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About
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Indonesia
English
Hi,
Semi
S
Futuready Insurance
Futuready AJK
1. Insurance &Company Information
2. Customer Information
3. Address Information
4. Review &Confirmation
1. Insurance Product & Company Information
Category
Insurer Name
Product Name
Company Name
Month of Disbursement From
Please select the month of disbursement from. eg. 2020.12.01
Month of Disbursement To
Please select the month of disbursement to (usually last working day of the month). eg. 2020.12.31
Product Type
Please write the product type. eg. Individual Consumer/Modal Kerja
Company Client Name
Please enter BPR name. e.g. PT.BPR DAYA PERDANA NUSANTARA
Company Client Email
Please enter BPR email. e.g. branch@bprperdana.com
Loan ID
Please enter loan ID. e.g. 10010101401008077
2. Customer Information
Search customer
Search
These are searched customers. Please select customer.
Select Customer
Select
These are searched customers. Please select customer.
Identity Number
Select
KTP
e.g: 1028334657887
Customer Name
Please enter customer name.
Date of Birth
Date of Birth
Gender
Select
Male
Female
e.g: Male or Female
Age
Please enter customer age.
Email
Please enter customer email address.
Search Customer Job
Search
These are searched customer job.
Select Customer Job
Select
Please select customer job.
Disbursement Start Date
Please enter Disbursement Start-Date. eg. Today's Date
Tenor
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
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28
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41
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48
49
50
51
52
53
54
55
56
57
58
59
60
Please select the disbursement period 1-60 months.
Disbursement End Date
Please enter Disbursement End-Date. It depends on the tenor.
Disbursement Amount
Please enter total loan disbursement amount. e.g. 900000
3. Address Information
Search Postal Code
Search
Select Postal Code
Select
These are searched postal codes. Please select the postal code.
Address Type
Select
Home
Office
Province
Select
City / Kabupaten
Select
Kecamatan - Kelurahan / Desa
Select
Address
Address Detail
Country
Indonesia
Address
Please enter customer full address. eg. Jl. Raya Bogor No. 29 Mekarsari, Kec. Cimanggis, Kota Depok, DKI Jakarta 16952
Cellular Phone Number
+62
e.g: 085717440266
1. Insurance Product & Company Information
Category:
Insurer Name:
Product Name:
MJL Name:
Month From:
Month To:
Product Type:
Company Client Name:
CompanyClient Email:
2. Customer Information
Loan ID:
Customer Name:
Identity Number:
Date of Birth:
Age:
Gender:
Address:
Occupation:
Mobile Phone:
Email:
Disbursement Start:
Disbursement End:
Tenor:
Disbursement Amount:
Please fill in all input fields (Loan ID, Customer Name, KTP, Age, Address, Mobile Phone, Email, Amount...).
Acknowledgement
Category
Insurer Name
Company Name
Product Name
Product Type
Month Disbursement From
Month Disbursement To
BPR Name
BPR Email
Loan ID
Customer Name
Identity Number
Birthday
Age
Gender
Occupation
Mobile Phone
Email
Address
Disbursement Start
Disbursement End
Tenor
Disbursement Amount
Quote Number
Declining Contribute Rate
Declining Amount Contribution
Fixed Contribute Rate
Fixed Amount Contribution
Approved Loan Id
Confirm Rate Type
Select
Declining Rate
Fixed Rate
Please select confirm rate type.
Selected Contribute Rate
Selected Amount Contribution
Please check the data again.
I acknowledge that I have read, and do hereby accept the terms and conditions contained in this.
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