PES-22

STATISTICS INDONESIA
PASSENGER EXIT SURVEY CONFIDENTIAL
2022 The confidentiality of the data provided is guaranteed by
Act No. 16 of 1997 concerning Statistics.

Sign or fill in the answer 8. If the answer of Question 6 is 1 and Question 7 is 10 – 15,
1. Name : ................................................. a. How much income did you receive in this trip?
2. Age : …………… years old Currency: ……………… Value : …………………………………
3. Sex : Male -1 Female -2 b. Total contract value including income received above:
4. Nationality : …………………………………
Currency : ……………… Value : …………………………………
5. a. Country of residence : ………………………………
9. If the answer of Question 7 is 15
b. City of residence : ……………………………… How frequent do you usually visit Indonesia
6. Main Occupation: in one year?
Professional -1 Housewife -6
subject : ………………………… 10. If the answer of Question 7 is 4 or 15
Business Manager/Executive -2 Student -7 Name of institution/university attended : …………………………
Government/UN Official -3 Retired -8
Military -4 Others, please write down -9 a. Housing and Living cost (per month)
Clerical/Technical/Sales -5 (……………………………………) Currency : ……………… Value : …………………………………
7. Main purpose of visit:
b. Only for the answer of Question 7 is 4 (Long Education)
• Personal
Holiday, leisure, recreation -1 Beauty -6 Tuition fee (per semester)
Visiting friends, relatives -2 Religion/pilgrimages -7 Currency : ……………… Value : …………………………………
Training/course -3 Shopping -8
Long Education -4 Other personal purpose -9 11. Port of entry to Indonesia: ……………………………………………
Health -5 (……………………………………)
• Business and professional 12. a. Main destination city: ……………………………………………
Meeting -10 Convention -12
b. Other destination cities:
Incentive -11 Exhibition -13
Other business and professional purpose (………………………………) -14 1. ……………………………………………
• Work (employed by a resident entity) -15
2. ……………………………………………
13. How long did you stay in Indonesia? 2. How much do you spend for one ticket per person?
(night) Currency: ………………… Value: ……………………………………
14. a. Type of accommodation:
17. a. Did you use tour package (from travel agent in origin
Classified Hotel -1 Other commercial accommodation -16
country)?
Non Classified Hotel -2 (……………………………………)
Yes -1 No -2
Apartment Hotel -4 Residence of friend/relative -32
Villa -8 Others, please write down -64 b. How much did you spend for one pax?
(……………………………………) Currency : ……………… Value : …………………………………
b. Main accommodation used: ………………………
15. How many SIM Card did you use during this visit? 18. How much have you spent during your stay in Indonesia,
excluding the tour package in question 17.b?
- Indonesia Sim Card : …………………………………
Expenditure for one person
Provider name : …………………………………
Currency : ………………
- Origin Sim Card : …………………………………
16. a. Arrival Number of group members : ………………
1. What kind of transportation do you use? Details Value
- Airline
Airline name : ………………………………… a. Accommodation ………………………………………
- Ship b. Food and beverages ………………………………………
Ship name : …………………………………
- Bus c. Domestic Flight ………………………………………
Bus name/car number : …………………………………
d. Local Transportation
2. How much do you spend for one ticket per person?
1. Bus ………………………………………
Currency: ………………… Value: ……………………………………
2. Train ………………………………………
b. Departure:
1. What kind of transportation do you use? 3. Water transportation ………………………………………
- Airline
4. Other local transportation ………………………………………
Airline name : …………………………………
- Ship e. Vehicle rent ………………………………………
Ship name : …………………………………
- Bus f. Shopping ………………………………………
Bus name/car number : …………………………………
g. Souvenirs ……………………………………… ENUMERATOR REMARKS
h. Entertainment ……………………………………… Details Enumerator Supervisor
i. Health ……………………………………… Name

j. Beauty ……………………………………… Date

k. Training/course cost ……………………………………… Sign

l. Local Tour Package ………………………………………
m. Sightseeing ………………………………………
n. Guide Services ……………………………………… REMARKS/ADDITIONAL INFORMATION
o. Charity/transfer to Indonesia ………………………………………
p. Others ………………………………………
q. TOTAL AMOUNT ………………………………………