Izin Tinggal Terbatas Elektronik: Electronic Limited Stay Permit

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KEMENTERIAN HUKUM DAN HAK ASASI MANUSIA

REPUBLIK INDONESIA
KANTOR WILAYAH JAWA BARAT
KANIM KELAS II NON TPI BEKASI
KOMPLEK GOR BEKASI

IZIN TINGGAL TERBATAS ELEKTRONIK


ELECTRONIC LIMITED STAY PERMIT

NIORA : J1U1RACO10953
Permit Number : 2C21AM1380-T
Stay/Multiple Entries Permit Expiry : 17-04-2020
Stay Permit Index : II B

Full Name : MAKOTO TAKEKAWA


Place / Date of Birth : TOKYO / 05-06-1968
Passport Number : TZ1094491
Passport Expiry : 28-10-2025
Nationality : JEPANG
Gender : MALE
Address : APARTEMEN TRIVIUM S 1815, JL. INDUSTRI BLOK.C NO.1
SUKARESMI, CIKARANG SELATAN, BEKASI, JAWA BARAT 17530
Occupation : MANAGER PRODUKSI
Status : WORK

DISCLAIMER :
1. According to Article 71 Act Number 6 Year 2011 concerning Immigration, every changes of civil status, citizenship,
occupation, Guarantor, or change of address must be reported to Local Immigration Office in an immediate period of
time.
2. This Limited Stay Permit (online) must be attach to the bearer’s Passport at all times
3. For further information please do not hesitate to contact Local Immigration Office or do visit our website
www.imigrasi.go.id.

Bekasi, 18-04-2019
Head of Kanim Kelas II Non Tpi Bekasi Immigration Office.

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