{"id":538,"date":"2026-09-17T15:37:55","date_gmt":"2026-09-17T15:37:55","guid":{"rendered":"https:\/\/pexcellmanagement.com\/borang-pemohonan\/"},"modified":"2026-09-17T15:44:55","modified_gmt":"2026-09-17T15:44:55","slug":"borang-pemohonan","status":"publish","type":"page","link":"https:\/\/pexcellmanagement.com\/ms\/borang-pemohonan\/","title":{"rendered":"Borang Pemohonan"},"content":{"rendered":"<main id='bde-main'><section class=\"bde-f-container-538-106 bde-f-container pexcell-banner pexcell-banner-about\"><div class=\"bde-f-container-538-105 bde-f-container pexcell-banner-inner\"><h1 class=\"bde-f-text-538-100 bde-f-text pexcell-banner-title\">\nBorang.\n<\/h1><p class=\"bde-f-container-538-104 bde-f-container pexcell-breadcrumb\"><a class=\"bde-f-text-link-538-101 bde-f-text-link pexcell-breadcrumb-link\" href=\"\/\" target=\"_self\">\nHome\n<\/a><span class=\"bde-f-text-538-102 bde-f-text pexcell-breadcrumb-sep\">\n\u203a\n<\/span><span class=\"bde-f-text-538-103 bde-f-text pexcell-breadcrumb-current\">\nBorang Pemohonan\n<\/span><\/p><\/div><\/section><section class=\"bde-f-container-538-113 bde-f-container pexcell-apply\"><div class=\"bde-f-container-538-111 bde-f-container pexcell-apply-head\"><img decoding=\"async\" class=\"bde-f-image-538-107 bde-f-image pexcell-apply-logo\" src=\"https:\/\/pexcellmanagement.com\/wp-content\/uploads\/2026\/09\/Logo-P-excell.png\" alt=\"P-Excell Management\" loading=\"lazy\"><h2 class=\"bde-f-text-538-108 bde-f-text pexcell-apply-title\">\nBorang Permohonan Pembelian Rumah Dibawah P-Excell Management Sdn. Bhd.\n<\/h2><p class=\"bde-f-text-538-109 bde-f-text pexcell-apply-sub\">\nSila lengkapkan borang dibawah :-\n<\/p><span class=\"bde-f-text-538-110 bde-f-text pexcell-divider-red\">\n\n<\/span><\/div><div class=\"bde-f-container-538-112 bde-f-container pexcell-apply-form-slot\"><div class=\"bde-form-builder-538-114 bde-form-builder\">\n\n<form id=\"borang-permohonan-pembelian-rumah114\" class=\"breakdance-form breakdance-form--vertical\" data-options=\"{&quot;slug&quot;:&quot;custom&quot;,&quot;name&quot;:&quot;Borang Permohonan Pembelian Rumah&quot;,&quot;ajaxUrl&quot;:&quot;https:\\\/\\\/pexcellmanagement.com\\\/wp-admin\\\/admin-ajax.php&quot;,&quot;clearOnSuccess&quot;:true,&quot;hideOnSuccess&quot;:false,&quot;successMessage&quot;:&quot;Terima kasih! Permohonan anda telah diterima. Pihak kami akan menghubungi anda.&quot;,&quot;errorMessage&quot;:&quot;Maaf, permohonan tidak dapat dihantar. Sila semak medan wajib dan cuba lagi.&quot;,&quot;redirect&quot;:false,&quot;redirectUrl&quot;:&quot;&quot;,&quot;customJavaScript&quot;:&quot;&quot;,&quot;recaptcha&quot;:{&quot;key&quot;:&quot;&quot;,&quot;enabled&quot;:false},&quot;honeypot_enabled&quot;:false,&quot;popupsOnSuccess&quot;:[],&quot;popupsOnError&quot;:[]}\" data-steps=\"0\" >\n  \n  \n  \n<div class=\"breakdance-form-field breakdance-form-field--html\" >\n    \n    \n    \n    <div class=\"form-input-html\"\n    >\n  \n<\/div>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"nama_projek\">\n            Nama Projek<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"nama_projek\"\n    name=\"fields[nama_projek]\"\n    required\n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Projek Perumahan Batu Hampar (Hamparan)\" >Projek Perumahan Batu Hampar (Hamparan)<\/option>\n        <option value=\"Projek Perumahan KP Perdana Fasa 5D\" >Projek Perumahan KP Perdana Fasa 5D<\/option>\n        <option value=\"Projek Perumahan Taman Desa Tok Jamal\" >Projek Perumahan Taman Desa Tok Jamal<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"jenis_rumah\">\n            Jenis Rumah<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"jenis_rumah\"\n    name=\"fields[jenis_rumah]\"\n    required\n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Rumah Teres 1 Tingkat\" >Rumah Teres 1 Tingkat<\/option>\n        <option value=\"Rumah Teres 2 Tingkat\" >Rumah Teres 2 Tingkat<\/option>\n        <option value=\"Rumah Berkembar 2 Tingkat\" >Rumah Berkembar 2 Tingkat<\/option>\n        <option value=\"Rumah Berkembar 2 Tingkat (Daisy)\" >Rumah Berkembar 2 Tingkat (Daisy)<\/option>\n        <option value=\"Rumah Berkembar 2 Tingkat (Namesia)\" >Rumah Berkembar 2 Tingkat (Namesia)<\/option>\n        <option value=\"Rumah Berkembar 2 Tingkat (Camelia)\" >Rumah Berkembar 2 Tingkat (Camelia)<\/option>\n        <option value=\"Rumah Berkembar 2 Tingkat (Akasia)\" >Rumah Berkembar 2 Tingkat (Akasia)<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--html\" >\n    \n    \n    \n    <div class=\"form-input-html\"\n    >\n  \n<\/div>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"nama_penuh\">\n            Nama Penuh<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"nama_penuh\"\n    aria-describedby=\"nama_penuh\"\n    type=\"text\"\n    name=\"fields[nama_penuh]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"no_kp\">\n            No. K\/P (Baru)<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"no_kp\"\n    aria-describedby=\"no_kp\"\n    type=\"text\"\n    name=\"fields[no_kp]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"alamat\">\n            Alamat Tempat Tinggal<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"alamat\"\n    aria-describedby=\"alamat\"\n    type=\"text\"\n    name=\"fields[alamat]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"alamat_bandar\">\n            Bandar<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"alamat_bandar\"\n    aria-describedby=\"alamat_bandar\"\n    type=\"text\"\n    name=\"fields[alamat_bandar]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"alamat_negeri\">\n            Negeri<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"alamat_negeri\"\n    name=\"fields[alamat_negeri]\"\n    required\n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Johor\" >Johor<\/option>\n        <option value=\"Kedah\" >Kedah<\/option>\n        <option value=\"Kelantan\" >Kelantan<\/option>\n        <option value=\"Labuan\" >Labuan<\/option>\n        <option value=\"Malacca (Melaka)\" >Malacca (Melaka)<\/option>\n        <option value=\"Negeri Sembilan\" >Negeri Sembilan<\/option>\n        <option value=\"Pahang\" >Pahang<\/option>\n        <option value=\"Penang (Pulau Pinang)\" >Penang (Pulau Pinang)<\/option>\n        <option value=\"Perak\" >Perak<\/option>\n        <option value=\"Perlis\" >Perlis<\/option>\n        <option value=\"Sabah\" >Sabah<\/option>\n        <option value=\"Sarawak\" >Sarawak<\/option>\n        <option value=\"Selangor\" >Selangor<\/option>\n        <option value=\"Terengganu\" >Terengganu<\/option>\n        <option value=\"Putrajaya\" >Putrajaya<\/option>\n        <option value=\"Kuala Lumpur\" >Kuala Lumpur<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"alamat_poskod\">\n            Poskod<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"alamat_poskod\"\n    aria-describedby=\"alamat_poskod\"\n    type=\"text\"\n    name=\"fields[alamat_poskod]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--checkbox\" >\n    \n    \n    \n    <fieldset role=\"group\"\n    aria-label=\"Berlainan Alamat Surat-Menyurat?\"\n    >\n       <legend class=\"breakdance-form-field__label\">Berlainan Alamat Surat-Menyurat?<\/legend>\n          <div class=\"breakdance-form-checkbox\">\n          <input\n              type=\"checkbox\"\n              name=\"fields[alamat_berlainan]\"\n              value=\"Ya\"\n              id=\"alamat_berlainan-1\"\n              \n              \n                        >\n          <label class=\"breakdance-form-checkbox__text\" for=\"alamat_berlainan-1\">Ya<\/label>\n      <\/div>\n  <\/fieldset>\n\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"surat_alamat\">\n            Alamat Surat Menyurat\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"surat_alamat\"\n    aria-describedby=\"surat_alamat\"\n    type=\"text\"\n    name=\"fields[surat_alamat]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"surat_bandar\">\n            Bandar (Surat Menyurat)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"surat_bandar\"\n    aria-describedby=\"surat_bandar\"\n    type=\"text\"\n    name=\"fields[surat_bandar]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"surat_negeri\">\n            Negeri (Surat Menyurat)\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"surat_negeri\"\n    name=\"fields[surat_negeri]\"\n    \n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Johor\" >Johor<\/option>\n        <option value=\"Kedah\" >Kedah<\/option>\n        <option value=\"Kelantan\" >Kelantan<\/option>\n        <option value=\"Labuan\" >Labuan<\/option>\n        <option value=\"Malacca (Melaka)\" >Malacca (Melaka)<\/option>\n        <option value=\"Negeri Sembilan\" >Negeri Sembilan<\/option>\n        <option value=\"Pahang\" >Pahang<\/option>\n        <option value=\"Penang (Pulau Pinang)\" >Penang (Pulau Pinang)<\/option>\n        <option value=\"Perak\" >Perak<\/option>\n        <option value=\"Perlis\" >Perlis<\/option>\n        <option value=\"Sabah\" >Sabah<\/option>\n        <option value=\"Sarawak\" >Sarawak<\/option>\n        <option value=\"Selangor\" >Selangor<\/option>\n        <option value=\"Terengganu\" >Terengganu<\/option>\n        <option value=\"Putrajaya\" >Putrajaya<\/option>\n        <option value=\"Kuala Lumpur\" >Kuala Lumpur<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"surat_poskod\">\n            Poskod (Surat Menyurat)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"surat_poskod\"\n    aria-describedby=\"surat_poskod\"\n    type=\"text\"\n    name=\"fields[surat_poskod]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--tel\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"tel_bimbit\">\n            No. Tel Bimbit<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"tel_bimbit\"\n    aria-describedby=\"tel_bimbit\"\n    type=\"tel\"\n    name=\"fields[tel_bimbit]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--email\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"email\">\n            Email<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"email\"\n    aria-describedby=\"email\"\n    type=\"email\"\n    name=\"fields[email]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--date\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"tarikh_lahir\">\n            Tarikh Lahir\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"tarikh_lahir\"\n    aria-describedby=\"tarikh_lahir\"\n    type=\"date\"\n    name=\"fields[tarikh_lahir]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"tempat_lahir\">\n            Tempat Lahir\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"tempat_lahir\"\n    aria-describedby=\"tempat_lahir\"\n    type=\"text\"\n    name=\"fields[tempat_lahir]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"jantina\">\n            Jantina\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"jantina\"\n    name=\"fields[jantina]\"\n    \n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Lelaki\" >Lelaki<\/option>\n        <option value=\"Perempuan\" >Perempuan<\/option>\n        <option value=\"Lain-lain\" >Lain-lain<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"status_kahwin\">\n            Status Perkahwinan\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"status_kahwin\"\n    name=\"fields[status_kahwin]\"\n    \n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Bujang\" >Bujang<\/option>\n        <option value=\"Berkahwin\" >Berkahwin<\/option>\n        <option value=\"Duda\" >Duda<\/option>\n        <option value=\"Janda\" >Janda<\/option>\n        <option value=\"Lain-lain\" >Lain-lain<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"bangsa\">\n            Bangsa\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"bangsa\"\n    name=\"fields[bangsa]\"\n    \n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Melayu\" >Melayu<\/option>\n        <option value=\"Cina\" >Cina<\/option>\n        <option value=\"India\" >India<\/option>\n        <option value=\"Lain-lain\" >Lain-lain<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"bangsa_lain\">\n            Nyatakan Bangsa (jika Lain-lain)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"bangsa_lain\"\n    aria-describedby=\"bangsa_lain\"\n    type=\"text\"\n    name=\"fields[bangsa_lain]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--checkbox\" >\n    \n    \n    \n    <fieldset role=\"group\"\n    aria-label=\"Permohonan Bersama\"\n    >\n       <legend class=\"breakdance-form-field__label\">Permohonan Bersama<\/legend>\n          <div class=\"breakdance-form-checkbox\">\n          <input\n              type=\"checkbox\"\n              name=\"fields[mohon_bersama]\"\n              value=\"Ya\"\n              id=\"mohon_bersama-1\"\n              \n              \n                        >\n          <label class=\"breakdance-form-checkbox__text\" for=\"mohon_bersama-1\">Ya<\/label>\n      <\/div>\n  <\/fieldset>\n\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"nama_kedua\">\n            Nama (Pemohon Kedua)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"nama_kedua\"\n    aria-describedby=\"nama_kedua\"\n    type=\"text\"\n    name=\"fields[nama_kedua]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"kp_kedua\">\n            No. K\/P (Baru) Pemohon Kedua\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"kp_kedua\"\n    aria-describedby=\"kp_kedua\"\n    type=\"text\"\n    name=\"fields[kp_kedua]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"nama_pasangan\">\n            Nama Pasangan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"nama_pasangan\"\n    aria-describedby=\"nama_pasangan\"\n    type=\"text\"\n    name=\"fields[nama_pasangan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"kp_pasangan\">\n            No. K\/P (Baru) Pasangan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"kp_pasangan\"\n    aria-describedby=\"kp_pasangan\"\n    type=\"text\"\n    name=\"fields[kp_pasangan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--date\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"lahir_pasangan\">\n            Tarikh Lahir Pasangan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"lahir_pasangan\"\n    aria-describedby=\"lahir_pasangan\"\n    type=\"date\"\n    name=\"fields[lahir_pasangan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"tempat_lahir_pasangan\">\n            Tempat Lahir Pasangan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"tempat_lahir_pasangan\"\n    aria-describedby=\"tempat_lahir_pasangan\"\n    type=\"text\"\n    name=\"fields[tempat_lahir_pasangan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--html\" >\n    \n    \n    \n    <div class=\"form-input-html\"\n    >\n  \n<\/div>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pekerjaan\">\n            Pekerjaan \/ Jawatan Pemohon<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pekerjaan\"\n    aria-describedby=\"pekerjaan\"\n    type=\"text\"\n    name=\"fields[pekerjaan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"majikan\">\n            Nama Majikan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"majikan\"\n    aria-describedby=\"majikan\"\n    type=\"text\"\n    name=\"fields[majikan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"majikan_alamat\">\n            Alamat Majikan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"majikan_alamat\"\n    aria-describedby=\"majikan_alamat\"\n    type=\"text\"\n    name=\"fields[majikan_alamat]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"majikan_bandar\">\n            Bandar (Majikan)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"majikan_bandar\"\n    aria-describedby=\"majikan_bandar\"\n    type=\"text\"\n    name=\"fields[majikan_bandar]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"majikan_negeri\">\n            Negeri (Majikan)\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"majikan_negeri\"\n    name=\"fields[majikan_negeri]\"\n    \n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Johor\" >Johor<\/option>\n        <option value=\"Kedah\" >Kedah<\/option>\n        <option value=\"Kelantan\" >Kelantan<\/option>\n        <option value=\"Labuan\" >Labuan<\/option>\n        <option value=\"Malacca (Melaka)\" >Malacca (Melaka)<\/option>\n        <option value=\"Negeri Sembilan\" >Negeri Sembilan<\/option>\n        <option value=\"Pahang\" >Pahang<\/option>\n        <option value=\"Penang (Pulau Pinang)\" >Penang (Pulau Pinang)<\/option>\n        <option value=\"Perak\" >Perak<\/option>\n        <option value=\"Perlis\" >Perlis<\/option>\n        <option value=\"Sabah\" >Sabah<\/option>\n        <option value=\"Sarawak\" >Sarawak<\/option>\n        <option value=\"Selangor\" >Selangor<\/option>\n        <option value=\"Terengganu\" >Terengganu<\/option>\n        <option value=\"Putrajaya\" >Putrajaya<\/option>\n        <option value=\"Kuala Lumpur\" >Kuala Lumpur<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"majikan_poskod\">\n            Poskod (Majikan)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"majikan_poskod\"\n    aria-describedby=\"majikan_poskod\"\n    type=\"text\"\n    name=\"fields[majikan_poskod]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--tel\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"majikan_tel\">\n            No. Telefon Majikan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"majikan_tel\"\n    aria-describedby=\"majikan_tel\"\n    type=\"tel\"\n    name=\"fields[majikan_tel]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"majikan_jenis\">\n            Jenis Majikan\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"majikan_jenis\"\n    name=\"fields[majikan_jenis]\"\n    \n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"KERAJAAN\" >KERAJAAN<\/option>\n        <option value=\"BADAN BERKANUN\" >BADAN BERKANUN<\/option>\n        <option value=\"SWASTA\" >SWASTA<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pasangan_kerja\">\n            Pekerjaan Pasangan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pasangan_kerja\"\n    aria-describedby=\"pasangan_kerja\"\n    type=\"text\"\n    name=\"fields[pasangan_kerja]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pasangan_majikan\">\n            Nama Majikan Pasangan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pasangan_majikan\"\n    aria-describedby=\"pasangan_majikan\"\n    type=\"text\"\n    name=\"fields[pasangan_majikan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pasangan_majikan_alamat\">\n            Alamat Majikan Pasangan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pasangan_majikan_alamat\"\n    aria-describedby=\"pasangan_majikan_alamat\"\n    type=\"text\"\n    name=\"fields[pasangan_majikan_alamat]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pasangan_majikan_bandar\">\n            Bandar (Majikan Pasangan)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pasangan_majikan_bandar\"\n    aria-describedby=\"pasangan_majikan_bandar\"\n    type=\"text\"\n    name=\"fields[pasangan_majikan_bandar]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--select\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pasangan_majikan_negeri\">\n            Negeri (Majikan Pasangan)\n        <\/label>\n    \n    <select\n    class=\"breakdance-form-field__input\"\n    id=\"pasangan_majikan_negeri\"\n    name=\"fields[pasangan_majikan_negeri]\"\n    \n    \n        \n    \n    >\n      <option value=\"\">Select...<\/option>\n          <option value=\"Johor\" >Johor<\/option>\n        <option value=\"Kedah\" >Kedah<\/option>\n        <option value=\"Kelantan\" >Kelantan<\/option>\n        <option value=\"Labuan\" >Labuan<\/option>\n        <option value=\"Malacca (Melaka)\" >Malacca (Melaka)<\/option>\n        <option value=\"Negeri Sembilan\" >Negeri Sembilan<\/option>\n        <option value=\"Pahang\" >Pahang<\/option>\n        <option value=\"Penang (Pulau Pinang)\" >Penang (Pulau Pinang)<\/option>\n        <option value=\"Perak\" >Perak<\/option>\n        <option value=\"Perlis\" >Perlis<\/option>\n        <option value=\"Sabah\" >Sabah<\/option>\n        <option value=\"Sarawak\" >Sarawak<\/option>\n        <option value=\"Selangor\" >Selangor<\/option>\n        <option value=\"Terengganu\" >Terengganu<\/option>\n        <option value=\"Putrajaya\" >Putrajaya<\/option>\n        <option value=\"Kuala Lumpur\" >Kuala Lumpur<\/option>\n  <\/select>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pasangan_majikan_poskod\">\n            Poskod (Majikan Pasangan)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pasangan_majikan_poskod\"\n    aria-describedby=\"pasangan_majikan_poskod\"\n    type=\"text\"\n    name=\"fields[pasangan_majikan_poskod]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--tel\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pasangan_majikan_tel\">\n            No. Telefon Majikan Pasangan\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pasangan_majikan_tel\"\n    aria-describedby=\"pasangan_majikan_tel\"\n    type=\"tel\"\n    name=\"fields[pasangan_majikan_tel]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--html\" >\n    \n    \n    \n    <div class=\"form-input-html\"\n    >\n  \n<\/div>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pendapatan_pemohon\">\n            Pendapatan Pemohon (RM)<span class=\"breakdance-form-field__required\">*<\/span>\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pendapatan_pemohon\"\n    aria-describedby=\"pendapatan_pemohon\"\n    type=\"text\"\n    name=\"fields[pendapatan_pemohon]\"\n    placeholder=\"Sila Masukkan Pendapatan Pemohon\"\n    value=\"\"\n                \n        \n        \n    required\n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pendapatan_pasangan\">\n            Pendapatan Pasangan (RM)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pendapatan_pasangan\"\n    aria-describedby=\"pendapatan_pasangan\"\n    type=\"text\"\n    name=\"fields[pendapatan_pasangan]\"\n    placeholder=\"Sila Masukkan Pendapatan Pasangan\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--html\" >\n    \n    \n    \n    <div class=\"form-input-html\"\n    >\n  \n<\/div>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--radio\" >\n    \n    \n    \n      <fieldset role=\"radiogroup\"\n          aria-label=\"Status Kediaman Sekarang\"\n      >\n          <legend class=\"breakdance-form-field__label\">Status Kediaman Sekarang<\/legend>\n                <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[status_kediaman][]\"\n                value=\"Sendiri\"\n                id=\"status_kediaman-1\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"status_kediaman-1\">Sendiri<\/label>\n        <\/div>\n            <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[status_kediaman][]\"\n                value=\"Menyewa\"\n                id=\"status_kediaman-2\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"status_kediaman-2\">Menyewa<\/label>\n        <\/div>\n            <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[status_kediaman][]\"\n                value=\"Menumpang\"\n                id=\"status_kediaman-3\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"status_kediaman-3\">Menumpang<\/label>\n        <\/div>\n            <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[status_kediaman][]\"\n                value=\"Lain-lain\"\n                id=\"status_kediaman-4\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"status_kediaman-4\">Lain-lain<\/label>\n        <\/div>\n      <\/fieldset>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"sewa_bulanan\">\n            Sewa Bulanan (RM)\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"sewa_bulanan\"\n    aria-describedby=\"sewa_bulanan\"\n    type=\"text\"\n    name=\"fields[sewa_bulanan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--number\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"tempoh_sewa\">\n            Tempoh Menyewa\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"tempoh_sewa\"\n    aria-describedby=\"tempoh_sewa\"\n    type=\"number\"\n    name=\"fields[tempoh_sewa]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--number\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"tempoh_tumpang\">\n            Tempoh Menumpang\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"tempoh_tumpang\"\n    aria-describedby=\"tempoh_tumpang\"\n    type=\"number\"\n    name=\"fields[tempoh_tumpang]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"pertalian_pemilik\">\n            Pertalian Pemilik dengan Pemohon\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"pertalian_pemilik\"\n    aria-describedby=\"pertalian_pemilik\"\n    type=\"text\"\n    name=\"fields[pertalian_pemilik]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"nama_pemilik\">\n            Nama Pemilik\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"nama_pemilik\"\n    aria-describedby=\"nama_pemilik\"\n    type=\"text\"\n    name=\"fields[nama_pemilik]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"kediaman_lain\">\n            Jika Lain-lain, Sila Nyatakan :\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"kediaman_lain\"\n    aria-describedby=\"kediaman_lain\"\n    type=\"text\"\n    name=\"fields[kediaman_lain]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--number\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"tempoh_terengganu\">\n            Tempoh Pemohon Tinggal di Negeri Terengganu?\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"tempoh_terengganu\"\n    aria-describedby=\"tempoh_terengganu\"\n    type=\"number\"\n    name=\"fields[tempoh_terengganu]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--html\" >\n    \n    \n    \n    <div class=\"form-input-html\"\n    >\n  \n<\/div>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--radio\" >\n    \n    \n    \n      <fieldset role=\"radiogroup\"\n          aria-label=\"Kaedah Pembelian\"\n      >\n          <legend class=\"breakdance-form-field__label\">Kaedah Pembelian<span class=\"breakdance-form-field__required\">*<\/span><\/legend>\n                <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[kaedah_beli][]\"\n                value=\"Sendiri\"\n                id=\"kaedah_beli-1\"\n                required\n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"kaedah_beli-1\">Sendiri<\/label>\n        <\/div>\n            <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[kaedah_beli][]\"\n                value=\"Pinjaman\"\n                id=\"kaedah_beli-2\"\n                required\n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"kaedah_beli-2\">Pinjaman<\/label>\n        <\/div>\n      <\/fieldset>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--radio\" >\n    \n    \n    \n      <fieldset role=\"radiogroup\"\n          aria-label=\"Sumber Pinjaman\"\n      >\n          <legend class=\"breakdance-form-field__label\">Sumber Pinjaman<\/legend>\n                <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[sumber_pinjaman][]\"\n                value=\"Kerajaan\"\n                id=\"sumber_pinjaman-1\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"sumber_pinjaman-1\">Kerajaan<\/label>\n        <\/div>\n            <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[sumber_pinjaman][]\"\n                value=\"Bank \/ Institusi Kewangan\"\n                id=\"sumber_pinjaman-2\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"sumber_pinjaman-2\">Bank \/ Institusi Kewangan<\/label>\n        <\/div>\n            <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[sumber_pinjaman][]\"\n                value=\"Majikan\"\n                id=\"sumber_pinjaman-3\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"sumber_pinjaman-3\">Majikan<\/label>\n        <\/div>\n      <\/fieldset>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--radio\" >\n    \n    \n    \n      <fieldset role=\"radiogroup\"\n          aria-label=\"Kelayakan Pinjaman Telah Disahkan?\"\n      >\n          <legend class=\"breakdance-form-field__label\">Kelayakan Pinjaman Telah Disahkan?<\/legend>\n                <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[pinjaman_lulus][]\"\n                value=\"Ya\"\n                id=\"pinjaman_lulus-1\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"pinjaman_lulus-1\">Ya<\/label>\n        <\/div>\n            <div class=\"breakdance-form-radio\">\n            <input\n                type=\"radio\"\n                name=\"fields[pinjaman_lulus][]\"\n                value=\"Tidak\"\n                id=\"pinjaman_lulus-2\"\n                \n                \n                \n                            >\n            <label class=\"breakdance-form-radio__text\" for=\"pinjaman_lulus-2\">Tidak<\/label>\n        <\/div>\n      <\/fieldset>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"jumlah_pinjaman\">\n            Jika YA, nyatakan Jumlah Pinjaman Maksima (RM) :\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"jumlah_pinjaman\"\n    aria-describedby=\"jumlah_pinjaman\"\n    type=\"text\"\n    name=\"fields[jumlah_pinjaman]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"simpanan\">\n            Simpanan Sendiri, Bank dan Lain-lain (RM) :\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"simpanan\"\n    aria-describedby=\"simpanan\"\n    type=\"text\"\n    name=\"fields[simpanan]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--text\" >\n    \n    \n            <label class=\"breakdance-form-field__label\" for=\"kwsp\">\n            Jumlah KWSP (RM) :\n        <\/label>\n    \n    <input\n    class=\"breakdance-form-field__input\"\n    id=\"kwsp\"\n    aria-describedby=\"kwsp\"\n    type=\"text\"\n    name=\"fields[kwsp]\"\n    placeholder=\"\"\n    value=\"\"\n                \n        \n        \n    \n    \n    \n    \n    \n    \n>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--html\" >\n    \n    \n    \n    <div class=\"form-input-html\"\n    >\n  \n<\/div>\n\n\n    \n    \n<\/div>\n\n\n<div class=\"breakdance-form-field breakdance-form-field--checkbox\" >\n    \n    \n    \n    <fieldset role=\"group\"\n    aria-label=\"Pengakuan\"\n    >\n       <legend class=\"breakdance-form-field__label\">Pengakuan<span class=\"breakdance-form-field__required\">*<\/span><\/legend>\n          <div class=\"breakdance-form-checkbox\">\n          <input\n              type=\"checkbox\"\n              name=\"fields[pengakuan][]\"\n              value=\"Saya mengaku bahawa segala butir-butir yang di berikan dalam borang ini adalah benar dan saya bertanggungjawab atas segalanya.\"\n              id=\"pengakuan-1\"\n              \n              \n                        >\n          <label class=\"breakdance-form-checkbox__text\" for=\"pengakuan-1\">Saya mengaku bahawa segala butir-butir yang di berikan dalam borang ini adalah benar dan saya bertanggungjawab atas segalanya.<\/label>\n      <\/div>\n        <div class=\"breakdance-form-checkbox\">\n          <input\n              type=\"checkbox\"\n              name=\"fields[pengakuan][]\"\n              value=\"Saya juga bersetuju pihak P-Excell Management Sdn Bhd. menarik balik tawaran dan \/ atau pembelian rumah dipohon ini, jika sekiranya kelak didapati keterangan-keterangan yang diberi dalam borang ini tidak benar walaupun setelah tawaran atau pembelian rumah ini di tandatangani.\"\n              id=\"pengakuan-2\"\n              \n              \n                        >\n          <label class=\"breakdance-form-checkbox__text\" for=\"pengakuan-2\">Saya juga bersetuju pihak P-Excell Management Sdn Bhd. menarik balik tawaran dan \/ atau pembelian rumah dipohon ini, jika sekiranya kelak didapati keterangan-keterangan yang diberi dalam borang ini tidak benar walaupun setelah tawaran atau pembelian rumah ini di tandatangani.<\/label>\n      <\/div>\n        <div class=\"breakdance-form-checkbox\">\n          <input\n              type=\"checkbox\"\n              name=\"fields[pengakuan][]\"\n              value=\"Saya bersetuju kesemua wang pendaftaran bagi permohonan ini TIDAK dikembalikan kepada saya sekiranya saya MENOLAK tawaran membeli yang dikeluarkan kepada saya.\"\n              id=\"pengakuan-3\"\n              \n              \n                        >\n          <label class=\"breakdance-form-checkbox__text\" for=\"pengakuan-3\">Saya bersetuju kesemua wang pendaftaran bagi permohonan ini TIDAK dikembalikan kepada saya sekiranya saya MENOLAK tawaran membeli yang dikeluarkan kepada saya.<\/label>\n      <\/div>\n  <\/fieldset>\n\n\n\n    \n    \n<\/div><div class=\"breakdance-form-field breakdance-form-footer\">    \n    \n    \n    \n    \n            \n            <button type=\"submit\" class=\"button-atom button-atom--primary breakdance-form-button breakdance-form-button__submit\"  >\n    \n        <span class=\"button-atom__text\">Hantar Permohonan<\/span>\n\n        \n        \n            <\/button>\n    \n    <input type=\"hidden\" name=\"form_id\" value=\"114\">\n    <input type=\"hidden\" name=\"post_id\" value=\"538\">\n<\/div>\n\n  \n<\/form>\n\n\n<\/div><\/div><\/section><\/main>","protected":false},"excerpt":{"rendered":"<p>Borang. Home \u203a Borang Pemohonan Borang Permohonan Pembelian Rumah Dibawah P-Excell Management Sdn. Bhd. Sila lengkapkan borang dibawah :- Nama Projek* Select&#8230; Projek Perumahan Batu Hampar (Hamparan) Projek Perumahan KP Perdana Fasa 5D Projek Perumahan Taman Desa Tok Jamal Jenis Rumah* Select&#8230; Rumah Teres 1 Tingkat Rumah Teres 2 Tingkat Rumah Berkembar 2 Tingkat Rumah [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_breakdance_hide_in_design_set":false,"_breakdance_tags":"","footnotes":""},"class_list":["post-538","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/pexcellmanagement.com\/ms\/wp-json\/wp\/v2\/pages\/538","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pexcellmanagement.com\/ms\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pexcellmanagement.com\/ms\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pexcellmanagement.com\/ms\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pexcellmanagement.com\/ms\/wp-json\/wp\/v2\/comments?post=538"}],"version-history":[{"count":3,"href":"https:\/\/pexcellmanagement.com\/ms\/wp-json\/wp\/v2\/pages\/538\/revisions"}],"predecessor-version":[{"id":567,"href":"https:\/\/pexcellmanagement.com\/ms\/wp-json\/wp\/v2\/pages\/538\/revisions\/567"}],"wp:attachment":[{"href":"https:\/\/pexcellmanagement.com\/ms\/wp-json\/wp\/v2\/media?parent=538"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}