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SHELVITA ANDRIANI, S.H.

NOTARIS
KABUPATEN LAHAT
Surat Keputusan Menteri Kehakiman dan HAM RI
No. C-601. HT.03.01- Th 2002 Tanggal 25 Maret 2002
Jl. Kombes H. Barlian No.14 Lahat Sumatera Selatan Telp. (0731) 325928

Lahat, 07 September 2017

To :
Embassy of Australia
Jakarta- Indonesia

RE : Tourist Visa Application

Dear Sir/Madam,

I, The Undersigned :
Name : Shelvita Andriani, SH.
Position : Notary at Kabupaten Lahat

Name Passport No. Relation Position


Mr. David Tarius X 209747 Employee Administration

He would like to spend His holiday in Australia that is organized by Avia Tour and Travel, Jakarta-
Indonesia, which will be taken place at Oktober 2017. All expenses related to the said vacation
program will be fully borne by Him.

It is hereby guaranteed that as soon as the vacation program is over, He will return immediately to
Indonesia without seek for any employment and permanent residence after the completion of the trip.

Therefore, i would be very grateful if you could respectively grant His the necessary tourist visa for His
vacation programme mentioned above.

Thank you for your kindly assistance and good cooperation had given.

Your Sincelery,

SHELVITA ANDRIANI, SH
(Notary at Lahat)
SHELVITA ANDRIANI, S.H.
NOTARIS
KABUPATEN LAHAT
Surat Keputusan Menteri Kehakiman dan HAM RI
No. C-601. HT.03.01- Th 2002 Tanggal 25 Maret 2002
Jl. Kombes H. Barlian No.14 Lahat Sumatera Selatan Telp. (0731) 325928

SLIP GAJI

Periode Gaji Untuk Tahun : 2018 Bulan : September


Periode Absen : 3 September 2018 s/d 1 Oktober 2018

Nomor Referensi : 06091979 Nama Pegawai: David Tarius


Posisi : Administrasi

Gaji Pokok : Rp. 3.200.000


Uang Transport : Rp. 200.000
Uang Makan : Rp. 300.000
Lembur : Rp. 200.000

Sub Total : Rp. 3.900.000

Potongan : BPJS Ketengakerjaan Rp. 25.000


PPH

Total Pembayaran Bersih : Rp. 3.875.000

Dibuat Oleh
Accounting
SHELVITA ANDRIANI, S.H.
NOTARIS
KABUPATEN LAHAT
Surat Keputusan Menteri Kehakiman dan HAM RI
No. C-601. HT.03.01- Th 2002 Tanggal 25 Maret 2002
Jl. Kombes H. Barlian No.14 Lahat Sumatera Selatan Telp. (0731) 325928

SLIP GAJI

Periode Gaji Untuk Tahun : 2018 Bulan : Oktober


Periode Absen : 1 Oktober 2018 s/d 1 November 2018

Nomor Referensi : 06091979 Nama Pegawai: David Tarius


Posisi : Administrasi

Gaji Pokok : Rp. 3.200.000


Uang Transport : Rp. 200.000
Uang Makan : Rp. 300.000
Lembur : Rp. 200.000

Sub Total : Rp. 3.900.000

Potongan : BPJS Ketengakerjaan Rp. 25.000


PPH

Total Pembayaran Bersih : Rp. 3.875.000

Dibuat Oleh
Accounting