Kepada
KepadaYth.
Yth.
Bpk/
Bpk/Sdr
Sdr
Bpk. Burhanudin- Sri Mulyani (Ani) ....................................................................................
....................................................................................
Debong Tengah Rt II/IV ....................................................................................
....................................................................................
Tegal ....................................................................................
....................................................................................
………………………………..
………………………………..
Yang dikhitan :
DWI INDRAWAN
Putra Bpk. Burhanudin- Sri Mulyani
Hormat kami :