BERITA ACARA PENYERAHAN KENDARAAN

Cabang : KENDARI

Pada hari ini ______ tanggal __________ jam ______ di Kota __________ telah diterima 1 (satu) unit kendaraan karena Debitor dan/atau Saya telah WANPRESTASI.
Adapun data Kendaraan adalah sebagai berikut:
No Kontrak : 2211121229 No RAL : 0062RAL20221200025

Nama STNK : INDRIYANI No Polisi : DT 1184 JF

Nama Customer : INDRIYANI No Rangka : MHKA6GJ6JNJ148426

Merek / Type : CALYA No Mesin : 3NRH667710

Tahun : 2022 Warna : ABU-ABU METALIK

Komponen Diisi oleh Collector Diisi oleh Collateral Diisi saat Penebusan Komponen Diisi oleh Collector Diisi oleh Collateral Diisi saat Penebusan

OK NOK NA OK NOK NA OK NOK NA

OK NOK NA OK NOK NA OK NOK NA
KELENGKAPAN DAN ACCESSORIES
BODY KIRI
AC Kaca Pintu Belakang (Kiri)
Angka Kilometer (WAJIB
MENGISI NOTES) Kaca Pintu Depan (Kiri)

Ban Kaca Spion (Kiri)

Ban Cadangan Listplank (Kiri)

Bodi Strip Pintu Belakang (Kiri)
CD Player Pintu Depan (Kiri)
Console Box
Sun Roof
Dashboard
BODY BELAKANG
Dongkrak Bagasi / Box (untuk Pick Up)
Emblem Bemper Belakang
Fog Lamp Kaca Belakang
Kunci / Remote Lampu Mundur
Panel Instrument / Lampu Rem
Dashboard
Radio / Tape / CD Player Lampu Sign (Belakang)

Pintu Belakang
Seat / Jok
ENGINE COMPONENT
Spion Dalam
Engine
Steer
Gesekan No. Mesin
Tanduk
Gesekan No. Rangka
Tanggal STNK (WAJIB
MENGISI NOTES) Sistem Pendingin
Toolset / Dongkrak
Sistem Pengisian / AKI
Velg
Sistem Rem
BODY DEPAN
Komponen Diisi oleh Collector Diisi oleh Collateral Diisi saat Penebusan
Bemper Depan
YA TIDAK YA TIDAK YA TIDAK
Grill
KONDISI SERAH TERIMA MOBIL
Head Lamp
Kendaraan Hidup
Kaca Depan
Mobilisasi dengan Derek
Kap Mesin
STNK Ada
Lampu Sign (Depan)
Keur Ada
Wiper Depan
Komponen Diisi oleh Collector Diisi oleh Collateral Diisi saat Penebusan
BODY KANAN
Kilometer Kendaraan KM KM KM
Kaca Pintu Belakang
(Kanan) Keterangan Tambahan
Kaca Pintu Depan (Kanan)

Kaca Spion (Kanan/Kiri)

Listplank (Kanan/Kiri)

Pintu Belakang (Kanan)

Pintu Depan (Kanan)

Roof (Kanan)
* BAM Wajib diisi oleh Collector jika Kendaraan masuk Pool lebih dari H+1 dari tanggal serah terima Kendaraan oleh Customer

Berita Acara Mobilisasi (BAM*) :

Serah Terima dari Customer Serah Terima ke Collateral Mengetahui Penebusan Unit

Service Head /
Customer Collector AR Officer Collateral** AR Head Collateral Mgt** Mengerahkan Unit Penerima Unit

(------------------------) (------------------------) (------------------------) (------------------------) (------------------------) (------------------------) (------------------------) (------------------------)

___/___/_______ ___/___/_______ ___/___/_______ ___/___/_______ ___/___/_______ ___/___/_______ ___/___/_______ ___/___/_______

(1) Berkas asli disimpan Customer (harap membawa saat menebus kendaraan) ** Tanda Tangan Collateral, Collateral Mgt & SEH sesuai cabang di wilayah penitipan unit
(2) Salinan 1 disimpan PT Toyota Astra Financial Services (Branch)
(3) Salinan 2 disimpan Petugas Pool
Jangka waktu penyelesaian 7 hari sejak tanggal penarikan
 INSTALLMENT SCHEDULE
Branch : KENDARI Tenor : 60
Agreement No : 2211121229 Realization Date : 26/04/2022
Customer Name : INDRIYANI Overdue Days : 24
Outstanding AR : 213,948,000 OS LC Inst Amount : 190,176
Unit/Type/Color/Plate : TOYOTA CALYACALYA 1.2 G MT OS LC Admin Fee : 20,000
Color/License Plate : ABU-ABU METALIK/DT 1184 JF OS Inst Due Amount : 3,962,000
Cust Address : JL MAYJEN SUTOYO LORONG SERIGALA NO Amount To Be Paid : 6,172,176
32 F RT/RW009/005 TIPULU KENDARI
BARAT
Prepaid Amount : 4,000

Due Date Inst Amount Inst Paid Inst Paid OS AR LC LC Inst Amt LC Inst LC Admin LC Admin
Amount Date Days Paid Amt Fee Fee Paid

1 25/05/2022 3,962,000 3,962,000 11/06/2022 233,758,000 17 134,708 0 20,000 0

2 25/06/2022 3,962,000 3,962,000 20/07/2022 229,796,000 25 198,100 0 20,000 0

3 25/07/2022 3,962,000 3,962,000 24/08/2022 225,834,000 30 237,720 0 20,000 0

4 25/08/2022 3,962,000 3,962,000 24/09/2022 221,872,000 30 237,720 0 20,000 0

5 25/09/2022 3,962,000 3,962,000 30/10/2022 217,910,000 35 275,030 0 20,000 0

6 25/10/2022 3,962,000 3,962,000 24/11/2022 213,948,000 30 234,660 0 20,000 0

7 25/11/2022 3,962,000 0 - 209,986,000 24 190,176 0 20,000 0

8 25/12/2022 3,962,000 0 - 206,024,000 0 0 0 0 0

9 25/01/2023 3,962,000 0 - 202,062,000 0 0 0 0 0

10 25/02/2023 3,962,000 0 - 198,100,000 0 0 0 0 0

11 25/03/2023 3,962,000 0 - 194,138,000 0 0 0 0 0

12 25/04/2023 3,962,000 0 - 190,176,000 0 0 0 0 0

13 25/05/2023 3,962,000 0 - 186,214,000 0 0 0 0 0

14 25/06/2023 3,962,000 0 - 182,252,000 0 0 0 0 0

15 25/07/2023 3,962,000 0 - 178,290,000 0 0 0 0 0

16 25/08/2023 3,962,000 0 - 174,328,000 0 0 0 0 0

17 25/09/2023 3,962,000 0 - 170,366,000 0 0 0 0 0

18 25/10/2023 3,962,000 0 - 166,404,000 0 0 0 0 0

19 25/11/2023 3,962,000 0 - 162,442,000 0 0 0 0 0

20 25/12/2023 3,962,000 0 - 158,480,000 0 0 0 0 0

21 25/01/2024 3,962,000 0 - 154,518,000 0 0 0 0 0

22 25/02/2024 3,962,000 0 - 150,556,000 0 0 0 0 0

23 25/03/2024 3,962,000 0 - 146,594,000 0 0 0 0 0

24 25/04/2024 3,962,000 0 - 142,632,000 0 0 0 0 0

25 25/05/2024 3,962,000 0 - 138,670,000 0 0 0 0 0

26 25/06/2024 3,962,000 0 - 134,708,000 0 0 0 0 0

27 25/07/2024 3,962,000 0 - 130,746,000 0 0 0 0 0

28 25/08/2024 3,962,000 0 - 126,784,000 0 0 0 0 0

29 25/09/2024 3,962,000 0 - 122,822,000 0 0 0 0 0

30 25/10/2024 3,962,000 0 - 118,860,000 0 0 0 0 0

31 25/11/2024 3,962,000 0 - 114,898,000 0 0 0 0 0

32 25/12/2024 3,962,000 0 - 110,936,000 0 0 0 0 0

33 25/01/2025 3,962,000 0 - 106,974,000 0 0 0 0 0

34 25/02/2025 3,962,000 0 - 103,012,000 0 0 0 0 0

Printed by: -

Printed date: 12/19/2022 3:55:02 PM

 INSTALLMENT SCHEDULE
Due Date Inst Amount Inst Paid Inst Paid OS AR LC LC Inst Amt LC Inst LC Admin LC Admin
Amount Date Days Paid Amt Fee Fee Paid

35 25/03/2025 3,962,000 0 - 99,050,000 0 0 0 0 0

36 25/04/2025 3,962,000 0 - 95,088,000 0 0 0 0 0

37 25/05/2025 3,962,000 0 - 91,126,000 0 0 0 0 0

38 25/06/2025 3,962,000 0 - 87,164,000 0 0 0 0 0

39 25/07/2025 3,962,000 0 - 83,202,000 0 0 0 0 0

40 25/08/2025 3,962,000 0 - 79,240,000 0 0 0 0 0

41 25/09/2025 3,962,000 0 - 75,278,000 0 0 0 0 0

42 25/10/2025 3,962,000 0 - 71,316,000 0 0 0 0 0

43 25/11/2025 3,962,000 0 - 67,354,000 0 0 0 0 0

44 25/12/2025 3,962,000 0 - 63,392,000 0 0 0 0 0

45 25/01/2026 3,962,000 0 - 59,430,000 0 0 0 0 0

46 25/02/2026 3,962,000 0 - 55,468,000 0 0 0 0 0

47 25/03/2026 3,962,000 0 - 51,506,000 0 0 0 0 0

48 25/04/2026 3,962,000 0 - 47,544,000 0 0 0 0 0

49 25/05/2026 3,962,000 0 - 43,582,000 0 0 0 0 0

50 25/06/2026 3,962,000 0 - 39,620,000 0 0 0 0 0

51 25/07/2026 3,962,000 0 - 35,658,000 0 0 0 0 0

52 25/08/2026 3,962,000 0 - 31,696,000 0 0 0 0 0

53 25/09/2026 3,962,000 0 - 27,734,000 0 0 0 0 0

54 25/10/2026 3,962,000 0 - 23,772,000 0 0 0 0 0

55 25/11/2026 3,962,000 0 - 19,810,000 0 0 0 0 0

56 25/12/2026 3,962,000 0 - 15,848,000 0 0 0 0 0

57 25/01/2027 3,962,000 0 - 11,886,000 0 0 0 0 0

58 25/02/2027 3,962,000 0 - 7,924,000 0 0 0 0 0

59 25/03/2027 3,962,000 0 - 3,962,000 0 0 0 0 0

60 25/04/2027 3,962,000 0 - 0 0 0 0 0 0

Printed by: -

Printed date: 12/19/2022 3:55:02 PM

 KEMENTERIAN HUKUM DAN HAK ASASI MANUSIA
REPUBLIK INDONESIA
KANTOR WILAYAH SULAWESI TENGGARA
KANTOR PENDAFTARAN JAMINAN FIDUSIA

SERTIFIKAT JAMINAN FIDUSIA

NOMOR : W27.00032393.AH.05.01 TAHUN 2022

TANGGAL : 20-05-2022 JAM : 16:53:22

DEMI KEADILAN
BERDASARKAN KETUHANAN YANG MAHA ESA

PEMBERI FIDUSIA PENERIMA FIDUSIA

Nama : INDRIYANI Nama : PT TOYOTA ASTRA FINANCIAL
SERVICES
Alamat : JALAN MAYJEN SUTOYO NO 32 F, RT
009, RW 005, DESA/KELURAHAN Alamat : KOMPLEKS RUKO SULTAN ALAUDDIN
TIPULU, KECAMATAN KENDARI BLOK BA NO 19, RT 000, RW 000,
BARAT, KOTA KENDARI, PROVINSI DESA/KELURAHAN GUNUNG SARI,
SULAWESI TENGGARA, KODE POS KECAMATAN RAPPOCINI, KOTA
93122 MAKASSAR, PROVINSI SULAWESI
SELATAN, KODE POS 90221

Jaminan Fidusia ini di berikan untuk menjamin pelunasan utang PEMBERI FIDUSIA sejumlah Rp.
237.720.000,00 (dua ratus tiga puluh tujuh juta tujuh ratus dua puluh ribu rupiah)

Berdasarkan perjanjian

Pembiayaan Multiguna, yang dibuat dibawahtangan dan bermeterai cukup, tertanggal 26-04-2022 (dua
puluh enam April dua ribu dua puluh dua) Nomor 2211121229

Dengan nilai penjaminan sejumlah Rp 237.720.000,00 (dua ratus tiga puluh tujuh juta tujuh ratus dua
puluh ribu rupiah)

Obyek Jaminan Fidusia sesuai yang tertuang dalam Akta nomor 1529, tanggal 19 Mei 2022 yang

dibuat Notaris SYAMSURIANA, SH., M.KN, S.H., M.Kn. berkedudukan di SULAWESI SELATAN.

a.n. MENTERI HUKUM DAN HAK ASASI MANUSIA

REPUBLIK INDONESIA
KEPALA KANTOR WILAYAH SULAWESI TENGGARA

SILVESTER SILI LABA, S.H.

( 196701061993031001 )

Sertifikat Jaminan Fidusia ini di proses melalui Online System yang Aplikasinya diisi oleh Pemohon. Apabila dikemudian hari format isian tidak
sesuai dengan data yang sebenarnya maka Pemohon dapat menerima sanksi sesuai dengan peraturan perundang-undangan.
LOS/Setting/PersonalCustomerView

CUSTOMER-VIEW Customer Exposure Obligor Exposure

[-] Customer Main Information

Customer Model Name Employee Expired Date 31/12/9999

Customer No 0062C20220300160 Gender Female

Customer Name INDRIYANI Birth Place / Date KENDARI, 21/06/1998

ID Type KTP NPWP 950867036811000

ID No 7471056106980001 Mother Maiden Name WARIMA

MAIN DATA ADDRESS FAMILY JOB DATA CONTACT PERSON FINANCIAL DATA

OTHER ATTRIBUTE APPLICATION LISTING AGREEMENT LISTING CUSTOMER ADDRESS HISTORY

[-] Customer Main Data

Salutation Nationality WNI

Prefix Name Country

Full Name INDRIYANI Education D3

Customer Suffix Name Religion Islam

Nick Name Is VIP No

Is Premium No Premium Note

Marital Status Single SID No

Num Of Dependents 0 Customer Group

Num Of Residence (Last 3 Affiliation with

- No
Years) Multifinance

Num Of Education
0 Family Card Num -
Dependents

RIP No Other Asset Owned

[-] Contact Information

True / Verified by Sales
Mobile Phone 1 082226651657
Admin
Mobile Phone 2 -

Mobile Phone 3 -

Mobile Phone Verified By

-
Collector

E-Mail 1 indriyanikdi98@gmail.com

E-Mail 2 -
LOS/Setting/PersonalCustomerView

CUSTOMER-VIEW Customer Exposure Obligor Exposure

[-] Customer Main Information

Customer Model Name Employee Expired Date 31/12/9999

Customer No 0062C20220300160 Gender Female

Customer Name INDRIYANI Birth Place / Date KENDARI, 21/06/1998

ID Type KTP NPWP 950867036811000

ID No 7471056106980001 Mother Maiden Name WARIMA

MAIN DATA ADDRESS FAMILY JOB DATA CONTACT PERSON FINANCIAL DATA

OTHER ATTRIBUTE APPLICATION LISTING AGREEMENT LISTING CUSTOMER ADDRESS HISTORY

[-] Customer Address Listing

CUSTOMER
ADDRESS
BUILDING BUILDING PHONE PHONE DOES NOT
NO TYPE ADDRESS NOTES
OWNERSHIP TYPE 1 2 HAVE
NAME
FIXEDLINE
JL MAYJEN SUTOYO LORONG SERIGALA NO 32 F
Residence Perumahan 000-
1 RT 009 /RW 005, TIPULU, KENDARI BARAT, Milik Sendiri - Yes
Address / Cluster 000
KENDARI, 93122
Job JL MAYJEN SUTOYO RT 000 /RW 000, TIPULU, 000-
2 Lainnya - - Yes
Address KENDARI BARAT, KENDARI, 93122 000
Legal JL MAYJEN SUTOYO NO 32 F RT 009 /RW 005, 000-
3 Milik Sendiri - - Yes
Address TIPULU, KENDARI BARAT, KENDARI, 93122 000
LOS/Setting/PersonalCustomerView

CUSTOMER-VIEW Customer Exposure Obligor Exposure

[-] Customer Main Information

Customer Model Name Employee Expired Date 31/12/9999

Customer No 0062C20220300160 Gender Female

Customer Name INDRIYANI Birth Place / Date KENDARI, 21/06/1998

ID Type KTP NPWP 950867036811000

ID No 7471056106980001 Mother Maiden Name WARIMA

MAIN DATA ADDRESS FAMILY JOB DATA CONTACT PERSON FINANCIAL DATA

OTHER ATTRIBUTE APPLICATION LISTING AGREEMENT LISTING CUSTOMER ADDRESS HISTORY

[-] Job Data

Profession Name PEGAWAI SWASTA

Professional No

Job Position STAFF

Job Status CONTRACT

Company Name APOTEK BALI PERDANA

Internal Employee No

Industry Type Name JASA KEMASYARAKATAN DAN SOSIAL

Company Scale

Investment Type

Number Of Employee 0

Employment
01/01/2019
Establishment Date

[-] Job Address

Address JL MAYJEN SUTOYO

Rt / Rw 000 / 000

Zipcode 93122

Kelurahan TIPULU

Kecamatan KENDARI BARAT

City KENDARI

Phone 1 000 - 000

Phone 2 -

Phone 3 -

Fax -

[-] Job Address Info

Building Location Class

Rent Finish Date

Building Price Estimates 0.00

Building Stay Length 120

[-] Other Business

LOS\New Application\Asset View

ASSET DATA VIEW

Application No. 0062APP20220300055 Num Of Asset 1

Customer Name INDRIYANI Tenor 60

Product Offering Name MULTIGUNA NON PAKET DIC HK DP 20% Interest/Margin Type Fixed Rate

Currency IDR Installment Scheme Regular Fixed Installment

[-] Asset Info

Asset Name TOYOTACALYACALYA 1.2 G MT No. Mesin 3NRH667710

Main Supplier HADJI KALLA - KENDARI 3 No. Rangka MHKA6GJ6JNJ148426

Sales Person PARASANGIA DZAKWAN MERONDA License Plate No DT 1184 JF

SPK Valid No SPK No -

SALES PARASANGIA DZAKWAN MERONDA

BRANCH MANAGER MUHAMMAD ASRI

ADMINISTRATION HEAD RUSAINI SUDIRMAN

Asset Price 178,200,000.00 Asset Condition NEW

Down Payment 35,640,000.00 Asset Usage Pribadi

Notes

Asset for Online Transport No Usage Asset for Online Transport -

Market Price Standard 0.00 % Upping 0.000000 %

[-] Top Up Agreement

[-] Asset Attributes

MADE IN JAPAN

COLOR ABU-ABU METALIK

REGION Region3

CYLINDER

[-] Asset User

Username INDRIYANI

User Relationship CUST

[-] Asset Owner

Owner Name INDRIYANI

ID Type KTP

Owner ID No. 7471056106980001

Owner Relationship CUST

Owner Address JL MAYJEN SUTOYO NO 32 F

OwnerRt / OwnerRw 009 / 005

Owner Kelurahan TIPULU

Owner Kecamatan KENDARI BARAT

Owner City KENDARI

Owner Zipcode 93122

Asset Tax Date 26/03/2023

Notes

[-] Asset Location

Location Address JL MAYJEN SUTOYO NO 32 F

LocationRt / LocationRw 009 / 005

Location Kelurahan TIPULU

Location Kecamatan KENDARI BARAT

Location City KENDARI

Location Zipcode 93122

[-] Asset Accessories

[-] Asset Document List

 Customer Detail Task Detail

Task Id 1606133258 Assignment Date 14 Mar 2022 14:34

Application ID 0062APP20220300055 Retrieved Date
Form FSPH_NEW Submitted Date 18 Mar 2022 13:00
Branch SURVEY AREA 3 Field Person Name ERYC
Priority Normal Task Status Released
Note Direction: -. Source: DEALER Applic
ation No: 0062APP20220300055, Tot
al Unit(s): 1, Product Code: MULTIG
UNA NON PAKET , DP: 371 (20. %), Y
ears of Working: 3 year(s), Industry
Type: JASA KEMASYARAKATAN DA
N SOSIAL, Profession: PEGAWAI S
WASTA, CustName: INDRIYANI Spou
seName: (Personal) namaSO: ERYC
(HP:0) (noHPCustomer : 0822266516
57) (Company Name : APOTEK BALI
PERDANA) Unit: CALYA
Voice Note -

Answer History Task History

Question Label Submitted Answer

Validitas Alamat [ Alamat Sesuai, Customer Ditemukan/Dikenal ]

Foto Rumah Tampak Depan

Foto Lingkungan

Foto Akses Jalan

Foto Lainnya 1

Foto Lainnya 2

Alamat

Kelurahan

Kecamatan

RW

RT

Kodepos

Akses Rumah

Tipe Rumah

Lama Tinggal

Kondisi Rumah

Status Kepemilikan Rumah

Jumlah Tanggungan

Status Pernikahan

Jenis Pendapatan Lain

Jumlah Mobil Pribadi Yang Dimiliki

Pendapatan Lain

Tujuan Penggunaan Unit

Profesi

Jumlah Sumber Informasi

Sumber Informasi

Jumlah Tanggungan dalam pendidikan

Pekerjaan Ilegal [ Tidak ]

Apakah YBS Sering Didatangi Oleh Collector [ Tidak ]

Apakah ybs terindikasi aktif di Organisasi [ Tidak ]

Masyarakat

Sebutkan jika iya tidak

Notes ALAMAT YBS BETUL DAN DITEMUKAN(DARI ARAH MANDONGAN

SESUDAH PERTAMINA TIPULU ADA LORONG PERTAMA SEBELAH
KIRI YANG ADA GAPURA LORONG SERIGALA NAIK KE ATAS,,,DAPAT
PERTIGAAN PERTAMA SEBELAH KANAN MASUK KE SITU RUMAH
PALING UJUNG WARNA IJO ADA DI GOOGLE MASP LORONG
SERIGALA TIPULU)BETUL YBS TINGGAL DI LOASI,,,YBS DI KENAL DI
LINGKUNGAN DENGAN PANGGILAN MBA INDRI SEBAGAI SEORANG
WIRASWASTA YANG SUDAH TINGGAL DI ALAMAT TERSEBUT SEJAK
TAHUN 2000 DARI KECIL HINGGA SEKARANG,RUMAH YBS
PERMANENT DAN TERAWAT.SAYA MENDAPATKAN INFORMASI DARI
TETANGGA YBS

Landmark/Patokan

Kode Surveyor [D]

Negative Survey [ No ]

High Risk Business [ Tidak ]

High Risk Customer [ Tidak ]

High Risk Product [ Tidak ]