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Formulir 2a PU

BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
1 10018019710 3672031306840004 AAN JUMANA 13-06-1984 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
2 14020637741 3672020804950003 ACHMAD ALVIN 08-04-1995 01-07-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
3 14019083246 3672020302800002 ACHMAD NAZIULLAH 03-02-1980 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
4 13030644101 7501132307940001 ACON DANI 23-07-1994 01-09-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
5 17008481859 3672031508960001 ADAM SAPUTRA HARJA 15-08-1996 01-02-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
6 12000193800 3672031203870003 ADAM SURYANA 12-03-1987 01-01-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
7 14011295111 3604081508920001 ADE AIP HERMAWAN 15-08-1992 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
8 14011295129 3672035008920002 ADE LISNAWATI PUTRI 10-08-1992 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
9 06K50165237 3673011603840002 AFIANSYAH 16-03-1984 01-08-2006 3,732,014.30 0.00 33,214.93 11,196.04 138,084.53 74,640.29 74,640.29 37,320.14 369,096.22
10 14011294940 3672031201900003 AFIFI 12-01-1990 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
11 17002748386 3673011904930003 AFRIZAL AFRIANSYAH 19-04-1993 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
12 12029320582 3672031611840002 AGUNG NUGROHO 16-11-1984 01-08-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
13 14025643447 3672030802920002 AGUS ALI 08-02-1992 01-08-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
14 15046023931 3672011708930002 AGUS IRAWAN 17-08-1993 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
15 12000193867 3672031008860004 AGUS PRASETYO 10-08-1986 01-01-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
16 13001437808 3672031408890001 AGUS PRIMA 14-08-1989 01-02-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
17 09010426105 3604012408780213 AGUS ROMDHAN SULASTIYA 24-08-1978 01-06-2009 3,696,140.00 0.00 32,895.65 11,088.42 136,757.18 73,922.80 73,922.80 36,961.40 365,548.25
18 03K50119074 3672060107640003 AGUS SURYA 01-07-1964 01-10-2003 3,957,044.00 0.00 35,217.69 11,871.13 146,410.63 79,140.88 79,140.88 39,570.44 391,351.65
19 12010812282 3672031908910003 AGUS SUSANTO 19-08-1991 01-03-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
20 06K50073100 3672031608700001 AGUS SUSANTO 16-08-1970 01-03-2006 3,715,707.80 0.00 33,069.80 11,147.12 137,481.19 74,314.16 74,314.16 37,157.08 367,483.51
21 97K52033309 1980120111920124 AGUS SYAM SUKANDAR 19-08-1978 01-12-1997 4,851,621.70 0.00 43,179.43 14,554.87 179,510.00 97,032.43 97,032.43 48,516.22 479,825.38
22 03K50119447 3672061201770002 AGUSJI 12-01-1977 01-10-2003 3,788,543.50 0.00 33,718.04 11,365.63 140,176.11 75,770.87 75,770.87 37,885.44 374,686.96
23 12005961326 3604082907910002 AHMAD BASRI 29-07-1991 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
24 03K50118993 3672030412760002 AHMAD HADI 04-12-1976 01-10-2003 3,930,953.60 0.00 34,985.49 11,792.86 145,445.28 78,619.07 78,619.07 39,309.54 388,771.31
25 17021318054 3672062509870003 AHMAD HAFID 25-09-1987 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
26 16021855974 3672031009910002 AHMAD HOTIB 10-09-1991 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
27 11009680379 3672031606890002 AHMAD MASHURI 16-06-1989 01-03-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
28 12005961375 3201171108910005 AHMAD MAULANA YUSUF 11-08-1991 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
29 16021855909 3604071305920002 AHMAD MUBAROK 13-05-1992 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
30 17002748410 3205242504910001 AHMAD PURKON 25-04-1991 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
31 11028495163 3604080202900003 AHMAD REBUDIN 02-02-1990 01-10-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
32 06K50073233 3672030812850002 AHMAD ROUF 08-12-1985 01-03-2006 3,957,050.60 0.00 35,217.75 11,871.15 146,410.87 79,141.01 79,141.01 39,570.51 391,352.30
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
33 18064150792 3672031800920006 AHMAD SOLIHIN 18-11-1992 01-08-2018 3,622,215.00 0.00 32,237.71 10,866.65 134,021.96 72,444.30 72,444.30 36,222.15 358,237.07
34 11038139611 3604050309860006 AHMAD SUPANDI 03-09-1986 01-12-2011 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
35 12005961383 3604010602821038 AHMAD WILDAN 06-02-1982 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
36 12037739492 3672031510710001 AHMAD YANI 15-10-1971 01-11-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
37 10018019496 3672032203770004 AHMAD YANI 22-03-1977 01-07-2010 3,671,136.70 0.00 32,673.12 11,013.41 135,832.06 73,422.73 73,422.73 36,711.37 363,075.42
38 97K52033325 3604062512760002 AJAT SUDRADJAT 25-12-1976 01-12-1997 4,759,228.10 0.00 42,357.13 14,277.68 176,091.44 95,184.56 95,184.56 47,592.28 470,687.65
39 14020637758 3604022203870030 AJAT SUDRAJAT 22-03-1987 01-07-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
40 10018019595 3672031309810001 AJI PRIHANDONO 13-09-1981 01-07-2010 3,671,136.70 0.00 32,673.12 11,013.41 135,832.06 73,422.73 73,422.73 36,711.37 363,075.42
41 97K52033317 3672033005750001 AKHMAD RIDWAN 30-05-1975 01-12-1997 3,914,647.10 0.00 34,840.36 11,743.94 144,841.94 78,292.94 78,292.94 39,146.47 387,158.59
42 16017090339 3604052607900003 ALEX HARCHY SAPUTRA 26-07-1990 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
43 13009891907 3672030902940002 ALFAN FAUZI . YP 09-02-1994 01-04-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
44 14011294957 3604060805770003 ALI MISRI 08-05-1977 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
45 14011294965 3672032005910001 ALI ROHMAN 20-05-1991 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
46 06K50226260 3672030502740004 AMIRUDIN 05-02-1974 01-07-2006 3,718,969.10 0.00 33,098.82 11,156.91 137,601.86 74,379.38 74,379.38 37,189.69 367,806.04
47 15023054032 3672030909860001 AMIRULLOH 09-09-1986 01-04-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
48 15046024004 3672031906920002 ANDI RUSTAMA 19-06-1992 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
49 06K50165211 3672061612790001 ANDI SUWANDI 16-12-1979 01-08-2006 4,222,237.00 0.00 37,577.91 12,666.71 156,222.77 84,444.74 84,444.74 42,222.37 417,579.24
50 04K50013002 3672081001840004 ANDRI PRIYONO 10-01-1984 01-02-2004 3,732,014.30 0.00 33,214.93 11,196.04 138,084.53 74,640.29 74,640.29 37,320.14 369,096.22
51 18064150800 3672035505950003 ANGGIE ANGGRAEINI 15-05-1995 01-08-2018 3,622,215.00 0.00 32,237.71 10,866.65 134,021.96 72,444.30 72,444.30 36,222.15 358,237.07
52 14011295590 3673021812900001 ANJAS SUKMA 18-12-1990 01-04-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
53 15046024087 3604052104900001 ANNAS MUSTAQIM 21-04-1990 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
54 09015436034 3672061612870001 ANTONI NURCAHYA 16-12-1987 01-08-2009 3,699,401.30 0.00 32,924.67 11,098.20 136,877.85 73,988.03 73,988.03 36,994.01 365,870.79
55 97K52033341 3672012512650001 ANWAR YUSUF YUSRIANTO 25-12-1965 01-12-1997 5,668,056.90 0.00 50,445.71 17,004.17 209,718.11 113,361.14 113,361.14 56,680.57 560,570.84
56 10010134996 3672082507840006 APANDI 25-07-1984 01-04-2010 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
57 04K50013267 3214010804790002 APIN WAHYUDIN 08-04-1979 01-02-2004 3,743,972.40 0.00 33,321.35 11,231.92 138,526.98 74,879.45 74,879.45 37,439.72 370,278.87
58 04K50013168 1980120111920125 ARIDIN 07-05-1972 01-02-2004 3,746,146.60 0.00 33,340.70 11,238.44 138,607.42 74,922.93 74,922.93 37,461.47 370,493.89
59 13000163652 3672051201860001 ARIE FIKRI 12-01-1986 01-01-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
60 09015435952 3604080312810001 ARIS SETYOWANTONI 03-12-1981 01-08-2009 3,708,098.10 0.00 33,002.07 11,124.29 137,199.63 74,161.96 74,161.96 37,080.98 366,730.89
61 03K50118829 3672052112800001 ARIS SUSANTO 21-12-1980 01-10-2003 3,936,389.10 0.00 35,033.86 11,809.17 145,646.40 78,727.78 78,727.78 39,363.89 389,308.88
62 13006344330 3403010404780002 ARISTANTO 04-04-1978 01-03-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
63 13009891931 3672012002810003 ARIYADI 20-02-1981 01-04-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
64 03K50119207 3672030310760001 ARJAYA 03-10-1976 01-10-2003 3,735,275.60 0.00 33,243.95 11,205.83 138,205.20 74,705.51 74,705.51 37,352.76 369,418.76
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
65 09015436018 3202160101820064 ASEP SAEPAH 01-01-1982 01-08-2009 3,676,572.20 0.00 32,721.49 11,029.72 136,033.17 73,531.44 73,531.44 36,765.72 363,612.98
66 13026262678 3604042307830084 ASEP SAEPUL JAMIL 23-07-1983 01-08-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
67 09015436000 3604052808890001 ASEP YANA KOSWARA 28-08-1989 01-08-2009 3,707,011.00 0.00 32,992.40 11,121.03 137,159.41 74,140.22 74,140.22 37,070.11 366,623.39
68 12005961391 3604081703710001 ASFANDI 17-03-1971 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
69 04K50013887 3672030307820001 ASMAN PRABOWO 03-07-1982 01-02-2004 3,675,485.10 0.00 32,711.82 11,026.46 135,992.95 73,509.70 73,509.70 36,754.85 363,505.48
70 09010425917 1980120111920126 ASMANI 01-05-1987 01-06-2009 3,711,359.40 0.00 33,031.10 11,134.08 137,320.30 74,227.19 74,227.19 37,113.59 367,053.45
71 16061268401 3672030205740004 ASMAT DARYANTO 02-05-1974 01-12-2016 4,017,921.60 0.00 35,759.50 12,053.76 148,663.10 80,358.43 80,358.43 40,179.22 397,372.44
72 10018019538 3672031606840006 ASMU'IN 16-06-1984 01-07-2010 4,109,185.20 0.00 36,571.75 12,327.56 152,039.85 82,183.70 82,183.70 41,091.85 406,398.41
73 14019083279 3604310207920004 ASMUNI 02-07-1992 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
74 11026890183 3672032502860005 ASNGAD 25-02-1986 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
75 11026890159 3604081402800002 ASTARI 14-02-1980 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
76 04K50013234 3672035507760004 ASTURI 15-07-1976 01-02-2004 3,746,146.60 0.00 33,340.70 11,238.44 138,607.42 74,922.93 74,922.93 37,461.47 370,493.89
77 14032768765 3672035404950007 ATI SUGIANTI 14-04-1995 01-10-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
78 07K50047714 3604050306770002 ATO SUHARTA 03-06-1977 01-03-2007 3,718,969.10 0.00 33,098.82 11,156.91 137,601.86 74,379.38 74,379.38 37,189.69 367,806.04
79 14019083287 3604082107840002 ATO SUNARTO 21-07-1984 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
80 12005961292 3604053108870002 AUGUSTRIAS MUHAR 31-08-1987 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
81 10018019546 3672060212830001 BAHTONI THOHIR 02-12-1983 01-07-2010 3,671,136.70 0.00 32,673.12 11,013.41 135,832.06 73,422.73 73,422.73 36,711.37 363,075.42
82 03K50119223 3672031209730002 BAMBANG SETIAWAN 12-09-1973 01-10-2003 3,730,927.20 0.00 33,205.25 11,192.78 138,044.31 74,618.54 74,618.54 37,309.27 368,988.69
83 03K50119082 3604062804800001 BERTO SIHITE 28-04-1980 01-10-2003 4,807,050.60 0.00 42,782.75 14,421.15 177,860.87 96,141.01 96,141.01 48,070.51 475,417.30
84 13019280380 3672032110830001 BUDIMAN 21-10-1983 01-06-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
85 12005961334 3604081106860001 BUDIYANTO 11-06-1986 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
86 15003082847 3672032907930006 CANDRA BIN SANUSI 29-07-1993 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
87 03K50118894 3672032105800001 CATUR SINGGIH 21-05-1980 01-10-2003 4,447,266.70 0.00 39,580.67 13,341.80 164,548.87 88,945.33 88,945.33 44,472.67 439,834.67
KUSMARTONO
88 10018019686 3672061003870005 CHAERUL SURYATAMA 10-03-1987 01-07-2010 3,671,136.70 0.00 32,673.12 11,013.41 135,832.06 73,422.73 73,422.73 36,711.37 363,075.42
89 15046023956 3672031510910001 CHRISTANDI 15-10-1991 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
90 11026890233 3201141910790001 DADI ROSYADI ALISYAHBANA 19-10-1979 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
91 12005961243 3672030407910001 DAMAN 04-07-1991 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
92 09010426048 3604080501740001 DAMANHURI 05-01-1974 01-06-2009 3,713,533.60 0.00 33,050.45 11,140.60 137,400.74 74,270.67 74,270.67 37,135.34 367,268.47
93 14011295608 3672032402940001 DANANG DINDA SAPUTRA 24-02-1994 01-04-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
94 03K50119454 3672060912820002 DANI SAHRANI 09-12-1982 01-10-2003 3,789,630.60 0.00 33,727.71 11,368.89 140,216.33 75,792.61 75,792.61 37,896.31 374,794.46
95 13026262629 3672030205880003 DARIP 02-05-1988 01-08-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
96 12005961219 3209012304930002 DARJAT 23-04-1993 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
97 14011294973 3672031710900004 DEDE SUHERI 17-10-1990 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
98 06K50073241 3202270407850004 DEDEN 04-07-1985 01-03-2006 3,735,275.60 0.00 33,243.95 11,205.83 138,205.20 74,705.51 74,705.51 37,352.76 369,418.76
99 04K50013903 3672031011740003 DEDI 10-11-1974 01-02-2004 3,762,453.10 0.00 33,485.83 11,287.36 139,210.76 75,249.06 75,249.06 37,624.53 372,106.60
100 09013320628 3672031112850002 DEDI ISWANDI 11-02-1985 01-04-2009 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
101 16021856063 1980120111920127 DENI HERDIANA 06-06-1980 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
102 12012213901 3602142201900002 DIAN YANUAR 22-01-1990 01-03-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
103 13026262645 3604022309930212 DICKY FADILAH 23-09-1993 01-08-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
104 17021318039 3672012803930003 DICKY FIRMANSYAH 28-03-1993 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
105 08009217681 3672031509850001 DIDI SUHARTO 13-09-1985 01-05-2008 4,170,062.80 0.00 37,113.56 12,510.19 154,292.32 83,401.26 83,401.26 41,700.63 412,419.22
106 15060548763 3604050306910003 DINUR FATONI 03-06-1991 01-12-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
107 14011294981 3672031511810002 DODY STANZA 15-11-1981 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
108 06K50226286 3673012808820003 DONI AGUS SETIAWAN 28-08-1982 01-07-2006 3,718,969.10 0.00 33,098.82 11,156.91 137,601.86 74,379.38 74,379.38 37,189.69 367,806.04
109 11038139595 3604051909870002 DWI ADINUGROHO 19-09-1987 01-12-2011 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
110 16021855883 3672030611920002 DWI ANDRIANTO 06-11-1992 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
111 10018019579 3604071605870002 DWI CAHYONO 16-05-1987 01-07-2010 3,707,011.00 0.00 32,992.40 11,121.03 137,159.41 74,140.22 74,140.22 37,070.11 366,623.39
112 16021856048 3672030606850003 EDI MAWARDI 06-06-1985 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
113 17049509643 3672032511890001 EDI SUNARDI 25-11-1989 01-09-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
114 11028495155 3672030912860001 EDI SUSANTO 09-12-1986 01-10-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
115 15003082912 3672030301900003 EFAN SUPRIYATNA 30-10-1987 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
116 16055591933 3672022208910001 EGYSTA KARVINDRA 22-08-1991 01-11-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
SAPUTRA
117 11026890043 3672032408880003 EKA HABIJAR AGUSTIAN 24-08-1988 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
118 09015435937 3672032808840003 EKO DWIYANTO 28-08-1984 01-08-2009 3,707,011.00 0.00 32,992.40 11,121.03 137,159.41 74,140.22 74,140.22 37,070.11 366,623.39
119 18005905064 3273102202750002 ENDAN SUPRIATNA 22-02-1975 01-01-2018 3,622,200.00 0.00 32,237.58 10,866.60 134,021.40 72,444.00 72,444.00 36,222.00 358,235.58
120 04K50013028 3672031204750003 ENDI SUHENDI 12-04-1975 01-02-2004 3,724,404.60 0.00 33,147.20 11,173.21 137,802.97 74,488.09 74,488.09 37,244.05 368,343.61
121 17021318088 3604230502830003 ERGA ASURI DARMA 05-02-1983 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
WINANGUN
122 00ND0036555 3173076702780002 ERNI RACHMAWATI 27-02-1978 01-03-2000 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
123 11028495262 3604032008890236 ERWIN SYAH 20-08-1989 01-10-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
124 16055591941 3672035610910001 ESTRI LARASATI INAYAH 16-10-1991 01-11-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
125 11028495189 3672034701890002 ETI LISNAWATI 07-01-1989 01-10-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
126 17002748402 3672030301940002 F. PRIYATNA 03-01-1994 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
127 12005961417 3202330101710023 FACHRUDIN 01-01-1971 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
128 12005961227 3672031003910007 FADILA 17-02-1991 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
129 16008735090 3205010712930004 FAISAL MAULANA YUSUF 12-12-1993 01-02-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
130 14018707662 3673062602850001 FAJAR FEBRIANSYAH 26-02-1985 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
131 04K50013937 3603062002840004 FAJAR HARDIANTO 20-02-1984 01-02-2004 3,938,563.30 0.00 35,053.21 11,815.69 145,726.84 78,771.27 78,771.27 39,385.63 389,523.91
132 16017090255 3276102305860001 FAJAR MARTHA 23-05-1986 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
133 14011295616 3672030607950001 FARID SAHRI 06-07-1995 01-04-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
134 12033059937 1803032402920002 FATMA FEBRIANSYAH 24-02-1992 01-10-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
135 16021855982 3672030604730004 FATULLOH 06-04-1973 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
136 15046024012 3604080607950001 FAUZUL ULUM 06-07-1995 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
137 16021855875 1807170702940002 FEBRI NURHARYANTA 07-02-1994 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
138 17021318021 3672030101930005 FEBRIANTO HINDIO 01-01-1993 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
139 08009217715 3672081906800005 FENDAR JUNIANDAR 19-06-1980 01-05-2008 3,720,056.20 0.00 33,108.50 11,160.17 137,642.08 74,401.12 74,401.12 37,200.56 367,913.55
140 14025643496 3672034910950001 FERA ERLY YANI 09-10-1995 01-08-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
141 16037773641 3604053112920003 FERDY ROBIYANTO 31-12-1992 01-09-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
142 16017090271 3672035502950004 FITRI ANA SALAMAH 15-02-1995 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
143 04K50013911 3672031506640003 GATOT MUHAMMAD 15-06-1964 01-02-2004 3,762,453.10 0.00 33,485.83 11,287.36 139,210.76 75,249.06 75,249.06 37,624.53 372,106.60
WAHYUDI
144 15003082953 3604051902960002 GEMA TAKBIRUL IDFI 19-02-1996 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
145 14011294999 3604051401910002 GERRI NURDIANSYAH 14-01-1991 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
146 17021318070 3604151208860007 GUFRON 12-08-1986 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
147 13006344371 5206073112931017 GULAMAN 31-12-1993 01-03-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
148 12037739450 3672032803870002 GUN GUN GUNAWAN 28-03-1987 01-11-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
149 17002748436 3604051303840004 HABUDIN 13-03-1984 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
150 14025643439 3672030909950001 HADI MAULANA 09-09-1995 01-08-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
151 16021856006 3672031005950001 HADID RUHIANA 10-05-1995 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
152 17002748444 3672060404780003 HADIYONO 04-04-1978 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
153 16055591958 3604080409980001 HAIDIR RUSMAN 04-09-1998 01-11-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
154 16002051122 3672053107940002 HALIFATURROHMAN 31-07-1994 01-01-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
155 12010812704 3604052106820001 HANS FERDIANSYAH 21-06-1982 01-04-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
156 03K50118837 3672082609780001 HARI EDI 26-09-1978 01-10-2003 4,421,176.30 0.00 39,348.47 13,263.53 163,583.52 88,423.53 88,423.53 44,211.76 437,254.34
157 14006957881 3672031210780001 HARTONO 12-10-1978 01-01-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
158 03K50119231 3672031402770001 HASAN BASRI 14-02-1977 01-10-2003 4,353,769.50 0.00 38,748.55 13,061.31 161,089.47 87,075.39 87,075.39 43,537.70 430,587.81
159 13001437782 1872012601730004 HASBULLAHSYAH 26-01-1973 01-02-2013 4,170,049.60 0.00 37,113.44 12,510.15 154,291.84 83,400.99 83,400.99 41,700.50 412,417.91
160 16017090396 3672062707850005 HASBULLOH 27-07-1985 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
161 15003082920 3672060603720001 HAYUMI 06-03-1972 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
162 09010425925 3672030701870003 HENDRA LESMANA 07-01-1987 01-06-2009 3,718,969.10 0.00 33,098.82 11,156.91 137,601.86 74,379.38 74,379.38 37,189.69 367,806.04
163 15003082938 3672031908870005 HENDRA RIZKI 19-08-1987 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
164 03K50118977 3604022012760401 HENDRA WAHYUDI 20-12-1976 01-10-2003 4,949,457.40 0.00 44,050.17 14,848.37 183,129.92 98,989.15 98,989.15 49,494.57 489,501.33
165 03K50119371 3604060303780004 HENDRAWAN 03-03-1978 01-10-2003 3,907,037.40 0.00 34,772.63 11,721.11 144,560.38 78,140.75 78,140.75 39,070.37 386,405.99
166 17021318062 3672031102870002 HERI PUTRA 11-02-1987 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
167 10018019603 3672051809800004 HERI YANTO 18-09-1980 01-07-2010 3,671,136.70 0.00 32,673.12 11,013.41 135,832.06 73,422.73 73,422.73 36,711.37 363,075.42
168 10018019744 3672034608860004 HEROH 06-08-1986 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
169 04K50013259 3672031105780002 HERU WAHYUDI 11-05-1978 01-02-2004 3,743,972.40 0.00 33,321.35 11,231.92 138,526.98 74,879.45 74,879.45 37,439.72 370,278.87
170 09015436026 3672033001880001 HEZPINUS YAKHINAN 30-01-1988 01-08-2009 3,700,488.40 0.00 32,934.35 11,101.47 136,918.07 74,009.77 74,009.77 37,004.88 365,978.31
HAREFA
171 14011295004 3672031510920001 HIDAYATULLOH 15-10-1992 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
172 09010425933 3672031009870002 HIKMATULLAH 10-09-1987 01-06-2009 3,711,359.40 0.00 33,031.10 11,134.08 137,320.30 74,227.19 74,227.19 37,113.59 367,053.45
173 16021856022 3604072704910002 HUMAEDI 27-04-1991 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
174 11026890076 3672031008890002 HUSAERI 10-08-1988 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
175 14011295624 3209310502910003 IBNATO 05-02-1991 01-04-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
176 16061268385 3672060707730001 IBROHIM 15-10-1973 01-12-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
177 03K50119488 3672080408640003 ICHSANUDIN 04-08-1964 01-10-2003 5,108,174.00 0.00 45,462.75 15,324.52 189,002.44 102,163.48 102,163.48 51,081.74 505,198.41
178 14002288190 3672050202950002 IDHAM HOLID 02-02-1995 01-02-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
179 09010426030 3672030404680004 IDIN MUHIDIN 04-04-1968 01-06-2009 4,150,495.00 0.00 36,939.41 12,451.49 153,568.32 83,009.90 83,009.90 41,504.95 410,483.97
180 03K50118928 3604022205780066 IGUT ADHI DARMAWAN 22-05-1978 01-10-2003 5,008,170.70 0.00 44,572.72 15,024.51 185,302.32 100,163.41 100,163.41 50,081.71 495,308.08
181 16017090289 3601120204780004 IHSAN 02-04-1978 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
182 10018019785 3312121702840003 IHWAN SAPUTRO 17-02-1984 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
183 13006344397 3672020910840003 IIM MUSTAQIM 09-10-1984 01-03-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
184 13033612527 3672061703830002 IIN SOLIHIN 12-03-1983 01-10-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
185 15003082839 3672030404940002 IKHWAN SAPUTRA 04-04-1994 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
186 16034204004 3604031804950306 ILHAM APRIANDA 17-04-1994 01-08-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
187 12000193826 3672031904880002 IMAM FATULLOH 19-04-1988 01-01-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
188 04K50013069 3604221006870002 IMAN MUNANDAR 10-06-1987 01-02-2004 3,958,131.10 0.00 35,227.37 11,874.39 146,450.85 79,162.62 79,162.62 39,581.31 391,459.16
189 09010426006 3672031210840001 INDRA CIPTO 12-10-1984 01-06-2009 3,709,185.20 0.00 33,011.75 11,127.56 137,239.85 74,183.70 74,183.70 37,091.85 366,838.41
190 08009217657 3604052605830001 INDRA GUNAWAN 26-05-1983 01-05-2008 3,729,840.10 0.00 33,195.58 11,189.52 138,004.08 74,596.80 74,596.80 37,298.40 368,881.18
191 15046023964 3672032012840001 IPAN SUHENDRA 20-12-1984 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
192 03K50119504 3672081811740003 IR EKO SAPUTRO 18-11-1974 01-10-2003 5,217,951.30 0.00 46,439.77 15,653.85 193,064.20 104,359.03 104,359.03 52,179.51 516,055.39
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
193 16008734994 3604291111780002 IRFAN 11-11-1978 01-02-2016 3,708,098.10 0.00 33,002.07 11,124.29 137,199.63 74,161.96 74,161.96 37,080.98 366,730.89
194 15046023915 3672031103920001 IRFAN PUJA SAKTI 11-03-1992 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
195 02K50162100 3672080207710003 IRWAN IRMAWAN 02-07-1971 01-08-2002 10,983,688.80 0.00 97,754.83 32,951.07 406,396.49 219,673.78 161,880.00 80,940.00 999,596.17
196 17008481842 3672051006970001 ISKANDAR CAHYADI 10-06-1997 01-02-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
197 10018019652 3672030408750001 ISMAIL 04-08-1975 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
198 14011295632 3214172606890003 IWAN 26-06-1989 01-04-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
199 16017090354 1980120111920129 IYAS BIN SARMAN 01-07-1984 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
200 13006344389 3672030506800001 JAHIDI 05-06-1980 01-03-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
201 13009891949 3672061508810002 JAHRONI 15-08-1981 01-04-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
202 16021856055 3672032006950003 JAINAL ABDUL HUSEN 20-06-1995 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
203 13001437766 3604030105680336 JAMALUDIN 01-05-1968 01-02-2013 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
204 12029320525 3672030702870001 JAMHARI 07-02-1987 01-08-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
205 14019083303 3672030602930003 JAMJURI 06-02-1993 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
206 16017090313 3672030903940003 JOHAN 09-03-1994 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
207 06K50073159 3672030703830003 JOHENI 07-03-1983 01-03-2006 3,742,885.30 0.00 33,311.68 11,228.66 138,486.76 74,857.71 74,857.71 37,428.85 370,171.37
208 17002748394 3672022501920001 JOKO SUSILO 25-01-1992 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
209 13026262611 3604320709880005 JUBEDI 07-09-1988 01-08-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
210 15037514286 3672032303850001 JUFLAENI 23-03-1985 01-08-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
211 17002748428 1801041612830006 JUHARDI 16-12-1983 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
212 06K50073126 3672030709790002 JUHI 07-09-1979 01-03-2006 3,723,317.50 0.00 33,137.53 11,169.95 137,762.75 74,466.35 74,466.35 37,233.18 368,236.11
213 12000193875 3604080506840003 JUM ATO 05-06-1984 01-01-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
214 12037739484 3672031708780004 JUMAN 17-08-1978 01-11-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
215 17002748378 3604071205880003 JUMRONI 12-05-1988 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
216 03K50118936 3672010509790003 JUWANTO 05-09-1979 01-10-2003 5,011,402.30 0.00 44,601.48 15,034.21 185,421.89 100,228.05 100,228.05 50,114.02 495,627.70
217 03K50118787 3672081003720002 KAMALUDIN 10-03-1972 01-10-2003 4,737,492.70 0.00 42,163.69 14,212.48 175,287.23 94,749.85 94,749.85 47,374.93 468,538.03
218 12005961284 3672031603870001 KAMSARI 16-03-1987 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
219 04K50013192 3672031406800001 KAMSIN 14-07-1978 01-02-2004 3,760,278.90 0.00 33,466.48 11,280.84 139,130.32 75,205.58 75,205.58 37,602.79 371,891.59
220 10018019751 3672032507900003 KHAIRUL EKSAN 25-07-1990 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
221 12029320533 3604080202920001 KHOIRUL HUDA 02-02-1992 01-08-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
222 06K50073191 3672062507830001 KODAR SUPRATMAN 25-07-1983 01-03-2006 3,938,563.30 0.00 35,053.21 11,815.69 145,726.84 78,771.27 78,771.27 39,385.63 389,523.91
223 17016349379 3275030905960023 KRISNA RIANTO 09-05-1996 01-03-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
224 16029882202 3604071504930003 LILIS HARDIYANTO 15-04-1993 01-07-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
225 14011295012 3672022008880002 LUQMAN ARIEF 20-08-1988 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
226 03K50119470 3174032509700006 LUTFI 25-09-1970 01-10-2003 3,998,353.80 0.00 35,585.35 11,995.06 147,939.09 79,967.08 79,967.08 39,983.54 395,437.20
227 11026890241 3604011207841386 M. ARIF SETIAWAN 12-07-1984 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
228 14020637709 3672060210760002 M. BUANG 02-10-1976 01-07-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
229 16037773633 3673053001970001 M. JAGAT ALAM YASA A 30-01-1997 01-09-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
230 10018019470 1404190909820002 M. TAHIR 09-09-1982 01-07-2010 3,671,136.70 0.00 32,673.12 11,013.41 135,832.06 73,422.73 73,422.73 36,711.37 363,075.42
231 03K50119108 3601343003740001 M.ILHAM 30-03-1974 01-10-2003 3,933,127.80 0.00 35,004.84 11,799.38 145,525.73 78,662.56 78,662.56 39,331.28 388,986.35
232 09010425941 3672031203800003 MAD BUANG 12-03-1980 01-06-2009 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
233 03K50118845 3672030203760002 MAD MU'I 02-03-1976 01-10-2003 3,913,560.00 0.00 34,830.68 11,740.68 144,801.72 78,271.20 78,271.20 39,135.60 387,051.08
234 18064150818 3672061408800002 MAD SUFI 14-08-1980 01-08-2018 3,622,215.00 0.00 32,237.71 10,866.65 134,021.96 72,444.30 72,444.30 36,222.15 358,237.07
235 11009680411 3672030808880005 MADI SUPRIYADI 08-08-1988 01-03-2011 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
236 14020637782 3672032811880001 MADJU'I 28-11-1988 01-07-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
237 03K50119116 3672030511810001 MADLEMAN 05-11-1981 01-10-2003 3,839,637.20 0.00 34,172.77 11,518.91 142,066.58 76,792.74 76,792.74 38,396.37 379,740.11
238 09010425958 3173080204820007 MAHMUD 02-04-1982 01-06-2009 3,711,359.40 0.00 33,031.10 11,134.08 137,320.30 74,227.19 74,227.19 37,113.59 367,053.45
239 07K50047680 3672031503830007 MAHMUDI IMAWAN 15-03-1983 01-03-2007 3,735,275.60 0.00 33,243.95 11,205.83 138,205.20 74,705.51 74,705.51 37,352.76 369,418.76
240 11038139587 3673012005830002 MARKOCO 20-05-1983 01-12-2011 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
241 06K50073209 3672030509840002 MASDAR 05-09-1984 01-03-2006 3,736,362.70 0.00 33,253.63 11,209.09 138,245.42 74,727.25 74,727.25 37,363.63 369,526.27
242 04K50013952 3672030707780004 MASNI 07-07-1978 01-02-2004 4,572,240.30 0.00 40,692.94 13,716.72 169,172.89 91,444.81 91,444.81 45,722.40 452,194.57
243 14019083311 3672030107890003 MASTUR 20-06-1988 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
244 15060548797 3672034905910001 MAYA SUGESTINA WARDANI 09-05-1991 01-12-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
245 14019083329 3672033004910001 MESIDIN 30-05-1981 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
246 03K50119124 3672032007790002 MIRSAD 20-07-1979 01-10-2003 4,426,611.80 0.00 39,396.85 13,279.84 163,784.64 88,532.24 88,532.24 44,266.12 437,791.93
247 06K50073142 3672030804810003 MISBAK 06-04-1981 01-03-2006 3,746,146.60 0.00 33,340.70 11,238.44 138,607.42 74,922.93 74,922.93 37,461.47 370,493.89
248 03K50119025 3672030307790003 MISFANDI 03-07-1979 01-10-2003 4,426,611.80 0.00 39,396.85 13,279.84 163,784.64 88,532.24 88,532.24 44,266.12 437,791.93
249 04K50013960 3672032306750002 MISNAN 23-06-1975 01-02-2004 3,753,756.30 0.00 33,408.43 11,261.27 138,888.98 75,075.13 75,075.13 37,537.56 371,246.50
250 17058219548 3672030405950002 MISNAN 04-05-1995 01-10-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
251 15046024137 3672031707890002 MISNAN 17-07-1989 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
252 14011295020 3672061408930001 MISNAN 14-08-1993 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
253 17008481883 3672082310940001 MISRI AFANDI 23-10-1994 01-02-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
254 16021855966 3672030404770003 MISTAM 03-01-1982 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
255 03K50118902 3672012605760002 MOCHAMAD MANSUR 26-05-1976 01-10-2003 5,178,805.80 0.00 46,091.37 15,536.42 191,615.81 103,576.12 103,576.12 51,788.06 512,183.90
256 03K50119009 3604022411750033 MOCHAMMAD ANDIK 24-11-1975 01-10-2003 5,824,497.00 0.00 51,838.02 17,473.49 215,506.39 116,489.94 116,489.94 58,244.97 576,042.75
WIJAYANTA
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
257 16017090248 3604080706940002 MUALLIMATUS SHOLIHAT 07-01-1994 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
258 11038139603 3201240101790018 MUH ROMLI 01-01-1979 01-12-2011 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
259 10018019553 3672031311800001 MUHAMAD 13-11-1980 01-07-2010 4,123,317.50 0.00 36,697.53 12,369.95 152,562.75 82,466.35 82,466.35 41,233.18 407,796.11
260 14011295657 3672031708780002 MUHAMAD ALI 17-08-1978 01-04-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
261 14020076833 3301191106760001 MUHAMAD EPENDI 11-06-1976 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
262 15060548755 3604041306900355 MUHAMAD REZAL 13-06-1990 01-12-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
ADITIARMAN
263 14018707654 3604051306840002 MUHAMAD RUSIDI 13-06-1984 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
264 17002748329 3672030503890001 MUHAMAD SENIMIN 05-03-1989 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
265 14011295038 3672030909850002 MUHAMMAD BUANG 09-09-1985 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
266 13009891857 3604052504930003 MUHAMMAD HILMAN FARIZ 25-04-1993 01-04-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
267 16017090347 3604020406930167 MUHAMMAD ILHAM 04-06-1993 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
FIRMANSYAH
268 17008481867 1271030202810010 MUHAMMAD RAFIAN 02-02-1981 01-02-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
269 03K50119017 3672061408770001 MUHAMMAD RUSDI 14-08-1977 01-10-2003 4,434,221.50 0.00 39,464.57 13,302.66 164,066.20 88,684.43 88,684.43 44,342.22 438,544.51
270 15046024053 3672082011950001 MUHAMMAD WAHYUDIN 20-11-1995 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
271 07K50047672 3672035107800004 MUHAYAROH 11-07-1980 01-03-2007 4,662,459.70 0.00 41,495.89 13,987.38 172,511.01 93,249.19 93,249.19 46,624.60 461,117.26
272 14025643504 3672032408920002 MUHIDIN 24-08-1993 01-08-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
273 03K50119033 3672031402770002 MUHIT 14-02-1977 01-10-2003 3,929,866.50 0.00 34,975.81 11,789.60 145,405.06 78,597.33 78,597.33 39,298.67 388,663.80
274 17049509635 3602140505980005 MUKHLIS 05-05-1998 01-09-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
275 11026890167 3604081501740002 MUKMIN 15-01-1974 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
276 17002748352 3604040405770470 MUKSIN 04-05-1977 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
277 08015238762 3672030304900002 MULYADI 03-04-1990 01-05-2008 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
278 11026890100 3672031202840004 MUNIR 12-02-1984 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
279 10018019728 3302252708660001 MUSLIH 27-08-1966 01-07-2010 3,873,337.30 0.00 34,472.70 11,620.01 143,313.48 77,466.75 77,466.75 38,733.37 383,073.06
280 10018019694 3672031512750002 NAHRAWI 15-12-1975 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
281 10018019587 3672031409820002 NANA MASNA 14-09-1982 01-07-2010 3,671,136.70 0.00 32,673.12 11,013.41 135,832.06 73,422.73 73,422.73 36,711.37 363,075.42
282 13001437790 3672061608830003 NANA SETIAWAN 16-08-1983 01-02-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
283 10018019769 3604050508850006 NANANG BAGUS SANTOSA 05-08-1985 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
284 10018019462 3604012305790022 NANANG MULYANA 23-05-1979 01-07-2010 3,901,601.90 0.00 34,724.26 11,704.81 144,359.27 78,032.04 78,032.04 39,016.02 385,868.44
285 15003082870 1802050104900003 NANANG SETIAWAN 01-04-1990 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
286 16017090297 3604082512910001 NATA NUGROHO 25-12-1991 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
287 03K50119132 3604011409720148 NAZARUDIN 14-09-1972 01-10-2003 3,900,514.80 0.00 34,714.58 11,701.54 144,319.05 78,010.30 78,010.30 39,005.15 385,760.92
288 09010426188 3209290107710214 NENDA 01-07-1971 01-06-2009 3,743,972.40 0.00 33,321.35 11,231.92 138,526.98 74,879.45 74,879.45 37,439.72 370,278.87
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
289 04K50012996 3672060505790001 NIKMATULLAH 05-05-1979 01-02-2004 3,751,582.10 0.00 33,389.08 11,254.75 138,808.54 75,031.64 75,031.64 37,515.82 371,031.47
290 11026890084 3672030105920001 NITI UTOMO 01-05-1992 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
291 10018019645 3672056301830006 NUNY JANUARTI 23-01-1983 01-07-2010 4,171,136.70 0.00 37,123.12 12,513.41 154,332.06 83,422.73 83,422.73 41,711.37 412,525.42
292 06K50165203 3672030502830002 NUR ARI SUSILO 05-02-1983 01-08-2006 3,727,665.90 0.00 33,176.23 11,183.00 137,923.64 74,553.32 74,553.32 37,276.66 368,666.17
293 10018019736 3672081304800002 NURMAT 13-04-1980 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
294 13026262660 3672037004920001 NURUL KHOTIMAH 30-04-1992 01-08-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
295 14019083345 3672031204770001 NUSDIN 12-04-1977 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
296 17021318096 3672031704960001 OFAN PARESTIAN 17-04-1996 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
297 03K50119397 3604221410740001 OJI FAHRUROJI 14-10-1974 01-10-2003 3,940,737.50 0.00 35,072.56 11,822.21 145,807.29 78,814.75 78,814.75 39,407.38 389,738.94
298 17002748311 3209371710910001 OKKY OKTORA 17-10-1991 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
299 16031972272 3672062402930001 OMAN NASRULLOH 24-02-1993 01-08-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
300 13033612568 3604061204750003 OMAN ROHMAN 12-04-1975 01-10-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
301 17049509627 3522110603960003 PAMBUDI 06-03-1996 01-09-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
302 03K50118852 3673031410780001 PAWIT 14-10-1978 01-10-2003 4,776,611.80 0.00 42,511.85 14,329.84 176,734.64 95,532.24 95,532.24 47,766.12 472,406.93
303 14011295046 3672030307810004 PENDI AFENDI 03-07-1981 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
304 13006344322 3211051607740001 PRIMA MONTANA 16-07-1974 01-03-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
305 11009680353 3175031705800007 PRIYONO 17-05-1980 01-03-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
306 16055591966 3604055603940001 PUPPY TWINAWATI 16-03-1994 01-11-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
307 14032768757 3518084602960006 PUTRI RIZKI DARMAWANTI 06-02-1996 01-10-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
308 03K50118761 3672031201690002 RADEN AHMAD SUBANDI 12-01-1969 01-10-2003 3,934,214.90 0.00 35,014.51 11,802.64 145,565.95 78,684.30 78,684.30 39,342.15 389,093.85
309 08011559922 3604080106750001 RAHMATULLAH 01-06-1975 01-07-2008 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
310 03K50119041 3672032908710001 RAJIDIN USMAN 29-08-1971 01-10-2003 3,948,347.20 0.00 35,140.29 11,845.04 146,088.85 78,966.94 78,966.94 39,483.47 390,491.53
311 15046024046 3672081910880002 RANDI JATMIKO 19-10-1988 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
312 03K50119421 3672030801810004 REBUDIN 08-01-1981 01-10-2003 4,196,153.20 0.00 37,345.76 12,588.46 155,257.67 83,923.06 83,923.06 41,961.53 414,999.54
313 17002748295 3604052107690003 RESTU TURWINDRATNO 21-07-1969 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
314 09010426097 3672032701830006 RIBUT WAHYUDI 27-01-1983 01-06-2009 3,691,791.60 0.00 32,856.95 11,075.37 136,596.29 73,835.83 73,835.83 36,917.92 365,118.19
315 15023054024 3672032910840002 RIFQI NUR RIZQI 29-10-1984 01-04-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
316 14020637717 3672082210870002 RIZKI FAUZI 22-10-1987 01-07-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
317 13001437816 3672082504820002 RIZKI FIRDAUS 30-04-1980 01-02-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
318 15046024038 3672030305930001 ROBET SORIF 03-05-1993 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
319 12013682385 3604050205860006 ROCHYANTO 02-05-1986 01-05-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
320 03K50119306 3604080812710001 ROHANI 08-12-1971 01-10-2003 3,822,243.60 0.00 34,017.97 11,466.73 141,423.01 76,444.87 76,444.87 38,222.44 378,019.89
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
321 03K50119686 3672030302690002 ROHASI 03-02-1969 01-10-2003 3,753,756.30 0.00 33,408.43 11,261.27 138,888.98 75,075.13 75,075.13 37,537.56 371,246.50
322 12029320574 3672011505820001 ROHIMUDIN 15-04-1982 01-08-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
323 04K50013044 3604080810820001 ROHMAN 08-10-1982 01-02-2004 3,762,453.10 0.00 33,485.83 11,287.36 139,210.76 75,249.06 75,249.06 37,624.53 372,106.60
324 03K50119405 3672030405800004 ROHMAN 04-05-1980 01-10-2003 4,426,611.80 0.00 39,396.85 13,279.84 163,784.64 88,532.24 88,532.24 44,266.12 437,791.93
325 12039295287 3672030311910001 ROHMAN SUHERMAN 03-11-1991 01-12-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
326 03K50118860 3672031904820001 8299083KT ROHMAT WAHYUDI 19-04-1982 01-10-2003 3,908,124.50 0.00 34,782.31 11,724.37 144,600.61 78,162.49 78,162.49 39,081.25 386,513.52
327 03K50119660 3672031805740001 ROJALI 18-05-1974 01-10-2003 3,860,292.10 0.00 34,356.60 11,580.88 142,830.81 77,205.84 77,205.84 38,602.92 381,782.89
328 16017090263 3672031706870002 RONI HAWASI 17-06-1987 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
329 04K50013200 3604080811790002 ROSIIN 08-11-1979 01-02-2004 3,746,146.60 0.00 33,340.70 11,238.44 138,607.42 74,922.93 74,922.93 37,461.47 370,493.89
330 11026890050 1207021009980003 RUBI SAFRIZAL 10-09-1998 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
331 03K50119439 3672011212820001 RUDI SAFARUDI 12-12-1982 01-10-2003 3,749,407.90 0.00 33,369.73 11,248.22 138,728.09 74,988.16 74,988.16 37,494.08 370,816.44
332 15046023980 3672032505940004 RUDIYANI 25-05-1994 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
333 03K50119090 3604062710650001 RUDY RACHMANSYAH 27-10-1965 01-10-2003 3,864,640.50 0.00 34,395.30 11,593.92 142,991.70 77,292.81 77,292.81 38,646.41 382,212.95
334 04K50013101 3672030805720003 RUMBIYANTO 08-05-1972 01-02-2004 3,807,024.20 0.00 33,882.52 11,421.07 140,859.90 76,140.48 76,140.48 38,070.24 376,514.69
335 03K50119256 3672030207760005 RUSLAN EFENDI 02-07-1976 01-10-2003 4,211,372.60 0.00 37,481.22 12,634.12 155,820.79 84,227.45 84,227.45 42,113.73 416,504.76
336 3272030802840041 1811283 HK RUSLY HARMAYN 08-02-1984 3,622,215.00 0.00 32,237.71 10,866.65 134,021.96 72,444.30 72,444.30 36,222.15 358,237.07
337 16021855990 3672032306900001 SABIT 23-06-1990 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
338 03K50119702 3672030204690003 SAEFUDIN 02-04-1969 01-10-2003 3,768,975.70 0.00 33,543.88 11,306.93 139,452.10 75,379.51 75,379.51 37,689.76 372,751.69
339 09015435945 3672080808870004 SAFANI 08-08-1987 01-08-2009 3,709,185.20 0.00 33,011.75 11,127.56 137,239.85 74,183.70 74,183.70 37,091.85 366,838.41
340 14020637766 3604080907890003 SAFRUDIN 09-07-1989 01-07-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
341 12000193891 3672030503700003 SAFTARIA 05-03-1970 01-01-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 0.00 0.00 249,645.67
342 11028495239 3604073005730002 SAHIRI 30-05-1973 01-10-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
343 16061268393 3672032212920001 SAID 22-12-1992 01-12-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
344 03K50118746 3672081606800001 SAIFUL IBRAHIM 16-06-1980 01-10-2003 5,072,279.90 0.00 45,143.29 15,216.84 187,674.36 101,445.60 101,445.60 50,722.80 501,648.49
345 04K50013010 3672031710820002 SAKRIM 17-10-1982 01-02-2004 3,762,453.10 0.00 33,485.83 11,287.36 139,210.76 75,249.06 75,249.06 37,624.53 372,106.60
346 11009680395 3604250204720003 SAMAN 02-04-1972 01-03-2011 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
347 15003082896 3672030406890003 SAMSUNI 04-06-1989 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
348 13001437774 3604150510760005 SAMTURI 05-10-1976 01-02-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
349 16017090305 1980120111920134 SANTA BIN SUIMAN 11-05-1989 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
350 11026890118 3604080306740001 SANTANI 03-06-1974 01-09-2011 4,360,049.60 0.00 38,804.44 13,080.15 161,321.84 87,200.99 87,200.99 43,600.50 431,208.91
351 16021855891 3672032308940002 SANTOMI 23-04-1994 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
352 09010425966 3604071204700005 SANURI 12-04-1970 01-06-2009 3,701,575.50 0.00 32,944.02 11,104.73 136,958.29 74,031.51 74,031.51 37,015.76 366,085.82
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
353 14019083360 3672031808920004 SAPTUNI 18-08-1992 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
354 15003082904 3604060307690002 SAPTURI 03-07-1969 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
355 11026890126 3604080406780002 SARBANI 04-06-1978 01-09-2011 4,360,049.60 0.00 38,804.44 13,080.15 161,321.84 87,200.99 87,200.99 43,600.50 431,208.91
356 14011295095 3604082001880001 SARIFUDIN 20-01-1988 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
357 17062318369 3672031108940004 SARIN 11-08-1994 01-11-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
358 14011295053 3672030502910003 SARIYANI 06-05-1992 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
359 16021855867 3604072507930002 SARMADI 25-07-1993 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
360 15046024103 3672034205940001 SARMAJE 02-05-1994 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
361 14011295061 3672030106890001 SARMAN 01-06-1989 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
362 15046024061 3672031502900002 SARMANI 15-02-1990 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
363 03K50120585 1980120111920136 SARMANI 25-09-1971 01-10-2003 3,738,536.90 0.00 33,272.98 11,215.61 138,325.87 74,770.74 74,770.74 37,385.37 369,741.31
364 04K50120849 1805111006760011 SARMANI 10-06-1976 01-02-2004 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
365 15046023998 3672032701830008 SARMIN 27-01-1983 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
366 09010426055 3673010510710003 SARTONO 05-10-1971 01-06-2009 3,715,707.80 0.00 33,069.80 11,147.12 137,481.19 74,314.16 74,314.16 37,157.08 367,483.51
367 16017090230 3672030407940002 SARWADI 04-07-1994 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
368 06K50073175 3672030405850003 SARWANI 04-05-1985 01-03-2006 3,742,885.30 0.00 33,311.68 11,228.66 138,486.76 74,857.71 74,857.71 37,428.85 370,171.37
369 15003082946 3672032006820004 SELAMET 20-06-1982 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
370 16017090388 3604061112910001 SELAMET 11-12-1991 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
371 04K50013945 3672032507780003 SELURI 25-07-1978 01-02-2004 3,746,146.60 0.00 33,340.70 11,238.44 138,607.42 74,922.93 74,922.93 37,461.47 370,493.89
372 09010425974 3672031001810004 SENIDIN 10-01-1981 01-06-2009 3,697,227.10 0.00 32,905.32 11,091.68 136,797.40 73,944.54 73,944.54 36,972.27 365,655.75
373 11026890092 3672030107860001 SENIMIN 20-12-1987 01-09-2011 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
374 06K50073134 3604080905780001 SERANI 09-05-1978 01-03-2006 3,899,427.70 0.00 34,704.91 11,698.28 144,278.82 77,988.55 77,988.55 38,994.28 385,653.39
375 15046023949 3672031212890001 SETIADI WARDANA 12-12-1989 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
376 03K50119157 3672032803790002 SINDUNG JAYA 28-03-1979 01-10-2003 4,348,347.20 0.00 38,700.29 13,045.04 160,888.85 86,966.94 86,966.94 43,483.47 430,051.53
377 15046024111 3672035501910002 SIPA ASTUTI 15-01-1991 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
378 16021856030 3604056401900003 SISKA SASTIKA DEWI 24-01-1990 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
379 15046023907 3604056411960001 SITI AMANAH 24-11-1996 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
380 10018019678 3604051303910005 SLAMET RIADI 13-03-1991 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
381 14032768773 3672031111920001 SLAMET RIYADI 11-11-1992 01-10-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
382 14011295079 3672031010870004 SOFAN 10-10-1987 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
383 14011295673 3604062501840003 SOFIAN 25-01-1984 01-04-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
384 13026262652 3672032311820001 SONI NOVIANTO 23-11-1982 01-08-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
385 17002748279 3604050701690001 SRI SUSILOHADI S SOS 07-01-1969 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
386 09010426014 3672032509810001 SUBANDI 25-09-1981 01-06-2009 3,709,185.20 0.00 33,011.75 11,127.56 137,239.85 74,183.70 74,183.70 37,091.85 366,838.41
387 13009891956 3672031010840001 SUBANI 10-10-1984 01-04-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
388 08011559914 3604081507760001 SUDIYANTO 15-07-1976 01-07-2008 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
389 15003082888 3672061202880002 SUEB 12-02-1988 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
390 04K50013218 3604072206730002 SUGENDI 22-06-1973 01-02-2004 3,760,278.90 0.00 33,466.48 11,280.84 139,130.32 75,205.58 75,205.58 37,602.79 371,891.59
391 14011295087 3604300605780007 SUGIYARTO 06-05-1978 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
392 14020076841 3672036810890002 SUHA AENNY 28-10-1989 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
393 13019280364 3672073004840002 SUHARSONO 30-04-1984 01-06-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
394 12033059903 3672031011890001 SUHEL 10-11-1989 01-10-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
395 04K50012970 3672032007810002 SUHENDRA SAPUTRA 20-07-1981 01-02-2004 3,702,662.60 0.00 32,953.70 11,107.99 136,998.52 74,053.25 74,053.25 37,026.63 366,193.34
396 15046023923 3604052211790001 SUHERI 22-11-1979 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
397 14018707670 3604050202880002 SUHERMAN 02-02-1988 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
398 16021855941 3672030303930004 SUJADI 03-03-1993 01-05-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
399 12005961250 3672031204900001 SUKADI 12-04-1990 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
400 14019083378 3672030405900002 SUKARDI 04-05-1990 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
401 04K50013150 3672030502790003 SULAEMAN 05-02-1979 01-02-2004 3,762,453.10 0.00 33,485.83 11,287.36 139,210.76 75,249.06 75,249.06 37,624.53 372,106.60
402 06K50073183 3672032904800003 SUMANTA 29-04-1980 01-03-2006 3,757,017.60 0.00 33,437.46 11,271.05 139,009.65 75,140.35 75,140.35 37,570.18 371,569.04
403 09010426196 3672061009800002 SUMARJONO 10-09-1980 01-06-2009 3,707,011.00 0.00 32,992.40 11,121.03 137,159.41 74,140.22 74,140.22 37,070.11 366,623.39
404 03K50120353 3314096103770004 SUNARNI 21-03-1977 01-10-2003 4,973,373.60 0.00 44,263.03 14,920.12 184,014.82 99,467.47 99,467.47 49,733.74 491,866.65
405 97K52033200 3604081407730002 SUPARNO 14-07-1973 01-12-1997 7,267,025.90 0.00 64,676.53 21,801.08 268,879.96 145,340.52 145,340.52 72,670.26 718,708.87
406 03K50118795 3404140805770002 SUPRAPTO 08-05-1977 01-10-2003 7,306,121.90 0.00 65,024.48 21,918.37 270,326.51 146,122.44 146,122.44 73,061.22 722,575.46
407 11026890068 3672052105900003 SUPRAPTONO 21-05-1990 01-09-2011 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
408 13033612584 3604051509850005 SUPRIYADI 15-09-1985 01-10-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
409 07K50047698 3672030801800005 SUPRIYADI 08-01-1980 01-03-2007 3,730,927.20 0.00 33,205.25 11,192.78 138,044.31 74,618.54 74,618.54 37,309.27 368,988.69
410 15046024145 3672031504930001 SUPRIYADI B 15-04-1993 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
411 15054386535 1980120111920138 SUPRIYADI BIN MAD SUFI 15-09-1985 01-10-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
412 03K50119264 3672081006810001 SUPRIYANTO 10-06-1981 01-10-2003 4,620,072.70 0.00 41,118.65 13,860.22 170,942.69 92,401.45 92,401.45 46,200.73 456,925.19
413 13030644150 3672030306820001 SURAH MAN 03-06-1982 01-09-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
414 15046023972 3672032907890001 SURYADI 29-07-1989 01-09-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
415 14019083394 3209171305890012 SUTARA 13-05-1989 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
416 16017090420 3276011608860015 SUTARJO 16-08-1986 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
417 13009891964 3672031511930001 SUWANDI 15-11-1993 01-04-2013 3,730,927.20 0.00 33,205.25 11,192.78 138,044.31 74,618.54 74,618.54 37,309.27 368,988.69
418 06K50226278 3672030503740002 SUWANDI 05-03-1974 01-07-2006 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
419 04K50013093 3672031506730001 SUYITNO 15-06-1973 01-02-2004 3,743,972.40 0.00 33,321.35 11,231.92 138,526.98 74,879.45 74,879.45 37,439.72 370,278.87
420 12037739443 3212100103880006 SUYONO AGUS PRIYANTO 01-03-1988 01-11-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
421 11038139579 3672031704880003 SYAFIIN 17-04-1988 01-11-2011 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
422 12019243042 3672030811760001 SYARIFUDIN 08-11-1976 01-06-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 0.00 0.00 249,645.67
423 09010425909 3672031710860001 TARMAD 17-10-1986 01-06-2009 3,707,011.00 0.00 32,992.40 11,121.03 137,159.41 74,140.22 74,140.22 37,070.11 366,623.39
424 13009891923 3208130709860003 TEDI MULYADI 07-09-1986 01-04-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
425 04K50013036 3672030912740001 TEGUH AGUNG SAPUTRA 09-12-1974 01-02-2004 3,736,362.70 0.00 33,253.63 11,209.09 138,245.42 74,727.25 74,727.25 37,363.63 369,526.27
426 03K50119165 3672032506630001 TEKAD HARYANTO 25-06-1967 01-10-2003 3,877,685.70 0.00 34,511.40 11,633.06 143,474.37 77,553.71 77,553.71 38,776.86 383,503.11
427 09010426071 3672030405700001 TIKA JATMIKA 04-05-1970 01-06-2009 3,712,446.50 0.00 33,040.77 11,137.34 137,360.52 74,248.93 74,248.93 37,124.47 367,160.96
428 06K50073217 3672032803810001 TONI MULYANI 28-03-1981 01-03-2006 3,718,969.10 0.00 33,098.82 11,156.91 137,601.86 74,379.38 74,379.38 37,189.69 367,806.04
429 13030644143 3672050704810001 TOPIK 07-04-1981 01-09-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
430 14020637774 3672063107870001 TRI WIYANTO 31-07-1987 01-07-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
431 16017090438 3604081102810001 TRIYONO 11-02-1981 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
432 04K50013226 3672031611680001 TUBAQIS 16-11-1968 01-02-2004 3,816,808.10 0.00 33,969.59 11,450.42 141,221.90 76,336.16 76,336.16 38,168.08 377,482.31
433 16008735009 3672031312800003 TUFI PRIANSYAH 13-12-1980 01-02-2016 3,735,275.60 0.00 33,243.95 11,205.83 138,205.20 74,705.51 74,705.51 37,352.76 369,418.76
434 12013682393 3604082707860010 TUMI 27-07-1986 01-05-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
435 12005961342 3672031502850002 TURADI 15-02-1985 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
436 14011295103 3672031601920003 USMAN 16-01-1992 01-03-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
437 14019083410 3672030703870003 USMAN 07-03-1987 01-05-2014 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
438 17002748303 3604040510720315 USMAN MAKSUM 05-10-1972 01-01-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
439 17021318013 3672011107970003 VIKY IRHAM 11-07-1997 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
440 97K52033267 3672010305740003 WAGIMAN 03-05-1974 01-12-1997 6,437,661.00 0.00 57,295.18 19,312.98 238,193.46 128,753.22 128,753.22 64,376.61 636,684.67
441 03K50119173 3672030101690003 WAHONO 01-10-1969 01-10-2003 3,907,037.40 0.00 34,772.63 11,721.11 144,560.38 78,140.75 78,140.75 39,070.37 386,405.99
442 17008481875 3672012306860001 WANDI KURNIAWAN SUJIWO 23-06-1986 01-02-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
443 03K50119066 3672050907790005 WARNO 09-07-1979 01-10-2003 5,184,241.30 0.00 46,139.75 15,552.72 191,816.93 103,684.83 103,684.83 51,842.41 512,721.47
444 06K50226294 3604060405840001 WENDRA 04-05-1984 01-07-2006 3,732,014.30 0.00 33,214.93 11,196.04 138,084.53 74,640.29 74,640.29 37,320.14 369,096.22
445 15003082854 3604051803950003 WIDINA RIDLA HERNAWAN 18-03-1995 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
446 13006344355 3209061307840006 YANA KOSASIH 13-07-1984 01-03-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
447 17021318047 3673011103960003 YANA SURYANA 11-03-1996 01-04-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
448 15003082862 3672030704900003 YANTO 07-04-1990 01-02-2015 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
Formulir 2a PU
BPJS Ketenagakerjaan
RINCIAN IURAN TENAGA KERJA

NPP Nama Perusahaan Nama Unit Kerja Periode Laporan


15010801 RUSAMAS SARANA USAHA RUSAMAS SARANA USAHA 11 2018

No. Nomor Nomor Induk Nomor Tgl Iuran JHT TK Iuran JP


Referensi Kependudukan Pegawai Nama Tenaga Kerja Tanggal Lahir Kepesertaan Jumlah Upah Jumlah Rapel Iuran Jkk Iuran JKM Total Iuran
(NIK) (Rp.) (Rp.) (Rp.) (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) Pemberi Kerja (Rp.) Tenaga Kerja (Rp.) (Rp.)
449 16017090412 3672031511840001 YANTO 20-05-1986 01-04-2016 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
450 04K50013929 3672031011720004 YANTO 10-11-1972 01-02-2004 3,757,017.60 0.00 33,437.46 11,271.05 139,009.65 75,140.35 75,140.35 37,570.18 371,569.04
451 12005961367 3672031601860002 YANWAR BAHARI 16-01-1986 01-02-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
452 04K50013176 3601231007830002 YASER ARAFAT 10-07-1983 01-02-2004 3,748,320.80 0.00 33,360.06 11,244.96 138,687.87 74,966.42 74,966.42 37,483.21 370,708.94
453 10018019660 3672031910870003 YOPI IRWAN SUTEDI 19-10-1987 01-07-2010 3,670,049.60 0.00 32,663.44 11,010.15 135,791.84 73,400.99 73,400.99 36,700.50 362,967.91
454 17062318377 3672031808980001 YUDA AJI RAHMATIAR 18-08-1998 01-11-2017 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
455 12013682401 3276021309850007 YUDI SETIYAWAN 13-09-1985 01-05-2012 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
456 10018019561 3672031307760001 YUDIANTO 13-07-1978 01-07-2010 3,671,136.70 0.00 32,673.12 11,013.41 135,832.06 73,422.73 73,422.73 36,711.37 363,075.42
457 13030644127 3672036807840003 YULI TRIHASTUTI 28-07-1984 01-09-2013 3,623,304.30 0.00 32,247.41 10,869.91 134,062.26 72,466.09 72,466.09 36,233.04 358,344.80
458 03K50119496 3672061207670003 YULIFAR DARMAWAN 12-07-1967 01-10-2003 3,841,811.40 0.00 34,192.12 11,525.43 142,147.02 76,836.23 76,836.23 38,418.11 379,955.14

Jumlah Seluruhnya 1,734,701,300.80 0.00 15,438,841.00 5,204,103.00 64,183,948.00 34,694,026.00 34,491,300.00 17,245,649.00 171,257,867.00

Keterangan
*) Isian formulir ini dapat disampaikan kepada BPJS Ketenagakerjaan dalam bentuk media elektronik (softcopy) ataupun hasil cetakan dari sistem
penggajian perusahaan peserta yang bersangkutan, dengan aturan / format yang sesuai dengan ketentuan BPJS Ketenagakerjaan

, 07 November 2018

(Nama dan Tanda Tangan Pimpinan Perusahaan)


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