revisi 02, 11 June 2019

Forms - HRD/RCM-01
HRD-DEPT.

APPLICATION FORM
Position Applied for : Pricing Actuary Date : 30 April 2024
Basic Information (* mandatory fileds)
Name (Full name/Underline Surname) (according KTP) : Jonathan Ryan Wilianto

Place & Date of Birth :Jakarta, 6 Nov 2000 Email Address: jonathanryan576@gmail.com

Citizenship : Indonesia Sex : M Religion : Christian

KTP Number : 3172010611001001 NPWP Number: 3172010611001001

Civil Status :  Single :  Married :  Others :

Where do you live ?  In own home  In rented home  In parents/in-laws/in relatives home

Home Address (according to KTP): Current Address:

Jl. Jembatan II Sinar Budi RT 3 RW 4 Pejagalan, Same as home address.
Penjaringan, Jakarta Utara

Phone number : Home: - Office : - Mobile No.: 0895365313233

How soon can you join : immeadiately Minimum Salary Acceptable : IDR 16.000.000

Additional Information
Languange Proficiency :
Reading Writing Speaking
Language
Poor Fair Good Poor Fair Good Poor Fair Good
1 English   
2 Indonesian   
3
4

HEALTH When was your latest medical check-up ?

Healthy as a horse

Blood Type : O

Please check which of the following test was performed :

 Chest X-Ray  Electrocardiogram ( ECG )
 Blood Count/Culture  Blood Pressure
 Laboratory Examination of Stool, Urine, etc.  Complete Physical Exam

 Others, specify :  Result :

Do you suffer from any serious ailment of physical handicap whose effects impair your ability to
handle the job you are applying for ?  No  Yes, describe :

Education/Pro. Qualifications/Seminar

Name and Address of Inclusive Dates Degree Major Honors/

University Subject Awards
From To
Academy Jun 15 Jun 18 High school Natural Highest mark in
science the national
exam.

University Aug 18 Sep 22 Bachelor Actuarial Best actuarial

science science graduate

Post Graduate / Advance Study

Others Courses

Name some of the Seminars / Workshop you have attended during the last 5 (five) years:

Name of Seminar/Workshop Place Date *) Conducted by :

*) Name of Organization
 Present Employment
Company Name : Sun Life Financial Indonesia

Address : Blok 6.3 Gede Agung Menara Sun Life Jalan Doktor Ide Anak Agung Gde Agung Kawasan
Mega Kuningan, RT.5/RW.2, Kuningan, Kuningan Tim., Kecamatan Setiabudi, Kota Jakarta Selatan,
Daerah Khusus Ibukota Jakarta 12950

Line of Business :  Insurance  Banking  Leasing

 Consumer Goods  Others:

Product / Services : Insurance

Date joined : 7 Nov 2023 Monthly salary : Prohibited from disclosing gross/net*

State various positions held in your present company, starting with the earliest :

Position From-- (Month &Year) – to Monthly Salary

Valuation actuary 7 Nov 2023 Present Prohibited to disclose

Description of Current Job

Report to : Gunawan Indrayana Supervise : -

Main Responsibilities / Significant Achievements :

1. Automation of various reports.
2. Contestant for Sun Star Awards 2023.

Your Position In Organization

I’m reporting to my manager who reports to the Appointed Actuary who reports to Chief
Actuary Officer who reports to the CEO.
 Current Remuneration

Present Annual Remuneration broken down into :

 Basic Salary /month x 12 =

 Annual Bonus =

 Transportation (non-refundable) /month x 12 =

 Others, specify =

Total Annual Remuneration =

Others Benefits :

No. of days’ vacation leave per year : No. of working days per week :

Past Employment History

1st Company 2nd Company 3rd Company

Sun Life Financial
Name & Address Indonesia
Of Company

Insurance
Nature Of Business,
Product & Services

7 Nov 2023 - Present

 Date Joined & Position

Date Left & Position

Prohibited from
Salary On Joining disclosing

Salary On Leaving

Reason for leaving

Family
Spouse’s name (if married) :

Spouse’s Occupation (if working) : Company’s name :

Spouse’s place & date of birth : Date of married :

No Name of Children Sex Place & Date of Birth Education

Family Relation Name Age Education Occupation

Father

Mother

Sibling

Sibling

Sibling

Emergency Contact
Emergency Contact’s Name : Viliana Liunardi

Emergency Contact’s Number : 081930008797

Relationship to Emergency Contact’s : Mother

Others
Do you have any relatives in Manulife Indonesia?  No  Yes, if yes, name and relationship:

Do you have any source of income besides your employment? Describe :

Fixed income obligations

Are you in debt? If you are, to whom, how much and reason:
Not in debt

Are you bonded by any Organisation?  No  Yes, if yes, please specify the organization name
and your position:

Leisure interest/sports/hobbies: Reading, watching movies, playing games.

Are you involved in any administrative, civil or criminal case?

No

If yes, please give the detail of the case

Other Information
Have you ever been suspended or asked to resign from any position?
No

If yes, please explain where & why?

Have you ever been subject to any internal disciplinary proceedings for an incident which relates to
your honesty or integrity?
No
________________________________________________________________________________

If yes, please explain where & why?

Explain any periods of unemployment:

No periods of unemployment
Have you applied with our company before?
No

If yes, give date applied?

Are you refer this position by Manulife’s employee? Yes  No

If Yes, please state our staff name :

Use this space below for additional information you wish to provide concerning yourself or your job
responsibilities (e.g. major achievements, goals, personal interest, etc.)
My hope is to learn as much as I can, giving my best to this company and being well compensated
while doing so.

Name at least 3 (three) persons in business or profession who have known you for at least 5 (five)
years, but who are not your previous employers or your relatives:

Name Phone Number Position Title Company Name

I hereby acknowledge that all the information provided herein is to the best of my knowledge true and
accurate. In the event I am selected for the job, I hereby allow Manulife, my prospective employer, to
verify independently the information contained herein prior to my actual employment and to request
for documentary evidence which supports the statements I have made above such as certificates or
diploma, latest pay slip from my present company, etc. Any material misrepresentation or mission of
information may be grounds for my prospective employer’s decision to reject my application or, in the
event I am hired, for my immediate termination while under probation.

Jonathan Ryan Wilianto

Applicant’s Signature & Date