FORMULIR SIUMK
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NO. KTP *
Nama Lengkap *
Jenis Kelamin *
Tempat, Tanggal Lahir ( Umur ) *
Alamat *
Status *
Pendidikan Terakhir *
Nama Usaha *
Alamat Usaha *
No. Telp *
NPWP *
Bentuk Usaha *
Kegiatan Usaha *
Jumlah Modal Usaha (Rp) *
Jumlah Tenaga *
Hasil Penjualan/ Tahun (Rp) *
Lampiran *
Required
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