MAI Client

Client Data Form

Please fill in this form to register your data.

Company Information

Company Name *

Nature Of Business *

Company Address *

Postal Code *

Phone *

Email

Website

Correspondence

Pick Up

Email

Delivery

Delivery Address

Business License & Legal Information

Trading Company *

Please upload document if PKP or Non PKP

You can upload any type of file with a maximum size of 5 MB

Please upload NPWP *

You can upload any type of file with a maximum size of 5 MB

Please upload SPPKP *

You can upload any type of file with a maximum size of 5 MB

Person In Charge Information

Marketing

Name *

Position *

Phone Number *

Office Number extension

Email

Finance

Name *

Position *

Phone Number *

Office Number extension

Email

Legal

Name *

Position *

Phone Number *

Office Number extension

Email

Specifics Information from Client

Confirmation

By submitting below, I certify all information is true and correct to the best of my knowledge.