DATA PEGAWAI

DATA PEGAWAI

DEPARTEMENT

: ...................................................................................................................

DEPARTEMENT

: ........................................................................................................

NO. INDUK PEGAWAI

: ...................................................................................................................

NO. INDUK PEGAWAI

: ........................................................................................................

NAMA PEGAWAI

: ...................................................................................................................

NAMA PEGAWAI

: ........................................................................................................

JABATAN

: ...................................................................................................................

JABATAN

: ........................................................................................................

NO. KTP

: ...................................................................................................................

NO. KTP

: ........................................................................................................

NO. NPWP

: ...................................................................................................................

NO. NPWP

: ........................................................................................................

JENIS KELAMIN

JENIS KELAMIN

TEMPAT/TGL.LAHIR

: ...................................................................................................................

TEMPAT/TGL.LAHIR

: ........................................................................................................

ALAMAT SEKARANG

: ...................................................................................................................

ALAMAT SEKARANG

: ........................................................................................................

PRIA

WANITA

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ALAMAT ASAL

: ...................................................................................................................

PRIA

........................................................................................................
ALAMAT ASAL

: ........................................................................................................

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........................................................................................................

TELP/HP

: ...................................................................................................................

TELP/HP

: ........................................................................................................

TANGGAL MASUK

: ...................................................................................................................

TANGGAL MASUK

: ........................................................................................................

PENDIDIKAN TERAKHIR

: ...................................................................................................................

PENDIDIKAN TERAKHIR

: ........................................................................................................

STATUS PERNIKAHAN

BELUM MENIKAH

MENIKAH

STATUS PERNIKAHAN

BELUM MENIKAH

TANGGUNGAN PEGAWAI

ISTRI/SUAMI

ANAK

TANGGUNGAN PEGAWAI

ISTRI/SUAMI

JANDA/DUDA

DATA ANGGOTA KELUARGA

DATA ANGGOTA KELUARGA

NAMA

TTL

NAMA

PENDIDIKAN

NAMA ISTRI/SUAMI

NAMA ISTRI/SUAMI

NAMA ANAK 1

NAMA ANAK 1

NAMA ANAK 2

NAMA ANAK 2

NAMA ANAK 3

NAMA ANAK 3

NAMA ANAK 4

NAMA ANAK 4

TTL

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WANITA

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.......................................................
MENIKAH

JANDA/DUDA

ANAK

TTL

PENDIDIKAN