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EITI Indonesia Reporting Form for Mineral and Coal Production Unit – 2009

Contract or Permit Type: KK/PKP2B/KP/IUPK/IUP

Filling Instructions:
– To be filled by the Company are included in the “Scope of the EITI Reporting Indonesia”.
– For all items reported revenue is revenue paid by coal producers are listed on a “cash basis”
– Please pay attention to “Explanation of Type Acceptance” at the end of this template