Follow the steps to complete the form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Input your personal data in the 'A. Data Pemohon' section. Provide your full name, NIK (National Identity Number), address, phone number, and email. Specify your relationship to the participant.
3. If applicable, enter data for the 'B. Data Wali Anak' section for children under 18 years of age. Fill in their name, NIK, address, phone number, email, and your relationship to the child.
4. In the 'B. Data Peserta' section, enter details about the participant. This includes their name, NIK or passport number (if they are an international worker), participant number, place and date of birth, mother's name, and last company name.
5. Fill in the cause of death and the date of death in the designated fields.
6. Indicate whether the participant has children who are under 23 years old, unmarried, or not working by selecting 'ada' or 'tidak ada'.
7. For the 'C. Metode Pembayaran' section, choose your preferred payment method, whether it is via bank transfer or cashless. Provide the name of the bank and account number as necessary.
8. Prepare the supporting documents as outlined in the 'D. Dokumen Pendukung' section. Ensure to have a valid BPJS card, identification for heirs or guardians, death certificate, certificate of heirs, family card, active bank book, and any additional documents required.
9. Review all provided information for accuracy. Once confirmed, save your changes, then download, print, or share the completed form.

Start filling out your ID BPJS Ketenagakerjaan Formulir 4 online today!