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Surat Keterangan Catatan Kepolisian

Surat Keterangan Catatan Kepolisian

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Published by: balhi on Sep 23, 2010
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03/13/2015

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PEMERINTAH KABUPATEN BOGOR

KECAMATAN RUMPIN
KANTOR DESA CIBODAS
Alamat : Jl. Raya Cibodas Rm!i" Bo#o$ Kod% Pos &'()* H!. *+)',-).//)(
SURAT KETERANGAN CATATAN KEPOLISIAN
Nomo$ : /., 0 0 0 0 -*l*
1a"# b%$ta"da ta"#a" di ba2a3 i"i4 5%!ala D%sa Cibodas K%6amata" Rm!i" Kab!at%" Bo#o$ d%"#a"
i"i m%"%$a"#5a" ba32a :
Nama 7%"#5a! : 8888888888888888888888.
T%m!at 0 T#l la3i$ : 8888888888888888888888.
J%"is 5%lami" : 8888888888888888888888.
P%"didi5a" : 8888888888888888888888.
A#ama : 888888888888888888888.....
9a$#a N%#a$a : 8888888888888888888888.
Stats P%$5a2i"a" : 8888888888888888888888.
P%5%$:aa" : 8888888888888888888888.
No KTP : 8888888888888888888888.
Alamat : 8888888888888888888888.
D%"#a" i"i m%"%$a"#5a" d%"#a" s%s"##3"ya ba32a "ama t%$s%bt di atas adala3 b%"a$ 2a$#a D%sa
5ami4 m%"$t s%!%"#%ta3a" 5ami s%sai d%"#a" $%#ist%$ ya"# ada ; Berkelakuan Baik dan Tidak
Tercatat dalam Gerakan 30 S / PKI atau r!ani"a"i terlaran! lainn#a<.
S$at P%$mo3o"a" SKCK i"i dibat "t5 m%l%"#5a!i !%$sya$ata": .
888888888888888888888888888888888888888888
888888888888888888888888888888888888888888
D%mi5ia" !%$mo3o"a" s$at 5%t%$a"#a" 6atata" 5%!olisia" = SKCK > i"i 5ami bat d%"#a" s%b%"a$"ya
"t5 di!%$#"a5a" s%ba#aima"a m%sti"ya.
Cibodas4 8888888888.
KEPA7A DESA CIBODAS
M%"#%ta3i4
Nomo$ : Nomo$ : Nomo$ :
CAMAT RUMPIN DANRAMI7 RUMPIN KAPO7SEK RUMPIN
88888888. 8888888888 8888888888.
NIP. 888888 NRP88888888. NRP88888888..

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