LAMPIRAN IV

PERATURAN KEPALA BKPM

NOMOR : TAHUN 2009
TANGGAL :
Bent uk Izin Prinsi p Penana ma n Modal
KOP SURAT BKPM atau PDPPM atau PDKPM
IZIN PRINSIP PENANAMAN MODA
Nomor :
Sehubungn !engn "ermohonn #ng Su!r $m"% &n 'ngg(
))))***************+ !n mem"er h' % &n Pen!,' r n Penn m n Mo!(
Nomor ***********)) 'ngg(* * ************** (bila ada), !engn %n% !%ber%' hu&n
bh- ber!$ r&n Un!ng. Un!ng Nomor 2/ Thun 2000 'en' ng
Penn m n Mo!( !n Un!ng. Un!ng Nomor 10 Thun 199/ 2o* Nomor 10
Thun 2003 'en' ng Ke"benn+ Un!ng. Un!ng Nomor 0 Thun 1945
'en' ng P2& Pengh$%( n $ebg% mn 'e(h !%ubh 'er&h%r !engn
Nomor 53 Thun 2004+ Pemer% n' h Re"ub(%& In!one$% member%&n IZIN
PRINSIP PENANAMAN MODA $ebg% pers e t u! uan prinsi p "asili t as
"iskal dan izin seme nt ar a $m"% !engn "eru$ h n mem"er o( eh I6%n
U$h+ $ebg% ber%&u' :
I# DATA PRO$EK %
1* Nm Peru$h n :
2* A(m' :
5* Lo&$% Pro#e& :
7* B%!ng U$h 89 :
Pro!u&$%
:en%$ Brng; :$ KBLI S'u
n
K"$%' $ Ke'erngn
**************************************
************
*********
***
*********
***
*********************
*******
***********************
*******
**************************************
************
*********
***
*********
***
*********************
*******
***********************
*******
*) Persyaratan sesuai Peraturan Presiden No. 111 Tahun 2007 dan peraturan sektoral
/* Nm "emegng $hm 89 :
*) prosentase atas nilai nominal modal saham
3* N%(% In<e$' $% =R";US>9 89
* Mo!( Te'"
& Pembe(% n !n Pem' ngn Tnh :
))))))))))***
& Bngunn ; Ge!ung : ))))))))))***
& Me$%n;Per ( ' n !n Su&u ?!ng : ))))))))))***
. L%n. (%n : ))))))))))***
Sub :um(h : ))))))))))***
b* Mo!( Ker2 =un' u& 1 turn over) :
))))))))))***
:um(h889 : ))))))))))***
89 oret yan! tidak perlu
889 termasuk nilai mesin"peralatan dan suku adan! yan! akan diimpor.
0* Penggun n Teng Ker2 In!one$% :
II# 'asili t as Penana ma n Modal %
1* Pembeb$ n Be M$u& ' $ "eng% m"or n me$%n+ brng !n bhn
$e$u% !engn Sur' Ke"u' u$ n Men' er% Keungn Nomor
103;PMK*011; 2009*
2* Pengur ngn P2& Pengh$%(n =PPh9 B!n un' u& Penn m n Mo!(
!% b%!ng @ b%!ng u$h 'er' en' u !n; ' u !% !er h. !er h 'er' en' u+
$e$u% Per' ur n Pember% n' h No* 1 Thun 2000 2o* No* 32 Thun
2004*
III* L%n ***
III# ain& lain %
1* :ng& -&'u "en#e( e$ % n "ro#e& "(%ng (m / =(%m9 'hun $e2 &
!%'erb%'&nn# I6%n Pr%n$%" Penn m n Mo!(*
2* Permohonn un'u& men!"' &n ,$%(%'$ "enn m n mo!(
$ebg% mn !%m&$u! !(m bu'%r II !%$m"%&n &e"! PTSP
BKPM*
5* Peru$h n #ng $%" bero"er $%; ber "ro!u&$% &omer $% ( -2%b
meng2 u&n "er mohonn I6%n U$h &e PTSP #ng mener b%'&n I6%n
Pr%n$%"n#*
7* Peru$h n -2%b men#m"% &n L"orn Keg%' n Penn m n
Mo!( =LKPM9+ me( &$ n&n &e' en' un (%ng&ungn h%!u" !n
&e' en' un. &e' en' un (%nn#*
/* Khu$u$ bg% "eru$h n "enn m n mo!( $%ng+ !(m h( 'er2!%
"er$e(%$%hn n' r "eru$ h n !engn Pemer% n' h Re"ub(%&
In!one$% #ng '%!& !"' !%$e(e$ %&n $eAr mu$#-r h+
Pemer%n' h In!one$% ber$e!% meng%&u'% "en#e( e$ % n menur u'
&e' en' un &on<en$% 'en' ng "en#e( e$ % n "er$e(%$%hn n' r Negr
!n Brg Negr A$%ng mengen% "enn m n mo!( $e$u% !engn
Un!ng. un!ng Nomor / Thun 1934*
3* A"b%( Peru$h n meng% ng%n&n "erubhn b%!ng u$h 'er m$ u&
"erubhn 2en%$ !n &"$%' $ "ro!u&$% $er' ; ' u "erubhn
"en#er' n !(m mo!( "er$eron #ng meng&% b' &n 'er2!%n#
"erubhn "ro$en' $ e &e"em%(%&n $hm $%ng Peru$h n -2%b
mem%(%&% I6%n Pr%n$%" Perubhn+ $e!ng&n un' u& "erubhn
&e' en' un (%nn# "eru$ h n me( &u&n "e("or n ' $ "erubhn
'er$ebu' &e PTSP "ener b% ' I6%n Pr%n$%"n#*
0* Ke'en' un #ng 'erAn' um !(m I6%n Pr%n$%" Penn m n Mo!( %n%+
$e-&' u. -&'u !"' !%ubh b%(mn 'ern#' "ene' "nn# '%!&
benr ' u 'er!"' &e&e(%run*
PTSP
BKPM;PCPPM;PCKPM
**********************************************
Tembu$ n !%$m"%&n &e"! D'h* = P$( 57 #' =59 !n P$( 5/ #'
=79 9
2
BACAN KOORCINASI PENANAMAN
MOCAL
KEPALA+
GITA BIR:ABAN
3