Developing A Community Based Management Model of Lesan River Protection Forest
FILLED BY PROGRAM ADMINISTRATOR OF TFCA KALIMANTAN
Record Date: _________________________
Proposal Number: _______________________
Note: _________________________________________________________________________________ Result:
❒
Accepted
❒
Rejected
PART A – DATA OF APPLICANT 1. Name of organization:Operation Wallacea Trust (OWT) 2. Address: Taman Cimanggu, Jl. Akasia III Blok P VI No. 4 Bogor-Jawa Barat
3. Type of organization:
__
❒Foundation ❒Association❒University❒Others
Legality Document:Notary Deed Hamid Prioegi, SH No.: Deed No. 01 date 1 October 2004,Establishment ofOrganization:Date 1 October 2004. Adjustment of the institution legality according new foundation law: Notary Deed Ny. Yatni Sudiyatni, SH No. 05 date 19 August 2013.Concerning that the foundation name should be in Bahasa Indonesia, we adjust the name of Operation Wallacea Trust, so that its abbreviation is still OWT (because this name has become our brand), to become Operasi Wallacea Terpadu (OWT). With the change of deed, besides complying with the foundation law and regulation, the institution domicile which was formerly in Baubau, Buton, Southeast Sulawesi, was moved to Bogor, West Java. 4. No. NPWP Organisasi :03.317.511.8-404.00 5. Organization goal:Empowering community for conservation, empowermentof community and government in managing natural resources and environment 6. Person in charge: Dr. Edi PurwantoPosition:Chairman of Foundation 7. Telephone no.:
(office)
(HP)
(facs)
+62 251 8111145 HP:08129655233 8. Email: purwanto.owt@gmail.com
Website: www.owt.or.id
9. Management structure of organization (name of Governing Board, Executive Board, and Supervisory Board, and division name within the organization: