VENDOR MASTER DATA CREATION FORM

(A) VENDOR INFORMATION

* COMPANY NAME : CV.PUTERATEK

* COUNTRY : INDONESIA

* ADDRESS : Ruko Golden Madrid Blok D No. 26 RT 005 RW 002 Jl. Letnan Sutopo BSD City
* POSTAL CODE / CITY : 15310
* TAX REGISTER NO. : 42.267.508.2-411.000
* VAT NO.
* NATURE OF THE BUSINESS (must) : Manufacturer
OWNER : AI ROHANIAH
NUMBER OF EMPLOYEES : 4
BUSINESS REVENUES : 500000000

(B) PERSON TO CONTACT

NAME : AI ROHANIAH
TELEPHONE : 87722794061
FAX : -
HANDPHONE : -
EMAIL : Puteratek@yahoo.com

LANGUAGE :
If Others, please specific : Bahasa Indonesia

(C) BANK INFORMATION

* BANK NAME : BRI

* BANK ADDRESS : Ruko Golden Madrid 2
* STREET / REGION / CITY : Jl. Letnan Sutopo, Rw. Mekar Jaya, Kec. Serpong, Kota Tangerang Selatan, Banten 15310
* BANK BRANCH : BRI KCP PASAR MODERN BSD
* SWIFT CODE : BRINDJAXXX
* BANK NUMBER : 217-01-000397-56-5
* IBAN NO. : -

* TRANSACTION CURRENCY : Others

If Others, please specific : IDR

* PAYMENT METHODS : Others

If Others, please specific : Transfer

* PAYMENT TERMS : Others

INCOTERM : 45 hari

(D) ESSENTIAL INFORMATION

* BUSINESS LICENSE : 1257000462476

* BANK A/C OPENING LICENSE : -
* TAX REGISTRATION CERTIFICATE : 42.267.508.2-411.000

DISCLAIMER
I hereby certify that all information provided herein are reviewed to be true, complete and accurate.

SUPPLIER SIGN/COMPANY STAMP DYSTAR REQUESTOR APPROVE BY VP, GLOBAL PROCUREMENT

DATE: 19 March 2024 DATE: DATE: