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Tuesday, April 26, 2011

Contoh Format Surat Keterangan dan Pengantar Desa / Kelurahan


PEMERINTAH KABUPATEN KEBUMEN
KECAMATAN ………………  DESA ……………………
RT …………… RW ……………
 

SURAT PENGANTAR / KETERANGAN
Nomor : ……………………………….

Yang bertanda tangan di bawah ini menerangkan bahwa :
Nama                      :    ...................................................................................................
Tempat / tgl lahir      :    ...................................................................................................
Kewarganegaraan    :    ...................................................................................................
Agama                     :    ...................................................................................................
Alamat                     :    ...................................................................................................
Surat bukti diri          :    KTP No......................................... KK No.................................
Pekerjaan                 :    ...................................................................................................
Keperluan                :    ...................................................................................................
Berlaku mulai           :    ...................................................................................................
Keterangan              :    ...................................................................................................
                                    ...................................................................................................

Demikian keterangan ini kami buat dengan sebenar-benarnya untuk menjadikan periksa dan dapat digunakan seperlunya.

Nomor           :    ......................................................................
Tanggal         :    ......................................................................

…………………….., ………………………..


Ketua RW …………..



(……………………..)
Ketua RT …………..



(……………………..)
Tanda Tangan



(……………………..)



Download format Surat Keterangan tipe Ms. Word (rtf) disini

Contoh-contoh surat yang lainnya, langsung aja cek di TKP

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