POLICE OF THE REPUBLIC OF INDONESIA

SULAWESI SELATAN
WAITER CENTRE POLICE
Jalan Perintis Kemerdekaan KM 16 Makassar

SIGNS LETTER REFORT LOSS

No : SKTLK / 98 / II / 2014 / WCP
---------- On Monday, February 24, 2014 at 15.00 pm, at the centre of the room maid integrated policing in
Waiter Centre Police of South Sulawesi has come a women named :---------------------------------------------------

---------- Name : ZARDILLA ------------------------------------------------------------------------------

---------- Place / date of birth : December, 20, 1980 / Surabaya ---------------------------------------------------
---------- Religion : Islam --------------------------------------------------------------------------------------
---------- Job : Indonesian Labor ----------------------------------------------------------------------
---------- Address : Jln. S. Dg. Jarung No. 283 Kec. Tinggimoncong Kab. Gowa, South
Sulawesi, Indonesia. -----------------------------------------------------------------

---------- Reforts that it has lost the goods / securities in the form : ------------------------------------------------------

---------- 1 (one) sheet Indonesian identity card ---------------------------------------------------------------------------

---------- 1 (one) sheet HKID ------------------------------------------------------------------------------------------------------
---------- 1 (one) sheet passport book and a work visa from Hong Kong -----------------------------------------
---------- 1 (one) sheet employment contracts Hong Kong ------------------------------------------------------------
---------- And a few other important document ---------------------------------------------------------------------------

---------- Scene at : Jl. Urip Sumoharjo Makassar on the date January, 20 th, 2014 in the name of victim :
above losses form the foregoin, done by The Rober di copet. -------------------------------------------------------------

----------- Reprting justify all the information given above and to strengthen the reporting signature below. ----

INFORMAN / PELAPOR

ZARDILLA

---------- Similary, signs letter to report this loss is made in good faith, on the strength of the oath of office
and signed, then given to the person concerned in order to be used properly. ---------------------------------------

Makassar, Februari, 24th, 2014

Acknowledge / Mengetahui, Issue . By/ yang membuat Laporan,
a.n. KA SPKT POLDA SULSEL BA YANMAS SPKT II
KA SIAGA SPKT II

IDHAN HN. MUKTADIR

KOMPOL NRP 65010104 BRIPKA NRP 80090472
Notes :
1. This statements is not a replacement of the letter / document is missing, but rather as a basis for obtaining the missing letter
2. This letter is valid 1 month from the date of issuance .
3. When letters / documents missing has been found, the letter is considered void and returned to the issuing
.
 POLICE OF THE REPUBLIC OF INDONESIA
SULAWESI SELATAN
WAITER CENTRE POLICE
Jalan Perintis Kemerdekaan KM 16 Makassar

SIGN LETTER REPORT LOSS

No : SKTLK / 498 / VII / 2016 / WCP
---------- On Monday, July 11, 2016 at 19.30 pm, at the centre of the room maid integrated policing in Waiter
Centre Police of South Sulawesi has came woman named :---------------------------------------------------------------

---------- Name : SAHRIYANTI SAAD,S Hut,MSi ---------------------------------------------------

---------- Place / date of birth : July, 05, 1982 / Pare – Pare --------------------------------------------------------
---------- Religion : Islam --------------------------------------------------------------------------------------
---------- Job : Lecturer ----------------------------------------------------------------------------------
---------- Address : Per Bukit Madani Blok A6 / 7 Rt 006 Rw 006 Kel Tamalanrea Jaya Kec
Tamalanrea Makassar . -------------------------------------------------------------

---------- Reports that it has lost the goods / securities in the forms : ----------------------------------------------------

---------- 1 (one) sheet Resident Card ( Japan ) ----------------------------------------------------------------------------

---------- 1 (one) sheet Garuda Frequent Flyer Card----------------------------------------------------------------------
---------- 1 (one) apartment key --------------------------------------------------------------------------------------------------

---------- Scene at : International Airport Jakarta or Makassar on the date July, 02 th, 2016 in the name of
victim --------------------------------------------------------------------------------------------------------------------------------------

----------- Reporting justify all the information given above and to strengthen the reporting signature below. --

INFORMAN

SAHRIYANTI SAAD,S Hut,MSi

---------- Similary, sign letter to report this loss is made in good faith, on the strength of the oath of office and
signed, then given to the person concerned in order to be used properly. ---------------------------------------

Makassar, July, 11 th, 2016

Acknowledge Issue . By
a.n. KA SPKT POLDA SULSEL
KA SIAGA SPKT III BA YANMAS SPKT II

SYARIFUDDIN ,S.Sos SABRI DJAMIL

A K B P NRP 58081144 BRIPKA NRP 84110451

Notes :
1. This statements is not a replacement of the letter / document is missing, but rather as a basis for obtaining the missing letter
2. This letter is valid 1 month from the date of issuance .
3. When letters / documents missing has been found, the letter is considered void and returned to the issuing
.
POLICE OF THE REPUBLIC OF INDONESIA
SULAWESI SELATAN
WAITER CENTRE POLICE
Jalan Perintis Kemerdekaan KM 16 Makassar
 SIGNS LETTER REFORT LOSS
No : SKTLK / 98 / II / 2014 / WCP
---------- On Monday, February 24, 2014 at 15.00 pm, at the centre of the room maid integrated policing in
Waiter Centre Police of South Sulawesi has come a women named :---------------------------------------------------

---------- Name : ZARDILLA ------------------------------------------------------------------------------

---------- Place / date of birth : December, 20, 1980 / Surabaya ---------------------------------------------------
---------- Religion : Islam --------------------------------------------------------------------------------------
---------- Job : Indonesian Labor ----------------------------------------------------------------------
---------- Address : Jln. S. Dg. Jarung No. 283 Kec. Tinggimoncong Kab. Gowa, South
Sulawesi, Indonesia. -----------------------------------------------------------------

---------- Reforts that it has lost the goods / securities in the form : ------------------------------------------------------

---------- 1 (one) sheet Indonesian identity card ---------------------------------------------------------------------------

---------- 1 (one) sheet HKID ------------------------------------------------------------------------------------------------------
---------- 1 (one) sheet passport book and a work visa from Hong Kong -----------------------------------------
---------- 1 (one) sheet employment contracts Hong Kong ------------------------------------------------------------
---------- And a few other important document ---------------------------------------------------------------------------

---------- Scene at : Jl. Urip Sumoharjo Makassar on the date January, 20 th, 2014 in the name of victim :
above losses form the foregoin, done by The Rober. ------------------------------------------------------------------------

----------- Reprting justify all the information given above and to strengthen the reporting signature below. ----

INFORMAN / PELAPOR

ZARDILLA

---------- Similary, signs letter to report this loss is made in good faith, on the strength of the oath of office
and signed, then given to the person concerned in order to be used properly. ---------------------------------------

Makassar, Februari, 24th, 2014

Acknowledge / Mengetahui, Issue . By/ yang membuat Laporan,
a.n. KA SPKT POLDA SULSEL BA YANMAS SPKT II
KA SIAGA SPKT II

IDHAN HN. MUKTADIR

KOMPOL NRP 65010104 BRIPKA NRP 80090472
Notes :
1. This statements is not a replacement of the letter / document is missing, but rather as a basis for obtaining the missing letter
2. This letter is valid 1 month from the date of issuance .
3. When letters / documents missing has been found, the letter is considered void and returned to the issuing
.
 SIGNS LETTER REFORT LOSS
No : SKTLK / 98 / II / 2014 / WCP
---------- On Monday, February 24, 2014 at 15.00 pm, at the centre of the room maid integrated policing in
Waiter Centre Police of South Sulawesi has come a women named :---------------------------------------------------

---------- Name : ZARDILLA ------------------------------------------------------------------------------

---------- Place / date of birth : December, 20, 1980 / Surabaya ---------------------------------------------------
---------- Religion : Islam --------------------------------------------------------------------------------------
---------- Job : Indonesian Labor ----------------------------------------------------------------------
---------- Address : Jln. S. Dg. Jarung No. 283 Kec. Tinggimoncong Kab. Gowa, South
Sulawesi, Indonesia. -----------------------------------------------------------------

---------- Reforts that it has lost the goods / securities in the form : ------------------------------------------------------

---------- 1 (one) sheet Indonesian identity card ---------------------------------------------------------------------------

---------- 1 (one) sheet HKID ------------------------------------------------------------------------------------------------------
---------- 1 (one) sheet passport book and a work visa from Hong Kong -----------------------------------------
---------- 1 (one) sheet employment contracts Hong Kong ------------------------------------------------------------
---------- And a few other important document ---------------------------------------------------------------------------

---------- Scene at : Jl. Urip Sumoharjo Makassar on the date January, 20 th, 2014 in the name of victim :
above losses form the foregoin, done by The Rober. ------------------------------------------------------------------------

----------- Reprting justify all the information given above and to strengthen the reporting signature below. ----

INFORMAN / PELAPOR

ZARDILLA

---------- Similary, signs letter to report this loss is made in good faith, on the strength of the oath of office
and signed, then given to the person concerned in order to be used properly. ---------------------------------------

Makassar, Februari, 24th, 2014

Acknowledge / Mengetahui, Issue . By/ yang membuat Laporan,
a.n. KA SPKT POLDA SULSEL BA YANMAS SPKT II
KA SIAGA SPKT II

IDHAN HN. MUKTADIR

KOMPOL NRP 65010104 BRIPKA NRP 80090472
Notes :
1. This statements is not a replacement of the letter / document is missing, but rather as a basis for obtaining the missing letter
2. This letter is valid 1 month from the date of issuance .
3. When letters / documents missing has been found, the letter is considered void and returned to the issuing
.