COPY REGULATION OF THE MINISTER OF FINANCE OF THE REPUBLIC OF INDONESIA NUMBER 162/PMK.07/2015 REGARDING

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1 COPY REGULATION OF THE MINISTER OF FINANCE NUMBER 162/PMK.07/2015 REGARDING GRANT FROM CENTRAL GOVERNMENT TO REGIONAL GOVERNMENT FOR THE PURPOSE OF FUNDING ASSISTANCE FOR POST-DISASTER REHABILITATION AND RECONSTRUCTION BY THE GRACE OF GOD ALMIGHTY THE MINISTER OF FINANCE, Considering : whereas in order to implement the provision of Article 22 paragraph (7) and Article 26 of Government Regulation Number 2 of 2012 regarding Regional Grant, it is necessary to stipulate the Regulation of the Minister of Finance regarding Grant from Central Government to Regional Government for the Purpose of Funding Assistance for Post-Disaster Rehabilitation and Reconstruction; In view of : Government Regulation Number 2 of 2012 regarding Regional Grant (Supplement Number 5272 to the State Gazette of the Republic of Indonesia Number 5 of 2012); BE IT HEREBY RESOLVED: To stipulate : REGULATION OF THE MINISTER OF FINANCE REGARDING GRANT FROM CENTRAL GOVERNMENT TO REGIONAL GOVERNMENT FOR THE PURPOSE OF FUNDING ASSISTANCE FOR POST-DISASTER REHABILITATION AND RECONSTRUCTION. CHAPTER I GENERAL REQUIREMENTS Article 1 As intended herein, the following terms shall have the corresponding meaning as referred to hereunder: 1. Central Government, hereinafter referred to as Government, shall mean the President of the Republic of Indonesia holding the power of Administration of the State Government the Republic of Indonesia as stipulated in the Constitution of the Republic of Indonesia of Regional Government shall mean Governor, Regent, or Mayor, and regional apparatus as the administrative element of regional government.

2 -2-3. State Budget Revenues and Expenditures, hereinafter abbreviated as APBN, shall mean annual financial planning of Central state government which is approved by the House of Representatives. 4. Regional Budget Revenues and Expenditures, hereinafter abbreviated as APBD, shall mean annual financial planning of Regional Government which is jointly discussed and approved by the Regional Government and the Regional Legislative Council, and stipulated under Regional Government Regulation. 5. Grant from Government to Regional Government, hereinafter referred to as Grant, shall mean granting with transfer of right over something from Government to Regional Government whose purpose has specifically been stipulated and carried out under agreement. 6. Regional Grant Agreement, hereinafter abbreviated as PHD, shall mean written agreement regarding grant between Government and Regional Government stipulated in an agreement or other equivalent form. 7. Budget User, hereinafter abbreviated as PA, shall mean an official having the authority to use the budget in state ministry/non-ministerial government agency/relevant agency. 8. Assistant Budget User, hereinafter abbreviated as PPA, shall mean organizational unit within the Ministry of Finance which is determined by the Minister of Finance and responsible for budget management. 9. Proxy of Budget User, hereinafter abbreviated as KPA, shall mean an official gaining power from PA to carry out part of the authority and responsibility of budget use in relevant state ministry/non-ministerial government agency. 10. Determination Letter of Grant shall mean a letter issued by the Minister of Finance or authorized officer to Regional Government containing the work and amount of Grant sourced from domestic revenue and/or foreign loan. 11. Work Plan and Budget, hereinafter abbreviated as RKA, shall mean document containing details of activities and amount of funding for 12 (twelve) months. 12. Expenditure Fund Plan or equivalent document, hereinafter referred to as RDP, shall mean budget planning document which includes the detail need of fund in the form of grant budget expenditure for the purpose of Funding Assistance for Post-Disaster Rehabilitation and Reconstruction which constitutes compilation of RKA.

3 Budget Execution Document/Allotment, hereinafter abbreviated as DIPA, shall mean a budget execution document which is prepared by PA/KPA. 14. National Disaster Management Authority, hereinafter abbreviated as BNPB, shall mean non ministerial government agency in compliance with the legislations which in this case shall act as the Executing Agency responsible for grant program for the purpose of Funding Assistance for Post-Disaster Rehabilitation and Reconstruction. 15. State Treasury Office, hereinafter abbreviated as KPPN, shall mean a vertical agency of the Directorate General of Treasury gaining power from and to carry out part of the functions of State General Treasurer. 16. Budget Execution Document, hereinafter abbreviated as DPA, shall mean document containing revenues and expenditures of Regional Government which is used as the basis of implementation by PA. 17. State General Treasury Account, hereinafter referred to as RKUN, shall mean an account where the state s money is kept as determined by the Minister of Finance as State General Treasurer to receive all state revenues and to pay all state expenditures in central bank. 18. Regional General Treasury Account, hereinafter abbreviated as RKUD, shall mean an account where the regional government s money is kept as determined by the Governor or Regent/Mayor to receive all regional revenues and to pay all regional expenditures in the designated bank. 19. Statement of Responsibility, hereinafter abbreviated as SPTJM, shall mean a statement issued by fund user declaring that fund user shall be responsible in formal and material respect to KPA for any activity funded with such fund. 20. Payment Instruction, hereinafter abbreviated as SPM, shall mean a document issued by PA/KPA or other appointed officer to disburse fund sourced from DIPA or other equivalent document. 21. Fund Disbursement Order, hereinafter abbreviated as SP2D, shall mean a warrant issued by Proxy of State General Treasurer for execution of expenditure at the expense of the State Budget based on SPM.

4 Disaster shall mean an event or a series of events threatening and disturbing the community life and livelihood, caused by natural and/or non-natural as well as human factors resulting in human fatalities, environmental damage, loss of material possessions, and psychological impact. 23. Rehabilitation shall mean repairing and recovering all aspects of public or community services to an adequate level at postdisaster areas particularly to normalize or achieve reasonable recovery of all aspects of government administration and community life at post-disaster areas. 24. Reconstruction shall mean rebuilding of all facilities and infrastructure, agencies at post-disaster areas, at government and community levels particularly aiming to enable growth and development in economic, social and cultural activities, enforcement of law and order, and revival of public participation. CHAPTER II FORM AND SOURCE OF GRANT Article 2 (1) Grant for the purpose of funding assistance for post-disaster Rehabilitation and Reconstruction shall be in cash. (2) Grant as referred to in paragraph (1) shall be sourced from domestic revenue. CHAPTER III GRANT BUDGET USER, ASSISTANT GRANT BUDGET USER, AND PROXY OF GRANT BUDGET USER Article 3 (1) The Minister of Finance as Grant PA shall have the authority over Grant budget execution. (2) In order to execute the authority as referred to in paragraph (1), Grant PA shall appoint: a. Director General of Fiscal Balance as Grant PPA; b. Director of Financing and Regional Capacity as Grant KPA.

5 -5- (3) PPA as referred to in paragraph (2) letter a shall have task and function as follows: a. reviewing RKA and supporting document submitted by KPA; b. preparing RDP based on Budget Ceiling determined by the Minister of Finance; and c. preparing accountability report of grant management for the purpose of funding assistance for post-disaster Rehabilitation and Reconstruction in compliance with the provision of legislations. (4) KPA as referred to in paragraph (2) letter b shall have task and function as follows: a. preparing RKA as well as the supporting document; b. preparing DIPA; c. appointing the officer responsible for issuing Payment Request Letter; d. appointing the officer responsible for examining Payment Request Letter and signing SPM; and e. preparing accountability report of grant management for the purpose of funding assistance for post-disaster Rehabilitation and Reconstruction in compliance with the provision of legislations. Article 4 (1) Grant PPA and KPA shall be fully responsible for distribution of grant fund for the purpose of funding assistance for postdisaster Rehabilitation and Reconstruction from RKUN to RKUD in compliance with the provision of legislations. (2) Governor/Regent/Mayor shall be responsible in formal and material respect for implementation and use of grant work fund for the purpose of funding assistance for post-disaster Rehabilitation and Reconstruction. CHAPTER IV GRANT PROVISION AND BUDGET Section One Grant Provision Article 5 Allocation of grant fund for funding assistance for post-disaster Rehabilitation and Reconstruction shall be stipulated in the APBN and/or APBN Amendment.

6 -6- Article 6 (1) The Head of BNPB shall propose the amount of grant and list of names of Regional Government proposed as grant recipient to the Minister of Finance, in this case Director General of Fiscal Balance, by virtue of copy of Budget Section-State General Treasurer (BA-BUN) Fund Reallocation Letter (SPP). (2) Director General of Fiscal Balance on behalf of the Minister of Finance shall issue Determination Letter of Grant to Regional Government respectively based on the proposal as referred to in paragraph (1). (3) Based on the Determination Letter of Grant as referred to in paragraph (2), Regional Grant Agreement is executed between the Minister of Finance or authorized officer and Governor/Regent/Mayor or authorized officer. (4) Based on the Determination Letter of Grant as referred to in paragraph (2), Governor/Regent/Mayor shall prepare RKA in conformity with the determined amount of grant. (5) In preparing RKA as referred to in paragraph (4), Governor/Regent/Mayor shall coordinate with BNPB. Section Two Preparation of Grant RDP Article 7 Result of Government Internal Supervisory Apparatus (APIP) review which is carried out at the proposal of BA fund use request shall be used as the basis to carry out review of APIP for BA Article 8 (1) RKA and all supporting document shall be submitted by KPA to PPA. (2) PPA shall prepare RDP based on: a. RKA prepared by KPA; b. BA BUN Fund Relocation Letter (SPP); and c. Determination Letter of Grant. (3) PPA shall submit RDP as referred to in paragraph (2) to the Director General of Budget for the process of preparation and ratification of DIPA. (4) Procedure of preparation and ratification of DIPA shall be implemented in compliance with the provision of legislations.

7 -7- Section Three Grant Budgeting in the Regional Budget Revenues and Expenditures Article 9 (1) Grant shall be carried out under the PHD between the Minister of Finance or authorized officer and the Governor/Regent/Mayor or authorized officer. (2) Grant shall be carried out in accordance with the regional finance management mechanism. Article 10 (1) Regional Government shall budget grant revenue to Other Revenues in the APBD. (2) Regional Government shall budget grant use as expenditure in the APBD based on Grant Validation Order (SPPH) and RKA, and record it in the DPA of Regional Disaster Management Authority or working unit determined as administrator of disaster management in the region. (3) In the event that PHD requires matching fund or other liabilities, Regional Government shall budget it in the APBD. Article 11 (1) Regional Government may amend the RKA due to: a. changes in the scope of work; and/or b. surplus of fund from the previous year. (2) RKA amendment as referred to in paragraph (1) shall be carried out in accordance with the guidelines stipulated by the Head of BNPB. (3) RKA amendment as referred to in paragraph (1) shall be reported to BNPB. (4) RKA amendment as referred to in paragraph (1) shall be contained in the APBD and stated in the DPA. Article 12 (1) In the event that SPPH is received after the stipulation of APBD, use of grant fund may be implemented after the Governor/Regent/Mayor amends the Regulation of Governor/ Regent/Mayor regarding the breakdown of APBD and inform such matter to the Chairman of the Regional Legislative Council.

8 -8- (2) Amendment to the Regulation of Governor/Regent/Mayor as referred to in paragraph (1) shall be stated in the DPA and afterwards budgeted in the APBD-Amendment. (3) In the event that SPPH is received after the stipulation of APBD- Amendment, use of grant fund may be implemented after the Governor/Regent/Mayor amends the Regulation Governor/ Regent/Mayor regarding the breakdown of APBD-Amendment and inform such matter to the Chairman of the Regional Legislative Council. (4) Amendment to the Regulation Governor/Regent/Mayor as referred to in paragraph (3) shall be stated in the DPA and afterwards reported in the Financial Statements of Regional Government. CHAPTER V DISTRIBUTION OF GRANT Article 13 (1) Distribution of Grant shall be carried out in accordance with the APBN and APBD mechanisms. (2) Distribution of Grant shall be carried out by transfer from RKUN RKUD. (3) Distribution of Grant as referred to in paragraph (1) and paragraph (2) shall be carried out in lump sum amount stated in PHD. Article 14 (1) Governor/Regent/Mayor shall submit a letter requesting consideration of the distribution to the Head of BNPB, in this case the Deputy of Rehabilitation and Reconstruction, by enclosing the following documents: a. DPA; b. Grant Use RKA; c. SPTJM; and d. Decree of the Head of the Region regarding appointment of treasury officer. (2) Based on the document as referred to in paragraph (1), BNPB shall carry out technical and substantive verification as the basis to issue letter of distribution consideration. (3) Letter of distribution consideration as referred to in paragraph (2) shall be submitted by BNPB to the Governor/ Regent/ Mayor.

9 -9- (4) SPTJM as referred to in paragraph (1) letter c shall be prepared by using the format as set out in Appendix I which forms an inseparable part hereof. (5) Letter of distribution consideration as referred to in paragraph (2) shall use the format as set out in Appendix II which forms an inseparable part hereof. Article 15 (1) For the purpose of Distribution of Grant, the Governor/Regent/Mayor or authorized officer shall submit a request for distribution of grant to the Director General of Fiscal Balance. (2) Request for distribution of grant as referred to in paragraph (1) shall be enclosed with supporting document as follows: a. SPTJM; b. Official Report of Payment (BAP); c. Letter of Grant distribution consideration from BNPB; and d. other documents required in the Regional Grant Agreement. (3) Request for distribution of grant as referred to in paragraph (1) shall be prepared by using the format as set out in Appendix III which forms an inseparable part hereof. (4) BAP as referred to in paragraph (2) letter b shall be prepared by using the format as set out in Appendix IV which forms an inseparable part hereof. Article 16 (1) Based on the request for distribution of grant, KPA shall issue and submit Payment Request Letter and SPM to KPPN. (2) Based on the SPM as referred to in paragraph (1), KPPN shall issue SP2D as the basis for fund transfer from RKUN to RKUD. (3) Regional Government shall deliver receipt to the Directorate General of Fiscal Balance no later than 10 (ten) days after receiving such fund.

10 -10- (4) Receipt as referred to in paragraph (3) shall be prepared by using the format as set out in Appendix V which forms an inseparable part hereof. (5) Procedure for issuing Payment Request Letter, SPM, and SP2D shall be implemented in compliance with the provision of legislations. Article 17 (1) Regional Government shall complete the post-disaster rehabilitation and reconstruction work no later than 12 (twelve) months after the transfer of fund from RKUN to RKUD is made. (2) The Minister of Finance, in this case the Director General of Fiscal Balance, may extend the implementation period of the work on recommendation from the Regional Government. (3) Recommendation for the extension of the implementation period of the work shall be submitted by the Regional Government no later than 1 (one) month prior to completion of relevant work. (4) Extension of implementation period as referred to in paragraph (2) shall be carried out after such recommendation of the Regional Government is approved by the Head of BNPB. Article 18 (1) Governor/Regent/Mayor shall be fully responsible for the work implementation and use of fund sourced from grant fund for the purpose of funding assistance for post-disaster Rehabilitation and Reconstruction. (2) In the event of surplus of fund after the work is completed and output is achieved, the remaining fund shall be deposited to the state s account. CHAPTER VI ADMINISTRATION AND REPORTING Article 19 (1) Directorate General of Debt and Risk Management shall represent the coordinator of preparation of accountability report of BA grant management in compliance with the provision under Regulation of the Minister of Finance regarding accounting system and financial reporting of grant.

11 -11- (2) PPA shall submit the accountability report to the Directorate General of Debt and Risk Management as the coordinator every biannually and annually. (3) PPA shall prepare financial statements at the level of Supporting Accounting Unit of State General Treasurer (UAPBUN) based on the result of combined data processing and financial statements at the level of Proxy of Budget User Accounting Unit-State General Treasurer (UAKPA-BUN) of the grant management. (4) In carrying its task of preparing the financial statements as referred to in paragraph (1), PPA shall form/appoint PPA Accounting Unit within the Directorate General of Fiscal Balance. (5) KPA shall organize the administration, accounting, and financial reporting of the implementation of distribution of Grant in compliance with the provision of legislations. (6) For the purpose of financial reporting, KPA shall prepare Financial Statements which include: a. Statement of Budget Realization; b. Balance Sheet; c. Notes to the Financial Statements; d. Statement of Government Operations (LO); and e. Statement of Changes in Equity (LPE). Article 20 Regional Government shall organize the administration, accounting and financial reporting of grant realization in compliance with the provision of legislations. Article 21 (1) Governor/Regent/Mayor or appointed officer shall submit quarterly work implementation report to the Head of BNPB, in this case Deputy of Rehabilitation and Reconstruction, with a copy to the Director General of Fiscal Balance. (2) Work implementation report as referred to in paragraph (1) shall be submitted no later than 10 (ten) business days after the relevant quarter ends. (3) Governor/Regent/Mayor or appointed officer shall submit final work implementation report to the Head of BNPB, in this case Deputy of Rehabilitation and Reconstruction, with a copy to the Director General of Fiscal Balance no later than 30 (thirty) days after the work implementation ends. (4) Quarterly Work Implementation Report as referred to in paragraph (2) shall be prepared by using the format as set out in Appendix VI which forms an inseparable part hereof.

12 Promulgated in Jakarta On August 24, 2015 MINISTER OF FINANCE -12- CHAPTER VII MONITORING and evaluation Article 22 The Ministry of Finance and BNPB shall carry out monitoring and evaluation of work implementation and use of grant fund for the purpose of funding assistance for post-disaster Rehabilitation and Reconstruction jointly or separately in accordance to their respective authority. CHAPTER VIII CLOSING Article 23 This Ministerial Regulation shall come into effect as of the date of its promulgation. For public cognizance, this Ministerial Regulation shall be announced by publishing it in the State Gazette of the Republic of Indonesia. Enacted in Jakarta on August 12, 2015 MINISTER OF LAW AND HUMAN RIGHTS OF MINISTER OF FINANCE, THE REPUBLIC OF INDONESIA, Signed. YASONNA H. LAOLY Signed. BAMBANG P. S. BRODJONEGORO STATE GAZETTE NUMBER 1263 OF 2015 Certified true copy Head of General Bureau on his behalf Head of Administration Dept. of the Ministry Signed and sealed GIARTO NIP

13 APPENDIX I REGULATION OF THE MINISTER OF FINANCE NUMBER 162/PMK.07/2015 REGARDING GRANT FROM CENTRAL GOVERNMENT TO REGIONAL GOVERNMENT FOR THE PURPOSE OF FUNDING ASSISTANCE FOR POST-DISASTER REHABILITATION AND RECONSTRUCTION MINISTER OF FINANCE -13- FORMAT OF STATEMENT OF RESPONSIBILITY (LETTERHEAD) STATEMENT OF RESPONSIBILITY The undersigned: Name:...(1) Position:...(2) in its capacity as User of Grant Fund in the Province/Regency/Municipality of...(3) for the work of Post-Disaster Rehabilitation and Reconstruction and in accordance with the Regional Grant Agreement No:...(4) dated...(5) hereby truthfully state that I shall be fully responsible for the correctness of calculation and determination of the amount as the use of grant fund in the amount of...(6) (...(7) rupiah) in compliance with the provision of legislations and state that such work of Post-Disaster Rehabilitation and Reconstruction has been allocated in the Budget Execution Document. This statement is made truthfully to be used accordingly...., date...(8)...(9) Sealed Stamp Duty of Rp (10)...(11) NIP....(12) Copy: 1....(13)

14 INSTRUCTION FOR COMPLETING THE STATEMENT OF RESPONSIBILITY NUMBER DESCRIPTION OF CONTENT (1) Fill in the name of user of grant fund (Governor or Regent/Mayor or authorized officer) (2) Fill in the position of user of grant fund(governor or Regent/Mayor or authorized officer) (3) Fill in the name of Regional Government receiving the grant (4) Fill in the number of Regional Grant Agreement (5) Fill in the date, month, year of Regional Grant Agreement (6) Fill in the requested value of distribution of grant (in figures) (7) Fill in the requested value of distribution of grant (in words) (8) Fill in the place, date, month, year of letter issuance (9) Fill in the position of the signatory (Governor /Regent/Mayor or authorized officer) (10) Fill in the signature (Governor /Regent/Mayor or authorized officer) (11) Fill in the name of the signatory (Governor/Regent/ Mayor or authorized officer) (12) Fill in the Civil Servant Registered Number of the signatory if any (Governor /Regent/Mayor or authorized officer) (13) Fill in the relevant state ministry/non ministerial government agency Certified true copy Head of General Bureau on his behalf MINISTER OF FINANCE, Head of Administration Dept. of the Ministry Signed and sealed GIARTO NIP Signed. BAMBANG P. S. BRODJONEGORO

15 APPENDIX II REGULATION OF THE MINISTER OF FINANCE NUMBER 162/PMK.07/2015 REGARDING GRANT FROM CENTRAL GOVERNMENT TO REGIONAL GOVERNMENT FOR THE PURPOSE OF FUNDING ASSISTANCE FOR POST-DISASTER REHABILITATION AND RECONSTRUCTION MINISTER OF FINANCE -15- FORMAT OF LETTER OF DISTRIBUTION CONSIDERATION (LETTERHEAD OF BNPB) LETTER OF DISTRIBUTION CONSIDERATION To The Governor/Regent/Mayor or authorized officer in Office Referring to your letter No....(1), dated...(2) regarding...(3) in accordance with the Regional Grant Agreement No....(4), dated...(5), after carrying out technical and substantive verification, hereby we declare that the document you have submitted is qualified and may be used as the attachment to the request for distribution of grant to the Ministry of Finance in the amount of Rp.... (6) (... (7) rupiah). Furthermore, you may proceed with further process in accordance with the predetermined procedure. Thank you for your attention. Sealed Jakarta,... (8) Deputy of Rehabilitation and Reconstruction,... (9) NIP....(10) Copy: 1....(11)

16 INSTRUCTION FOR COMPLETING THE FORMAT OF LETTER OF DISTRIBUTION CONSIDERATION NUMBER DESCRIPTION OF CONTENT (1) Fill in the number letter from the Regional Government (2) Fill in the date of the letter from the Regional Government (3) Fill in the subject of letter (4) Fill in the number of the Regional Grant Agreement (5) Fill in the date of the Regional Grant Agreement (6) Fill in the requested value of distribution of grant (in figures) (7) Fill in the requested value of distribution of grant (in words) (8) Fill in the place, date, month, year of letter issuance (9) Fill in the name of the signatory (10) Fill in the registered number of the signatory (11) Fill in the relevant state ministry/non ministerial government agency MINISTER OF FINANCE, Signed. BAMBANG P. S. BRODJONEGORO Certified true copy Head of General Bureau on his behalf Head of Administration Dept. of the Ministry Signed and sealed GIARTO NIP

17 APPENDIX III REGULATION OF THE MINISTER OF FINANCE NUMBER 162/PMK.07/2015 REGARDING GRANT FROM CENTRAL GOVERNMENT TO REGIONAL GOVERNMENT FOR THE PURPOSE OF FUNDING ASSISTANCE FOR POST-DISASTER REHABILITATION AND RECONSTRUCTION MINISTER OF FINANCE -17- FORMAT OF REQUEST FOR DISTRIBUTION OF GRANT (LETTERHEAD) Number :...(1) Attachment :...(2) Subject : Request for Distribution of Grant To The Director of Financing and Regional Capacity, Directorate General of Fiscal Balance Ministry of Finance of the Republic of Indonesia In its capacity as the Proxy of Grant Budget User Jln. Wahidin No. 1 Jakarta With reference to the Regional Grant Agreement No....(3), dated...(4), hereby we would like to submit a request for distribution of grant for the work of Post-Disaster Rehabilitation and Reconstruction for Fiscal Year...(5) in the amount of Rp....(6) (...(7) rupiah). The said grant fund shall be distributed to the Regional General Treasury Account Province/Regency/Municipality of...(8), in Bank...(9) under the Account name of...(10) Account No.:...(11). In order to support the abovementioned request for distribution of grant, hereby we enclose the supporting documents as follows: a) Statement of Responsibility ; b) Official Report of Payment; c) Letter of Distribution Consideration of Grant from BNPB; d)...(12) Hereby we conclude our request, and thank you for your attention...., date...(13)...(14) Sealed (15) Copy:...(16) NIP....(17)

18 (18)

19 NUMBER MINISTER OF FINANCE INSTRUCTION FOR COMPLETING THE REQUEST FOR DISTRIBUTION OF GRANT DESCRIPTION OF CONTENT (1) Fill in the ordinal number of the letter (2) Fill in the attached documents (3) Fill in the number of the Regional Grant Agreement (4) Fill in the date of the Regional Grant Agreement (5) Fill in the fiscal year of request for distribution of grant (6) Fill in the requested value of distribution of grant (in figures) (7) Fill in the requested value of distribution of grant (in words) (8) Fill in the name of the Regional Government (9) Fill in the name of beneficiary bank of the distribution of grant (10) Fill in the name of bank account of the Regional Government (11) Fill in the number of bank account of the Regional Government (12) Fill in other documents required in the grant agreement (13) Fill in the place, date, month, year of letter issuance (14) Fill in the position of the signatory (Governor/Regent/Mayor or authorized officer) (15) Fill in the signature (Governor /Regent/Mayor or authorized officer) (16) Fill in the name of signatory (Governor/Regent/Mayor or authorized officer) (17) Fill in the Civil Servant Registered Number of the signatory (Governor/Regent/Mayor or authorized officer) (18) Fill in the relevant state ministry/non ministerial government agency Certified true copy Head of General Bureau on his behalf MINISTER OF FINANCE, Head of Administration Dept. of the Ministry Signed and sealed GIARTO NIP Signed. BAMBANG P. S. BRODJONEGORO

20 APPENDIX IV REGULATION OF THE MINISTER OF FINANCE NUMBER 162/PMK.07/2015 REGARDING GRANT FROM CENTRAL GOVERNMENT TO REGIONAL GOVERNMENT FOR THE PURPOSE OF FUNDING ASSISTANCE FOR POST-DISASTER REHABILITATION AND RECONSTRUCTION MINISTER OF FINANCE -20- FORMAT OF OFFICIAL REPORT OF PAYMENT OFFICIAL REPORT OF PAYMENT (BAP) No. BAP-.../PK.4.2/HPD/20.. I. On this day, date of... month of..., year of..., we, the undersigned: II. Name :... Position : Grant Commitment-Maker Officer to Regional Government Address : Jl. Dr. Wahidin No. 1 Gedung Radius Prawiro Lt 12, Jakarta hereinafter referred to as the FIRST PARTY; Name :. Position : Regional General Treasurer of the Province/ Regency/Municipality of... Address :. hereinafter referred to as the SECOND PARTY. On the basis of: 1. a. Number and Date of PHD :... b. Amount of Grant in the PHD : Rp a. Number and Date of DIPA :... b. Amount of Grant (DIPA portion) :... c. Work Description : Disbursement Request... In words :... III. IV. The Second Party reserves the right to receive payment from the First Party in the amount of Rp.... (... rupiah). The Second Party agrees upon the said amount of payment of grant and to be transferred to the following Account: Number of Account :... Name of Account :... Name of Bank :... This Official Report of Payment (BAP) is made truthfully to be used accordingly. SECOND PARTY Regional General Treasurer Stamp Sealed Duty of... Rp NIP.... FIRST PARTY Commitment-Maker Officer Sealed... NIP.... Certified true copy Head of General Bureau on his behalf Head of Administration Dept. of the Ministry Signed and sealed GIARTO NIP MINISTER OF FINANCE, Signed. BAMBANG P. S. BRODJONEGORO

21 APPENDIX V REGULATION OF THE MINISTER OF FINANCE NUMBER 162/PMK.07/2015 REGARDING GRANT FROM CENTRAL GOVERNMENT TO REGIONAL GOVERNMENT FOR THE PURPOSE OF FUNDING ASSISTANCE FOR POST-DISASTER REHABILITATION AND RECONSTRUCTION MINISTER OF FINANCE -21- FORMAT OF GRANT RECEIPT (LETTERHEAD) Received from For the Purpose of : Director of Financing and Regional Capacity, Directorate General of Fiscal Balance, Ministry of Finance in its capacity as the Proxy of Grant Budget User for the Purpose of Post-Disaster Rehabilitation and Reconstruction : Distribution of Grant Expenditure for the work of Post- Disaster Rehabilitation and Reconstruction Details : RECEIPT DATE AMOUNT (Rp.) IN WORDS (1) (2) (3) The abovementioned fund is received by: Number of Account :...(4) Name of Account :...(5) Name of Bank :...(6)..., date...(7)...(8) Sealed Stamp Duty of Rp (9)...(10) NIP....(11)

22 INSTRUCTION FOR COMPLETING THE GRANT RECEIPT NUMBER DESCRIPTION OF CONTENT (1) Fill in the date the fund is received (2) Fill in the amount of received fund (in figures) (3) Fill in the amount of received fund (in words) (4) Fill in the number of beneficiary account (5) Fill in the name of beneficiary account (6) Fill in the name of beneficiary bank (7) Fill in the place, date, month, year of letter issuance (8) Fill in the position of the signatory, in this case the Regional General Treasurer (9) Fill in the signature of the Regional General Treasurer (10) Fill in the name of the signatory, in this case the Regional General Treasurer (11) Fill in the Civil Servant Registered Number of the signatory, in this case the Regional General Treasurer MINISTER OF FINANCE, Signed. BAMBANG P. S. BRODJONEGORO Certified true copy Head of General Bureau on his behalf Head of Administration Dept. of the Ministry Signed and sealed GIARTO NIP

23 APPENDIX VI REGULATION OF THE MINISTER OF FINANCE NUMBER 162/PMK.07/2015 REGARDING GRANT FROM CENTRAL GOVERNMENT TO REGIONAL GOVERNMENT FOR THE PURPOSE OF FUNDING ASSISTANCE FOR POST-DISASTER REHABILITATION AND RECONSTRUCTION The Repoerting Period :. Year :... NO. DESCRIP- TION OF WORK FUND CEILING LOCAT- ION VOLUME MINISTER OF FINANCE -23- FORMAT OF QUARTERLY WORK IMPLEMENTATION REPORT Period of Report (LETTERHEAD) :... WORK IMPLEMENTATION REPORT POST-DISASTER REHABILITATION AND RECONSTRUCTION WEIGHT NAME OF CONTRACTOR CONTRACT/WORK NO. & DATE OF CONTRACT QUARTER... VALUE OF CONTRACT/ WORK (RP) CEILING SURPLUS RP CONTRACT/ WORK REALIZATION FINANCIAL PHYSICAL TTB RP % % % REMAINING VALUE OF CONTRACT/ WORK = =11/ =6X13 15= I a a/y II b b/y III c c/y Total y 100% XXX XXX XXX RP NOTES..., date Sealed... NIP....

24 NUMBER MINISTER OF FINANCE INSTRUCTION FOR COMPLETING THE QUARTERLY WORK IMPLEMENTATION REPORT (1) Fill in the ordinal number DESCRIPTION OF CONTENT (2) Fill in the name of work in accordance with the Work Plan and Budget, including the revision thereto (3) Fill in the fund ceiling in accordance with the Work Plan and Budget, including the revision thereto (4) Fill in the location of work (5) Fill in the volume of work (6) Fill in the weight = percentage value (individual fund ceiling/total fund ceiling) (7) Fill in the name of vendor/contractor, leave it blank in case of non-contractual work (8) Fill in the number and date of contract agreement, leave it blank in case of non-contractual work (9) Fill in the value of contract or work. For non-contractual work the value is equal to the figures in ceiling. (10) Fill in the surplus value of ceiling or surplus of tender = (3)-(9) (11) Fill in the value of cumulative contract or non-contractual work payment realization up to the date of the report in Rupiah (12) Fill in the cumulative payment sum of the value of contract or non-contractual work up to the date of the report in % = (11:9xl00%) (13) Fill in the physical realization in %, in accordance with the contract or non-contractual work implementation report (14) Fill in the weighted physical realization = (6)x(l3) (15) Fill in the cumulative remaining value of contract or non-contractual work not yet paid up to the date of the report = (9)-(11) (16) Fill in other relevant additional information Certified true copy Head of General Bureau on his behalf Head of Administration Dept. of the Ministry Signed and sealed GIARTO NIP MINISTER OF FINANCE, Signed. BAMBANG P. S. BRODJONEGORO

25 Notes: MINISTER OF FINANCE Information shall include the following: 1. Ordinal number 2. Name of work in accordance with the Work Plan and Budget, including the revision thereto 3. Fund ceiling in accordance with the Work Plan and Budget, including the revision thereto 4. Location of work 5. Volume of work 6. Weight = Percentage value (individual fund ceiling/total fund ceiling) 7. Name of vendor/contractor, leave it blank in case of non-contractual work 8. Number and date of contract agreement, leave it blank in case of non-contractual work 9. Value of contract or work. For non-contractual work the value is equal to the figures in ceiling. 10. Surplus value of ceiling or surplus of tender = (3)-(9) 11. Value of cumulative contract or non-contractual work payment realization up to the date of the report in Rupiah 12. Cumulative payment sum of the value of contract or non-contractual work up to the date of the report in % = (11:9xl00%) 13. Physical realization in %, in accordance with the contract or non-contractual work implementation report 14. Weighted physical realization = (6)x(l3) 15. Cumulative remaining value of contract or non-contractual work not yet paid up to the date of the report = (9)-(11) 16. Other relevant additional information The report shall be prepared as informative as possible, which contains details of work and finances, which consists of plan, realization, obstacles and problems which have been followed up and which need to be followed up.