Resident Registration Form

1 Identitas Kepala Keluarga

Head of Household Name *

Enter the full name as shown on the ID or Passport.

Wajib diisi.

Gender *

Pilih salah satu.

Select gender according to official documents.

Phone Number *

Nomor HP tidak valid.

Enter an active number that can be contacted.

Place of Birth *

Wajib diisi.

Enter place of birth as per official document.

Date of Birth *

Pilih tanggal lahir.

Pick date of birth as per official document.

2 Alamat & Rumah

Pilih Rumah *

Silakan pilih rumah.

Pilih rumah berdasarkan blok/nomor, misal B5 atau nomor 12.

House Ownership Status *

Pilih status rumah.

Select ownership status.

Address as per KTP

Required if Indonesian citizen.

Citizenship Status *

Pilih kewarganegaraan.

Select according to official documents.

Country of Origin

Required for foreign nationals.

Religion *

Pilih agama.

Choose based on your belief.

3 Data Keluarga

Spouse Name

Leave blank if unmarried.

Spouse Date of Birth

Children Data 0 anak

4 Dokumen

Upload KTP

Upload Family Card (KK)

5 RT 006 Rules

I have read and agree to the RT 006 rules above

Mohon setujui aturan.