INTERNATIONAL MILITARY STUDENT INFORMATION
1.
NAME OF NATIVE COUNTRY:
2. DATE PREPARED:
INDONESIA
4.
3. ARRIVAL DATE U.S.:
18 JULY 2007
NAME OF STUDENT
a. FULL NAME:
HOTMANGARADJA PANDJAITAN
b. NAME(S) BY WHICH INDIVIDUAL PREFERS TO BE ADDRESSED:
(1)
OFFICIAL CORRESPONDANCE
HOTMANGARDJA PANDJAITAN
(2)
ORALLY AT OFFICIAL GATHERINGS
HOTMA
c. FULL NAME IN NATIVE ALPHABET:
HOTMANGARADJA PANDJAITAN
d. VARIANTS, ALIASES OR NICKNAMES:
5.
WORKSHEET CONTROL NO.
6. IMS' SERVICE NUMBER (NRP#)
7. HOSTING SERVICE
28690
8.
RANK
a. ENGLISH LANGUAGE:
b. NATIVE LANGUAGE:
10. POSITION/BILLET
a. PRESENT POSITION:
DEPARTMENT OF
9. DATE OF RANK
MAJOR GENERAL
15 OCT 2006
MAYOR JENDERAL
DANPUSTERAD- COMMANDER FOR ARMY TERRITORY CENTER
b.
MILITARY ADDRESS:
c.
ANTICIPATED POSITION UPON RETURN TO COUNTRY:
d.
DATE OF DEPARTURE FROM US:
JL RAY SETU NO. 27 JAKATA TIMUR
11. IMS' BRANCH OF SERVICE:
(KESATUAN EX: SIPIL/ GOL, AD, AL, AU)
SAME AS ABOVE
12. SEX:
ARMY
MALE
13. DATE OF BIRTH:
14. PLACE OF BIRTH:
14 OCT 1953
15. HOME ADDRESS
KOMPLEK PATI AD F/14
PALEMBANG
16. TELEPHONE NUMBER
a. HOME:
b. WORK:
17. MARITAL STATUS:
021-8728063
021-8445837
d. EMAIL:
MARRIED
c. FAX:
021-8441966
e. MOBILE NO:
0818693050
18. CITIZENSHIP:
INDONESIAN
19. NATIONALITY:
INDONESIAN
20. RELIGIOUS AFFILIATION:
CHRISTIAN
21. TITLES, HONORIFICS:
GELAR KESARJANAAN
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INTERNATIONAL MILITARY STUDENT INFORMATION
22. HIGH ORDER DECORATIONS : (TANDA JASA)
BINGTANG KEP NARARYA
S.L. KESETIAAN XXIV
S.L. DWIJA SISTHA
S.L. NEGARA KAMBOJA
23. PHYSICAL DESCRIPTION:
a. HEIGHT (Inches):
b. WEIGHT (Pounds):
67.5
c. COLOR OF HAIR:
140
e. FACIAL HAIR:
d. COLOR OF EYES:
BLACK
BROWN
f. EXISTING MEDICAL CONDITIONS:
BLACK
GOOD
24. MEMBERSHIP IN ORGANIZATIONS:
25. PREFERENCES:
Food: __________________; Drink: _________________ ; Sport: _______________________ ;
Hobbies: ___________________________; Entertainment: _________________________
26. PUBLISHED WORKS - BY OR ABOUT:
TAHUN, JURUSAN, TEMPAT – LOKASI:
27. CIVILIAN EDUCATION:
28. LANGUAGES:
INDONESIA, ENGLISH
29. INTERNATIONAL TRAVEL/TRAINING:
US PROGRAM ATTENDED:
1981
1981
1986
KAMBOJA
MALYASIA
FIJI
ENGLAND
GERMAN
FRANCE
COAT IH
31. DATE OF PHOTO, IF SUBMITTED:
32. MILITARY/ CAREER SERVICE (FROM
YEARS
TAHUN, TEMPAT – LOKASI:
JAPAN
BOSNIA
AUSTRALIA
SINGAPORE
SELANDIA BARU
AFRICA
AMERICAL USA
VIETNAM
TAHUN, TEMPAT – LOKASI:
30. PHOTO SUBMITTED:
1978
E.EMENTARY SCHOOL, JUNIOR HIGH SCHOOL, SENIOR HIGH
RANK
YEAR TO
YEAR):
POSITION
UNIT/SCHOOL
LOCATION
2LT
DANTON- Platoon Leader
KOPASSUS
JAKARTA
1LT
PASI INTEL- Intel Officer
GROUP-1 PARAKO
JAWA BARAT
1LT
DANKI- Company Commander
YON-12 GROUP 1
JAWA BARAT
CAPT
DANDEN-2- Detachement
Commander
YON-22 GROUP-1
JAWA TENGAH
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INTERNATIONAL MILITARY STUDENT INFORMATION
YEARS
RANK
POSITION
UNIT/SCHOOL
LOCATION
1988
MAJ
KASI-1- Intel Officer
DEN 81
JAKARTA
1992
MAJ
WADAN- Executive Officer
DEN 81
JAKARTA
1994
LTC
PASI OPS – Operation Officer
SAT INTEL
JAKARTA
1996
COL
PAHLI POLKAM-
MABES TNI
JAKARTA
1997
COL
ATHAN- Defense Attache
2001
COL
DAN GROUP-3
GROUP-3
JAWA BARAT
2002
COL
DANREM
KOREM 163
BALI
2003
COL
PABAN OPSKIK
KODIKLATAD
BANDUNG
2004
BG
KADIS
DISPENAD
JAKARTA
2006
BG
WAASPAM- Deputy Assistant for
Security Staff Army
MABESAD
JAKARTA
2006
MG
DANPUS- Commander of Army
Territorial Center
PUSTERAD
JAKARTA
GERMAN
33. ADDITIONAL MILITARY DEPLOYMENT:
DATE FROM TO
RANK
POSITION
UNIT ASSIGNED
LOCATION
DETAIL OF
ASSIGNMENT
34. DEPENDENCY DATA
a. FULL NAME OF SPOUSE:
b. DATE OF BIRTH OF SPOUSE:
30 APRIL 1958
CATHARINA DWIASTUTI
c. PLACE OF BIRTH OF SPOUSE:
JAKARTA
f.
SPOUSES BACKGROUND:
d. CITIZENSHIP OF SPOUSE:
e. NATIONALITY OF SPOUSE
INDONESIAN
INDONESIAN
BACHELOR DEGREE
g. INFORMATION ON CHILDREN:
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INTERNATIONAL MILITARY STUDENT INFORMATION
NAME
SEX
DATE OF BIRTH
ABRAHAM PANDJAITAN
MALE
7 APRIL 1983
JEREMIAH PANDJAITAN
MALE
23 NOV 1986
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