Translation of Kartu Tanda Penduduk

(Indonesian Identity Card)

Province
City

: Banten
: Tangerang Selatan (South Tangerang)

NIK (Citizen Number) : xxxxxxxxxxxxxxxxxxxxx

Name
: Zerosugar.
Place, Date of Birth
: Jakarta, 09 June 1975
Sex
: Male
Address
: Jl. Peluru Blok E-35 / 26
Neighborhood Ward
: 005 / 007
Married
Village Administrative Unit : Benda Baru
District
: Pamulang
City
: South Tangerang
Religion
: Moslem
Occupation
: Civil Servant
Valid thru
: 09 June 2015
On behalf of City Mayor
District Head
Signed
H. Abu Hurairah

Blood Type :
Marital Status

Translation of KARTU KELUARGA

(Family Registers)
No. 3603252505090022
Name of Head of Family

: Zerosugar

District

Address
Neighborhood Ward
Village Administrative Unit

: Jl. Peluru Blok E-35 / 26

: 005 / 007
: Benda Baru

City
: South Tangerang
Postal Code : 15416
Province
: Banten

N
o
1
1
2
3
4
5
No
10
1
2
3
4
5

Full Name

Citizen Number

Sex

Marital
Status
11

Relation

Nationality

12

13

Issued on 25-05-2009
Head
Copy I. Head of Family
II. RT (Neighborhood Ward)
signed
III. Sub District
IV. District
Hurairah

Place of
Birth
5

Date of
Birth
6

Religio
n
7

Immigration Document
Passport Number
KITA/KITAP
14
15

Head of Family

: Pamulang

Education

Occupation

Parents
Father
16

Mother
17

District

signed
Zerosugar.

H. Abu

Translation of Kutipan Akta Nikah

(Marriage Certificate)
(Page 1)

(Page 2)

Republic of Indonesia
Religion Affair Service

Day
: Monday
Date, month, year : 05 September 2011
Hijri Calendar
: 15 Jumadil Awal 1422
Time
: 08.00

District : Cimahi Selatan (South Cimahi)

City
: Tangerang Selatan
Province : Jawa Barat (West Java)
Page (3)
Witnessed by wali nikah
1.
2.
3.
4.
5.
6.

Name
: Bapaknya Luna Maya
Place, Date of Birth : Zurich, 05 - 11 - 1966
Nationality
: Indonesia
Religion
: Islam
Address
: Sukowati
Occupation
: Businessman

Act as a family representative, with the marriage gift of

27.9 grams of gold, and praying accessories, in cash.
Bandung, 06 September 2010
Religious Affairs Service Office of South Cimahi
Signed
I Gde Sekali

Hereby, is the marriage of

1.
2.
3.
4.
5.
6.
7.
8.

Name
: Zerosugar
Father
: H. Zerosin
Place, Date of Birth : Jakarta, 09 June 1975
Nationality
: Indonesia
Religion
: Islam
Address
: Jl. Cimanuk
Marital Status
: Not married
Occupation
: Civil Servant

with a woman, namely

1.
2.
3.
4.
5.
6.
7.
8.

Name
: Luna Maya
Father
: Bapaknya
Place, Date of Birth : Bali, 07 Juni 1974
Nationality
: Indonesia
Religion
: Islam
Address
: Sukowati
Marital Status
: Not married
Occupation
: Actress