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1. Declarant Information: Full legal name, identification details, address, and contact information of the person making the declaration
2. Purpose of Declaration: Clear statement of the purpose and intended use of the financial declaration
3. Financial Statement Overview: Summary of total assets, liabilities, and net worth being declared
4. Income Declaration: Detailed declaration of all sources of income, including employment, business, investments, and other income streams
5. Asset Declaration: Comprehensive list and values of all assets including real estate, vehicles, investments, and bank accounts
6. Liability Declaration: List of all debts and financial obligations
7. Source of Funds Verification: Declaration of the origin of funds and assets listed
8. Tax Compliance Statement: Declaration of compliance with Indonesian tax regulations and reporting requirements
9. Truth and Accuracy Statement: Legal statement confirming the truth and accuracy of all declared information
10. Authentication Section: Space for notarization and official certification of the document
1. Foreign Currency Holdings: Declaration of any foreign currency holdings, required if the declarant holds significant foreign currency assets
2. Business Interests: Details of business ownership and interests, required if the declarant has business holdings
3. Trust and Beneficial Ownership: Declaration of trust arrangements and beneficial ownership positions, required if applicable
4. Dependent Financial Support: Details of financial support provided to dependents, required if declaring for visa or immigration purposes
5. Financial History: Statement of significant financial transactions in the past period, required for specific regulatory purposes
6. Third-Party Guarantees: Details of any financial guarantees provided by third parties, required if applicable
1. Schedule A - Bank Statements: Copies of relevant bank statements supporting the declaration
2. Schedule B - Asset Documentation: Supporting documents for major assets (property titles, vehicle registration, etc.)
3. Schedule C - Income Verification: Supporting documents verifying declared income sources
4. Schedule D - Tax Returns: Copies of relevant tax returns and tax payment receipts
5. Schedule E - Company Financial Statements: Financial statements for declared business interests, if applicable
6. Appendix 1 - Identity Documents: Copies of identification documents and any required certifications
7. Appendix 2 - Supporting Declarations: Any additional declarations or certifications from third parties
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Chief Financial Officer
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