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

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

(PO Box)
PO Box
(Phone No. )
Nomor Telepon 		ex: (+62)21_ 000 0000
(Fax No.)
Fax 		ex: (+62)21_ 000 0000
(Tax Number)
No. NPWP
 
(Upload Tax Number Document)
Upload NPWP
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Maximum file size 500kb (*.pdf, *.jpg, *.jpeg) mandatory only for local vendor and optional for foreign vendor

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

Pihak yang mendaftar telah diberi otorisasi oleh vendor yang berwenang
Admin Information
(First Name)
Nama Depan
(Mobile Phone)
Nomor Handphone
ex: (+62)800 0000 0000
Email Address
Email
 
(User Name)
User Name
 
(Password)
Password
 

(Last Name)
Nama Belakang
(Email Confirmation)
Konfirmasi Email
   
 
 
(Password Confirmation)
Konfirmasi Password
   


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