KEPOLISIAN NEGARA REPUBLIK INDONESIA : DAERAH SUMATERA UTARA Nomor : 02 o3sisaag RESOR KOTA BESAR MEDAN LLM, Said No. Medan =20235 as POLICE RECORD Nomor: SKCK/YANMAS/13 594/VIYAN 2 3 /2022/SAT INTELKAM This sto certify that I HARI YUDA PARULIAN SIMARMATA senis Kelamin LAKHLAK! Sax Kebangsaan Netonalty, INDONESIA cama felgion KRISTEN ‘Tempat dan to ahir Ear des eee, MEDAN, 29 SEPTEMBER 1999 a “JUN. RAWA\I GG. TAPANULI INO. 11, KEL. TEGAL S MANDALA III, KEC Curent address MEDAN DENAl, KOTA MEDAN, PROV. SUMATERA UTARA Pekerigan . Occupation ‘Nomor Kartu Tanda Penduduk Gea +1271042909990012 ‘Nomor Paspot! KFFAS/ KFFAR* ‘Passport KTASIKFTAP numbor ‘Bumus sisi jai =M32 Wim 22 Fingerprints Formula wa luatk ini kepada ‘As of screening through the issue here of by virtue of ‘Catalan Kepolsian vang ada: Existing Police record pahue satan atau Ki lam K the boaror hereof proves not to be involved in any criminal cases selama ia berada di Indonesia dari. during his/her stay in indonesia from: pe CECE eee ‘sampai dengan: 29 NOVEMBER 2022 unt ea ytepaos. MELAMAR PEKERJAAN cea teres oa ~ 29 MEI 2023 Imvohn er SRO cota "one yang dak perks