Iqbal

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Personnel Records

Photo

Personal Information
Full Name / Nama Lengkap MOCHAMMAD IQBAL OKTAFIAN

Nick Name / Panggilan IQBAL Nationality INDONESIA

NIK / Identity Number 647104.061097.0001 Sex Male Female

Place & Date of Birth / TTL BALIKPAPAN , 06 OKTOBER 1997

Religion / Agama ISLAM


Covid-19 Vaccination/ 1st Dosage SINOVAC
Vaksinasi Covid-19
2nd Dosage SINOVAC

Booster
Current Address / Alamat Street JALAN JENDRAL AHMAD YANI RT 18 NO 07 GSU BALIKPAPAN TENGAH
Domisili
City / Regency BALIKPAPAN
Address (based on ID Card) / Street JALAN JENDRAL AHMAD YANI RT 18 NO 07 GSU BALIKPAPAN TENGAH
Alamat sesuai KTP
City / Regency BALIKPAPAN
Contact Information / Phone 1 6.28781E+12
Nomor HP dan Email aktif
6.28595E+12 E-Mail Address [email protected]
Phone 2
m

Educational & Employment History


Educational Background/ Name of the University / School SMA NEGERI 6 BALIKPAPAN

Pendidikan Terakhir Major or Specialty IPS

Period From 2012 End 2015

Academic Degree Acquired LULUS

Last Job Career/ Company PT RECON SARANA UTAMA

Pekerjaan Terakhir Period Apr-22 Position HELPER ELECTRICAL

Family Information
Marriage Status/ Status
Pernikahan Single Married Divorced

Parents/ Orang Tua No Name Status Age Profession

1 MOCH SANUDDIN Father 63 PENSIUNAN

2 FARIDA Mother 63 IRT

Spouse/ Istri/Suami No Name Status Age Profession

1
Children/ Anak No Name Status Age Profession

Other
Family Card Number/ No.
647104 02120 90040
KK
Bank Account Number 7825292543 Bank BCA

BPJS Kesehatan 0001 7923 89374 BPJS Jamsostek

NPWP 41.357.641.4-729.000

Emergency Contact
Name / Nama Kontak MOCH SANUDDIN Relationship ORANG TUA
Emergency (Saudara/
Keluarga/ Kerabat dekat) Address JALAN JENDRAL AHMAD YANRI RT18 NO 07 GSU BPPN TENGAH
Contact Information/ Nomor Phone 1 6.28595E+12
Kontak Emergency (Saudara/
Keluarga/ Kerabat dekat) Phone 2 6.28595E+12 E-Mail Address

Hereby I declare that all information above are truth

Balikpapan / ……………….. 2022

(__________________________)

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