Skip Navigation Links
Skip Navigation Links
Registration Vendor
      * Yellow field is mandatory             * White field is optional             * Grey field is read only

Main Info
Nama Perusahaan Pertamina
(Pertamina Company Name)
Title
(Title)
v
Nama Perusahaan
(Company Name) 		Enter company name without a title ex: Pertamina ( PT.Pertamina )
Alamat
(Address)
Alamat (Lanjutan)
(Address - Cont)
Kode Pos
(Zip Code)
Negara
(Country)
Propinsi
(Province)
Kota / Kabupaten
(City)
Kecamatan
Lokasi
(Registration Location)
Jenis Vendor
(Vendor Type)
v

PO Box
(PO Box)
Nomor Telepon
(Phone No. ) 		ex: (+62)21_ 000 0000
Fax
(Fax No.) 		ex: (+62)21_ 000 0000
No. NPWP
(Tax Number)
 
Upload NPWP
(Upload Tax Number Document)
Clear selectionBrowse...
Clear selectionBrowse...
Maximum file size 500kb (*.pdf, *.jpg, *.jpeg)

Upload Surat Kuasa
(Upload Power Of Attorney)
Clear selectionBrowse...
Clear selectionBrowse...
Maximum file size 500kb (*.pdf, *.jpg, *.jpeg)

Admin Information
Nama Depan
(First Name)
Nomor Handphone
(Mobile Phone)
ex: (+62)800 0000 0000
Email
Email Address
 
User Name
(User Name)
 
Password
(Password)
 
Pertanyaan Keamanan
(Security Question)
Nama Belakang
(Last Name)
Konfirmasi Email
(Email Confirmation)
   
 
 
Konfirmasi Password
(Password Confirmation)
   
Jawaban Keamanan
(Security Answer)

Captcha image
Show another codeShow another code
Save
Cancel