KTP DAN AKTA LAHIR DALAM BAHASA INGGRIS

  CIVIL REGISTRY OFFICE

       (INDONESIAN NATIONALITY)

EXCERPT OF BIRTH CERTIFICATE

No. 4137/1997

Based on general list concerning Birth by virtue of Stbd. 1920 No. 751 Jo. 1927 No. 564 at TANGERANG, it was recorded that in TANGERANG on the twenty second of June, Sunday, 07.30 WIB O’clock. In the year nineteen ninety seven, a female child named TRESNA UTAMI was born as a THIRD daughter to the married couple of HASRUL HASIBUAN and SRI HARTATI

This excerpts is in accordance with the current conditions.

Tangerang, on date the eight of July year nineteen ninety seven

Head of the Civil Registry Office of MUNICIPALITY OF TANGERANG.

Drs. H.U. BACHRUDIN

NIP. 480043007.

IDENTITY CARD REPUBLIK OF INDONESIA

SERIAL REGISTER NUMBER : 3603176206970XXX

NAME : TRESNA UTAMI

CITY / BIRTH OF DATE : TANGERANG, 22-06-1997

SEX : FEMALE                                         BLOOD TYPE: O

ADRESS : BINONG PERMAI BLOK B 12 NO 30

                             RT/RW : 001/002

SUBDISTRICT : CURUG

                   DISTRICT : TANGERANG

RELIGION : MOESLEM

MARITAL STATUS : HAVE NOT MARRIED

OCCUPATION : STUDENT

VALID TO : 30 – 12 – 2020

NATIONALITY : INDONESIA.