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    Microsoft Word - Supplier Registration Form REV 4

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    PT Arinda Ananda Arsindo
    This document is a supplier registration form that collects key information about potential suppliers. It requests company details, ownership structure, points of contact for marketing, finance, accounting and taxes. It also asks for financial information like currency, bank details, payment terms and credit limits. Legal documents required include business licenses, tax registration codes and details of company establishment and shareholders. The form must be signed by representatives from procurement, finance and legal departments.

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd

    Microsoft Word - Supplier Registration Form REV 4

    Uploaded by

    PT Arinda Ananda Arsindo
    159 views3 pages
    This document is a supplier registration form that collects key information about potential suppliers. It requests company details, ownership structure, points of contact for marketing, finance, accounting and taxes. It also asks for financial information like currency, bank details, payment terms and credit limits. Legal documents required include business licenses, tax registration codes and details of company establishment and shareholders. The form must be signed by representatives from procurement, finance and legal departments.

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    Microsoft Word - Supplier registration form REV 4

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    This document is a supplier registration form that collects key information about potential suppliers. It requests company details, ownership structure, points of contact for marketing, finance, accounting and taxes. It also asks for financial information like currency, bank details, payment terms and credit limits. Legal documents required include business licenses, tax registration codes and details of company establishment and shareholders. The form must be signed by representatives from procurement, finance and legal departments.

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    159 views3 pages

    Microsoft Word - Supplier Registration Form REV 4

    Uploaded by

    PT Arinda Ananda Arsindo
    This document is a supplier registration form that collects key information about potential suppliers. It requests company details, ownership structure, points of contact for marketing, finance, accounting and taxes. It also asks for financial information like currency, bank details, payment terms and credit limits. Legal documents required include business licenses, tax registration codes and details of company establishment and shareholders. The form must be signed by representatives from procurement, finance and legal departments.

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    of 3

    SUPPLIER REGISTRATION FORM

    Company Information

    Company Name : _______________________________________________________________ (PT / CV / Individual / Others)*


    Address : __________________________________ Postal Code : __________________________________
    City : __________________________________ Country : __________________________________
    Phone/ Fax No : ________________ /_________________ Website : __________________________________
    Supply : Goods (Spare parts / Oil & Gas / Fuel / Stationery / IT / Household)*
    Services (Transporter / Vehicle Rental / Outsource / Insurance / Repair & Mtn ___________________)*
    Others ____________________________________________________________ (include investments)
    Ownership : Local PMA Joint Vtr Others _________________________________________
    PIC Marketing : Name _____________________________________ Title _________________________________________
    E-mail ________________________ Phone/ HP/ Fax No ___________ ext. ____ /__________ /__________

    Financial Information
    Currency : IDR Currency : USD Others __________
    Bank : __________________________________ Bank : __________________________________
    Branch : __________________________________ Branch : __________________________________
    Account No : __________________________________ Account No : __________________________________
    Beneficiary Name : __________________________________ Beneficiary Name : __________________________________
    Address : __________________________________ Address : __________________________________
    Term of Payment : 30 days 45 days 60 days Others __________________ days (after invoice received)
    Credit Limits : Rp. _____________________________________________________________________________ per month
    Bank Reff. Letter : __________________________________________________________________________________ (If any)
    PIC Finance-Billing : Name _____________________________________ Title _________________________________________
    E-mail ________________________ Phone/ HP/ Fax No ___________ ext. ____ /__________ /__________

    1• In case of Beneficiary Name is not the same with Company Name, Vendor has to submit Statement Letter.

    Legal & Taxes Information


    Trade Business Lisc. : ___________________________________________________________________________________ (SIUP)
    Coy Reg Code : ____________________________________________________________________________________ (TDP)
    Tax Reg Code : __________________________________________________________________________________ (NPWP)

    SKT No : _________________________________________________________________ (Surat Keterangan Terdaftar)

    SKPPKP : _____________________________________________(Surat Keputusan Pengukuhan Pengusaha Kena Pajak)


    Pengurus/Direksi Masa Jabatan : _______________________________________________________________________________
    Pesero Komanditer/Komisaris Masa Jabatan : ______________________________________________________________________
    Pemegang Saham : 1. _______________________________________________________________________________________
    2. _______________________________________________________________________________________
    Pendirian Perusahaan : No. Akta :____________________________________ Tanggal : _________________________________
    Notaris : ____________________________________
    Pengesahan Menteri Hukum dan HAM :
    No.AHU : ____________________________________ Tanggal : __________________________________
    Perubahan Sesuai UU No.40/2007 :
    No.Akta : ____________________________________ Tanggal : __________________________________
    Notaris : _____________________________________
    Persetujuan Menteri Hukum dan HAM :
    No.AHU : _____________________________________
    Keterangan / Catatan mengenai yang berhak dan berwenang mewakili perusahaan sebagaimana diatur dalam Anggaran Dasar Perseroan :
    Establishment Deed : _________________________________________________________________________________________
    PIC Accounting-Tax : Name _____________________________________ Title _________________________________________
    E-mail ________________________ Phone/ HP/ Fax No ___________ ext. ____ /__________ /__________

    1• In case of Vendor is not PKP (Pengusaha Kena Pajak), Vendor has to submit Statement Letter of Non PKP.
    2• All the Legal & Taxes documents have to be copied and submitted.
    3• In case of changes in Shareholder, Latest Shareholder Resolution Deed have to be copied and submitted.

    Acknowledge & approved by,

    (______________________)
    Name :
    Title :
    Date :
    PRO/FRM/004/01/12
    Filled by Puninar

    Vendor Code : _____________________________________________________________________________ (Procurement)


    Input By, Checked by,

    (______________________) (______________________) (______________________)


    Procurement Finance Dept Legal Dept

    For further information, please contact:


    PUNINAR LOGISTIC
    Jl. Raya Cakung Cilincing KM 1,5, Cakung, Jakarta Timur 13910
    Phone: 021-4602278 Fax: 021-46835553
    E-mail: procurement@puninar.com (Procurement Dept.) and ho-cashmgt@puninar.com (Finance & Treasury Dept.)

    * Cross if not necessary. PRO/FRM/004/01/12

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