polingorder.agensi.org
Open in
urlscan Pro
156.67.222.89
Public Scan
URL:
https://polingorder.agensi.org/
Submission: On May 23 via api from US — Scanned from SG
Submission: On May 23 via api from US — Scanned from SG
Form analysis 1 forms found in the DOM
<form id="wafmData_form2">
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-user fa-w-14" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="user" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512"
data-fa-i2svg="">
<path fill="currentColor"
d="M224 256c70.7 0 128-57.3 128-128S294.7 0 224 0 96 57.3 96 128s57.3 128 128 128zm89.6 32h-16.7c-22.2 10.2-46.9 16-72.9 16s-50.6-5.8-72.9-16h-16.7C60.2 288 0 348.2 0 422.4V464c0 26.5 21.5 48 48 48h352c26.5 0 48-21.5 48-48v-41.6c0-74.2-60.2-134.4-134.4-134.4z">
</path>
</svg><!-- <i class="fa fa-user"></i> --></span></div><input name="name-cust" type="text" class="form-control form-control-wafm" placeholder="Name Cust (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-user fa-w-14" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="user" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512"
data-fa-i2svg="">
<path fill="currentColor"
d="M224 256c70.7 0 128-57.3 128-128S294.7 0 224 0 96 57.3 96 128s57.3 128 128 128zm89.6 32h-16.7c-22.2 10.2-46.9 16-72.9 16s-50.6-5.8-72.9-16h-16.7C60.2 288 0 348.2 0 422.4V464c0 26.5 21.5 48 48 48h352c26.5 0 48-21.5 48-48v-41.6c0-74.2-60.2-134.4-134.4-134.4z">
</path>
</svg><!-- <i class="fa fa-user"></i> --></span></div><input name="nik" type="text" class="form-control form-control-wafm" placeholder="NIK (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-map-marked-alt fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="map-marked-alt" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M288 0c-69.59 0-126 56.41-126 126 0 56.26 82.35 158.8 113.9 196.02 6.39 7.54 17.82 7.54 24.2 0C331.65 284.8 414 182.26 414 126 414 56.41 357.59 0 288 0zm0 168c-23.2 0-42-18.8-42-42s18.8-42 42-42 42 18.8 42 42-18.8 42-42 42zM20.12 215.95A32.006 32.006 0 0 0 0 245.66v250.32c0 11.32 11.43 19.06 21.94 14.86L160 448V214.92c-8.84-15.98-16.07-31.54-21.25-46.42L20.12 215.95zM288 359.67c-14.07 0-27.38-6.18-36.51-16.96-19.66-23.2-40.57-49.62-59.49-76.72v182l192 64V266c-18.92 27.09-39.82 53.52-59.49 76.72-9.13 10.77-22.44 16.95-36.51 16.95zm266.06-198.51L416 224v288l139.88-55.95A31.996 31.996 0 0 0 576 426.34V176.02c0-11.32-11.43-19.06-21.94-14.86z">
</path>
</svg><!-- <i class="fa fa-map-marked-alt"></i> --></span></div><input name="tempat-tanggal-lahir" type="text" class="form-control form-control-wafm" placeholder="Tempat, Tanggal-Lahir (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-user fa-w-14" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="user" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512"
data-fa-i2svg="">
<path fill="currentColor"
d="M224 256c70.7 0 128-57.3 128-128S294.7 0 224 0 96 57.3 96 128s57.3 128 128 128zm89.6 32h-16.7c-22.2 10.2-46.9 16-72.9 16s-50.6-5.8-72.9-16h-16.7C60.2 288 0 348.2 0 422.4V464c0 26.5 21.5 48 48 48h352c26.5 0 48-21.5 48-48v-41.6c0-74.2-60.2-134.4-134.4-134.4z">
</path>
</svg><!-- <i class="fa fa-user"></i> --></span></div><input name="alamat-lengkap-kel-kec-" type="text" class="form-control form-control-wafm" placeholder="Alamat Lengkap, Kel,Kec,Kota. (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-whatsapp fa-w-14" aria-hidden="true" focusable="false" data-prefix="fab" data-icon="whatsapp" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 448 512" data-fa-i2svg="">
<path fill="currentColor"
d="M380.9 97.1C339 55.1 283.2 32 223.9 32c-122.4 0-222 99.6-222 222 0 39.1 10.2 77.3 29.6 111L0 480l117.7-30.9c32.4 17.7 68.9 27 106.1 27h.1c122.3 0 224.1-99.6 224.1-222 0-59.3-25.2-115-67.1-157zm-157 341.6c-33.2 0-65.7-8.9-94-25.7l-6.7-4-69.8 18.3L72 359.2l-4.4-7c-18.5-29.4-28.2-63.3-28.2-98.2 0-101.7 82.8-184.5 184.6-184.5 49.3 0 95.6 19.2 130.4 54.1 34.8 34.9 56.2 81.2 56.1 130.5 0 101.8-84.9 184.6-186.6 184.6zm101.2-138.2c-5.5-2.8-32.8-16.2-37.9-18-5.1-1.9-8.8-2.8-12.5 2.8-3.7 5.6-14.3 18-17.6 21.8-3.2 3.7-6.5 4.2-12 1.4-32.6-16.3-54-29.1-75.5-66-5.7-9.8 5.7-9.1 16.3-30.3 1.8-3.7.9-6.9-.5-9.7-1.4-2.8-12.5-30.1-17.1-41.2-4.5-10.8-9.1-9.3-12.5-9.5-3.2-.2-6.9-.2-10.6-.2-3.7 0-9.7 1.4-14.8 6.9-5.1 5.6-19.4 19-19.4 46.3 0 27.3 19.9 53.7 22.6 57.4 2.8 3.7 39.1 59.7 94.8 83.8 35.2 15.2 49 16.5 66.6 13.9 10.7-1.6 32.8-13.4 37.4-26.4 4.6-13 4.6-24.1 3.2-26.4-1.3-2.5-5-3.9-10.5-6.6z">
</path>
</svg><!-- <i class="fab fa-whatsapp"></i> --></span></div><input name="tlp-wa" type="text" class="form-control form-control-wafm" placeholder="Tlp/Wa (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-user fa-w-14" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="user" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512"
data-fa-i2svg="">
<path fill="currentColor"
d="M224 256c70.7 0 128-57.3 128-128S294.7 0 224 0 96 57.3 96 128s57.3 128 128 128zm89.6 32h-16.7c-22.2 10.2-46.9 16-72.9 16s-50.6-5.8-72.9-16h-16.7C60.2 288 0 348.2 0 422.4V464c0 26.5 21.5 48 48 48h352c26.5 0 48-21.5 48-48v-41.6c0-74.2-60.2-134.4-134.4-134.4z">
</path>
</svg><!-- <i class="fa fa-user"></i> --></span></div><input name="name-cust" type="text" class="form-control form-control-wafm" placeholder="Name Cust (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-map-marked-alt fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="map-marked-alt" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M288 0c-69.59 0-126 56.41-126 126 0 56.26 82.35 158.8 113.9 196.02 6.39 7.54 17.82 7.54 24.2 0C331.65 284.8 414 182.26 414 126 414 56.41 357.59 0 288 0zm0 168c-23.2 0-42-18.8-42-42s18.8-42 42-42 42 18.8 42 42-18.8 42-42 42zM20.12 215.95A32.006 32.006 0 0 0 0 245.66v250.32c0 11.32 11.43 19.06 21.94 14.86L160 448V214.92c-8.84-15.98-16.07-31.54-21.25-46.42L20.12 215.95zM288 359.67c-14.07 0-27.38-6.18-36.51-16.96-19.66-23.2-40.57-49.62-59.49-76.72v182l192 64V266c-18.92 27.09-39.82 53.52-59.49 76.72-9.13 10.77-22.44 16.95-36.51 16.95zm266.06-198.51L416 224v288l139.88-55.95A31.996 31.996 0 0 0 576 426.34V176.02c0-11.32-11.43-19.06-21.94-14.86z">
</path>
</svg><!-- <i class="fa fa-map-marked-alt"></i> --></span></div><input name="alamat-lengkap-kel-kec-" type="text" class="form-control form-control-wafm" placeholder="Alamat Lengkap, Kel,Kec,Kota. (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-address-card fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="address-card" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M528 32H48C21.5 32 0 53.5 0 80v352c0 26.5 21.5 48 48 48h480c26.5 0 48-21.5 48-48V80c0-26.5-21.5-48-48-48zm-352 96c35.3 0 64 28.7 64 64s-28.7 64-64 64-64-28.7-64-64 28.7-64 64-64zm112 236.8c0 10.6-10 19.2-22.4 19.2H86.4C74 384 64 375.4 64 364.8v-19.2c0-31.8 30.1-57.6 67.2-57.6h5c12.3 5.1 25.7 8 39.8 8s27.6-2.9 39.8-8h5c37.1 0 67.2 25.8 67.2 57.6v19.2zM512 312c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16z">
</path>
</svg><!-- <i class="fa fa-address-card"></i> --></span></div><input name="merek-unit" type="text" class="form-control form-control-wafm" placeholder="Merek Unit (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-address-card fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="address-card" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M528 32H48C21.5 32 0 53.5 0 80v352c0 26.5 21.5 48 48 48h480c26.5 0 48-21.5 48-48V80c0-26.5-21.5-48-48-48zm-352 96c35.3 0 64 28.7 64 64s-28.7 64-64 64-64-28.7-64-64 28.7-64 64-64zm112 236.8c0 10.6-10 19.2-22.4 19.2H86.4C74 384 64 375.4 64 364.8v-19.2c0-31.8 30.1-57.6 67.2-57.6h5c12.3 5.1 25.7 8 39.8 8s27.6-2.9 39.8-8h5c37.1 0 67.2 25.8 67.2 57.6v19.2zM512 312c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16z">
</path>
</svg><!-- <i class="fa fa-address-card"></i> --></span></div><input name="type-unit" type="text" class="form-control form-control-wafm" placeholder="Type Unit (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-address-card fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="address-card" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M528 32H48C21.5 32 0 53.5 0 80v352c0 26.5 21.5 48 48 48h480c26.5 0 48-21.5 48-48V80c0-26.5-21.5-48-48-48zm-352 96c35.3 0 64 28.7 64 64s-28.7 64-64 64-64-28.7-64-64 28.7-64 64-64zm112 236.8c0 10.6-10 19.2-22.4 19.2H86.4C74 384 64 375.4 64 364.8v-19.2c0-31.8 30.1-57.6 67.2-57.6h5c12.3 5.1 25.7 8 39.8 8s27.6-2.9 39.8-8h5c37.1 0 67.2 25.8 67.2 57.6v19.2zM512 312c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16z">
</path>
</svg><!-- <i class="fa fa-address-card"></i> --></span></div><input name="tahun" type="text" class="form-control form-control-wafm" placeholder="Tahun Kendaraan (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-address-card fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="address-card" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M528 32H48C21.5 32 0 53.5 0 80v352c0 26.5 21.5 48 48 48h480c26.5 0 48-21.5 48-48V80c0-26.5-21.5-48-48-48zm-352 96c35.3 0 64 28.7 64 64s-28.7 64-64 64-64-28.7-64-64 28.7-64 64-64zm112 236.8c0 10.6-10 19.2-22.4 19.2H86.4C74 384 64 375.4 64 364.8v-19.2c0-31.8 30.1-57.6 67.2-57.6h5c12.3 5.1 25.7 8 39.8 8s27.6-2.9 39.8-8h5c37.1 0 67.2 25.8 67.2 57.6v19.2zM512 312c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16z">
</path>
</svg><!-- <i class="fa fa-address-card"></i> --></span></div><input name="nomor-polisi" type="text" class="form-control form-control-wafm" placeholder="Nomor Polisi (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-address-card fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="address-card" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M528 32H48C21.5 32 0 53.5 0 80v352c0 26.5 21.5 48 48 48h480c26.5 0 48-21.5 48-48V80c0-26.5-21.5-48-48-48zm-352 96c35.3 0 64 28.7 64 64s-28.7 64-64 64-64-28.7-64-64 28.7-64 64-64zm112 236.8c0 10.6-10 19.2-22.4 19.2H86.4C74 384 64 375.4 64 364.8v-19.2c0-31.8 30.1-57.6 67.2-57.6h5c12.3 5.1 25.7 8 39.8 8s27.6-2.9 39.8-8h5c37.1 0 67.2 25.8 67.2 57.6v19.2zM512 312c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16z">
</path>
</svg><!-- <i class="fa fa-address-card"></i> --></span></div><input name="pencaian" type="text" class="form-control form-control-wafm" placeholder="Pencaian (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-address-card fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="address-card" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M528 32H48C21.5 32 0 53.5 0 80v352c0 26.5 21.5 48 48 48h480c26.5 0 48-21.5 48-48V80c0-26.5-21.5-48-48-48zm-352 96c35.3 0 64 28.7 64 64s-28.7 64-64 64-64-28.7-64-64 28.7-64 64-64zm112 236.8c0 10.6-10 19.2-22.4 19.2H86.4C74 384 64 375.4 64 364.8v-19.2c0-31.8 30.1-57.6 67.2-57.6h5c12.3 5.1 25.7 8 39.8 8s27.6-2.9 39.8-8h5c37.1 0 67.2 25.8 67.2 57.6v19.2zM512 312c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16z">
</path>
</svg><!-- <i class="fa fa-address-card"></i> --></span></div><input name="tenor" type="text" class="form-control form-control-wafm" placeholder="Tenor (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-address-card fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="address-card" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
d="M528 32H48C21.5 32 0 53.5 0 80v352c0 26.5 21.5 48 48 48h480c26.5 0 48-21.5 48-48V80c0-26.5-21.5-48-48-48zm-352 96c35.3 0 64 28.7 64 64s-28.7 64-64 64-64-28.7-64-64 28.7-64 64-64zm112 236.8c0 10.6-10 19.2-22.4 19.2H86.4C74 384 64 375.4 64 364.8v-19.2c0-31.8 30.1-57.6 67.2-57.6h5c12.3 5.1 25.7 8 39.8 8s27.6-2.9 39.8-8h5c37.1 0 67.2 25.8 67.2 57.6v19.2zM512 312c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16zm0-64c0 4.4-3.6 8-8 8H360c-4.4 0-8-3.6-8-8v-16c0-4.4 3.6-8 8-8h144c4.4 0 8 3.6 8 8v16z">
</path>
</svg><!-- <i class="fa fa-address-card"></i> --></span></div><input name="agsuran" type="text" class="form-control form-control-wafm" placeholder="Agsuran (required)" required="">
</div>
<div class="input-group mb-3">
<div class="input-group-prepend"><span class="input-group-text"><svg class="svg-inline--fa fa-address-card fa-w-18" aria-hidden="true" focusable="false" data-prefix="fa" data-icon="address-card" role="img" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 576 512" data-fa-i2svg="">
<path fill="currentColor"
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</svg><!-- <i class="fa fa-address-card"></i> --></span></div><select name="finance" class="form-control">
<option value="">- Choose Finance -</option>
<option value="BFI">BFI</option>
</select>
</div>
</form>Text Content
AGENSI.ORG - Choose Finance -BFI KLIK