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CUSTOMER PROFILE
(COMPLETED by CUSTOMER)
Company Name :
Company Group :
Address :
Phone : Fax
Email : Website
NPWP No. :
NPWP Address :
PKP : No Yes, No. : Date :
Type of PKP : EPTE/Kawasan Berikat WAPU Non-WAPU Other
Notes: Please attach copy of NPWP and SPPKP
BILLING INFORMATION
(COMPLETED by CUSTOMER)
Billing Address :
SHIPPING INFORMATION
(COMPLETED by CUSTOMER)
Revenue per year : 0 - 1M > 1M - 10M > 10M - 100M > 100M
(IDR)
Annual Purchase : 0 - 50 Juta 50 Juta - 200 Juta
estimation (IDR)
> 200 Juta - 500 Juta > 500 Juta
Have you ever purchased any product at Kawan Lama : Yes No
CONTACT PERSON (COMPLETED by CUSTOMER)
(*) Mandatory
20
( (
Customer
COMPLETED by KAWAN LAMA GROUP
Language :
Account Type : Regular Account Big Account Potential Key Account Key Account
National Key Account
POD : Yes, reason
(Proof of Delivery) No
Transportation Zone :
Customer Type : Sister Company End User TPK Franchise E-Commerce
(For Delivery Purpose -
Attribute 2)
Proposed by: Reviewed by: Input by:
Date : Date : Date :
( ( ( ( ( (
2/2