CV TKO PAM

Lokasi Kerja :
CHECKLIST KELENGKAPAN BERKAS
KTP
SIM A/B1
SIM C
KTA SATPAM
NPWP
BPJS KESEHATAN PAS PHOTO
BPJS KETENAGAKERJAAN 4x6
VAKSIN
IJAZAH SATPAM
IJAZAH SEKOLAH
SURAT KETERANGAN SEHAT PHOTO FULL BODY
SKBN 6x8
SKCK
SERTIFIKAT
SURAT PENGALAMAN KERJA
KARTU KELUARGA
SLIK OJK

A. BIODATA

NAMA :….....................................................................
TEMPAT LAHIR :….....................................................................
TANGGAL LAHIR :….....................................................................
AGAMA :….....................................................................
JENIS KELAMIN :….....................................................................
STATUS PERKAWINAN :…..................................................................... NIK KTP :….....................................................................
ALAMAT KTP :…..................................................................... NOMOR KK :….....................................................................
:…..................................................................... NPWP :….....................................................................
TITIK KOORDINAT :…..................................................................... MEMILIKI SIM : YA/TIDAK
ALAMAT DOMISILI :…..................................................................... JENIS SIM :….....................................................................
:…..................................................................... :….....................................................................
TITIK KOORDINAT :….....................................................................
NO. HP / WA :…..................................................................... MEDIA SOSIAL
KONTAK DARURAT EMAIL :….....................................................................
NAMA :…..................................................................... FACEBOOK :….....................................................................
NO.HP :…..................................................................... INSTAGRAM :….....................................................................
HUBUNGAN :…..................................................................... TWITTER :….....................................................................
ALAMAT :…..................................................................... TIKTOK :….....................................................................
B. KESEHATAN C. DATA SERAGAM
TINGGI BADAN :…..................................................................... UKURAN SERAGAM : BAJU : S / M / L / XL / 2XL / 3XL / 4XL
BERAT BADAN :…..................................................................... CELANA : S / M / L / XL / 2XL / 3XL / 4XL
GOL.DARAH :…..................................................................... TOPI : 55 / 56 / 57 / 58 59 / 60

UKURAN SEPATU PDH : 38 / 39 / 40 / 41 / 42 / 43 / 44 / 45 / 46

/ 47 / 48
NO. BPJS KESEHATAN :….....................................................................
RIYAWAT PENYAKIT :….....................................................................
KOMORBID UKURAN SEPATU OLGA : 38 / 39 / 40 / 41 / 42 / 43 / 44 / 45 / 46
SERTIFIKAT VAKSIN COVID19 / 47 / 48
VAKSIN 1 VAKSIN 2 BOOSTER 1 BOOSTER 2

D. PENDIDIKAN FORMAL E. PENDIDIKAN NON FORMAL SATPAM/SAFETY

SMA/SMK :…..................................................................... JENIS IJAZAH :….....................................................................
DIPLOMA I / II / III / IV :…..................................................................... NO IJAZAH :….....................................................................
STRATA I / II / III :…..................................................................... NO KTA :….....................................................................
NO. IJAZAH TERAKHIR :…..................................................................... STATUS KTA AKTIF / PROSES PERPANJANG / NON AKTIF
TGL.MASA BERLAKU KTA :….....................................................................
SERTIFIKASI LAIN LAIN :….....................................................................
…......................................................................
…......................................................................
F. KEAHLIAN / HOBI / PRESTASI
BIDANG KETERANGAN PRESTASI
OLAHRAGA
BELADIRI
KESENIAN / MC
KEAGAMAAN
BAHASA
G. RIWAYAT KEUANGAN
NAMA BANK :…..................................................................... MEMILIKI PINJAMAN : YA / TIDAK
NOMOR REKENING :…..................................................................... PERBANKAN JUMLAH PINJAMAN SISA PINJAMAN SISA TENOR
KPR
KKB(MOBIL / MOTOR)
Saya menyatakan bahwa data disampaikan adalah yang sebenarnya. Apabila KTA
dikemudian hari ditemukan data yang salah dan palsu maka saya bersedia KARTU KREDIT
menerima sanksi dari perusahaan sesuai dengan peraturan perusahaan yang LAIN-LAIN
berlaku. NON PERBANKAN JUMLAH PINJAMAN SISA PINJAMAN SISA TENOR
KOPERASI
Jakarta, …..…................. 2023 PEGADAIAN
PINJAMAN ONLINE
RENTENEER
PRIBADI
( …...................................... ) LAIN-LAIN