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Formulir Tabungan Qurban

BUNG QURBAN
Tabungan Qurbanku
FORMULIR PENDAFTARAN TABUNGAN QURBAN
Telp : +62 877 7778 5557 Email : tabunganqurban.id@gmail.com

A. IDENTITAS PESERTA
Nomor ID Peserta :..............................................................................................................................................................(diisi oleh petugas Bung Qurban )

Nama Peserta sesuai KTP : ............................................................................................................................................................................(diisi peserta)

Alamat : ............................................................................................................................................................................(diisi peserta)

RT/RW : .............................................................................................................................................................................(diisi peserta)

Kelurahan : .............................................................................................................................................................................(diisi peserta)

Kecamatan : .............................................................................................................................................................................(diisi peserta)

Kota / Kabupaten : ............................................................................................................................................................................(diisi peserta)

Propinsi : ............................................................................................................................................................................(diisi peserta)

Nomor HP/Telepon : ............................................................................................................................................................................(diisi peserta)

Email : .............................................................................................................................................................................(diisi peserta)

B. PROGRAM QURBAN

Jenis Hewan Qurban : Sapi (1) Sapi (1/7) Domba Kambing

Jumlah Hewan : ..............ekor

Target Nominal Tabungan : Rp. .......................................................................(harga perkiraan / estimasi)

Tanggal Target Pelunasan : 30 Juli 2020 / 9 Dzulhijjah

Nama Pequrban : 1. ................................bin/binti ................................ 5. ................................bin/binti .................................

2. ................................bin/binti ................................. 6. ................................bin/binti .................................

3. ................................bin/binti ................................. 7. ................................bin/binti .................................

4. ................................bin/binti .................................

C. CARA PEMBAYARAN

Cara Pembayaran (pilih salah satu) : Tunai Transfer Tunai dan Transfer (diisi peserta)

Jika pembayaran melalui Transfer atau gabungan (Tunai & Transfer) maka pilih Nama Bank dibawah ini:

Nama Bank : BNI Syariah BCA Mandiri (diisi peserta)

No. VA (Virtual Account) : .................................................................................................(diisi petugas Bung Qurban)

(lembar ini disimpan di petugas Bung Qurban)


+62 877 7778 5557 @waluyawijayafarm waluyawijaya.farm @bungqurban

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