Sangatta, October 5th, 2017

Letter No : 445/870/1937/X/2017
To : Consulate - General of JAPAN
Jl. Sumatera No. 93, Surabaya,
Indonesia Phone: (62-31) 503-0008
Subject : Recommendation Letter for Visa Application

Dear Sir,

Herewith we would like to inform you that I am the undersigned,

Name : Drs. H. Mugeni, M.Si

Employee No : 19581019 198601 1 006
Position : 1st Assistant of District Government of KutaiTimur
(Asisten I PemerintahKabupatenKutaiTimur)

Certify that,

Name : dr. Hj. Anik Istyandari, M.P.H

Position : Director
Passport No. : B 0110368
Employee No. : 19680727 200212 2 0004

She ispermanent employee of Regional Public Hospital (Rumah Sakit Umum Daerah
Kudungga) in Sangatta, KutaiTimur, East Kalimantan who planning to have vacation to
your country on November 21st up to December 1st, 2017, with her family;

Name : Suwarti
Passport No. : B7783158
Relation : Mother

I acknowledged and guarantee that she and her family will not seek any employment or
permanent stay into your country and will return to Indonesia soon after their holiday trip
is completed. All kinds of expenses during the trip purpose are fully covered by her
personal account.

Kindly grant her and her family necessary entry visa to entry your country regarding her
vacation mentioned above. Your kind assistance will be very highly appreciated.

Sincerely yours,

Drs. H. Mugeni, M.Si

NIP. 195810 9 198601 1 006
Asisten I Setkab Kutai Timur
 Sangatta, October 5th, 2017

Letter No : 445/870/ /X/2017

To : Embassy of JAPAN
Jl. MH Thamrin No.24, Menteng
Jakarta Pusat 10350, Indonesia
Phone :+62-21 3192-4308
Subject : Recommendation Letter for Visa Application

Dear Sir,

Herewith we would like to inform you that I am the undersigned,

Name : Drs. H. Mugeni, M.Si

Employee No : 19581019 198601 1 006
Position : 1st Assistant of District Government of KutaiTimur
( Asisten I Pemerintah Kabupaten KutaiTimur )

Certify that,

Name : dr. Hj. Anik Istyandari, M.P.H

Position : Director
Passport No. : B 0110368
Employee No. : 19680727 200212 2 0004

She ispermanent employee of Regional Public Hospital (Rumah Sakit Umum Daerah
Kudungga) in Sangatta, KutaiTimur, East Kalimantan who planning to have vacation to
your country on November 21st up to December 1st, 2017, with her family;

Name : Suwarti
Passport No. : B7783158
Relation : Mother

I acknowledged and guarantee that she and her family will not seek any employment or
permanent stay into your country and will return to Indonesia soon after their holiday trip
is completed. All kinds of expenses during the trip purpose are fully covered by her
personal account.

Kindly grant her and her family necessary entry visa to entry your country regarding her
vacation mentioned above. Your kind assistance will be very highly appreciated.

Sincerely yours,

Drs. H. Mugeni, M.Si

NIP. 195810 9 198601 1 006
Asisten I Setkab Kutai Timur