Date : July, 24th 2023

Client Information Sheet

Client / Signatory Name : Siti Aminah. SH
Nationality : Indonesian
Passport Number : X2163248
Date of Issue : 30 May 2023
Exipration Date : 30 May 2033
Issued by : Batam , Indonesia
Date of Birth : 24 June 1971
Place of Birth : Banjarnegara
Street Address : Jl. Boulevard BB. 10 Beranda Bali
City/State/ZIP : Semarang, 50212
Country : Indonesia
Mobile Number : +62 812 1580 0030
E-mail Address : ysa@lawangsewumegah.co.id

Bussiness Information
Bussiness Name
Street Address
Government Registered
Registered Number
Legal Advisor Name
Legal Advisor Address
: PT. LAWANG SEWU MEGAH
: Jl. Urip Sumoharjo KM.12, Randugarut tugu, Semarang
: AHU-0132193.AH.01.11.TAHUN 2023
: No.43 11 July 2023
: Wahyu Warsito, SH.,M.Kn
: Boyolali , Indonesia

Bank Officer in Charge Information

Bank Name : Bank BNI (Bank Negara Indonesia)
Bank Address : Jl. Ahmad Yani No.15, Bekasi, Jawa Barat,
Indonesia 17113
SWIFT Code : BNINIDJA
Account Name : PT. LAWANG SEWU MEGAH
Account Number : 1782808689
Bank Officer in Charge Full Name : Mrs. Rini Yuliantini S.
Bank Officer in Charge Direct Line : +622188951946 / +62218203128
Bank Officer in Charge Direct Bank Email : rini.yuliantini@bni.co.id

I hereby certify that information above is TRUE and CORRECT

Signature & Company Seal / Stamp

Signatory Name : Siti Aminah. SH
Title : President Director
Passport Number : X2163248
Country of Issue : Indonesia
Date of Issue : 30 May 2023
Date of Expiry : 30 May 2033