Syrarat Rekanan BRI

I~

SMR01 RAKYAT INDONESIA ( PERSERO) PERSE RO) PT. PT. BANK RAKYAT

Tbk. HAL 1/1

FORMULIR

CHECKLIST

DOKUMEN

PENDAFTARAN

REKANAN

NAMA PERUSAHAAN ALAMATPERUSAHAAN 

KODEPOS

KOTA PROPINSI FAX

TELP EMAIL PERUSAHAAN CONTACT PERSON

1. Sura! Permohonan mena" re#anan $RI %&orma! Form SMR '1(1)

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2. Sura! Pem*a+aan #e,enaran o#umen *an- "+ana(+an-an" " a+a ma+era" %&orma! Form SMR 01-2)

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/0 Sura! Pem*a+aan !"a# a"2"+ *an- "+ana(+an3an" "+ana(+an3an" " a+a ma!era" %Forma+ Form SMR '1(/)

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4, Company

Pro&"2e eua" ketentuan

4. So&+ Co* a#+a en"r"an eruahaan %#huu un+u# PT0 +ermau# o#umen en-eahann*a)

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50 So&+ Co* a#+a uunan en-uru +era#h"r %#huu un+u# PT0 +ermau# o#umen en-eahann*a)

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7. So&+ Co* KTP en-uru eruahaan %O"re#" an Kom"ar") *an- ma"h ,ena#u

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80 So&+ Co* TOP *an- ma"h ,er+a#u.

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,er+a#u %IUT #huu PMA) 1'0 So&+ Co* SIUP an er""nan een" 2a"nn*a *an- ,er+a#u

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110 So&+ Co* SKOP a+au SITU a+au HO %I9"n :an--uan) *an- ma"h ,er2a#u

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12, So&+ Co* Sura+ I"n Ke-"a+an Khuu *an- ,er1a#u %SIU;K I SIU;PT I I"n Ops. Tena-a Kera)

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1/0 So&+ Co* Nera
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1>0 So&+ Co* Re#en"n- Koran a+au $u#u Ta,un-an Ta,un-an a+a nama Peruahaan " $an# $RI

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140 So&+ Co* NP?P

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150 So&+ Co* PKP *an- ,er2a#u

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+era#h"ran o&+
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170 So&+ Co* D o#umen Penu#un- Ia"nn*a

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60 So&+ Co* a#+a uunan em"2"#

.anarn

I
I

I ITan--a2

I PEMERIKSA II

PEMERIKSAI

KOP SURAT SURA T PERUSAHAAN KOP SURAT SURA T PERUSAHAAN

Form SMR

01-1

Nemer Lam"ran Per"ha2

Form SMR

KOP SURAT SURAT PERUSAHAAN ;a#ar+a0 Permohonan Mena" Re#anan Pen*e"a $aran- ana+au ;aa PT. $an# Ra#*a+ Inone"a %Perero) T,#.

01-2

B ='14

Keaa +h.

KepaJa Divis; Manajemen Aktiva Tetap an Pen-aaan Proer+" Ra#*a+ Inone"a %Perero) T,#. PT. PT. $an# Ra#*a+ 2(

Den-an horma+0 $erama "n" er#enan#an #am" men-au#an men-au#an ermohonan un+u# mena&+ar e,a-a" Re#anan Pen*e"a $aranana+au ;aa PT.  PT. $an# Ra#*a+ Inone"a %Perero) T,#. un+u# u, ,"an- e#eraan e,a-a" ,er"#u+@

1. 2.

3. .

s. $erama "n" #am" #am" 2am"r#an a+a(a+a eruahaan an er*ara+an 2a"n *an- "er2u#an un+u# menu#unuu2an mena" re#anan. Dem"#"an ermohonan #am"0 a+a erha+"an an #eraaman*a "ama"#an "ama"#an +er"ma #a"h.

Horma+ Kam"0 Tema+0 PTCUD

='14 0

P"m"nan Peruahaan0 - ITO - !ap Pe"#sa$aan

Nama ;a,a+an @

Tin%asan& 1. Ar"

 B 

Form SMR 01-2

KOP SURAT SURAT PERUSAHAAN

SURAT PERNYA PERNYATAAN KEASLIAN KEASLI AN

DOKUMEN

an- ,er+ana+an-an " ,aah ,aah "n"@ Nama Peruahaan  A2ama+ ;a,a+an

@ %"ha# *an- ,erenan- mea#"2" eruahaan)

Den-an "n" men*a+a#an men*a+a#an ,aha @ 1. Se2uruh o#umen *an- #am" 2am"r#an 2am"r#an +e2ah eua" en-an o#umen a2"n*a an ah menuru+ #e+en+uan an erunan-(unan-an *an- ,er2a#u. =. Aa,"2a "#emu"an har" "#e+emu#an ,aha o#umen(o#umen *an- +e2ah #am" ,er"#an +"a# ,enar0 ma#a #am" ,ere"a "#ena#an an#" an "mau#an aa Da&+ar San#" Peruahaan an a+au "#e2uar#an ar" Da&+ar Re-"+ra" Peruahaan. Dem"#"an ura+ en*a+aan "n" #am" #am" ,ua+ e,enar(,enarn*a0 a2am #on"" eha+0 er+a +"a# ,eraa " ,aah +e#anan "ha# manaun u-a. A+a erha+"an an #eraaman*a "ama"#an +er"ma #a"h.

Horma+ Kam"0 Tema+0 PTCUD P"m"nan Peruahaan0 (

='14 0

TID

(
Nama ;a,a+an @

T"naan@ 1. Ar"

 B 

Form SMR 01-3

KOP SURAT SURAT PERUSAHAAN

SURAT PERNYATMN PERNYATMN

TIDAK PAILIT

an- ,er+ana+an-an " ,aah "n"@ Nama Peruahaan  A2ama+ ;a,a+an

@ %"ha# *an- ,erenan- mea#"2" eruahaan)

Den-an "n" men*a+a#an ,aha PT C UD +"a# en-a"2an0 "n*a+a#an a"2"+0 %an'ata# +"a# ean- mena2an" an#" "ana.

ean- a2am

en-aaan

Dem"#"an ura+ en*a+aan "n" #am" #am" ,ua+ e,enar(,enarn*a0 a2am #on"" eha+0 er+a +"a# ,eraa " ,aah +e#anan "ha# manaun u-a. A+a erha+"an an #eraaman*a "ama"#an +er"ma #a"h.

Horma+ Kam"0 Tema+0 PTCUD P"m"nan Peruahaan0 -

201( r 

TTO

- !ap Pe"#sa$aan - Mate"ai

Nama ;a,a+an 

T"naan@ 1. Ar"

 B