal information, as well as expiry dates of certificates to be guaranteed by
n Guidelines
egistered has already been registered before.

imilar entity of responsibility

ed back to PTS administrator :

s related.
.

ertificates required, the cells may be left blank.

he certificates, to have the information filled in the form.
cates to be guaranteed by both the originator and the hierarchy app