Vendor Creation & Change Request: By returning the filled request form you confirm the receipt and acceptance of Kemira's Code of Conduct you can find on the second sheet of this request form! Address and Bank Details Vendor Name: Nama Vendor ANUGRAH JAYA Street Adress: Alamat JL. DHARMAWANGSA 58 Postal code: Kode Pos 60286 City: Kota SURABAYA Country: Negara INDONESIA Region: (optional) Propinsi JAWA TIMUR PO Box: (optional) PO Box (optional) PO Postal code: (optional) Kode Pos PO Box (optional) Telephone number: Nomor Telpon +62-31-5030570 Faxnumber: (optional) Nomor Fax (optional) +62-31-5030570 E-mail address: Alamat Email TAX registration number: NPWP Bank name: Nama Bank BANK CENTRAL ASIA Bank account: Nomor Rekening Bank 5650077727 Bank code/IBAN/ABA/Routing code (optional) Swift/Bic code: (optional) Kode SWIFT CENAIDJA Order currency: Mata Uang IDR Company Information Answer: YES NO any relationship (family, friend, other) with a person employed by Kemira in a senior position? YES DAVID HARIYANTO · We accept Kemira's Code of Conduct on the second page of this worksheet: · Does the supplier or any of its directors, shareholders or senior employees have · Sole proprietorship (business owned by 1 person)? Name of the owner:

Indonesia Supplier Creation Supplier Part en Anugrah Jaya (1)

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Page 1: Indonesia Supplier Creation Supplier Part en Anugrah Jaya (1)

Vendor Creation & Change Request:By returning the filled request form you confirm the receipt and acceptance of Kemira's Code of Conduct you can find on the second sheet of this request form!

Address and Bank DetailsVendor Name: Nama Vendor ANUGRAH JAYAStreet Adress: Alamat JL. DHARMAWANGSA 58 Postal code: Kode Pos 60286City: Kota SURABAYACountry: Negara INDONESIARegion: (optional) Propinsi JAWA TIMURPO Box: (optional) PO Box (optional)

PO Postal code: (optional) Kode Pos PO Box (optional)

Telephone number: Nomor Telpon +62-31-5030570Faxnumber: (optional) Nomor Fax (optional) +62-31-5030570E-mail address: Alamat Email

TAX registration number: NPWP

Bank name: Nama Bank BANK CENTRAL ASIABank account: Nomor Rekening Bank 5650077727Bank code/IBAN/ABA/Routing code (optional)Swift/Bic code: (optional) Kode SWIFT CENAIDJAOrder currency: Mata Uang IDR

Company InformationAnswer:

YES

NO any relationship (family, friend, other) with a person employed by Kemira in a senior position?

YES

DAVID HARIYANTO

· We accept Kemira's Code of Conduct on the second page of this worksheet:· Does the supplier or any of its directors, shareholders or senior employees have

· Sole proprietorship (business owned by 1 person)? Name of the owner: