KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI

UNIVERSITAS JEMBER
FAKULTAS EKONOMI DAN BISNIS
Jalan Kalimantan 37 – Kampus Bumi Tegal Boto, Kotak Pos 159 Jember 68121
Telepon 0331- 337990 –Faximele 0331- 332150
Email : fe@unej.ac.id

DOKUMENTASI KELULUSAN

FAKULTAS : Ekonomi dan Bisnis

JURUSAN : Akuntansi................................................................................................................
PROGRAM STUDI : D3 Akuntansi..........................................................................................................
TAHUN : 2015.......................................................................................................................

1. Nomor Induk Mahasiswa (NIM) :..........................................................................................................

2. Nama Lengkap :..........................................................................................................
3. Tempat / Tanggal Lahir : Bondowoso......................................................................................
4. Jenis Kelamin : Laki-Laki...........................................................................................
5. Agama : Islam................................................................................................
6. Warga Negara : Indonesia..........................................................................................
7. Alamat Asal : Dusun Donosuko RT 05 / RW 01 Kec. Klabang Kab. Bondowoso . .
............................................Telepon 085216204195 ......................
8. Alamat Sekarang : Jalan Riau No. 51, Kab. Jember.......................................................
...........................................Telepon 085216204195.......................
9. Pekerjaan : Mahasiswa.......................................................................................
10. Riwayat Pendidikan Nama di Ijazah Nama Sekolah Tahun Lulus
 SD : Nickolas Rafael Andre SDN 01 Klabang 2008
 SLTP : Nickolas Rafael Andre SMPN 01 Tapen 2011
 SLTA : Nickolas Rafael Andre SMAN 01 Prajekan 2014
11. Status Sipil : Belum Menikah................................................................................
12. Nama Istri / Suami :-.........................................................................................................
13. Nama Orang Tua : Haryadi.............................................................................................
14. Pekerjaan Orang Tua : Petani...............................................................................................
15. Alamat Orang Tua : Dusun Donosuko RT 05 / RW 01 Kec. Klabang Kab. Bondowoso. . .
16. Tanggal Lulus :..........................................................................................................
17. Tanggal Yudisium; No. SK :...................................................; No:..............................................
18. Nomor Ijazah :..........................................................................................................
Judul Tugas Akhir :PROSEDUR AKUNTANSI PENGAJUAN DAN PEMBAYARAN KLAIM
KECELAKAN LALU LINTAS PADA PT. ASURANSI JIWASRAYA
(PERSERO) KANTOR CABANG JEMBER
...........................................................................................................
...........................................................................................................
Judul Tugas Akhir (B. Inggris) : ACCOUNTING PROCEDURE FOR SUBMISSION AND PAYMENT OF
TRAFFIC ACCIDENT CLAIM IN PT. ASURANSI JIWASRAYA (PERSERO)
OF JEMBER BRANCH OFFICE
...........................................................................................................
19. Lama Penyusunan Tugas Akhir : ...........................tahun;........................ bulan;........................hari
20. Lama Studi :..............................tahun;........................bulan;.........................hari
21. Jumlah SKS Transkrip; IPK : 131........................sks; 2,77.............................................................
22. Nama Pembimbing 1 : Andriana, S.E, M.Sc, Ak.
23. Nama Pembimbing 2 :
24. Nama Dosen Wali : Aisa Tri Agustini, S.E., M.Sc.....................................................
25. Cuti : smt.....................; th.....................; smt.....................; th..................
26. Kegiatan Extrakurikuler : Sepak bola/Futsal ............................................................................
27. Nomor Telepon/HP : 085216204195.................................................................................

Mengetahui, Jember, 27 Desember 2018

Wakil Dekan I Yang bersangkutan,

FOTO
4X6
Dr. Zainuri, M.Si. Nickolas Rafael Andre
NIP. 196403251989021001 NIM 150803104023