Name/Nama
*
Order Number/Nomor Order
*
Use number only ex: 11557
Total Payment/Total Pembayaran
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Use number only ex: 90000
Date of Payment/Tanggal Pembayaran
*
DD MM YY (28 Mei 2013)
Bank Name/Nama Bank
*
ex: If you transfer from BCA please write "BCA"
Your Bank Account Name/Nama Akun Bank Anda
*
ex: Aulia Halimatussadiah
Bank Transfer to/Ditransfer ke
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Email/Email
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Verification
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