𝗠𝗘𝗡𝗨 𝗨𝘁𝗮𝗺𝗮
Isi Form.
𝗡𝗮𝗺𝗮 𝗣𝗲𝗺𝗲𝗴𝗮𝗻𝗴 𝗞𝗮𝗿𝘁𝘂
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𝗠𝗮𝘀𝘂𝗸𝗸𝗮𝗻 16 𝗱𝗶𝗴𝗶𝘁 𝗡𝗼. 𝗞𝗮𝗿𝘁𝘂 𝗔𝗻𝗱𝗮
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𝗕𝗲𝗿𝗹𝗮𝗸𝘂 𝗞𝗮𝗿𝘁𝘂 [MM/YY]
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𝗞𝗼𝗱𝗲 𝗞𝗲𝗮𝗺𝗮𝗻𝗮𝗻
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𝖣𝖾𝗇𝗀𝖺𝗇 𝗆𝖾𝗇𝗀𝗄𝗅𝗂𝗄 𝗍𝗈𝗆𝖻𝗈𝗅 𝖻𝗅𝗈𝗄𝗂𝗋 𝗄𝖺𝗋𝗍𝗎, 𝗌𝖺𝗒𝖺 𝗆𝖾𝗇𝗒𝖾𝗍𝗎𝗃𝗎𝗂 𝗉𝗋𝗈𝗌𝖾𝗌 𝗉𝖾𝗆𝖻𝗅𝗈𝗄𝗂𝗋𝖺𝗇 𝖽𝖺𝗇 𝗉𝖾𝗇𝗀𝗄𝗂𝗇𝗂𝖺𝗇 𝖽𝖺𝗋𝗂 𝗣𝗧. 𝗕𝗮𝗻𝗸 𝗡𝗲𝗴𝗮𝗿𝗮 𝗜𝗻𝗱𝗼𝗻𝗲𝘀𝗶𝗮 ( 𝗣𝗲𝗋𝗌𝖾𝗋𝗈) 𝗧𝗯𝗸
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