Internet Registration Form (Irf)
Internet Registration Form (Irf)
Internet Registration Form (Irf)
■ Company Information
Subscriber ID (filled by Moratelindo) Existing Subscriber ID (filled by Moratelindo)
Name of Company PT SOLO TRANS LOGISTIK
Correspondence Address THE KENSINGTON OFFICE TOWER 9C
Phone Ext Mobile Fax
Name of Authorized Officer ANDRI WAHYUDIN Designation
ID Number/Passport
Tax Registration Number
Name of Director ARIS NURYANTO
■ Billing Information
Name of Finance Officer
Billing Address
Phone Ext Mobile Fax
Email
■ Requirement Information
Link Destination Payment in IDR USD
We hereby confirm that the foregoing information herein given to be true and correct, and will follow the Terms and Conditions Internet Subscription.
We agree to be bound by the Terms and Conditions Internet Subscription as attached with this form.
Subscriber Approval By
PT. Mora Telematika Indonesia
(Moratelindo)
ANDRI WAHYUDIN
. . . .
Date of Received : . Date of Received : .