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Nama

Jenis Kelamin

Nomor HP

Email

Nomor KTP

Nomor NPWP (Opsional)

Domisili (Kabupaten/Kota)

Pekerjaan

Pekerjaan (Lainnya)

Penghasilan Per Bulan

Penghasilan Per Bulan

Penghasilan Per Bulan

Jumlah Pinjaman

Tenor Pinjaman

Tenor Pinjaman (Lainnya)

Lokasi Properti

Jenis Properti

Jenis Properti (Lainnya)

Jenis Sertifikat

Kepemilikan Properti

Apakah anda memiliki kartu kredit aktif?

Ya Tidak

Apakah anda memiliki kartu kredit aktif?

Ya Tidak

Apakah properti anda sedang dijaminkan

Ya Tidak

Apakah anda memiliki rekening di Bank tersebut?

Ya Tidak

Bank Penerbit Kartu Kredit

Limit Kartu Kredit yang dimiliki?

Kode Referral (opsional)

Bank Penerbit Kartu Kredit

Limit Kartu Kredit yang dimiliki?

Jumlah Pinjaman

Tenor Pinjaman

Tenor Pinjaman (Lainnya)

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