Application Form

Personal Information

First Name *

Last Name

Email *

Phone *

Date of Birth *

KTP Number *

Upload KTP *

Gender *

Male

Female

Number of dependents *

E.g. Wife, Children, Parents, Siblings

Education *

Elementary school
Junior high school
Senior high school
3-year diploma
4-year diploma
Bachelor's degree
Master's degree
Doctorate or Ph.D
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Marital Status *

Belum Kawin

Kawin

Cerai Hidup

Cerai Mati

Current Residential Address

Address

Street Address *

RT *

RW *

Kelurahan *

Kecamatan *

City *

Province *

Postal/Zip Code *

Employment Information

Job Title *

Current Employer Name *

Employer Type *

Government

State-owned enterprises

Private job

Others

Employment Contract Type *

Permament

Non-Permanent

Years of experience in current company *

0-1 Year

1-2 Years

2-4 Years

4+ Years

Total Years of experience *

0-3 Years

3-6 Years

6-10 Years

10+ Years

Income, Expenses & Obligations

Fixed Monthly Salary *

Monthly Net Pay

Fixed Monthly Expenses *

Rent, Food, Travel, Education etc. (Please do not include any loan obligations)

Total Outstanding Amount of Unsecured Loans *

KTA, Online Loans, Credit Cards

Fixed Monthly Installment on Unsecured Loans *

KTA, Online Loans

Total Outstanding Amount of Secured Loans (if present)

Car Loan, Home Loan, KMG, KUR, Mortgage

Fixed Monthly Installment on Secured Loans (if present)

Car Loan, Home Loan, KMG, KUR, Mortgage

Personal Bank Information

Bank Account Number *

Please input salary account details

Bank Name *

Bank Account Holder Name *

Upload Bank Statement of last 3 months (Salary Account) *

Please upload in pdf format only. If you have individual 1-month bank statements, you can merge them using: Merge PDF

Salary Proof

Upload Salary Slip of last month *

Upload Salary Slip of second last month *

Upload Salary Slip of third last month *

Other Documents

Upload Selfie *

Upload your selfie holding KTP in your hand

Upload Annual Tax Document (SPT)

Any Additional Comments or Questions?

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