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4 Rekening Ponsel Bicimanca: — RICIMBNIAG APLIKASI PEMBUKAAN REKENING PONSEL / REKENING PONSEL ACCOUNT APPLICATIO. “ap Pd oma ted Pot tes Nom Posel/ Mobile Number?~! tiara bu Kandung / Mother‘ Maiden Name */. ‘Alamat fompat Tiggal (ka berbeds dengan entits}/ Curent Home Address if dlfeent from fo)” {ens identitas / Type of Identification * ekerjaan /Occupotion* {TP /SnaPasspoc/RIMS/ATAS) [iwireswaste /entrepreneur — ]Pensiun /ension (Ditbu rumah taneza / Housewife Cecawal swasta/ private Employee [-]Pegawal Neger / Ci Servant Dteineya other: asa Dengan menandstanganifermuliin, sya menyatakan bahwa data yang tercantum pads formulrin adalah benar dan sayesetuu dengan Syerat dan Ketentuan Rekening Poncel dan Sank. {8 signing thls form, 1 hereby acknowledge that ai dat inthis form Is accurate endl ogre a be bound by Rekening Ponsel and Bank’ Terms and Conditions. ‘TANDATANGAN / SIGNATURE DIIS! OLEH BANK / TO BE FILLED BY BANK INasabah / Account Owner Signature Daftar Kelengkapan Dokumen / Document Checklist Z7 Fotokop arta identtas /Photceopy of Card ede Cabong Peni / ranch Code: Diproses / Processed by Disetulu/ Approved by "Nema Lengkap /Full Nome: Tangeal/ Date: nee Nama Lengkap/ Ful Name Nama Lengkap /Full Nome Informa Tambahan /Adational information: “wangeal/ Dore Tana / Date, ‘SYARAT dan KETENTUAN REKENING PONSEL Tok Fe eh ws eC pg HOG rN MKF Rleague FD YN UN a Pe ey es a nk san mena eee asks yo amar pcehya cpl Speryston chal nner esa Sets a pel aya cpet nal nc lang Poa yr et dons alr pm wae ‘Ravel wang etek yar wing le RlaniegPova ak kboseein wt mambo. "as dan so Peeing Pao! eal lo site hss Bark yang era pga ng elton en eth kenny ara pik ket aa ua ta ea mast am prog pean lh Langs Pain Singaran erat nang Ung een Nama 2 tah 204 tang Lanne ein Sinan, Tina jg ah mma eee pate akon tate ep ase pre Ut (Pease Glee re am ate te Sng ‘put dain Nar Rela Pre yr eter cosh mr patel abe anger a sen Gl ‘2, Pombulaan key Pose! ep! etm erg eh eri elenng pa kan bum tarsal Pepa Go sla (asta) dept kan ma aang Baka dengan ‘meen ests Gott aon Sanka aan panna yng mayen eqs Gp MME NOR ek Pens yay een Ter oe Nesta ‘ged pastor Ca Mabe 4 onblaa Reterng Pe fp et nan oh fon pasts yo tan weniger Kenan van la ropes tan) engin Cole yarg kan manta torpor ag hk sta pate son Got on esa) en moka ests es meme pecan aun Pen Feo den Go ia eben ak ata ere Roig Prslyag teers aah axl yng atta pda st parr Reig Pons. 14 Pangan Go Mi ag No etn aga mean pte ekg Peel tin man date Peak Pa tenn Pare nlan deen Poi og Pres nesta oan an ears ati Pn. 5. as rng Pra yay Pita ae cc aeons be yn tn prerelease Peri Retry Pt ‘conan at Pegi Mobo stagnant Bk wa a Foren Pot opt menglae Roo Poed ait rar merggnan ston Goi Bak an kanarya tates dn rt ag bert taps Go Mee bets jig oa mare ca eso eg Fate en Pay Rs Pos PNET Fame oe! es tegtyadpat mompere jaan bt reskin eacar are bouplforasl a, one ea pangiinan ung pombe ghana srt 2 “Tel tala than ear Bark TM navn COs Mato (NN én fp loka dein ment pee nates ang ber, 5k on Par kr osetia ambulances aan Bk ak flan bstkeclanan apn nail a flan ys yar lapan eon ssa ark meres et yg sh dn nga ph. ‘4 tena Pel ening Foe! ening il, ak cect wat eran ek Ps dan hye an aephon hk a: ons Pan pata i wart penoga tp tau pk og lk Bark emma anoying pe vin Gr yagrearbalhan atlany bhp wala pega hast ak yang

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