Regol PT Solid Gold Berjangka

Data Pribadi Nasabah
Customer Personal Data

+

Tempat Lahir

Place Of Birth

Tanggal Lahir

Date Of Birth

Navigate forward to interact with the calendar and select a date. Press the question mark key to get the keyboard shortcuts for changing dates.

Jenis Kelamin

Sex

Laki-laki

Male

Perempuan

Female

Warga Negara

Nationality

WNI

Indonesian Citizens

WNA

Foreign Nationals

Nomor Pokok Wajib Pajak (NPWP)

Taxpayer Registration Number

Nama Ibu Kandung

Mother's Maiden Name

Status Perkawinan

Marital Status

Tidak Kawin

Single

Kawin

Married

Janda

Widow/Women

Duda

Widow/Man

Nama Istri / Suami

Name of Wife / Husband

Alamat Rumah

Kode Pos

Status Kepemilikan

Ownership Status

Pribadi

Personal

Keluarga

Family

Sewa/Kontrak

Lease/Contract

Lainnya

Other

Dalam Keadaan darurat, pihak yang dapat dihubungi
In case of emergency, the person who could be contacted

+

Nama

Name

Alamat

Address

Kode Pos

Post Code

No. Telepon

Telephone Number

Hubungan dengan anda

Relationship with you

Data Pekerjaan Nasabah
Customer Occupation Data

+

Nama Perusahaan

Company Name

Bidang Usaha

Type of Business

Jabatan

Position

Lama Bekerja

Working Experience

Tahun

Alamat Kantor

Office Address

Kode Pos

Post Code

Data Rekening Bank Nasabah Untuk Penarikan
Customer Bank Account for Withdrawal

+

Nama

Name

Nama Bank

Bank Name

Cabang

Branch

Nomor A/C

Account Number

Mata Uang

Currency

IDR

USD

Jenis Rekening

Account Type

Giro

Current Account

Tabungan

Saving

Lainnya:

Other

Dokumen Yang Dilampirkan
Attached Document

+

Foto Terkini

Recent Photo(Maksimal 20MB)

Drop files or click to upload

KTP/SIM/Paspor/KITAS

ID Card / Driving License / Passport / Limited Staying Permit in Indonesia(Maksimal 20MB)

Drop files or click to upload

Dokumen Lainnya Yang Dilampirkan

Permintaan Demo Account Sistem Perdagangan Alternatif (BILATERAL)

Data Pribadi NasabahCustomer Personal Data

Dalam Keadaan darurat, pihak yang dapat dihubungiIn case of emergency, the person who could be contacted

Data Pekerjaan NasabahCustomer Occupation Data

Data Rekening Bank Nasabah Untuk PenarikanCustomer Bank Account for Withdrawal

Dokumen Yang DilampirkanAttached Document

Data Pribadi Nasabah
Customer Personal Data

Dalam Keadaan darurat, pihak yang dapat dihubungi
In case of emergency, the person who could be contacted

Data Pekerjaan Nasabah
Customer Occupation Data

Data Rekening Bank Nasabah Untuk Penarikan
Customer Bank Account for Withdrawal

Dokumen Yang Dilampirkan
Attached Document