PT. FLUID SCIENCE DYNAMICS INDONESIA Document No.

APPLICANT PERSONAL DATA FM-HR-01 / Rev. 0

Please complete and return this form to PT. FSD HR Officer.

As professionals, we use this form to comprehensively assess your background for suitability to position you apply for.
Therefore please be as complete in your response as you can.
The information you provide will be treated with utmost discretion and strict confidentiality.

POSITION APPLIED FOR : HR GENERALIST

SECTION 1 - PERSONAL INFORMATION

Full Name HANS MAHENTA FADLI Chinese Character (if any)

JL BRATASENA IX BLOK U7 NO 25, PAMULANG
Address

Telephone No. Phone 82322388642 WA 82322388642 Mobile/Pager

Date of Birth 2/3/1994 Age 30 Marital Status M
Nationality WNI NIK No. 1371110203940013 Religion ISLAM
Spouse's Name MUTIARA ANNISA No. of Children 1
National Service Experience / Commitment

SECTION 2 - EDUCATION

School / University From To Educational Qualification

UNIV ISLAM INDONESIA 2012 2017 S1

SECTION 3 - EMPLOYMENT HISTORY (start with current)

Name & Location of Nature of

From To Position Held Reason for Leaving
Company Business
2017 2018 PT KPSG OUTSORCING RECRUITMENT OFFICERBACK TO HOMETOWN
RSIA IBU DAN ANAK
2018 2022 HEALTHCARE KEPALA UNIT HRD MENCARI TANTANGAN BARU
CICIK
PT INDOLAB BY
2023 2023 HEALTHCARE HCGA PENGURANGAN KARYAWAN
MAYAPADA
2023 2024 PT INFOMEDIA OUTSORCING HC OPERATIONS

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SECTION 4 - SKILLS AND INTERESTS

INDONESIA
Language Spoken/Written

MICROSOFT OFFICE 365, HRMS, SAP, GOOGLE SPREADSHEET

Computer Skill
CANVA, VN EDITOR
BEI, PSYCHOTEST TOOLS, KPI
Technical Skill

Professional Qualification

DRIVING, EDITING, CONTENT CREATOR

Other Skill

Interests / Hobbies MEMBACA, OLAHRAGA

SECTION 5 - PROFESSIONAL CONTACT REFERENCE

PHONE NO. /
NAME TITLE RELATIONSHIP
EMAIL ADDRESS
MARCELLA HEAD HCGA 62 822-2021-4936 MANAGER
DR KHARISMA DIRECTOR 62 811-6613-444 DIRECTOR

SECTION 6 - SALARY AND AVAILABILITY

Current Remuneration Package Expected Remuneration Package

Salary 6.000.000 Salary 8.000.000
Benefits / ASSURANCE Benefits / ASSURANCE
Allowances BONUS Q1 & Q4 Allowances BONUS

Availability for commencement of employment (if selected) 15-Mar

Signature

Hereby I testify that above information is true. If deemed necessary, PT. Fluid Science
Dynamics Indonesia can verify any given information. Upon notification from PT. FSD, I will #VALUE!
provide relevant documents to support information I wrote in this form.

Date:21/02/2024

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