ICP Receipt

Invoice Date
Receipt # ICP 226811 2-October-2019
Billing Address: Mailing Address:

PT PLN (Persero) Sektor Pembangkitan Tarahan Attn: Oktavian Boby Suwandi

Attn: Oktavian Boby Suwandi Jalan Lintas Sumatera KM 15 Tarahan - Lampung
Jalan Lintas Sumatera KM 15 Tarahan - Lampung Selatan
Selatan Bandar Lampung, Lampung
Bandar Lampung Indonesia
Indonesia
All payments must be made in United States currency. Checks / Money Order must be drawn from a U.S. bank. You
are responsible for all taxes, banking or other service fees, including all applicable withholding taxes. If you are
paying by electronic transfer, please note (1) you are responsible for all electronic transfer, A.C.H. and banking
fees; (2) for electronic payments not drawn on a U.S. bank a fifty-dollar ($50) handling fee must be added at
the time payment is made; and (3) you must reference the Invoice # ICP 226811 above. Thank you.

Quantity Product Code Description Amount

1 ICP936Resched ICP 936 Reschedule 06-December-2019 $150.00

ICP ID: 84379 Subtotal $150.00

TOTAL $150.00
PAID IN FULL

Send Checks By Mail Send Wire Transfers To: Send Correspondence To:
To: TD Bank Individual Certification Programs
American Petroleum 1030 15th St NW API
Institute Washington, D.C. 20005 USA 200 Massachusetts Avenue, NW
P.O. Box 1425 ABA Routing # 054001725 (ACH) Washington, DC 20001
Merrifield, VA 22116- ABA Routing # 031101266 (Wire) Phone: 202-682-8064
1425 Credit To American Petroleum Fax: 202-682-8348
USA Institute email:
Account # 4251303172 inspector@api.org
REFERENCE: ICP SWIFT: NRTHUS33
226811
REFERENCE: ICP 226811

United States Federal Tax ID No. 13-0433-430 suwandi.boby1890@gmail.com