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03. Form 2 - Participant's Financial Summary

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17 views

03. Form 2 - Participant's Financial Summary

Uploaded by

kumalazetad
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Site Development for Grass Root Refinery Petrochemicals at Tuban (GRe@T) Project

No.: UM-003/PRPP-310/2024-S0
Dokumen Registrasi / Registration Documents

FORMULIR 2/FORM 2
IKHTISAR FINANSIAL PESERTA/PARTICPANT'S FINANCIAL SUMMARY
(Dicetak pada kop surat PESERTA/ Printed with PARTICIPANT’s letter head)

Company Name
Country of Domicile
Scope of business
Currency
Reporting Period January - December/April - March/other (specify)*

Trend Analysis (in Millions/Thousands/Full Amount)* (in Millions/Thousands/Full Amount)* (in Millions/Thousands/Full Amount)* (in Millions/Thousands/Full Amount)* (in Millions/Thousands/Full Amount)*
2019 2020 2021 2022 1st half 2023 audited or unaudited
1 Asset
Cash & Cash Equivalents
Restricted Cash
Short-term Investment
Cash - - - - -
Inventory
Trade Receivables-Related Parties
Trade Receivables-Third Parties
Trade Receivables-Other Parties
Trade Receivables - - - - -
Total Current Assets
Total Non Current Asset
Construction in Progress
Total Assets - - - - -

2 Liabililties & Equity


Trade Payables-Related Parties
Trade Payables-Third Parties
Trade Payables - - - - -
Total Current Liabilities
Total Liabilities
Total Equity
OK OK OK OK OK
3 Comprehensive Income
Revenue
Cost of sales
Gross Profit - - - - -
EBITDA - - - - -
Interest Expense
Depreciation & Amortization
EBIT - - - - -
Tax Expense (Income)
Net Profit
4 Others
Auditor's Opinion
Auditor
Auditor Category **
Auditor Domicile

Ditandatangani/ Signed:

_________________________
Nama/ Name : [cantumkan nama resmi pejabat yang berwenang/ state authorized person’s legal name]
Jabatan/ Title : [cantumkan jabatan pejabat yang berwenang/ state authorized person’s title]

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