Gross Commission Detail Statement

Period Ending 20-Sep-2019

(Agency: KOMALA [00135556])
Exchange rate:14,099

Policy Holder Year/ Issue Level Frequency Policy Inception Coverage Description Original Amount Original Amount Amount in IDR
Date/Due Date Premium Commission

75744281/NURHAY -/AG Bulanan 14-Mar-2011/ PRUsaver Penagihan Premi 141,667.00 4,250.01 4,250.01
ATI 14-Sep-2019

12535867/KOMALA 2/MA Bulanan 17-Apr-2018/ PRUlink syariah Penagihan Premi 375,000.00 112,500.00 112,500.00
SARI 17-Sep-2019 assurance acct

12884929/YUSUF 1/MA Bulanan 12-Apr-2019/ PRUlink generasi Penagihan Premi 916,667.00 275,000.10 275,000.10
SURYADI 12-Sep-2019 baru

12884929/YUSUF 1/MA Bulanan 12-Apr-2019/ PRUlink generasi Penagihan Premi 916,667.00 275,000.10 275,000.10
SURYADI 12-Aug-2019 baru

12323050/LUSINTO 2/MA Bulanan 20-Oct-2017/ PRUlink assurance Penagihan Premi 208,333.00 62,499.90 62,499.90
SUTOPO 20-Sep-2019 account

77596832/PIPIT 3/AG Bulanan 15-Jun-2011/ PRUlink assurance Penagihan Premi 125,000.00 6,250.00 6,250.00
FATKIYAH 15-Sep-2019 account

12399571/NURHAY 2/MA Bulanan 14-Dec-2017/ PRUlink assurance Penagihan Premi 250,000.00 75,000.00 75,000.00
ATI 14-Sep-2019 account

75744281/NURHAY -/AG Bulanan 14-Mar-2011/ PRUsaver Penagihan Premi 16,666.00 499.98 499.98
ATI 14-Sep-2019

12884929/YUSUF -/MA Bulanan 12-Apr-2019/ PRUsaver Penagihan Premi 1,083,333.00 32,499.99 32,499.99
SURYADI 12-Aug-2019

77596832/PIPIT -/AG Bulanan 15-Jun-2011/ PRUsaver Penagihan Premi 25,000.00 750.00 750.00
FATKIYAH 15-Sep-2019

18756082/MELLAS -/UM Bulanan 17-Sep-2013/ PRUsaver Penagihan Premi 291,667.00 8,750.01 8,750.01
ARI NOVIANTHIE 17-Sep-2019
BUDIANTO

51493098/FURRY -/UM Bulanan 11-Dec-2013/ PRUsaver Penagihan Premi 250,000.00 7,500.00 7,500.00
NALIRATIH 11-Sep-2019

33835423/RAHAYU -/AG Bulanan 06-Mar-2009/ PRUsaver Penagihan Premi 91,667.00 2,750.01 2,750.01
NINGSIH 06-Sep-2019

Prudential Life Assurance CONFIDENTIAL Page 1 of 5

(Date Printed: 30-Sep-2019)
 Policy Holder Year/ Issue Level Frequency Policy Inception Coverage Description Original Amount Original Amount Amount in IDR
Date/Due Date Premium Commission

06475896/NANI -/UM Bulanan 18-Sep-2012/ PRUsaver Penagihan Premi 133,333.00 3,999.99 3,999.99
ROHAENI 18-Sep-2019

77410668/SUSYAN -/AG Bulanan 16-Jun-2011/ PRUsaver Penagihan Premi 208,333.00 6,249.99 6,249.99
TI PRANATA 16-Sep-2019

77568265/PIPIT 3/AG Bulanan 14-Jun-2011/ PRUlink assurance Penagihan Premi 87,500.00 4,375.00 4,375.00
FATKIYAH 14-Sep-2019 account

12555683/ERICK -/MA Bulanan 16-May-2018/ PRUsaver syariah Penagihan Premi 561,667.00 16,850.01 16,850.01
RIFANTO 16-Sep-2019

12323050/LUSINTO -/MA Bulanan 20-Oct-2017/ PRUsaver Penagihan Premi 191,667.00 5,750.01 5,750.01
SUTOPO 20-Sep-2019

75744281/NURHAY 2/AG Bulanan 14-Mar-2011/ PRUlink assurance Penagihan Premi 33,334.00 10,000.20 10,000.20
ATI 14-Sep-2019 account

77596832/PIPIT -/AG Bulanan 15-Jun-2011/ PRUsaver Penagihan Premi 141,667.00 4,250.01 4,250.01
FATKIYAH 15-Sep-2019

12884929/YUSUF -/MA Bulanan 12-Apr-2019/ PRUsaver Penagihan Premi 1,083,333.00 32,499.99 32,499.99
SURYADI 12-Sep-2019

12535867/KOMALA -/MA Bulanan 17-Apr-2018/ PRUsaver syariah Penagihan Premi 375,000.00 11,250.00 11,250.00
SARI 17-Sep-2019

77568247/PIPIT -/AG Bulanan 14-Jun-2011/ PRUsaver Penagihan Premi 166,667.00 5,000.01 5,000.01
FATKIYAH 14-Sep-2019

77568247/PIPIT -/AG Bulanan 14-Jun-2011/ PRUsaver Penagihan Premi 83,333.00 2,499.99 2,499.99
FATKIYAH 14-Sep-2019

12555683/ERICK 2/MA Bulanan 16-May-2018/ PRUlink syariah Penagihan Premi 2,438,333.00 731,499.90 731,499.90
RIFANTO 16-Sep-2019 assurance acct

77568247/PIPIT 3/AG Bulanan 14-Jun-2011/ PRUlink assurance Penagihan Premi 416,667.00 20,833.35 20,833.35
FATKIYAH 14-Sep-2019 account

77568265/PIPIT -/AG Bulanan 14-Jun-2011/ PRUsaver Penagihan Premi 62,500.00 1,875.00 1,875.00
FATKIYAH 14-Sep-2019

77568265/PIPIT -/AG Bulanan 14-Jun-2011/ PRUsaver Penagihan Premi 137,500.00 4,125.00 4,125.00
FATKIYAH 14-Sep-2019

Prudential Life Assurance CONFIDENTIAL Page 2 of 5

(Date Printed: 30-Sep-2019)
 Policy Holder Year/ Issue Level Frequency Policy Inception Coverage Description Original Amount Original Amount Amount in IDR
Date/Due Date Premium Commission

12399571/NURHAY -/MA Bulanan 14-Dec-2017/ PRUsaver Penagihan Premi 100,000.00 3,000.00 3,000.00
ATI 14-Sep-2019
Total Commission 1,727,308.55

Prudential Life Assurance CONFIDENTIAL Page 3 of 5

(Date Printed: 30-Sep-2019)
 Gross Overriding Detail Statement
Period Ending 20-Sep-2019
(Agency: KOMALA [00135556])
Exchange rate:14,099

Category 1st Tier 2nd Tier 3rd Tier 4th Tier 5th Tier 6th Tier 7th Tier 8th Tier 9th Tier Producer / Level Servicing Year Overriding Overriding
Type %/Commis
sion
DIRECT KOMALA KOMALA/AG KOMALA - 7.14%/5,624.9 401.60
7

KOMALA KOMALA/MA KOMALA 2 20.00%/62,49 12,499.98

9.90

KOMALA KOMALA/MA KOMALA - 7.14%/16,850. 1,203.09

01

KOMALA KOMALA/MA KOMALA - 7.14%/3,000.0 214.20

0

KOMALA KOMALA/MA KOMALA 1 20.00%/275,0 55,000.02

00.10

DIRECT KOMALA KOMALA/AG KOMALA 2 20.00%/10,00 2,000.04

0.20

DIRECT KOMALA KOMALA/UM KOMALA - 7.14%/20,250. 1,445.84

00

KOMALA KOMALA/MA KOMALA - 7.14%/5,750.0 410.55

1

KOMALA KOMALA/MA KOMALA - 7.14%/11,250. 803.25

00

KOMALA KOMALA/MA KOMALA 1 20.00%/275,0 55,000.02

00.10

KOMALA KOMALA/MA KOMALA 2 20.00%/112,5 22,500.00

00.00

KOMALA KOMALA/MA KOMALA - 7.14%/32,499. 2,320.49

99

KOMALA KOMALA/MA KOMALA 2 20.00%/731,4 146,299.98

99.90

KOMALA KOMALA/MA KOMALA - 7.14%/32,499. 2,320.49

99

KOMALA KOMALA/MA KOMALA 2 20.00%/75,00 15,000.00

0.00

DIRECT KOMALA RAHAYUNIN RAHAYUNIN - 7.14%/3,999.9 285.59

GSIH/AG GSIH 9

Prudential Life Assurance CONFIDENTIAL Page 4 of 5

(Date Printed: 30-Sep-2019)
 Loan Deduction Detail Statement
Period Ending 20-Sep-2019
(Agency: KOMALA [00135556])
Exchange rate:14,099

Loan Description Loan No. Instalment Due Instalment Paid

SAMSUNG S2 BUNDLING INDOSAT 2428252 119,961 119,961

Total Loan Deduction 119,961

Outstanding Loan

Loan Description Loan No. Principal Loan Deduction This Period Deduction This Period Accumulative Accumulative Balance
Principal Interest Deduction Deduction
Principal Interest

SAMSUNG S2 2428252 5,758,173 119,961 - 5,278,284 - 479,889

BUNDLING INDOSAT

NOTE: This statement is available until 19-Dec-2019

Prudential Life Assurance CONFIDENTIAL Page 5 of 5

(Date Printed: 30-Sep-2019)