Customer Registration

Customer Name/ Company Name

Trading Name

General Manager

Owner

Purchasing Manager

Accounting Manager

Type of Business

Phone

Phone 2

Facsimile / Website

Mobile

Email

ID Type :KTPKitasPassport

ID Name

ID Number

NPWP Name

NPWP Number

Delivery Address

Sub District

City / District

Province

Post Code

Please attach your selected ID

Please attach your NPWP