New Customer Creation Form

Customer Information (as per NPWP):

Customer Name PT. ENVIROTAMA SOLUSINDO
NPWP (Tax ID) 31.472.529.2-407.000
Address:
Street Jl. Jatiwangi No. 84 – Cikedokan, Kp. Kamurang RT 001/ RW 001
City, State, Zip Cikedokan, Cikarang Barat, Kab. Bekasi, Jawa Barat 17841
Business Phone (+62) 851-7674-7674
Email Address purchasing@eslab.co.id
Billed to (Address): Please tick here if the same as NPWP address
Street Address Jl. Jatiwangi No. 84 – Cikedokan, Kp. Kamurang RT 001/ RW 001
City, State, Zip Cikedokan, Cikarang Barat, Kab. Bekasi, Jawa Barat 17841

Shipped to (Address): Please tick here if the same as NPWP address

Street Address Jl. Jatiwangi No. 84 – Cikedokan, Kp. Kamurang RT 001/ RW 001
City, State, Zip Cikedokan, Cikarang Barat, Kab. Bekasi, Jawa Barat 17841

CONTACT DETAILS:
PIC on The Project Annisa Febryana
Office and Mobile 02185934498
Phone (+62) 851-7674-7674
Email Address purchasing@eslab.co.id
Finance (Accounts Payable):
Name Dwi Yuda
Phone +62 812-9252-0497
Email Address finance@eslab.co.id (cc : purchasing@eslab.co.id)

Attached Documents:
1. Tax ID ( NPWP ).
2. Invoicing Procedures (if applicable).
 Can the invoice be sent via courier or must it be delivered
 Is there an invoice receipt date
3. WAPU Certificate (if applicable).

*) Please pass this form to Finance after all information has been fulfilled

Requested,

Annisa Febryana
Purchasing Staff