(HIAMS)AS-IB CANDIDATE APPLICATION FORM

Format Number : __/HR/__/__

PT Hitachi Automotive Systems Indonesia Human Resources Department

Position Applied : QA Assistant Manager

Indicate : Ms. Mrs. Mr. √

Name (Full Name) Rio Yudha Prawira

Nick Name Rio

Sex (Male/ Female): Place and Date of Birth :
Male Lahat, December 20th,1985

Address Address (Temporary)

(Permanent/ Based on KTP ID) with Zip Code:
with Zip Code:
Kp. Kramat RT. 001 RW. 005 Desa Parigi Jl. Jaguar No. 24 Cikarang, Kabupaten
Kecamatan Cikande, Kabupaten Serang, Bekasi, Provinsi Jawa Barat 17530 Marital Status:
Provinsi Banten 42186 Single √

Married
Separated
Widowed
Contact Number :
HP 1 082297668438 HP 2 -
Home Number (62) - Office Number (May No (62) -
we contact you at
work?)
Age 34 Blood B Religion :
Type Islam
Height 155 cm Weight 50 kg
Email 1: [email protected] Email
2:
Passport Details
Passport Number: - Date of Issued : - Valid Date Until: -

Driving License
SIM A Number & Plat Number: SIM A Date of Issued: SIM A Valid Date Until:
1320170200219 02-02-2017 02-02-2022

SIM B Forklift Number & Plat SIM B Forklift Date of Issued: SIM B Forklift Valid Date Until:
Number:

SIM C Number & Plat Number: SIM C Date of Issued: SIM C Valid Date Until:

Banking Details

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(HIAMS)AS-IB Recruitment & Selection Systems & Procedures
(HIAMS)AS-IB CANDIDATE APPLICATION FORM
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PT Hitachi Automotive Systems Indonesia Human Resources Department

Bank Account No: Bank Name & Code Bank Number: Branch Name & Address:
8730530481 BCA KCP METRO JABABEKA

FAMILY BACKGROUND (Family Members):

SIBLINGS/ FAMILY NAME AGE OCCUPATION ADDRESS & TELEPHONE
RELATIONSHIP (for NUMBER
Sibling including You)
FATHER Junianto Dec. - -

MOTHER Deni Agustina 57 Self-employed Serang

ST
1 SISTER/ BROTHER Diah Natalia Utami 35 Private Employee Depok
2ND SISTER/ BROTHER Rio Yudha Prawira 34 Private Employee Cikarang
RD
3 SISTER/ BROTHER M. Leonardo 26 Employee Tarakan
TH
4 SISTER/ BROTHER M. Deo Bramanthio 23 Graduated Bogor
WIFE/ HUSBAND
1ST CHILD

2ND CHILD
3RD CHILD
4TH CHILD

EMPLOYMENT/ WORKING HISTORY:

Details Last/ Present Job Second/ Last Job Third/ Last Job
Name of the PT. Indonesia G-Shank PT. Plasticolors Eka Perkasa PT. Kodai Indonesia
Company Precision
Company Location Cikarang Cikarang Cikarang
Company Address Jl. Industri Utama I Blok RR Jl. Cendana Raya Blok F8 No. Jl. Kenari 2 Blok G1A No. 9
No. 5C-D Kawasan Industri 18 Delta Silicon 3 Industrial Kawasan Industri Delta
Jababeka, Cikarang Park, Lippo Cikarang. Silicon 5 Desa Cicau,
Selatan Cikarang
Company Telephone 021 – 89833366 021 - 29577560 -
Number
Date of Joining February 15th, 2018 July 1st, 2014 March 1st, 2014
Date of Leaving Current October 30th, 2017 June 30th, 2014
Product Stamping Part, Dies and Masterbatches Metal Parts
Jigs

Company Type (e.g: Manufacture Manufacture Manufacture

Trading/
Manufacture)
Company Size 100 – 150 Employees 80 – 100 Employees 10 – 50 Employees

Position ISO Dept. Head Management Representative QA/QC Vice Executive

Reported To General Manager Director General Manager

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(HIAMS)AS-IB CANDIDATE APPLICATION FORM
Format Number : __/HR/__/__
PT Hitachi Automotive Systems Indonesia Human Resources Department

Total Member/ 2 Members. 0 2 Members

subordinate

Total Basic Salary RP. 8.500.000,- Rp. 12.500.000,- Rp. 4.500.000,-

Total Allowances Transport: Rp. 10.000/day Transport: Rp 20.000 -

(Named Transport Meal: Rp. 15.000/day Meal: Provided
Allowance, Meals
Allowances)
Others Benefits (e.g Bonus, THR, BPJS Bonus, THR, BPJS -
Bonus/ THR/ BPJS,
etc)

Reasons of Leaving - Office politics. New offering from

Plasticolors
Main Job - Ensure the compliance - Ensure the compliance of - Develop QMS.
Descriptions (JD) of QMS and EMS to QMS and EMS to - Develop quality control
(please write min 3 International Standard International Standard ISO plan & FMEA.
JD) ISO 9001:2015, IATF 9001:2008 and ISO - New product handling.
16949:2016 and ISO 14001:2004. - Control quality
14001:2015. - Leading transition to ISO performance.
- Internal audit (system 2015 version. - Develop procedure and
audit, manufacturing - Internal audit. work instructions.
process audit, and
product audit).
- Ensuring the compliance
of customer specific
requirements.

EDUCATION QUALIFICATION :

QUALIFICATION NAME OF SCHOOL/ UNV PASSING PERIOD MAJOR & IPK ACHIEVEMENT
GRADE
FROM TO
Master Degree

University Degree

Academy Degree

Polytechnic Degree Institut Pertanian Bogor 2014 2017 Chemical Analyst

(2.83)
Senior High School SMA N 4 Bogor 2000 2013 Sciences

Junior High School SLTP N 1 Ciomas 1997 2000

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(HIAMS)AS-IB CANDIDATE APPLICATION FORM
Format Number : __/HR/__/__
PT Hitachi Automotive Systems Indonesia Human Resources Department

Elementary School SD N 13 Muara Enim 1991 1997

PROFESSIONAL TRAINING/ SEMINARS/ COURSES

NAME OF TRAINING, PLACE & NAME OF PERIOD SKILSS, HAND ON
VENUE INSTITUTIONS FROM TO EXPERIENCE, OTHERS
DETAILS
IATF 16949:2016 Arrowhead Consulting 2019 2019 IATF 16949:2016
Requirements
Internal Audit Based on IATF Arrowhead Consulting 2019 2019 Internal Audit

ISO 14001:2015 SGS Academy 2018 2018 ISO 14001:2015

Requirements
Internal Audit Based on ISO SGS Academy 2018 2018 Internal Audit
14001:2015
ISO 9001:2015 Phytagoras Consulting 2016 2016 ISO 9001:2015
Requirements
Internal Audit Bases on ISO Phytagoras Consulting 2016 2016 Internal Audit
9001:215
SPC & FMEA Dynaplast 2010 2010 SPC & FMEA
LANGUAGE CAPABILITY
Language Capability (Native, Fluent, Language Proficiency Current
Business) Test Score Progress of
Language
Speak Write Listen TOEIC/ JLPT Others
TOEFL
English Business Business Business
Japanese X X X
Others Language ____________ X X X
REFERENCES (Not your Family/relative member)
1ST REFERENCE 2ND REFERENCE 3RD REFERENCE
Name of the Dimas Satria Rinaldy Trisvellyn Yezalna Zainal
Reference
Occupation Sales Manager QA Manager
Relationship Ex-colleague Ex-colleague
Address Tangerang Tangerang
Telephone Number 081219034906 -
May we discrete enquiries about you from them? Yes No
STRONG & WEAKNESS POINTS

STRONG POINT WEAKNESS POINTS (TO BE IMPROVED)

SKILL ISO 9001:2015, ISO 14001:2015, IATF Dies, Production Process, Business and
16949:2016, Internal Audit, 7 QC Tools, Marketing Process, Financial
Core Tools (APQP, PPAP, FMEA, SPC,
MSA), Adobe Photoshop, Ms. Excel

KNOWLEDGE Quality Assurance System, Environmental Tax, Human Phsycological, etc.

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(HIAMS)AS-IB CANDIDATE APPLICATION FORM
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PT Hitachi Automotive Systems Indonesia Human Resources Department

Regulation, RoHS 3, REACH, ANSI, etc.

ATTITUDE Open to new experience and knowledge, A little bit introvert, less detail, sometimes
positive thinking toward the others, joking too much.
friendly.

EMERGENCY CONTACT (Could be your Family/relative/ Colleagues member)

Name, Relationship, Address in Complete, Telephone Name, Relationship, Address in Complete, Telephone
Number (1st Emergency Contact): Number (2nd Emergency Contact):
Deni Agustina, Mother, Serang M. Leonardo, Brother, Tarakan
081298704976 085384398185

YOUR EXPECTATION TO PT HITACHI AUTOMOTIVE SYSTEMS INDONESIA ((HIAMS)AS-IB :

Basic Salary IDR 12.000.000 / month Transport IDR 50.000 / day
(Negotiable) Allowance
Bonus Est. 1 x basic salary /year Meals Allowance IDR 35.000 / day
THR 1 x basic salary /year Others BPJS or medical insurance
Allowance
Others Benefits:

CAREER 1 Year after joining: 3 years after joining:

EXPECTATION Permanent employee Promotion
Availability to Joining Immediately 1 month notice √ Not Specify, based on the reason
(HIAMS)AS-IB ____________________________
1. Any of your friend work in (HIAMS)AS-IB?, If yes, please name the person, and position/ station work?
No.

2. Are you preferred to join our Study Aboard or Overseas Training Program? (Sometime these programs will
take long term period of more than 14 days).
Yes

3. Are you preferred to be place in different Department (from your previous experience), or different
position that you are applying ? And are you accepted for Shift or Overtime working hours?
Yes

I, declare that the particulars given above are correct and true to the best of my knowledge
and belief and no attempt has been made by me to Conceal or withhold pertinent
information, which you are at liberty to verify at any time. I also understand that any
misrepresentation of facts in the application is sufficient cause for termination of my
services/ employment in PT Hitachi Automotive Systems Indonesia ((HIAMS)AS-IB), if

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(HIAMS)AS-IB Recruitment & Selection Systems & Procedures
(HIAMS)AS-IB CANDIDATE APPLICATION FORM
Format Number : __/HR/__/__
PT Hitachi Automotive Systems Indonesia Human Resources Department

appointed.
Place: ______________, Date: _____________, Applicant’s Signature: _______________

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