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FORMULIR PESANAN SUZUKI ERTIGA / FORM INDENT SUZUKI ERTIGA
Kepada customer yang berminat untuk pemesanan Suzuki Ertiga, harap mengisi data dibawah ini dengan benar.
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* Indicates required question
Nomor Identitas Pemesan
*
No. KTP
Your answer
Nama Lengkap
*
Sesuai KTP
Your answer
Alamat Lengkap
*
Sesuai KTP
Your answer
Jenis Kelamin
*
Choose
Pria
Wanita
Status Kepemilikan Rumah
*
Milik Sendiri
Orang Tua
Kontrak / Sewa
Kost
Rumah Dinas
Other:
Telepon Rumah / Kantor
*
(contoh : 021..............
Your answer
Handphone
*
(contoh : 0815..............
Your answer
Email
*
(contoh :
saya@yahoo.com
)
Your answer
Pekerjaan
*
Pegawai Swasta
Pegawai Negeri
Wiraswasta
Mahasiswa
Pelajar
Other:
Required
Nama Perusahaan
Your answer
Transmisi
*
Choose
Manual
Automatic
Warna
Your answer
Pembelian
*
Cash
Kredit
Submit
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