F APPLICATION FORM

BITAYA TAMANT — paront Names: CHUSE BANADUR TAMPERE _

» RALU- 4, BUNUTANU, nuwaver LMEUHAN UT 2, OWA ST)

ephone No: 981******* Mobile No: 98 66683164 Fux: =

‘Qualification. School LEAVINU (ERrrFecATE (SLE)

Ave: 31 Years SOR): mate Date of Birth: (9 MAY 1992

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Passport No: 121 98 021 Date of Issues: 04 APQ 2024 Expiry Date: 03 APR 2052

Place of Birth: '9 MAY (992 Email Address bijayaderangbipaga E@ gmalioms

Moritul Status: MARKED Nationality: NEPACE ae

International Driving Licence. Yes: ND No NO _ Date of Expire: SO

Educational High School Univeristy From: 2012 To 22) =

Certificate Heid: B.AB.B.SC.B.COM.H.N.D.M.A.M.SC.NM.COM_P.H.D.TOEFLIELTS.RS.A

Employment:

Current Company/Previous Company: WIRE House

From: 29's; 2019 Last net Salary: f 20x (Rp. 419,800)

Referred By:

Document attach (No’s)__P?P-No- 2) FG O2]

Position applied for: FACTORY wo RKER.

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