PRINT DATE

18/10/2011

10:32:02

01-11-2011

PERIOD FROM

TO

30-11-2011

LIST TAGIHAN PREMI UL

PREMI
TERTUNGGAK
NO POLIS

NAMA

ALAMAT

NO TELP

PLAN

PAY FREQ

TP

AGEN

TOTAL TAGIHAN

STU

RAJAWALI-1
1100237643

SUI LIE

Komp. Nagoya Point

L No. 1-2-3 Pasar

0778-452636

UF1

Half Yearly

1,200,000.00

0.00

0.00

1.200.000,00

0300009102

TJUNG DJUN KHIONG

Komplek Perumahan
Taman Seruni Indah

0778-462597

UF1

Half Yearly

2,000,000.00

1,000,000.00

15,000,000.00

18.000.000,00

1100325674

SAUT MT SIREGAR

Mekar Sari Blok D/40

Rt.005/005
Batam

0778-326040

UF1

Half Yearly

5,000,000.00

0.00

0.00

5.000.000,00

ORPHAN HO

0600080554

KIM HONG

Jl. Garuda No. 36 A

Rt.001/005 Kel.

0614143216

UF1

Quarterly

875,000.00

125,000.00

875,000.00

1.875.000,00

LINA

0600085247

SEA KOK HENG

Jl. Garuda No. 36 A

Rt.001/005 Kel.

0614143216

UF1

Quarterly

875,000.00

125,000.00

875,000.00

1.875.000,00

LINA

0600041888

KIT FONG

Bengkong Indah
Swadebi Blok G No.

UF1

Quarterly

750,000.00

0.00

750,000.00

1.500.000,00

LINA

1100253310

LEO CANDRA

Jl. Ombak No. 88 A

Rt.018
Dumai

076536139

UF1

Quarterly

600,000.00

0.00

0.00

600.000,00

0400002481

YUNUS

Orchird Park C2 280

Batam 29432

0778-462945

UF1

Quarterly

750,000.00

150,000.00

12,000,000.00

12.900.000,00

LINA

0400002285

DJAUW LIN

Taman Seruni Indah

Blok K No. 28

0778-462417

UF1

Quarterly

1,250,000.00

250,000.00

15,000,000.00

16.500.000,00

LINA

1100237627

MAMAN SURYANA

Bida Ayu Blok P No.

70 Rt.02/16

01536000477

UF1

Quarterly

750,000.00

0.00

0.00

750.000,00

0300009096

FO HIONG

Taman Seruni Indah

Blok G No.8 Rt.03/01

0778-463826

UF1

Quarterly

750,000.00

0.00

9,000,000.00

9.750.000,00

LINA

0600092161

KIM HONG

Jl. Garuda No. 36 A

Rt.001/005 Kel.

0614143216

UF1

Quarterly

875,000.00

125,000.00

875,000.00

1.875.000,00

LINA

0300008114

FO HIONG

Taman Seruni Indah

Blok G No.8 Rt.03/I

0778-463826

UF1

Quarterly

600,000.00

0.00

7,200,000.00

7.800.000,00

LINA

1100324783

LIM SWEE SENG

Tampines ST 41 Blk
411 05-241

6567835041

UF1

Quarterly

1,250,000.00

0.00

0.00

1.250.000,00

TIO JOE HOI

0600125093

LELY

JL. RAMBAI NO.84

DUMAI

UF1

Yearly

5,000,000.00

1,000,000.00

3,000,000.00

9.000.000,00

LINA

0600122609

ERNI

Jl. Kamboja No. 103

Dumai 28813

UF1

Yearly

2,500,000.00

500,000.00

3,000,000.00

6.000.000,00

LINA

0300008642

SUYANTO

Komplek Nagoya Hill

Ruko Mall Blok P

0778-7043389

UF1

Yearly

6,000,000.00

1,500,000.00

30,000,000.00

37.500.000,00

LINA

0300008633

EKAWATI

Komplek Nagoya Hill

Ruko Mall Blok P

0778-7043389

UF1

Yearly

6,000,000.00

1,500,000.00

37,500,000.00

45.000.000,00

LINA

0600127131

NAYAN

Budi Kemuliaan No.

168
Dumai 28813

UF1

Yearly

2,500,000.00

0.00

2,500,000.00

5.000.000,00

LINA

0600127033

FERI SAPRY

Jl. Ombak No. 90

ABC
Dumai

UF1

Yearly

5,000,000.00

1,000,000.00

16,000,000.00

22.000.000,00

LINA

0600126288

ALENG

Jl. Budi Kemuliaan

No. 168
Dumai

UF1

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

LINA

0600122144

ROSMINI

Jl. Sukajadi No. 9 F

Dumai 28812

UF1

Yearly

10,000,000.00

2,000,000.00

12,000,000.00

24.000.000,00

LINA

076531326

ORPHAN HO
LINA

ORPHAN HO

ORPHAN HO

PRINT DATE

18/10/2011

10:32:02

01-11-2011

PERIOD FROM

TO

30-11-2011

LIST TAGIHAN PREMI UL

PREMI
TERTUNGGAK
NO POLIS

NAMA

ALAMAT

NO TELP

PLAN

PAY FREQ

TP

AGEN

TOTAL TAGIHAN

STU

0600125226

TEK KHUAN

Jl. Sudirman No. 39

A
Dumai 28813

076537644

UF1

Yearly

3,100,000.00

500,000.00

3,600,000.00

7.200.000,00

LINA

0600125100

SANIBAR

Jl. Takari No. 267 Rt.

003
Dumai 28811

076532189

UF1

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

LINA

0600120794

DESMA SANTOSO

Jl. Jend. Sudirman

NO. 425
Dumai

076533966

UF1

Yearly

3,000,000.00

600,000.00

3,600,000.00

7.200.000,00

LINA

0600121067

AHONG

Jl. Jend. Sudirman

No. 425
Dumai

076533966

UF1

Yearly

2,500,000.00

0.00

2,500,000.00

5.000.000,00

LINA

0600132211

KOK TIE

Jl. Gajah Mada No.

223/109
Dumai

UF1

Yearly

3,000,000.00

600,000.00

6,600,000.00

10.200.000,00

LINA

0600125119

MAIMUNAH

Jl. S. Syarif Kasim

No. 68 Rt.001/-

UF1

Yearly

5,000,000.00

1,000,000.00

5,000,000.00

11.000.000,00

LINA

0600125084

ABIE

Jl. Rambai No. 84

Dumai 28811

076538283

UF1

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

LINA

0600127042

MERI

Jl. Jeruk No. 48

Dumai 28813

076534592

UF1

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

LINA

0600127122

ALENG

Jl. Budi Kemuliaan

No. 168
Dumai

UF1

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

LINA

0900066301

MARINI

Jl. Prof. M. Yamin

No. 168 Rt. 01

UF1A

Half Yearly

1,250,000.00

550,000.00

1,800,000.00

3.600.000,00

ABIE

1000107251

SELAMAT

JL.PROF M.YAMIN
NO.168 RT.001/-

UF1A

Half Yearly

2,000,000.00

1,000,000.00

3,000,000.00

6.000.000,00

RUSLI

0900179851

ATJAI SUARDI

Jl. Merdeka No. 8 Rt.

018/Dumai

UF1A

Half Yearly

2,400,000.00

1,100,000.00

3,500,000.00

7.000.000,00

RUDYANTO

1100338780

ASIP

Sawang No. 18
Tg. Batu 29662

UF1A

Half Yearly

3,500,000.00

0.00

0.00

3.500.000,00

TIO JOE HOI

0900169452

SELAMAT

JL.NANGKA
NO.98-A
DUMAI

UF1A

Quarterly

625,000.00

275,000.00

900,000.00

1.800.000,00

RUDYANTO

0800225488

LE KEOK

Jl. Hasanuddin Gg.

Langsat No.4A 019/-

UF1A

Quarterly

1,125,000.00

375,000.00

1,500,000.00

3.000.000,00

ABIE

1000022716

DAVID SOFIAN

Jl. Semangka No. 35

Dumai 28822

UF1A

Quarterly

2,000,000.00

1,000,000.00

3,000,000.00

6.000.000,00

RUDYANTO

0900063936

ANDI SUSANTO

Jl. S Parman
Rt.004/001 Tg. Batu

UF1A

Quarterly

625,000.00

275,000.00

900,000.00

1.800.000,00

RAHMAD

1000103421

ERITA/

RUMAH MAKAN
RINA RINI JL.DWI

077921170

UF1A

Quarterly

1,250,000.00

250,000.00

1,500,000.00

3.000.000,00

RAHMAD

1100291001

YIN YIN

Komp. Duta Mas

Cluster VI Florida

07786096838

UF1A

Quarterly

625,000.00

0.00

0.00

625.000,00

1000103430

SUHARDI

RUMAH MAKAN
RINARINI JL.DWI

UF1A

Quarterly

1,250,000.00

250,000.00

1,500,000.00

3.000.000,00

RAHMAD

0800019908

FITRI CANTIKA

Padang Panjang
Simpang Empat

UF1A

Quarterly

650,000.00

850,000.00

500,000.00

2.000.000,00

LINA

0800088137

SOK HUAN

Jl. Kesuma No. 70

Jaya Mukti
Dumai

076535723

UF1A

Quarterly

625,000.00

275,000.00

900,000.00

1.800.000,00

ABIE

0800164239

KIM KUAN

Jl. Natuna No. 445

Rt. 007/Dumai

076531674

UF1A

Quarterly

625,000.00

875,000.00

1,500,000.00

3.000.000,00

ABIE

076532744

ERWIMO PRIYO NUGROHO

PRINT DATE

18/10/2011

10:32:02

01-11-2011

PERIOD FROM

TO

30-11-2011

LIST TAGIHAN PREMI UL

PREMI
TERTUNGGAK
NO POLIS

NAMA

ALAMAT

TP

AGEN

TOTAL TAGIHAN

NO TELP

PLAN

PAY FREQ

STU

076533249

UF1A

Quarterly

750,000.00

450,000.00

1,200,000.00

2.400.000,00

ABIE

0800173372

DEWI

Jl. Ombak Gg.

Pinang No. 10

0900114703

CAROLINE PURNAMA SARI

Taman Kota Blok A4

No. 4
Batam

UF1A

Quarterly

625,000.00

125,000.00

750,000.00

1.500.000,00

DJONG SU KONG

0900114712

CAROLINE PURNAMA SARI

Taman Kota Blok A4

No. 4
Batam

UF1A

Quarterly

625,000.00

125,000.00

750,000.00

1.500.000,00

DJONG SU KONG

0900172609

SYAMSUR

Hotel Horizon Jl.

Ahmad Yani

076531781

UF1A

Quarterly

1,250,000.00

1,750,000.00

3,000,000.00

6.000.000,00

RUDYANTO

0900172618

SYAMSUR

Hotel Horizon Jl.

Ahmad Yani

076531781

UF1A

Quarterly

1,250,000.00

1,750,000.00

3,000,000.00

6.000.000,00

RUDYANTO

0900170551

TIE SUAN

Jl. Rambai No.84

Dumai 28812

UF1A

Quarterly

1,025,000.00

475,000.00

1,500,000.00

3.000.000,00

RUDYANTO

1000115790

YURNANI BINTI BURHAN

BENGKONG ABADI
II JL.GG.MERPATI I

UF1A

Quarterly

750,000.00

300,000.00

1,050,000.00

2.100.000,00

RAHMAD

1000103449

ERITA/

RUMAH MAKAN
RINARINI JL.DWI

077921170

UF1A

Quarterly

1,250,000.00

250,000.00

1,500,000.00

3.000.000,00

RAHMAD

1000103458

ERITA/

RUMAH MAKAN
RINA RINI JL.DWI

077921170

UF1A

Quarterly

1,250,000.00

250,000.00

1,500,000.00

3.000.000,00

RAHMAD

1000103734

ARFISESIYENTI

PERUM.YKB BLOK
B NO.08 RT.001/011

0778411371

UF1A

Quarterly

750,000.00

300,000.00

1,050,000.00

2.100.000,00

RAHMAD

1000248295

MAHASIN AMRI RIFAI

JL.KEPAU TUJUH
RT.024/- KEL.LUBUK

UF1A

Quarterly

875,000.00

625,000.00

1,500,000.00

3.000.000,00

NAYAN

1000269787

HARYANI

TOKO MAMPU JAYA

MOTOR JL.RAYA

UF1A

Quarterly

925,000.00

575,000.00

1,500,000.00

3.000.000,00

NAYAN

1100294960

HENDRY SUSANDRY

BAJU AJI PERMAI

KAV.LAMA

UF1A

Quarterly

1,250,000.00

0.00

0.00

1.250.000,00

RAHMAD

1100294978

DEWI

JL.OMBAK
GG.PINANG NO.10

UF1A

Quarterly

1,025,000.00

0.00

0.00

1.025.000,00

RUDYANTO

1100275318

FATMAWATI

DC mall Lt. Dasar

Blok B No.44 Jl.

UF1A

Quarterly

1,250,000.00

0.00

0.00

1.250.000,00

LENNY

1100354114

ANDRI

Jl. Sukajadi (P.

Diponegoro) No. 10

UF1A

Quarterly

625,000.00

0.00

0.00

625.000,00

ABIE

0700141788

ANDRI SATI SIREGAR

ANDRI SATI
SIREGAR APOTEK

UF1A

Quarterly

625,000.00

275,000.00

900,000.00

1.800.000,00

ABIE

0800227491

SUHAINI

Depot Air Bening Jl.

Takari No.57B

UF1A

Yearly

4,000,000.00

2,000,000.00

6,000,000.00

12.000.000,00

ABIE

0800223017

SO HUI

Jl. Nangka No.25

Dumai 28823

UF1A

Yearly

4,500,000.00

1,500,000.00

6,000,000.00

12.000.000,00

ABIE

1000264074

IKBAN

JL.PEMBANGUNAN
RT.018/DUMAI

UF1A

Yearly

8,250,000.00

3,750,000.00

12,000,000.00

24.000.000,00

NAYAN

0900176359

SAHIM

Jl. Sukajadi
(Diponegoro)

UF1A

Yearly

4,000,000.00

2,000,000.00

0.00

6.000.000,00

0700219030

AAN

Jl. Pertanian No. 14

(Kel. Jaya Mukti)

UF1A

Yearly

4,000,000.00

2,000,000.00

4,500,000.00

10.500.000,00

ABIE

1000259753

LAI HENG

JL.RAMBAI NO.84
DUMAI 28883

UF1A

Yearly

7,000,000.00

5,000,000.00

12,000,000.00

24.000.000,00

NAYAN

081372753889

076536036

0765439191

CHRISTIANA DWI R

PRINT DATE

18/10/2011

10:32:02

01-11-2011

PERIOD FROM

TO

30-11-2011

LIST TAGIHAN PREMI UL

PREMI
TERTUNGGAK
NO POLIS

NAMA

ALAMAT

NO TELP

PLAN

PAY FREQ

TP

AGEN

TOTAL TAGIHAN

STU

0900177427

MELISA

Jl. Sultan
Hasanuddin (Jl.

UF1A

Yearly

4,000,000.00

2,000,000.00

6,000,000.00

12.000.000,00

0800226565

NOVALIA

Jl. Nangka No.25

Dumai Batam 28812

UF1A

Yearly

2,500,000.00

1,100,000.00

3,600,000.00

7.200.000,00

ABIE

0800225460

BENNY

Toko Hari Dewi Jaya

Jl. P. Diponegoro

076532251

UF1A

Yearly

5,000,000.00

2,200,000.00

7,200,000.00

14.400.000,00

ABIE

0700202462

ANI

Jl. P. Diponegoro
No.12A ( Jl. Sukajadi

076535619

UF1A

Yearly

8,000,000.00

4,000,000.00

12,000,000.00

24.000.000,00

ABIE

0700219049

YENNY RAHMAT

Jl. Semangka Gg.

Semangka II No. 16

07657007898

UF1A

Yearly

5,000,000.00

1,000,000.00

3,000,000.00

9.000.000,00

ABIE

0700221154

ERDAWATY YUNAN

Jl. Sunaryo KM 04
No. 8 Rt.01/02 II

UF1A

Yearly

5,000,000.00

1,000,000.00

1,500,000.00

7.500.000,00

ERDAWATY YUNAN

0700222269

CHU TE GWAN

Komp.Baloi Mas Asri

Blk .Safire No.3

UF1A

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

CHU TE GWAN

0700225108

R FIRDAUS KURNIAWAN

Perum Anggrek Mas

Blok E No.3A Rt.004

UF1A

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

LINA

0700224209

CHU TE GWAN

Komp.Baloi Mas Asri

Blk Safire No.3

UF1A

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

CHU TE GWAN

0800224613

LETO

Toko Hari Dewi Jaya

Jl. P. Diponegoro

UF1A

Yearly

2,500,000.00

1,100,000.00

3,600,000.00

7.200.000,00

ABIE

0800225192

ALIANG

Jl. Nangka No.25

Dumai 28812

UF1A

Yearly

5,000,000.00

2,200,000.00

7,200,000.00

14.400.000,00

ABIE

0800223008

DEWI

Toko Hari Dewi Jaya

Jl. Diponegoro

076532251

UF1A

Yearly

5,000,000.00

2,200,000.00

7,200,000.00

14.400.000,00

ABIE

0800227482

SUHAINI

Depot Air Bening Jl.

Takari No.57B

076536036

UF1A

Yearly

4,000,000.00

2,000,000.00

6,000,000.00

12.000.000,00

ABIE

0800226556

WIYONO

Toko Bahari Jaya Jl.

Syekh Umar No.11

076534083

UF1A

Yearly

4,500,000.00

1,500,000.00

6,000,000.00

12.000.000,00

ABIE

0800228971

JHONSON CHANDRA

Depot Air Bening Jl.

Takari No.57B

076536036

UF1A

Yearly

4,000,000.00

2,000,000.00

6,000,000.00

12.000.000,00

ABIE

0800228981

JHONSON CHANDRA

Depot Air Bening Jl.

Takari No.57 B

076536036

UF1A

Yearly

4,000,000.00

2,000,000.00

6,000,000.00

12.000.000,00

ABIE

0800228990

JHONSON CHANDRA

Depot Air Bening Jl.

Takari No.57B

076536036

UF1A

Yearly

8,000,000.00

4,000,000.00

12,000,000.00

24.000.000,00

ABIE

0800229146

KONG TIAN

Jl. Berembang Gg.

Kedondong No.1 003/

UF1A

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

ABIE

0800229155

KONG HUI

Jl. Berembang Gg.

Kedondong No.1 003/

UF1A

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

ABIE

0800227240

NAPIYA

Toko Bahari Jaya Jl.

Syech Umar No.11

076534083

UF1A

Yearly

4,500,000.00

1,500,000.00

6,000,000.00

12.000.000,00

ABIE

0800228695

LIAN

Jl. Rambai No.18

002/- Rimba

077835033

UF1A

Yearly

4,500,000.00

1,500,000.00

6,000,000.00

12.000.000,00

ABIE

0900176331

SAHIM

Jl. Sukajadi
(Diponegoro) No.

0765439191

UF1A

Yearly

4,000,000.00

2,000,000.00

0.00

6.000.000,00

CHRISTIANA DWI R

0900176340

SAHIM

Jl. Sukajadi (
Diponegoro )

0765439191

UF1A

Yearly

4,000,000.00

2,000,000.00

0.00

6.000.000,00

CHRISTIANA DWI R

0778431533

0778431533

RUDYANTO

PRINT DATE

18/10/2011

10:32:02

01-11-2011

PERIOD FROM

TO

30-11-2011

LIST TAGIHAN PREMI UL

PREMI
TERTUNGGAK
NO POLIS

NAMA

ALAMAT

NO TELP

PLAN

PAY FREQ

TP

AGEN

TOTAL TAGIHAN

STU

0900177033

PATONAH

Jl. Kolam Air 01/02

Tg Batu Kota

UF1A

Yearly

5,000,000.00

1,000,000.00

6,000,000.00

12.000.000,00

RAHMAD

1000254612

LOSO

JL.BAMBU RT.018/DUMAI 28882

UF1A

Yearly

4,350,000.00

1,650,000.00

6,000,000.00

12.000.000,00

NAYAN

1000263175

HARIYANTO

JL.RAYA DUMAI
RT.016/- KEL.LUBUK

UF1A

Yearly

6,000,000.00

6,000,000.00

12,000,000.00

24.000.000,00

NAYAN

1000270518

SURYA WARNI

JL.TAKARI NO.267
RT.003/DUMAI

UF1A

Yearly

4,000,000.00

2,000,000.00

6,000,000.00

12.000.000,00

RUDYANTO

1000270527

ELLY

SALON SHELLA
JL.CEMPEDAK

UF1A

Yearly

4,000,000.00

2,000,000.00

6,000,000.00

12.000.000,00

AGI SUGIANTO

1000269428

SUSANTI

KEDAI KOPI RICKY

JL.CEMPEDAK

UF1A

Yearly

2,500,000.00

1,100,000.00

3,600,000.00

7.200.000,00

1000256690

HAIDA

JL.PEMBANGUNAN
RT.018/DUMAI

UF1A

Yearly

8,250,000.00

3,750,000.00

12,000,000.00

24.000.000,00

NAYAN

1000259762

NORHAYATI

JL.NERBIT BESAR
RT.015/- LUBUK

UF1A

Yearly

7,000,000.00

5,000,000.00

12,000,000.00

24.000.000,00

NAYAN

0700218963

FIOLINA SURYANI

Jl. Bintan Komp.

Perumahan BKR No.

UF1A

Yearly

2,500,000.00

2,500,000.00

240,304.00

5.240.304,00

0900176063

SAMSUDDIN

Toko Dumai Gipsum

Jl. S. Hasanuddin (Jl.

UF1A

Yearly

11,000,000.00

7,000,000.00

18,000,000.00

36.000.000,00

RUDYANTO

ABIE
RUDYANTO

PRINT DATE

18/10/2011

10:32:02

01-11-2011

PERIOD FROM

TO

30-11-2011

LIST TAGIHAN PREMI UL

PREMI
TERTUNGGAK
NO POLIS

NAMA

ALAMAT

NO TELP

PLAN

PAY FREQ

UF1A

Half Yearly

UF1A

TP

AGEN

TOTAL TAGIHAN

STU

RAJAWALI-2
1100132882

TIOE HUAT DE

PENGGILINGAN
PADI MARDI

3,000,000.00

1,500,000.00

4,500,000.00

9.000.000,00

TOMMY MARTIN

1000259548

ROBIN

MEGA LEGENDA
BLOK B3 NO.15

Quarterly

625,000.00

425,000.00

1,050,000.00

2.100.000,00

ROBIN

1100038263

FEBRIAYU PURWANTI TJIOE

BANDARA MAS
BLOK C5 NO.5

UF1A

Quarterly

800,000.00

250,000.00

0.00

1.050.000,00

ROCKY

1100135875

MARDIKI

PASAR CIPTA PURI

NO.34 OMBAK

UF1A

Quarterly

800,000.00

250,000.00

1,050,000.00

2.100.000,00

ORPHAN HO

1100112781

BAHRUL ULUM

JL.GARUDA SAKTI
KM 3,5 PERUM.

UF1A

Quarterly

625,000.00

275,000.00

900,000.00

1.800.000,00

BAHRUL ULUM

1100113027

LISA

RUKO KINTAM
BLOK F NO.2

0779431106

UF1A

Quarterly

750,000.00

150,000.00

900,000.00

1.800.000,00

ROHANI

1000261205

SARWIE

JL.JEND.A.YANI
NO.18-20

07617076835

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

SUANTO

1000258649

DONI YANTO

KOMP.BENGKONG
MAS BLOK A NO.1

07787223618

UF1A

Yearly

6,700,000.00

1,000,000.00

7,700,000.00

15.400.000,00

ALI SUSANTO

1000253722

TANTI WIDYANINGSIH

VILLA PESONA
ASRI BLOK A17

UF1A

Yearly

6,000,000.00

2,000,000.00

8,000,000.00

16.000.000,00

ROHANI

1000258470

DONI YANTO

KOMP.BENGKONG
MAS BLOK A NO.1

07787223618

UF1A

Yearly

2,500,000.00

1,300,000.00

3,800,000.00

7.600.000,00

1000251657

ROBIN

KOMP.MEGA
LEGENDA BLOK B3

07787495124

UF1A

Yearly

15,500,000.00

4,300,000.00

19,800,000.00

39.600.000,00

ROBIN

1000250220

SUHADI

JL.ANGKASA
GG.HARAPAN II

07617700168

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

SUANTO

1000270017

WELLA AGUSTINA

JL.CIDADAP
GIRANG BARU NO.8

0222013461

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

ERIYANTO

1100358207

LEE LEE

JL.MELATI NO.48
PEKANBARU 28000

UF1A

Yearly

18,000,000.00

0.00

0.00

18.000.000,00

SUANTO

1000251488

LISA

GRIYA MAS BLOK C

NO.01
BATAM

UF1A

Yearly

4,500,000.00

1,500,000.00

6,000,000.00

12.000.000,00

SUANTO

1000251666

HO AI GEK

RUKO KINTAMANI
BLOK F NO.2

UF1A

Yearly

8,000,000.00

4,000,000.00

12,000,000.00

24.000.000,00

SUANTO

1000253141

LILI

RUKO KINTAMANI
BLOK F NO.2

UF1A

Yearly

9,000,000.00

3,000,000.00

12,000,000.00

24.000.000,00

SUANTO

1000253259

LO PAT CAN

GRAHA NUSA
PERMAI BLOK B2

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

ALI SUSANTO

1000248910

TJING WANG

JL.TAMTAMA NO.19
PEKANBARU 28000

076137899

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

SUANTO

1000256770

ROBIN SUSANTO

TOKO MAS INDAH

JL.JEND.SUDIRMAN

076621163

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

SUANTO

1000255226

DONI YANTO

KOMP.BENGKONG
MAS BLOK A NO.1

07787223618

UF1A

Yearly

4,000,000.00

2,500,000.00

6,500,000.00

13.000.000,00

ALI SUSANTO

1000253796

LILIA

RUKO MAITRI
GARDEN II BLOK AA

UF1A

Yearly

8,000,000.00

2,000,000.00

10,000,000.00

20.000.000,00

LINA

07787495124

077931240

ALI SUSANTO

PRINT DATE

18/10/2011

10:32:02

01-11-2011

PERIOD FROM

TO

30-11-2011

LIST TAGIHAN PREMI UL

PREMI
TERTUNGGAK
NO POLIS

NAMA

ALAMAT

NO TELP

PLAN

PAY FREQ

TP

AGEN

TOTAL TAGIHAN

STU

1000252977

ARIFIN

PERUM.KINTAMANI
BLOK E NO.27

UF1A

Yearly

12,000,000.00

12,000,000.00

24,000,000.00

48.000.000,00

LINA

1000254532

ARIFIN

PERUM.KINTAMANI
BLOK E NO.27

UF1A

Yearly

12,500,000.00

11,500,000.00

24,000,000.00

48.000.000,00

LINA

1000254579

TANTI WIDYANINGSIH

VILA PESONA ASRI

BLOK A17 NO.3

UF1A

Yearly

6,000,000.00

2,000,000.00

8,000,000.00

16.000.000,00

ROHANI

1000249846

DIMIN

GRIYA MAS BLOK C

NO.01
BATAM

UF1A

Yearly

4,500,000.00

1,500,000.00

6,000,000.00

12.000.000,00

SUANTO

1000251479

LILIA

RUKO MAITRI
GARDEN II BKOK

UF1A

Yearly

10,000,000.00

5,000,000.00

15,000,000.00

30.000.000,00

LINA

1000250121

EDY

MITRA RAYA BLOK I

NO.81 RT.002/005

UF1A

Yearly

9,000,000.00

3,000,000.00

12,000,000.00

24.000.000,00

ALI SUSANTO

1000252903

WILLY AGUSTINUS
TANUWIHARJA

JL.CEMPAKA NO.65
RT.02/03

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

SUANTO

1000253339

LIWEN

KOMP.CENTER
VIEW BLOK G

UF1A

Yearly

9,000,000.00

3,000,000.00

12,000,000.00

24.000.000,00

ALI SUSANTO

1000253375

HENRY

JL.LINTAS DURI
PEKAN KM.80

UF1A

Yearly

6,000,000.00

2,000,000.00

8,000,000.00

16.000.000,00

ALI SUSANTO

1000253731

TANTI WIDYANINGSIH

VILLA PESONA
ASRI BLOK A17

UF1A

Yearly

6,000,000.00

2,000,000.00

8,000,000.00

16.000.000,00

ROHANI

1000251862

REBINA

PERUM.KINTAMANI
BLOK E NO.27

UF1A

Yearly

9,000,000.00

3,000,000.00

12,000,000.00

24.000.000,00

LINA

1000251675

NANI

KOMP GREEN
LAND BLOK C

07787227722

UF1A

Yearly

9,000,000.00

3,000,000.00

12,000,000.00

24.000.000,00

SUANTO

1000267272

PARMI

JL.TUANKU
TAMBUSAI NO.63

07618322168

UF1A

Yearly

8,000,000.00

4,000,000.00

12,000,000.00

24.000.000,00

ASNI

1000257392

DONI YANTO

KOMP.BENGKONG
MAS BLOK A NO.1

07787223618

UF1A

Yearly

2,500,000.00

1,300,000.00

3,800,000.00

7.600.000,00

1000270124

HENGKI

JL.BAMBU KUNING I
NO.99 RT.003/011

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

SUANTO

1000258504

REBINA

PERUM.KINTAMANI
BLOK E NO.27

UF1A

Yearly

9,000,000.00

3,000,000.00

12,000,000.00

24.000.000,00

LINA

1000258498

BUYUNG

KOMP.GRIYA MAS
BLOK D NO.3A

UF1A

Yearly

18,000,000.00

12,000,000.00

30,000,000.00

60.000.000,00

LINA

1000258433

HENRY

JL.LINTAS DURI
PEKAN KM 80

UF1A

Yearly

6,000,000.00

2,000,000.00

8,000,000.00

16.000.000,00

ALI SUSANTO

1000256994

NESIA KHOSASIH

RUKO PERMATA
NIAGA BLOK D

UF1A

Yearly

9,000,000.00

3,000,000.00

12,000,000.00

24.000.000,00

ANDY WILLIAM WIJAYA

1000261377

HENRY

JL.LINTAS DURI
PEKEN KM 80

UF1A

Yearly

6,000,000.00

2,000,000.00

8,000,000.00

16.000.000,00

ALI SUSANTO

1000258362

WATY

RUKO KINTAMANI
BLOK F NO.2

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

SUANTO

1000270821

LEE LEE

JL.MELATI NO.48
RT.02/05

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

SUANTO

1000270714

EDISON

JL.TUANKU
TAMBUSAI NO.63

UF1A

Yearly

4,500,000.00

1,500,000.00

6,000,000.00

12.000.000,00

ASNI

0778472745

0778432065

07787225800

ALI SUSANTO

PRINT DATE

18/10/2011

10:32:02

01-11-2011

PERIOD FROM

TO

30-11-2011

LIST TAGIHAN PREMI UL

PREMI
TERTUNGGAK
NO POLIS

NAMA

ALAMAT

NO TELP

TP

AGEN

TOTAL TAGIHAN

PLAN

PAY FREQ

STU

UF1A

Yearly

4,500,000.00

1,500,000.00

6,000,000.00

12.000.000,00

1000270705

EDISON

JL.TUANKU
TAMBUSAI NO.63

ASNI

1000257374

DONI YANTO

KOMP.BENGKONG
MAS BLOK A NO.1

07787223618

UF1A

Yearly

2,500,000.00

1,300,000.00

3,800,000.00

7.600.000,00

1000253974

ANDY WILLIAM WIJAYA

RUKO PERMATA
NIAGA BLOK D

0778432065

UF1A

Yearly

9,000,000.00

3,000,000.00

12,000,000.00

24.000.000,00

ANDY WILLIAM WIJAYA

1000261591

HERRY SUSANTO

JL.JAMBU NO.11B
RT.003/007

UF1A

Yearly

18,000,000.00

6,000,000.00

24,000,000.00

48.000.000,00

ASNI

1100215671

WALUYO

KOMP.BARU SEI
BINTI RT.004/013

UF1C

Quarterly

750,000.00

150,000.00

900,000.00

1.800.000,00

ROHANI

1100212769

EDI SUPRIYADI

SUNGAI LEKOP
BLOK A10 NO.6

UF1C

Quarterly

750,000.00

150,000.00

900,000.00

1.800.000,00

TET LOI DJONG

ALI SUSANTO