SUPPLMRI CUSTOMER PROFILE FORI}I

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l. General Information
r CompanyName* : EMERGO
r Jenis Vendor* : n Badan flPerorangan
x flEmployee EGovernment
r Addresst : TANGGA BATU 002/000, TANGGA BATU, BELANTIKAN RAYA
r NP:UfP/I(TP* : 63.367.887.5-713.000 I 6209032010940002
r Status Vendor* : [] PKP x
[Non PKP
' No SPPKPI : ......
SuratNon PKP * Job Title : .....-
r Email* : ...... ..,. Web Site : ......
t Clty : ...... . Mobile Phone: .."...
r Country : ...... . Offrce Phone : ......
r Zip Code : ...... Contact Person:

2. Type of Business
I ivlanuiauiurer I Trading I DistribuBorDealer f]x Contractor I Service Provider
I Freight i Transportation Services n .....
Core Eusiness. . - Secondary business: ..

3. Banking
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I Account Name afAccount..

4. Group Accountirg
-1-
Vendor (d) Uustomer (1)
o 1100-INTERCOMpAT{Y OTHERS (2104020101} o 4000-tNTERCOMpANy TRADE (11.02020101)
o 1200-TNTERCOMPANYLOAN {2201030101} o 4100-TNTEXCOMTANY OTHERS (110302010u
o 1300-TNTERCOMPA,NYTRADE NON COMM (210302010u o 4200-INTERCOMpATCy LOAN (12060L0101)

o 2000-3RD PARTY TRADE COMM (21030L0101,) o s000-3RD PARWTRADE {1L02010101}

o 2100-3RD PARTY OTHEftS t2104010101) o 5100-3RD ?ARTY OTHERS t1103010101)
o 2200-3RD PARTY LCAN (22O1010101) L.' SZUU.5fTIJ FAN I I LTJAI!'

o 2300-3RD PARTY TRADE NON COMM (2103010101) o 5400-PI-A5MA{120s010101}

u z4w-t,LA5MA(l1UJUlU1U1' o 56S0{il}/€STMENT(12O801SlO1i
o 2s00-TRANSPORTER (2r.030101,01) o HOIC-EMPLOYEE HO {1r.03010L01}
o 2600-3RD PARTY LOAN {21010101-0L} o xxlc-EMPLOYEE(110301010l-)
c HOlV,EMPLOYEEHO{21O401O1O1}

o xxlv-EMPLOYEE STTE {2104010L01}

Diperiksa Diperiksa
Pemo* AtasalPqrohon
(TAX)
I TACCOUNTTNC)

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d! Agung Kurniawan

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