SPT - 21 - Des - Bend - 2014 - pUSKESMAS pEUSANGAN

IDENTITAS BENDAHARA
1 Masa Pajak (dua digit)*) : 0 1 Tahun Pajak (dua digit) : 1 4

2 Nama Instansi *) : DINAS KESEHATAN KABUPATEN BIREUEN
3 NPWP Instansi *) : 0 0 4 0 9 4 6 4 5 1 0 2
4 Alamat Instansi *) : Jl. Sultan Iskandar Muda
5 No Telepon Instansi *) : 0644 21827
6 Email Instansi :
7 Nama Pimpinan Instansi *) : dr. AMIR ADDANI
8 Nama Bendahara Instansi *) : AGUSTALANI, SKM
9 NIP Bendahara *) : 197308021997031002
10 Tanggal SPT : 3 0 Bulan SPT 0 1 Tahun SPT 1 5
*) Wajib Diisi
0 0 0
Ke 1721 1 1 1
Induk Hal 2
0 0 0 2 2
3 3
4 4
5 5
6 6
Ke 1721-I
7 7
8 8
9 9
Ke 1721-T
Ke 1721-A2
Ke 1770-SS
Ke 1770-S
Ke Isi Data
Pegawai
ISILAH DAFTAR PPH 21 DISAMPING DI ITEM YG BERWARNA
KE INDUK HAL K
1 e Formulir 1721 A2 Ke 1770-SS
PUTIH
NO NAMA NIP GOL PANGKAT JABATAN NPWP
1 TAUFIK HELMI, SKM 19621223 198303 1 002 III.d Penata Tk.I 69.118.007.9-104.000
2 ERLIZA,Amd.Keb 19631009 198511 2 001 III.d Penata Tk.I 69.118.008.7-104.000
3 FAUZI 19651231 198603 1 060 III.d Penata Tk.I 69.118.017.8-104.000
4 MAIMUN 19631231 198703 1 068 III.d Penata Tk.I 78.032.635.1-104.000
5 MARDIANI,SKM 19690316 198803 2 002 III.d Penata Tk.I 69.118.010.3-104.000
6 ISKANDAR 19680103 198803 1 002 III.d Penata Tk.I 78.032.634.4-104.000
7 ROZANNA, AMD.KEB. 19680505 198803 2 001 III.d Penata Tk.I 69.118.018.6-104.000
8 ARNIZA ZA 19680510 198803 2 003 III.d Penata Tk.I 78.032.633.6-104.000
9 ZALIKHA ALI 19640510 198803 2 005 III.d Penata Tk.I 69.118.009.5-104.000
10 JAMILAH 19670616 198812 2 001 III.d Penata Tk.I 69.118.012.9-104.000
11 M. DAUD, AMK 19660112 198812 1 001 III.d Penata Tk.I 89.210.338.3-104.000
12 RUKIAH 19681010 198910 2 001 III.d Penata Tk.I 77.751.803.6-104.000
13 ZAHARA 19680606 199003 2 004 III.d Penata Tk.I 77.751.802.8-101.000
14 NURHAYATI, AMD.KEB. 19700820 199003 2 002 III.d Penata Tk.I 68.964.069.6-104.000
15 BAHRIATI, AMD.KEB. 19710402 199003 2 001 III.d Penata Tk.I 68.964.065.4-104.000
16 ERNA SURYANI 19660916 199102 2 001 III.d Penata Tk.I 69.118.014.5-104.000
17 RAIHANI 19680312 199102 2 001 III.d Penata Tk.I 69.118.013.7-104.000
18 YUSRAWATI, SST 19641231 198711 2 001 III.d Penata Tk.I 69.118.028.5-104.000
19 ZAIFULLI 19631231 198603 1 118 III.d Penata Tk.I 69.118.024.4-104.000
20 NURBAITI, AMK 19661231 198703 2 028 III.d Penata Tk.I 69.118.025.1-104.000
21 RUSLINA ALI 19640917 198703 2 004 III.d Penata Tk.I 69.118.026.9-104.000
22 ALPIDA UMIATI 19670522 198803 2 001 III.d Penata Tk.I 69.118.029.3-104.000
23 CUT RISNAYATI 19670626 198911 2 001 III.d Penata Tk.I 69.118.030.1-104.000
24 ROSDIATI 19680727 199003 2 007 III.d Penata Tk.I 69.118.019.4-104.000
25 SUSIANTI, Amd.Keb. 19700310 199103 2 006 III.d Penata Tk.I 69.118.020.2-104.000
26 ERRYANTI, S.Sos,SST 19721020 199202 2 001 IV.a Pembina 78.032.637.7-104.000
27 JUNIATI,Amd.Keb. 19730618 199202 2 001 III.d Penata Tk.I 78.032.638.5-104.000
28 KISMAWARDANI 19721104 199202 2 001 III.d Penata Tk.I 68.118.021.0-104.000
29 DAHLIANA 19730210 199302 2 001 III.d Penata Tk.I 77.751.804.4-104.000
30 RAHMI HAYATI 19730320 199302 2 002 III.d Penata Tk.I 69.118.022.8-104.000
31 MURDIATI, AMD.KEB. 19730725 199302 2 001 III.d Penata Tk.I 68.964.071.2-104.000
32 TAIBUR 19720704 199403 1 006 III.d Penata Tk.I 14.601.849.4-104.000
33 ASLIDAR 140 210 945 III.b Penata Muda Tk.I 78.032.640.1-104.000
34 CUT SALMIAH 19640812 198803 2 003 III.b Penata Muda Tk.I 69.118.032.7-104.000
35 RUSLI 19631231 198803 1 065 III.b Penata Muda Tk.I 78.032.641.9-104.000
36 YUSNIDAR 19711121 199203 2 003 III.d Penata Tk.I 69.118.033.5-104.000
37 MAWARDI, SKM 19661231 199303 1 061 III.d Penata Tk.I 69.118.037.6-104.000
38 ILYAWATI,AMKL 19690102 199401 2 001 III.d Penata Tk.I 07.803.264.2-104.000
39 ASNAWI, AMK 19720110 199503 1 001 III.d Penata Tk.I 69.118.034.3-104.000
40 JUNAIDI,SKM 19790319 200504 1 001 III.d Penata Tk.I 68.964.066.2-104.000
41 SURAIYA, SKM 19681231 199203 2 019 III.d Penata Tk.I 69.118.036.8-104.000
42 MANSUR, S.Kep. 19760316 199803 1 002 III.d Penata Tk.I 69.118.038.4-104.000
43 MUTIA HANUM, AMK 19731115 200003 2 002 III.c Penata 69.118.040.0-104.000
44 SAFRINA,AMD.KL 19740427 200012 2 001 III.d Penata Tk.I 77.751.805.1-104.000
45 ERNITA APRIDA, AMK 19760426 200112 2 002 III.d Penata Tk.I 69.118.039.2-104.000
46 drg. RINI KARTINIAWATY 19751115 201001 2 001 III.c Penata 14.602.154.8-104.000
47 dr. Eva Susanti 19800525 200907 2 001 III.c Penata 68.709.491.2-102.000
48 MUSTAFA, AMKL 19720319 199502 1 001 III.c Penata 77.751.086.9-104.000
49 LISA RISNANDA, Amd.Keb 19761023 200604 2 004 III.a Penata Muda 78.364.493.3-104.000
50 EVI JULIANTI, AMK 19760305 200212 2 004 III.c Penata 69.118.041.8-104.000
51 YUSLIANA, S.Pd 19690910 199803 2 003 III.c Penata 69.118.042.6-104.000
52 MULIDARYANI 19760313 199905 2 001 III.c Penata 77.751.808.5-104.000
53 NURBAYANI,AMG 19750611 200312 2 001 III.c Penata 16.562.520.3-101.000
54 NURLI IDAMAN 19760510 200701 2 027 II.d Pengatur Tk.I 16.574.188.5-101.000
55 MARTINI, SKM 19850316 200904 2 008 III.b Penata Muda Tk.I 16.895.697.7-104.000
56 ZANITA, SKM 19810822 200904 2 004 III.b Penata Muda Tk.I 15.596.464.6-104.000
57 MOHAMMAD IRFAN, SKM 18820119 201003 1 001 III.b Penata Muda Tk.I 78.987.940.0-104.000
58 NS. ELFIANA, S.KEP. 19820401 201003 2 001 III.b Penata Muda Tk.I 15.891.748.4-104.000
59 NURHAYATI ,AMD.KEP. 19700829 199403 2 001 III.b Penata Muda Tk.I 77.751.832.5-104.000
60 YUNIATI 19700626 199403 2 003 III.a Penata Muda 77.751.833.3-104.000
61 SYUKRI MONI 19730916 200012 1 001 III.b Penata Muda Tk.I 78.364.542.7-104.000
62 ERFINA,AMK 19771110 200504 2 003 III.b Penata Muda Tk.I 78.364.575.7-104.000
63 SRI KAMALIA 19701009 200012 2 002 III.b Penata Muda Tk.I 78.364.570.8-104.000
64 KEUMALA SUKMA HAYATI 19800623 200112 2 001 III.a Penata Muda 78.364.560.9-104.000
65 ZULIANA 19750726 200212 2 002 III.a Penata Muda 78.364.579.9-104.000
66 SUSI HERLINA,AMD.KEB 19810622 200604 2 004 III.b Penata Muda Tk.I 78.032.647.6-104.000
67 SUFIANA,AMD.KEB. 19811125 200604 2 006 III.a Penata Muda 78.032.646.8-104.000
68 VINA MORA AMD.KEP. 19790301 200604 2 006 III.b Penata Muda Tk.I 78.032.645.0-104.000
69 ABD.HADI,AMD.KEP 19830305 200604 1 009 III.b Penata Muda Tk.I 77.751.810.1-102.000
70 VIVI YANTI MALA,AMD.KEP 19770306 200604 2 003 III.b Penata Muda Tk.I 78.364.554.2-104.000
71 DIANA,AMKL 19740310 200604 2 007 III.b Penata Muda Tk.I 78.364.546.8-104.000
72 SUWARNI,AMD.AK 19770626 200604 2 011 III.b Penata Muda Tk.I 78.032.648.4-104.000
73 SAFRIDA,AMD.KEP 19740311 200604 2 006 iii.b Penata Muda Tk.I 78.364.557.5-104.000
74 KHAIRUNNISAK,AMD.KEB. 19770604 200604 2 013 III.a Penata Muda 07.775.184.2-104.000
75 HUSNIAR,AMD.KEB. 19770305 200604 2 010 III.a Penata Muda 78.364.507.0-104.000
76 YUSTIANOVA,AMD.KEB. 19770504 200604 2 019 III.b Penata Muda Tk.I 78.032.649.2-104.000
77 DESTY SAIDAH, AMD.KEP. 19791217 200604 2 009 III.b Penata Muda Tk.I 14.813.434.9-104.000
78 ONNI WAJBURNI, Amd.Keb 19761019 200701 2 002 II.d Pengatur Tk.I 77.735.821.9-104.000
79 MARLIANI,AMK 19750925 200701 2 001 III.a Penata Muda 78.364.550.0-104.000
80 ERMI SOFIATI,AMK 19710728 200701 2 001 III.a Penata Muda 77.751.839.0-104.000
81 DAHLIANI,AMD.KEB. 19760520 200701 2 003 III.a Penata Muda 77.230.997.7-104.000
82 ROSNIAR,AMK 19750513 200701 2 004 III.a Penata Muda 77.751.938.2-104.000
83 JUNIARNI,AMD.KEB. 19730623 200701 2 002 III.a Penata Muda 77.231.000.9-104.000
84 CUT ELLY AZRIYANI,AMD.AK 19791007 200701 2 001 III.a Penata Muda 78.364.571.6-104.000
85 MULIZAR, Amd.Keb. 19801214 200904 2 003 II.d Pengatur Tk.I 15.418.244.8-104.000
86 IFDAR,AMK 19750404 200701 1 004 III.a Penata Muda 77.230.990.2-104.000
87 YUSNI,AMKL 19780401 200701 2 002 III.a Penata Muda 78.364.577.3-104.000
88 NURLINDA,AMK 19740710 200701 2 004 III.a Penata Muda 78.032.650.0-104.000
89 RATNAWATI,AMK 19761016 200701 2 002 III.a Penata Muda 07.775.181.7-104.000
90 ZAHARA,AMK 19740626 200701 2 003 III.a Penata Muda 78.364.563.3-104.000
91 SAFNIDA,AMK 19741011 200701 2 002 III.a Penata Muda 78.364.556.7-104.000
92 NURLINA,AMD.KEB. 19740817 200701 2 005 III.a Penata Muda 77.231.004.1-104.000
93 ZAINIAR,AMD.KEB. 19731231 200701 2 024 III.a Penata Muda 77.230.999.3-104.000
94 IRMA YANTI 19760207 200701 2 002 II.c Pengatur 14.680.948.8-104.000
95 YUSRAWATI,AMD.KEB 19800909 200801 2 002 III.a Penata Muda 77.230.992.8-014.000
96 CUT NURMALIZA,AMD.KEB 19810303 200801 2 004 II.d Pengatur Tk.I 78.364.532.8-104.000
97 YUSMANIDAR,AMD.KEB 19810112 200801 2 001 III.a Penata Muda 77.751.829.1-101.000
98 YUSFASARI,AMD.KEB. 19810528 200801 2 001 III.a Penata Muda 78.364.511.2-104.000
99 PUTRI YANTI,AMD.KEB 19810912 200801 2 002 III.a Penata Muda 77.751.821.8-104.000
100 MURNIANA,AMK 19760805 200801 2 001 III.a Penata Muda 78.364.553.4-104.000
101 NURMAWATI,AMK 19760818 200801 2 005 III.a Penata Muda 78.032.652.6-104.000
102 DARMIATI,AMK 19760906 200801 2 002 III.a Penata Muda 78.364.555.9-104.000
103 JULIZAR,AMK 19761226 200801 2 001 III.a Penata Muda 78.364.568.2-104.000
104 ZUHURYATI,AMK 19770913 200801 2 001 III.a Penata Muda 77.751.835.8-104.000
105 ROSDIANA,AMD.KEB 19810706 200801 2 002 III.a Penata Muda 77.230.966.2-104.000
106 ROSNAWATI,AMD.KEB 19790312 200801 2 002 III.a Penata Muda 78.364.520.3-104.000
107 NUR AINI,AMD.KEB 19710405 200801 2 001 III.a Penata Muda 77.751.824.2-104.000
108 IRYANI,AMD.AK 19800511 200801 2 003 III.a Penata Muda 77.751.819.2-104.000
109 LINAWATI,AMK 19800420 200801 2 003 III.a Penata Muda 78.364.576.4-104.000
110 MUNIDAR,AMK 19790320 200801 2 003 III.a Penata Muda 77.230.967.0-104.000
111 MARYATI,AMK 19770326 200801 2 002 III.a Penata Muda 77.230.966.2-104.000
112 INTAN MAYASARI,AMD.KEB 19801217 200801 2 002 III.a Penata Muda 77.230.975.3-104.000
113 SURYANI,AMD.KEB. 19810926 200801 2 001 III.a Penata Muda 77.230.981.1-104.000
114 AGUSDIANA,AMD.KEB. 19820808 200801 2 001 III.a Penata Muda 77.231.010.8-104.000
115 ARNITA,AMD.KEB. 19820807 200801 2 003 III.a Penata Muda 14.813.411.7-104.000
116 ERNIDA,AMD.KEB. 19820602 200801 2 001 III.a Penata Muda 77.751.812.7-104.000
117 WARDANI,AMD.KEB. 19801129 200504 2 001 III.b Penata Muda Tk.I 78.364.564.1-104.000
118 SRI WAHYUNI,AMD.KEB. 19820215 200801 2 001 III.a Penata Muda 78.364.534.4-104.000
119 FARIDAH HANUM,AMD.AK 19810327 200801 2 004 III.a Penata Muda 77.230.984.5-104.000
120 ELI ZAHARA,AMD.KEB. 19830102 200801 2 001 III.a Penata Muda 77.751.811.9-104.000
121 FAKHRIAH,AMD.KEB. 19800701 200801 2 002 III.a Penata Muda 77.230.964.7-104.000
122 FITRIANI,AMK 19720511 200801 2 001 III.a Penata Muda 78.032.651.8-104.000
123 SARINI,AMD.KEB. 19791201 200801 2 006 III.a Penata Muda 77.230.980.3-104.000
124 HELMIANA,AMD.KEB. 19800513 200801 2 002 III.a Penata Muda 78.364.489.1-104.000
125 ROSLINAR,AMD.KEB 19790615 200801 2 004 III.a Penata Muda 78.364.499.0-104.000
126 LENNY SELVIANA,AMD.KEB. 19790112 200801 2 002 II.d Pengatur Tk.I 79.364.506.2-104.000
127 MAWADDAH,AMD.KEB. 19810104 200801 2 002 III.a Penata Muda 77.230.965.4-104.000
128 MARDIANA,AMD.KEB. 19810115 200801 2 002 III.a Penata Muda 78.364.521.1-004.000
129 ROZANA,AMD.KEB. 19820108 200801 2 003 III.a Penata Muda 77.751.820.0-104.000
130 MUSLINA,AMD.KEB. 19810605 200801 2 001 III.a Penata Muda 77.751.816.8-104.000
131 MUTIAWATI,AMD.KEB. 19820202 200801 2 003 III.a Penata Muda 77.230.983.7-104.000
132 LEHA NIAFRIANI, Amd.Kep. 19830415 201003 2 003 II.d Pengatur Tk.I 79.311.123.8-101.000
133 MISBAHUL JANNAH,AMD.KEB. 19820704 200801 2 002 III.a Penata Muda 77.231.012.4-104.000
134 TITIN MURDIANTI,AMD.KEB. 19820715 200801 2 002 III.a Penata Muda 78.364.512.0-104.000
135 RIZALDI, AMK 390031322 III.b Penata Muda Tk.I 77.751.841.6-104.000
136 NURMAIZAR, AMG 19850406 200904 2 007 II.d Pengatur Tk.I 78.914.658.6-104.000
137 Leni Zahara, AMG 19831107 200904 2 005 II.d Pengatur Tk.I 15.418.311.5-104.000
138 Zukhrina, S.Kep. 19870729 200904 2 002 III.a Penata Muda 15.418.310.7-104.000
139 Agustia Kameria, Amd.Keb. 19871101 200904 2 002 II.d Pengatur Tk.I 78.914.659.4-104.000
140 Lenny Heliana, Amd.Keb. 19830313 200904 2 007 II.d Pengatur Tk.I 15.596.463.8-104.000
141 Khairuddin, AMK 19841129 200904 1 002 II.d Pengatur Tk.I 16.250.402.1-104.000
142 ZAITUN, AMD.KEP. 19800413 201003 2 001 II.d Pengatur Tk.I 79.311.125.3-104.000
143 ULFA ZAKIAH, AMD.FAR. 19821205 201003 2 003 II.d Pengatur Tk.I 79.311.126.1-104.000
144 VUSPA SARI SIREGAR, AMD.K 19850921 201003 2 003 II.d Pengatur Tk.I 79.311.127.9-104.000
145 CUT LIA AZLIANA, AMD.KEP. 19840916 201003 2 002 II.d Pengatur Tk.I 16.036.319.8-104.000
146 CUT AYUYULIANTI, AMD.KEP. 19810420 201003 2 001 II.d Pengatur Tk.I 79.311.124.6-102.000
147 EDDEY SAPUTRA, AMD.KEP. 19820326 201003 1 001 II.d Pengatur Tk.I 78.913.734.6-104.000
148 IMELDA, SST 19851101 201003 2 003 III.a Penata Muda 48.327.963.4-104.000
149 CUT ELYSMA SANTI, Amd.Keb. 19780626 201003 2 002 II.d Pengatur Tk.I 57.807.459.3-104.000
150 ZAKIAH 19740327 200012 2 001 III.a Penata Muda 78.364.551.8-104.000
151 MAHDI 19610804 199906 1 001 II.d Pengatur Tk.I 00.000.000.0-000.000
152 SOUFNIDAR 19820107 200312 2 001 II.d Pengatur Tk.I 78.364.558.3-104.000
153 KARMI DARSEH 19770828 201103 2 001 II.c Pengatur 71.970.543.6-104.000
154 AZHAR 19751101 200504 1 001 II.d Pengatur Tk.I 77.230.987.8-104.000
155 MAHMUD 19800517 200504 1 001 II.c Pengatur 78.364.543.5-104.000
156 AZWANI 19730306 200604 1 004 II.c Pengatur 16.895.549.0-104.000
157 MUSMULYADI 19740603 200604 1 001 II.d Pengatur Tk.I 77.751.813.5-104.000
158 SAFRIZAL 19831120 200604 1 002 II.d Pengatur Tk.I 78.364.548.4-104.000
159 Syarifah Raudhah 19780722 200504 2 003 II.d Pengatur Tk.I 78.364.573.2-105.000
160 RAHMATINA, S.ST. 19770122 200504 2 001 III.a Penata Muda 77.231.003.3-104.000
161 ROSTINA 19760617 200504 2 001 II.d Pengatur Tk.I 77.230.993.6-104.000
162 HUSNA, Amd.Keb. 19770208 200604 2 003 II.c Pengatur 77.751.834.1-104.000
163 NUR IDAWATI 19790222 200604 2 002 II.c Pengatur 77.230.991.0-102.000
164 NURAIDAR, Amd.Keb. 19750102 200604 2 010 II.c Pengatur 78.364.518.7-104.000
165 FAUZIAH, Amd.Keb. 19740407 200604 2 010 II.c Pengatur 78.364.510.4-104.000
166 NURSIAH 19740327 200604 2 008 II.c Pengatur 78.364.495.8-104.000
167 NURHAYATI, Amd.Keb. 19750720 200604 2 013 II.c Pengatur 77.230.972.0-104.000
168 DELLIANA 19750727 200604 2 014 II.d Pengatur Tk.I 77.231.001.7-104.000
169 FARIDHAL 19790722 200604 1 008 II.d Pengatur Tk.I 78.364.559.1-104.000
170 MUSLINA 19790802 200604 2 011 II.d Pengatur Tk.I 78.364.552.6-104.000
171 ROSNITAWATI, AMD.Keb 19750905 201003 2 001 II.c Pengatur 77.760.451.3-104.000
172 FAUZIAH 19740303 200604 2 013 II.c Pengatur 77.751.825.9-104.000
173 SITI RADHIAH, Amd.Keb. 19771028 200701 2 001 III.a Penata Muda 14.875.187.8-104.000
174 SYAFIRA KEMALASARI 19771103 200701 2 001 II.c Pengatur 78.364.522.9-104.000
175 SYARIFAH ZUHRA, Amd.Keb. 19770402 200701 2 003 II.d Pengatur Tk.I 78.032.655.9-104.000
176 ERNILA, Amd.keb. 19770410 200701 2 004 II.c Pengatur 78.364.513.8-104.000
177 KHAIRUNA 19770429 200701 2 004 II.d Pengatur Tk.I 77.230.976.1-104.000
178 ELFIDA, Amd.Keb. 19750803 200701 2 004 II.d Pengatur Tk.I 77.231.005.8-104.000
179 RITA HANDAYANI, Amd.Keb. 19770906 200701 2 002 II.d Pengatur Tk.I 77.231.002.5-104.000
180 FARHATI, Amd.Keb. 19770923 200701 2 001 II.c Pengatur 78.364.516.1-104.000
181 JULIAWATI, Amd.Keb. 19760715 200701 2 002 II.c Pengatur 78.364.515.3-104.000
182 AISYAH 19760616 200701 2 007 II.c Pengatur 77.230.995.1-104.000
183 MARDALENA 19770312 200701 2 002 II.c Pengatur 77.751.818.4-104.000
184 SYAFRIDAH, Amd.Keb. 19761208 200701 2 002 II.d Pengatur Tk.I 78.364.485.9-104.000
185 HASANAH, Amd.Keb. 19770301 200701 2 004 II.c Pengatur 78.364.501.3-104.000
186 HERAWATI 19700412 200701 2 006 II.b Pengatur Muda Tk.I 77.230.989.4-104.000
187 MEUTIA 19740110 200701 2 003 II.d Pengatur Tk.I 78.364.530.2-104.000
188 NURMASYITHAH, Amd.Keb. 19731009 200701 2 002 II.c Pengatur 78.364.497.4-104.000
189 ROSNILAWATI 19750510 200701 2 003 II.a Pengatur Muda 78.364.508.8-104.000
190 HUSNA, SKM 19780310 200904 2 003 III.b Penata Muda Tk.I 88.978.839.4-104.000
191 HAYATI 19760608 200701 2 001 II.c Pengatur 77.231.007.4-104.000
192 MURSYIDAH 19730520 200701 2 006 II.d Pengatur Tk.I 78.364.525.2-104.000
193 YUSRIATI 19730328 200701 2 004 II.d Pengatur Tk.I 78.364.514.6-104.000
194 SYUKRIAH, Amd.keb. 19720603 200701 2 004 II.c Pengatur 78.364.500.5-104.000
195 IRMA, Amd.Keb. 19720308 200701 2 003 II.c Pengatur 78.032.658.3-104.000
196 NURAIDAWATI, Amd.Keb. 19731130 200701 2 001 II.c Pengatur 78.364.494.1-104.000
197 MARLINDA, Amd.Keb. 19760109 200701 2 002 II.d Pengatur Tk.I 77.230.994.4-104.000
198 RUSMALA DEWI, Amd.Keb. 19760621 200701 2 003 II.c Pengatur 78.364.484.2-104.000
199 ZULINA, Amd.Keb. 19761113 200701 2 001 II.d Pengatur Tk.I 77.231.011.6-104.000
200 ELVIANA, Amd.Keb. 19721018 200701 2 002 II.c Pengatur 78.364.523.7-104.000
201 METTI HERIZAWANI 19730120 200701 2 003 II.c Pengatur 77.751.837.4-104.000
202 CHALIDAH 19730320 200701 2 005 II.c Pengatur 77.751.809.3-104.000
203 AZIZAH 19730514 200701 2 005 II.c Pengatur 77.231.006.6-104.000
204 FALIL YULLAH 19790201 200701 1 001 II.c Pengatur 78.364.539.3-104.000
205 CUT SALIHATI 19781206 200701 2 003 II.b Pengatur Muda Tk.I 78.364.576.5-104.000
206 IBRAHIM 19610303 200701 1 003 II.b Pengatur Muda Tk.I 78.364.565.8-104.000
207 MURNI, Amd.Keb. 19751231 200701 2 015 II.c Pengatur 78.364.503.9-104.000
208 SALWA HANUM 19730315 200701 2 001 II.d Pengatur Tk.I 77.230.969.6-104.000
209 NAJMI SORAIYA 19810814 200701 2 002 II.c Pengatur 77.751.831.7-104.000
210 MERI JUANDA, S.Kep. 19750807 200701 1 003 III.a Penata Muda 78.032.659.1-104.000
211 RITAWATI, Amd.Keb 19761105 200701 2 005 II.c Pengatur 78.364.509.6-104.000
212 FAJRAINI 19770710 200701 2 004 II.b Pengatur Muda Tk.I 07.836.452.4-104.000
213 CUT NANAWATI 19770716 200701 2 002 II.d Pengatur Tk.I 77.231.009.0-104.000
214 HASMALINA, Amd.keb. 19731215 200701 2 034 II.c Pengatur 78.364.486.7-104.000
215 MARDIANA 19741111 200701 2 022 II.c Pengatur 78.032.660.9-104.000
216 ZURYATI 19750715 200801 2 002 II.b Pengatur Muda Tk.I 78.032.661.7-104.000
217 JULIATI 19780701 200801 2 002 II.c Pengatur 77.230.979.5-104.000
218 NURLAILA, AMD.KEB. 19780418 200801 2 003 II.d Pengatur Tk.I 77.231.008.2-104.000
219 SARADILLA, Amd.Keb. 19780417 200801 2 001 II.d Pengatur Tk.I 78.032.662.5-104.000
220 IDALAILA, Amd.Keb. 19780708 200801 2 002 II.d Pengatur Tk.I 77.230.988.6-104.000
221 NINA ZURITA 19780330 200801 2 003 II.c Pengatur 78.364.526.6-104.000
222 YULIANA, Amd.Keb. 19780415 200801 2 002 II.d Pengatur Tk.I 15.418.214.1-104.000
223 FITRI YANTI 19771211 200801 2 002 II.c Pengatur 78.364.492.5-104.000
224 NURLINA 19750824 200801 2 001 II.c Pengatur 77.751.836.6-104.000
225 HASNIDAR, Amd.Keb. 19780926 200801 2 001 II.c Pengatur 78.032.663.1-104.000
226 SUMARNI 19790509 200801 2 005 II.d Pengatur Tk.I 78.032.665.8-104.000
227 KAMARIAH, S.Kom 19731001 200801 2 001 III.a Penata Muda 78.364.545.0-104.000
228 SUSANTI, Amd.Keb. 19781114 200801 2 001 II.d Pengatur Tk.I 78.032.663.3-104.000
229 NURFIDA, S.Kep. 19820421 200801 2 002 III.a Penata Muda 15.418.312.3-104.000
230 KHAIRANITA 19790107 200801 2 003 II.d Pengatur Tk.I 78.364.531.0-104.000
231 SURYATI 19811231 200801 2 004 II.c Pengatur 07.775.182.8-101.000
232 T. ZULKIFLI, S.Kep. 19811228 200801 1 002 III.a Penata Muda 78.364.561.7-104.000
233 YANTI AFRINA, Amd.Keb. 19790411 200801 2 002 II.d Pengatur Tk.I 78.032.666.6-104.000
234 HERIZAL 19811106 200801 1 002 II.b Pengatur Muda Tk.I 14.911.927.3-104.000
235 HERANOVARINI 19801125 200801 2 002 II.c Pengatur 78.364.502.1-104.000
236 ERI MIRZAL 19830206 200801 1 002 II.c Pengatur 78.987.933.5-104.000
237 ASMAIZAR, Amd.Keb. 19761106 200801 2 001 II.c Pengatur 78.364.487.5-104.000
238 NURLINA 19800920 200801 2 004 II.c Pengatur 77.751.830.9-104.000
239 HANUM HANISAH 19781226 200801 2 001 II.c Pengatur 77.230.970.4-104.000
240 IRAWATI 19790323 200801 2 007 II.c Pengatur 77.280.971.2-104.000
241 ROSNITA 19761206 200801 2 001 II.b Pengatur Muda Tk.I 78.364.488.3-104.000
242 CUT YUSMAWATI, Amd.keb. 19740901 200801 2 001 II.c Pengatur 78.364.529.4-104.000
243 MAILIDA 19770512 200801 2 007 II.c Pengatur 77.230.978.7-104.000
244 NURAIDA, Amd.Keb. 19790630 200801 2 001 II.c Pengatur 77.751.840.8-104.000
245 SAFRINA 19790923 200801 2 003 II.b Pengatur Muda Tk.I 78.364.517.9-104.000
246 SUSIYANTI, Amd.Keb. 19780620 200801 2 001 II.d Pengatur Tk.I 77.230.974.6-104.000
247 MURIZAYANI 19760612 200701 2 004 II.c Pengatur 78.364.569.0-104.000
248 ZAINUDDIN 19790709 200701 1 003 II.c Pengatur 78.364.580.7-104.000
249 NUR MASYITHAH, Amd.keb. 19840202 200904 2 004 II.d Pengatur Tk.I 16.864.887.5-104.000
250 YULHAIDA 19820714 200801 2 002 II.c Pengatur 77.751.827.5-101.000
251 NURASYIAH 19760105 200801 2 002 II.c Pengatur 78.032.667.4-104.000
252 MULYANA 19830624 200801 2 001 II.c Pengatur 77.751.826.7-104.000
253 ROSMIWAR 19770809 200801 2 003 II.b Pengatur Muda Tk.I 78.364.541.9-104.000
254 HERAWATI 19821105 200801 2 003 II.b Pengatur Muda Tk.I 78.364.549.2-104.000
255 NURASMARANI 19770419 201001 2 005 II.b Pengatur Muda Tk.I 16.036.314.9-104.000
256 RAHMI 19750820 201001 2 002 II.b Pengatur Muda Tk.I 16.036.315.6-104.000
257 FERANITA 19710730 201001 2 001 II.a Pengatur Muda 48.324.610.4-104.000
258 LINDAWATI 19761225 200801 2 001 II.c Pengatur 78.032.669.0-104.000
259 IZARWANI 19830407 200904 2 008 II.c Pengatur 15.450.068.0-104.000
260 ERNADIA 19820428 200801 2 001 II.c Pengatur 77.751.815.0-104.000
261 MAYRISFIADI 19840519 200801 1 002 II.c Pengatur 78.364.554.3-104.000
262 RAHMA 19830709 200801 2 001 II.c Pengatur 78.032.668.2-104.000
263 YUSNA 19750620 199906 2 001 II.b Pengatur Muda Tk.I 78.364.566.6-104.000
264 SRI MASTUTI 19780616 200901 2 001 II.b Pengatur Muda Tk.I 15.418.264.3-104.000
265 ZAKIAH 19860720 201001 2 008 II.b Pengatur Muda Tk.I 48.324.608.8-104.000
266 DARYANI 19810701 200801 2 002 II.c Pengatur 78.032.670.8-104.000
267 DIAN MAYASARI, AMK 19830114 200904 2 006 II.d Pengatur Tk.I 07.891.465.6-104.000
268 FITRI YULLIANI 19770726 200904 2 001 II.b Pengatur Muda Tk.I 15.596.465.3-104.000
269 RAHMAD AFDHAL 19900515 201003 1 001 II.b Pengatur Muda Tk.I 78.913.728.8-104.000
270 HERI PUTRA 19861214 201003 1 001 II.b Pengatur Muda Tk.I 16.036.328.9-104.000
271 LISMAWATI 19900520 201003 2 001 II.b Pengatur Muda Tk.I 78.914.660.2-104.000
272 DONA NINGSIH 19811211 201003 2 002 II.b Pengatur Muda Tk.I
273 DEPI WAHYUNI 19790607 201003 2 001 II.b Pengatur Muda Tk.I 78.914.657.8-104.000
274 USMAN 19641231 199203 1 081 II.a Pengatur Muda 78.364.572.4-104.000
275 ROSLINA 19760622 200701 2 015 I.d Juru Tk.1 08.032.671.6-104.000
276 NURBAITI 19731210 200801 2 001 II.a Pengatur Muda 77.230.985.2-104.000
277 M. ALI 19691112 200901 1 001 II.a Pengatur Muda 15.418.245.5-104.000
278 NURLAILA 19760616 201001 2 009 I.b Juru Muda Tk.1 48.326.299.4-104.000
279 ROHANI 19601231 200604 2 025 I.b Juru Muda Tk.1 77.230.998.5-104.000
280 MASRI,AMK 19750311 200701 1 003 III.a Penata Muda 78.364.538.5-104.000
281 ERLINAWATI, AMK 19750315 200904 2 001 III.a Penata Muda 16.860.886.7-104.000
282 NURLAILA, AMD.KEB. 19860817 201003 2 001 II.d Pengatur Tk.I 16.444.698.1-104.000
283 USWATUN HASANAH, Amd.Keb19811027 200312 2 004 III.b Penata Muda Tk.I 79.311.305.1-104.000
284 FITRIANI, AMKG 19841212 201003 2 003 II.d Pengatur Tk.I 48.327.964.2-104.000
285 RITA SAHARA 19800131 201003 2 001 II.b Pengatur Muda Tk.I 79.068.850.1-102.000
286 IMANDA SASMITA, SKM 19800609 200904 2 002 III.b Penata Muda Tk.I 16.101.758.7-104.000
287 LINDAWATI, Amd.Pk. 19800608 200904 2 004 II.d Pengatur Tk.I 87.021.761.9-104.000
288 NURLIZAWATI, Amd.Kep 19840310 201003 2 002 II.d Pengatur Tk.I 48.327.157.3-104.000
289 CUT LAILA AMNA, Amd.Kg. 19850305 201003 2 002 II.c Pengatur 16.541.560.5-101.000
290 MAHDI, SKM 19661018 198803 1 013 III.d Penata Tk.I 69.111.711.3-104.000
291 dr. IKHSAN 19730825 200504 1 002 IV.a Pembina 06.860.748.9-104.000
292 dr. EMY HANDRIANY 19820424 200904 2 008 III.c Penata 79.311.225.1-104.000
293 dr. Eva Diana 19820508 201406 2 002 III.b Penata Muda Tk.I 15.450.289.2-104.000
294 dr. Suraiyyandar Zakiah 19840120 201406 2 003 III.b Penata Muda Tk.I 36.431.213.2-104.000
295 dr. Suryani 19850626 201406 2 003 III.b Penata Muda Tk.I 15.520.692.3-104.000
296 dr. Nurrahmi 19800625 201406 2 001 III.b Penata Muda Tk.I 71.949.604.4-104.000
297 dr. Etty Kartika Chandra 19840224 201406 2 002 III.b Penata Muda Tk.I 66.459.189.8-104.000
298 dr. Dara Farasina 19841101 201406 2 004 III.b Penata Muda Tk.I 15.596.323.4-104.000
299 dr. Millati Amalia 19870831 201406 2 001 III.b Penata Muda Tk.I 71.991.382.4-104.000
300 Salma, SKM, S.Kep. 19730223 200003 2 001 III.d Penata Tk.I 69.118.035.0-104.000
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Ke identitas WP
TUJANGAN
JABATAN/TUNJ
GAJI POKOK
KODE Jenis Gaji dan TUNJANGAN TUNJANGAN ANGAN
ALAMAT BULAN JML Gaji
KELUARGA Kelamin tunjangan 13 ISTRI ANAK FUNGSIONAL/
DESEMBER
TJUM
SEBULAN
Pante Pisang K3 Laki-laki 3,927,200 3,927,200 392,720 157,088 4,477,008 500,000

Pante Pisang TK 0 Wanita 3,807,300 3,691,100 0 0 3,807,300 500,000
Babah Jurong, kec. Kuta Blang, Kab. Bire K2 Laki-laki 3,691,100 3,691,100 369,110 147,644 4,207,854 500,000
Krueng Dheue, Kec. Peusangan, Kab. Bir K2 Laki-laki 3,578,400 3,578,400 357,840 143,136 4,079,376 500,000
Keude Matangglumpangdua, Kec. Peusang K 2 3,578,400 3,578,400 357,840 143,136 4,079,376 500,000
Tingkeum Manyang K2 Laki-laki 3,578,400 3,578,400 357,840 143,136 4,079,376 500,000
Cot Bada K2 Wanita 3,578,400 3,578,400 357,840 143,136 4,079,376 500,000
Matangglumpangdua TK 0 Wanita 3,578,400 3,578,400 0 0 3,578,400 500,000
Paya Cut, Kec. Peusangan, Kab. Bireuen K2 Wanita 3,578,400 3,578,400 357,840 143,136 4,079,376 500,000
Gp.Raya Dagang, Kec. Peusangan, Kab. TK 2 Wanita 3,578,400 3,578,400 0 143,136 3,721,536 500,000
Mns. Dayah, kec. Peusangan, Kab. Bireu K1 Laki-laki 3,578,400 3,578,400 357,840 71,568 4,007,808 500,000
Matang Cot paseh K2 Wanita 3,578,400 3,469,100 357,840 143,136 4,079,376 500,000
K2 Wanita 3,363,200 3,363,200 336,320 134,528 3,834,048 500,000
Meunasah Meucap TK 2 Wanita 3,469,100 3,469,100 0 138,764 3,607,864 600,000
Pante Piyeu K2 Wanita 3,469,100 3,469,100 346,910 138,764 3,954,774 500,000
Keude Matang K2 Wanita 3,469,100 3,469,100 346,910 138,764 3,954,774 500,000
Blang Asan TK 0 Wanita 3,469,100 3,469,100 0 0 3,469,100 500,000
Mns. Dayah K2 Wanita 3,691,100 3,578,400 369,110 147,644 4,207,854 500,000
Pante Gajah K2 Laki-laki 3,541,300 3,541,300 354,130 141,652 4,037,082 500,000
Blang Asan K2 Wanita 3,691,100 3,691,100 369,110 147,644 4,207,854 500,000
Bireuen K2 Wanita 3,541,300 3,541,300 354,130 141,652 4,037,082 500,000
Pante Gajah TK 2 Wanita 3,578,400 3,578,400 0 143,136 3,721,536 500,000
Matangglumpangdua K2 Wanita 3,578,400 3,469,100 357,840 143,136 4,079,376 500,000
Pante Piyeu K2 Wanita 3,469,100 3,469,100 346,910 138,764 3,954,774 500,000
Snb. Aceh K2 Wanita 3,469,100 3,469,100 346,910 138,764 3,954,774 500,000
Peusangan Selatan K2 Wanita 3,505,400 3,505,400 350,540 140,216 3,996,156 850,000
Peusangan Selatan TK 0 Wanita 3,363,200 3,363,200 0 0 3,363,200 600,000
Matang Sagoe TK 0 Wanita 3,363,200 3,260,500 0 0 3,363,200 500,000
Blang Panjoe K2 Wanita 3,363,200 3,363,200 336,320 134,528 3,834,048 500,000
Jangka Alue U K1 Wanita 3,363,200 3,363,200 336,320 67,264 3,766,784 500,000
Peusangan Selatan K2 Laki-laki 3,260,500 3,260,500 326,050 130,420 3,716,970 500,000
Gp.Raya Dagang TK 0 Wanita 3,293,800 3,293,800 0 0 3,293,800 265,000
TK 0 Laki-laki 3,293,800 3,293,800 0 0 3,293,800 265,000
Grugok K2 Wanita 3,363,200 3,363,200 336,320 134,528 3,834,048 500,000
Pante Baro K2 Wanita 3,363,200 3,363,200 336,320 134,528 3,834,048 500,000
Bale Stui K2 Laki-laki 3,260,500 3,160,900 326,050 130,420 3,716,970 500,000
Geulanggang Teungoh K2 Laki-laki 2,970,800 2,970,800 297,080 118,832 3,386,712 540,000
Pante Gajah TK 0 Wanita 3,363,200 3,363,200 0 0 3,363,200 600,000
Neheun K1 Laki-laki 3,064,400 2,940,000 306,440 61,288 3,432,128 600,000
Matang Sagoe K2 Wanita 2,940,000 2,850,300 294,000 117,600 3,351,600 500,000
Tingkeum Manyang TK 0 Wanita 3,064,400 3,064,400 0 0 3,064,400 500,000
Pante Gajah K1 Wanita 3,064,400 2,940,000 306,440 61,288 3,432,128 500,000
Pante Lhong K2 Wanita 2,940,000 2,940,000 294,000 117,600 3,351,600 750,000
Batu Phat Barat TK 1 Wanita 2,850,300 2,763,300 0 57,006 2,907,306 540,000
Gp.Raya Dagang K2 Laki-laki 3,128,200 3,032,600 312,820 125,128 3,566,148 500,000
K0 Wanita 2,543,500 2,543,500 254,350 0 2,797,850 185,000
Tingkeum Manyang, Kec. Kutablang, Kab. TK 0 Wanita 3,032,600 2,940,000 0 0 3,032,600 500,000
Gp.Raya Dagang K1 Wanita 2,940,000 2,850,300 294,000 58,800 3,292,800 500,000
Banda ACEH TK 0 Wanita 2,850,300 2,850,300 0 0 2,850,300 500,000
K2 Wanita 2,517,200 2,517,200 251,720 100,688 2,869,608 240,000
K1 Wanita 2,570,200 2,570,200 257,020 51,404 2,878,624 300,000
Bireuen TK 0 Wanita 2,570,200 2,570,200 0 0 2,570,200 185,000
Gp. Raya Dagang TK 0 Laki-laki 2,570,200 2,570,200 0 0 2,570,200 300,000
Gp.Raya Dagang K2 Wanita 2,570,200 2,570,200 257,020 102,808 2,930,028 300,000
Cot Girek TK 0 Wanita 3,001,200 3,001,200 0 0 3,001,200 265,000
Matangglumpangdua, Mns. Dayah, kec. Pe K 2 Laki-laki 2,734,600 2,734,600 273,460 109,384 3,117,444 265,000
Bireuen K1 Wanita 2,820,700 2,820,700 282,070 56,414 3,159,184 265,000
Paya Cut TK 2 Wanita 2,734,600 2,734,600 0 109,384 2,843,984 265,000
Neuhuen TK 0 Wanita 2,543,500 2,543,500 0 0 2,543,500 265,000
Mns. Timu Peusangan TK 0 Wanita 2,543,500 2,543,500 0 0 2,543,500 240,000
K2 Wanita 2,651,100 2,465,900 265,110 106,044 3,022,254 265,000
Mns. Dayah, kec. Peusangan, Kab. Bireu K2 Wanita 2,651,100 2,390,600 265,110 106,044 3,022,254 265,000
Mns. Mecat Nisam K2 Laki-laki 2,651,100 2,651,100 265,110 106,044 3,022,254 240,000
Pante Gajah, Kec. Peusangan, Kab. Bireu K2 Wanita 2,651,100 2,651,100 265,110 106,044 3,022,254 265,000
Kr. Baro BB. Krueng K1 Wanita 2,820,700 2,820,700 282,070 56,414 3,159,184 265,000
Punjot Jangka TK 0 Wanita 2,820,700 2,820,700 0 0 2,820,700 265,000
Blang Cirih K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 265,000
K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 240,000
K1 Wanita 2,293,500 2,293,500 229,350 45,870 2,568,720 240,000
Cot Gapu Bireuen TK 0 Wanita 2,706,300 2,706,300 0 0 2,706,300 300,000
Pante Gajah K0 Wanita 2,706,300 2,706,300 270,630 0 2,976,930 265,000
Lampoh Rayeuk Jangka K2 Wanita 2,970,100 2,970,100 297,010 118,804 3,385,914 265,000
Matang Sagoe, Kec. Peusangan, Kab. Bir K2 Wanita 2,706,300 2,706,300 270,630 108,252 3,085,182 265,000
Cot Buket Peusangan TK 0 Wanita 2,970,100 2,970,100 0 0 2,970,100 265,000
Pante Gajah TK 0 Wanita 2,623,600 2,623,600 0 0 2,623,600 240,000
K2 Wanita 2,440,300 2,293,500 244,030 97,612 2,781,942 240,000
Paya Cut K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 265,000
Blang Keude Gandapura K2 Wanita 2,706,300 2,706,300 270,630 108,252 3,085,182 265,000
Tingkeum Manyang K1 Wanita 2,706,300 2,706,300 270,630 54,126 3,031,056 265,000
Kuta Blang K1 Wanita 2,706,300 2,706,300 270,630 54,126 3,031,056 265,000
Mns. Dayah TK 0 Wanita 2,879,400 2,879,400 0 0 2,879,400 265,000
Langkuta, Kec. Jangka, Kab. Bireuen K2 Wanita 2,879,400 2,879,400 287,940 115,176 3,282,516 265,000
K2 Wanita 2,269,800 2,269,800 226,980 90,792 2,587,572 240,000
K2 Wanita 2,440,300 2,440,300 244,030 97,612 2,781,942 240,000
Suka Ramai B.Aceh K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 265,000
K2 Wanita 2,543,500 2,440,300 254,350 101,740 2,899,590 240,000
Gp. Raya Dagang K2 Wanita 2,706,300 2,706,300 270,630 108,252 3,085,182 265,000
Cot Rabo Tunong K2 Wanita 2,706,300 2,706,300 270,630 108,252 3,085,182 265,000
Kubu Psg Sbl Kreung K2 Wanita 2,706,300 2,706,300 270,630 108,252 3,085,182 265,000
Asan Biduen K2 Wanita 2,623,600 2,623,600 262,360 104,944 2,990,904 265,000
K0 Wanita 2,623,600 2,517,200 262,360 0 2,885,960 240,000
Lueng Daneun K2 Wanita 2,623,600 2,623,600 262,360 104,944 2,990,904 265,000
Kubu Psg Sbl Kreung K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 265,000
Kulu Kutablang K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 265,000
Jangka K2 Wanita 2,623,600 2,623,600 262,360 104,944 2,990,904 265,000
Ulee Ceue Jangka K2 Wanita 2,623,600 2,623,600 262,360 104,944 2,990,904 265,000
Kd.Matangglumpangdua K2 Wanita 2,543,500 2,440,300 254,350 101,740 2,899,590 265,000
Tanjong Paya, Kec. Peusangan, Kab. Bir K2 Wanita 2,623,600 2,543,500 262,360 104,944 2,990,904 240,000
Punjot Jangka TK 0 Wanita 2,543,500 2,543,500 0 0 2,543,500 265,000
Seuneubok Aceh K2 Wanita 2,651,100 2,543,500 265,110 106,044 3,022,254 185,000
K1 Wanita 2,543,500 2,440,300 254,350 50,870 2,848,720 240,000
Jangka Alue K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 265,000
Bugak Mesjid, Kec. Jangka, Kab. Bireuen K2 Wanita 2,543,500 2,440,300 254,350 101,740 2,899,590 240,000
Punjot Jangka TK 1 Wanita 2,543,500 2,440,300 0 50,870 2,594,370 265,000
Gp. Raya Dagang TK 0 Wanita 2,543,500 2,440,300 0 0 2,543,500 240,000
Cot Rabo Tunong TK 0 Wanita 2,543,500 2,543,500 0 0 2,543,500 265,000
K2 Wanita 2,543,500 2,440,300 254,350 101,740 2,899,590 240,000
K2 Wanita 2,440,300 2,440,300 244,030 97,612 2,781,942 240,000
Tanjongan, Kec. Jangka, Kab. Bireuen K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 265,000
Matamamplam, Kec. Peusangan, Kab. Bir K2 Wanita 2,543,500 2,440,300 254,350 101,740 2,899,590 240,000
Asan Biduen K2 Wanita 2,543,500 2,543,500 254,350 101,740 2,899,590 265,000
Kd.Lapang Gandapura TK 0 Wanita 2,543,500 2,543,500 0 0 2,543,500 265,000
Pante Peusangan K2 Wanita 2,543,500 2,440,300 254,350 101,740 2,899,590 240,000
TK 0 Wanita 2,293,500 2,293,500 0 0 2,293,500 240,000
Cot Ara Kutablang K2 Wanita 2,543,500 2,440,300 254,350 101,740 2,899,590 265,000
K1 Wanita 2,543,500 2,440,300 254,350 50,870 2,848,720 240,000
Cureh barat K2 Laki-laki 2,651,100 2,543,500 265,110 106,044 3,022,254 300,000
TK 0 Wanita 2,293,500 2,293,500 0 0 2,293,500 240,000
K1 Wanita 2,293,500 2,293,500 229,350 45,870 2,568,720 240,000
K1 Wanita 2,390,600 2,390,600 239,060 47,812 2,677,472 300,000
K0 Wanita 2,293,500 2,293,500 229,350 0 2,522,850 240,000
K1 Laki-laki 2,293,500 2,293,500 229,350 45,870 2,568,720 240,000
K2 Wanita 2,293,500 2,293,500 229,350 91,740 2,614,590 240,000
TK 0 Wanita 2,293,500 2,293,500 0 0 2,293,500 240,000
K1 Wanita 2,293,500 2,293,500 229,350 45,870 2,568,720 240,000
K1 Wanita 2,293,500 2,293,500 229,350 45,870 2,568,720 240,000
K2 Wanita 2,293,500 2,293,500 229,350 91,740 2,614,590 240,000
TK 0 Wanita 2,293,500 2,293,500 0 0 2,293,500 240,000
TK 0 Wanita 2,390,600 2,390,600 0 0 2,390,600 300,000
K2 Wanita 2,293,500 2,293,500 229,350 91,740 2,614,590 240,000
TK 0 Laki-laki 2,440,300 2,341,300 0 0 2,440,300 180,000
K2 Wanita 2,133,300 2,133,300 213,330 85,332 2,431,962 240,000
Rusep Dayah, Jangka K2 Laki-laki 2,365,800 2,365,800 236,580 94,632 2,697,012 240,000
Matang Cot paseh TK 0 Laki-laki 2,415,000 2,415,000 0 0 2,415,000 240,000
TK 0 Laki-laki 2,200,500 2,200,500 0 0 2,200,500 240,000
Cot Jabet, Kec.Gandapura, Kab. Bireuen K2 Laki-laki 2,293,500 2,293,500 229,350 91,740 2,614,590 240,000
Dsn Tgk baroh Pulo Blang, Jangka K0 Laki-laki 2,293,500 2,133,300 229,350 0 2,522,850 240,000
Pante Lhong TK 0 Wanita 2,365,800 2,365,800 0 0 2,365,800 240,000
Gp. Paya Bieng K2 Wanita 2,678,200 2,678,200 267,820 107,128 3,053,148 240,000
Bangka Jaya, Kec. Dewantara, Kab. Aceh K0 Wanita 2,569,500 2,491,100 256,950 0 2,826,450 240,000
K2 Wanita 2,650,400 2,650,400 265,040 106,016 3,021,456 240,000
TK 0 Wanita 2,650,400 2,650,400 0 0 2,650,400 240,000
TK 2 Wanita 2,569,500 2,569,500 0 102,780 2,672,280 240,000
Pante Peusangan K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
Matangglumpangdua K2 Laki-laki 2,517,200 2,517,200 251,720 100,688 2,869,608 240,000
Pante Piyeu, Kec. Peusangan, Kab. Bireu K2 Wanita 2,517,200 2,517,200 251,720 100,688 2,869,608 240,000
K2 Wanita 2,068,100 2,341,300 206,810 82,724 2,357,634 240,000
Kubu Raya K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
Gp. Raya Dagang, Kec. Peusangan, Kab. K2 Wanita 2,791,500 2,491,100 279,150 111,660 3,182,310 265,000
Pante Pisang TK 0 Wanita 2,569,500 2,491,100 0 0 2,569,500 240,000
TK 0 Wanita 2,569,500 2,569,500 0 0 2,569,500 240,000
Geulanggang Gampong, Kec. Kota Juang, K2 Wanita 2,678,200 2,678,200 267,820 107,128 3,053,148 240,000
Keude Matangglumpangdua, Kec. Peusang K 2 Wanita 2,678,200 2,678,200 267,820 107,128 3,053,148 240,000
Sagoe Bireun K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
Gp. Putoh K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
Kubu Psg Siblah Krueng TK 0 Wanita 2,569,500 2,569,500 0 0 2,569,500 240,000
K1 Wanita 2,678,200 2,678,200 267,820 53,564 2,999,584 240,000
Jangka Alue TK 0 Wanita 2,317,000 2,246,200 0 0 2,317,000 180,000
Pante Ara TK 0 Wanita 2,678,200 2,678,200 0 0 2,678,200 240,000
K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
K2 Wanita 2,293,000 2,293,000 229,300 91,720 2,614,020 180,000
TK 0 Wanita 2,570,200 2,570,200 0 0 2,570,200 300,000
Lueng Jangka K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
K2 Wanita 2,678,200 2,678,200 267,820 107,128 3,053,148 240,000
K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
Tanoh Mirah TK 0 Wanita 2,650,400 2,650,400 0 0 2,650,400 240,000
Mns. Meucap, Kec. Peusangan, Kab. Bire K2 Wanita 2,762,600 2,678,200 276,260 110,504 3,149,364 240,000
K2 Wanita 2,650,400 2,569,500 265,040 106,016 3,021,456 240,000
Bugak Kr. Mate K2 Wanita 2,678,200 2,569,500 267,820 107,128 3,053,148 240,000
K2 Wanita 2,650,400 2,650,400 265,040 106,016 3,021,456 240,000
Awe geutah Paya TK 0 Wanita 2,650,400 2,650,400 0 0 2,650,400 240,000
Alue Buya Gampong Jangka K2 Wanita 2,650,400 2,650,400 265,040 106,016 3,021,456 240,000
Dsn Mesjid, ds Cot Nga, Peusangan K2 Laki-laki 2,415,000 2,341,300 241,500 96,600 2,753,100 240,000
K2 Wanita 2,317,000 2,246,200 231,700 92,680 2,641,380 240,000
Tanoh Mirah TK 0 Laki-laki 2,246,200 2,177,700 0 0 2,246,200 180,000
Jangka Alue TK 0 Wanita 2,678,200 2,569,500 0 0 2,678,200 240,000
Peusangan Selatan K2 Laki-laki 2,623,600 2,623,600 262,360 104,944 2,990,904 300,000
K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
TK 0 Wanita 2,465,200 2,390,000 0 0 2,465,200 240,000
Kd.Matangglumpangdua K2 Wanita 2,678,200 2,678,200 267,820 107,128 3,053,148 240,000
K2 Wanita 2,569,500 2,491,100 256,950 102,780 2,929,230 240,000
Mns. Timu TK 0 Wanita 2,569,500 2,569,500 0 0 2,569,500 240,000
Bugak Blang,Jangka K2 Wanita 2,678,200 2,678,200 267,820 107,128 3,053,148 240,000
Ujong Blang Kutablang K2 Wanita 2,678,200 2,678,200 267,820 107,128 3,053,148 240,000
K2 Wanita 2,569,500 2,491,100 256,950 102,780 2,929,230 180,000
Jangka K2 Wanita 2,678,200 2,678,200 267,820 107,128 3,053,148 240,000
K2 Wanita 2,569,500 2,491,100 256,950 102,780 2,929,230 180,000
Dsn.Tgk.Muda Peusangan K2 Wanita 2,569,500 2,569,500 256,950 102,780 2,929,230 240,000
K1 Wanita 2,623,600 2,543,500 262,360 52,472 2,938,432 300,000
K2 Wanita 2,596,400 2,491,100 259,640 103,856 2,959,896 180,000
Pante Lhong, Kec Peusangan, kab Bireue K1 Laki-laki 2,623,600 2,543,500 262,360 52,472 2,938,432 300,000
Jangka K0 Laki-laki 2,317,000 2,246,200 231,700 0 2,548,700 240,000
K1 Laki-laki 2,415,000 2,415,000 241,500 48,300 2,704,800 240,000
Bireuen K2 Wanita 2,491,100 2,491,100 249,110 99,644 2,839,854 240,000
Dsn.Tgk.Muda Peusangan K2 Wanita 2,415,000 2,341,300 241,500 96,600 2,753,100 240,000
Mns. Timu, Kec. Peusangan, Kab. Bireuen K2 Wanita 2,491,100 2,491,100 249,110 99,644 2,839,854 240,000
K2 Wanita 2,491,100 2,491,100 249,110 99,644 2,839,854 240,000
K2 Wanita 2,491,100 2,415,000 249,110 99,644 2,839,854 180,000
Cot Batee Kuala Bireuen TK 0 Wanita 2,415,000 2,415,000 0 0 2,415,000 240,000
Pante Baro Kumbang TK 0 Wanita 2,415,000 2,415,000 0 0 2,415,000 240,000
K2 Wanita 2,596,400 2,596,400 259,640 103,856 2,959,896 240,000
Pante Baro Kumbang K0 Wanita 2,415,000 2,246,200 241,500 0 2,656,500 240,000
Kuta Blang K1 Laki-laki 2,341,300 2,341,300 234,130 46,826 2,622,256 240,000
TK 0 Wanita 2,293,500 2,293,500 0 0 2,293,500 240,000
Cot Bada Baroh, Kec. Peusangan, Kab. B K2 Wanita 2,341,300 2,269,800 234,130 93,652 2,669,082 240,000
Mns. Dayah K2 Wanita 2,341,300 2,269,800 234,130 93,652 2,669,082 240,000
TK 0 Wanita 2,246,200 2,177,700 0 0 2,246,200 180,000
Pante Sukon, Kec. Jangka, Kab. Bireuen K0 Wanita 2,246,200 2,177,700 224,620 0 2,470,820 240,000
K2 Wanita 2,177,700 2,177,700 217,770 87,108 2,482,578 180,000
K2 Wanita 2,177,700 2,177,700 217,770 87,108 2,482,578 180,000
TK 0 Wanita 2,089,300 2,089,300 0 0 2,089,300 180,000
K2 Wanita 2,133,300 2,046,700 213,330 85,332 2,431,962 240,000
Gp. Putoh Peusangan K2 Wanita 2,269,800 2,269,800 226,980 90,792 2,587,572 240,000
K0 Laki-laki 2,269,800 2,269,800 226,980 0 2,496,780 240,000
K0 Wanita 2,177,700 2,177,700 217,770 0 2,395,470 180,000
K2 Wanita 2,293,500 2,293,500 229,350 91,740 2,614,590 240,000
K1 Laki-laki 1,984,200 1,984,200 198,420 39,684 2,222,304 240,000
K1 Laki-laki 1,984,200 1,984,200 198,420 39,684 2,222,304 220,000
K2 Wanita 1,984,200 1,984,200 198,420 79,368 2,261,988 240,000
TK 1 Wanita 1,984,200 1,984,200 0 39,684 2,023,884 240,000
K2 Wanita 1,984,200 1,984,200 198,420 79,368 2,261,988 220,000
K2 Laki-laki 2,439,700 2,439,700 243,970 97,588 2,781,258 180,000
Geundot Jangka K1 Wanita 2,089,300 2,089,300 208,930 41,786 2,340,016 180,000
K1 Laki-laki 2,025,500 2,025,500 202,550 40,510 2,268,560 180,000
Jarummah Me K1 Laki-laki 2,706,300 2,706,300 270,630 54,126 3,031,056 265,000
K2 Wanita 2,390,600 2,293,500 239,060 95,624 2,725,284 240,000
TK 0 Wanita 2,293,500 2,293,500 0 0 2,293,500 240,000
K1 Wanita 2,293,500 2,293,500 229,350 45,870 2,568,720 240,000
K2 Wanita 1,984,200 1,984,200 198,420 79,368 2,261,988 220,000
K2 Wanita 2,570,200 2,570,200 257,020 102,808 2,930,028 300,000
K2 Wanita 2,293,500 2,293,500 229,350 91,740 2,614,590 240,000
K1 Wanita 2,293,500 2,293,500 229,350 45,870 2,568,720 240,000
TK 0 Wanita 2,133,300 2,133,300 0 0 2,133,300 240,000
K2 Laki-laki 3,578,400 3,578,400 357,840 143,136 4,079,376 540,000
K1 Laki-laki 3,096,500 3,096,500 309,650 61,930 3,468,080 540,000
K0 Wanita 2,678,900 2,678,900 267,890 0 2,946,790 185,000
K1 Wanita 2,056,160 0 205,616 41,123 2,302,899 185,000
TK 0 Wanita 1,993,360 0 0 0 1,993,360 185,000
TK 0 Wanita 1,993,360 0 0 0 1,993,360 185,000
TK 0 Wanita 1,993,360 0 0 0 1,993,360 185,000
TK 0 Wanita 1,993,360 0 0 0 1,993,360 185,000
TK 0 Wanita 1,993,360 0 0 0 1,993,360 185,000
TK 0 Wanita 1,932,480 0 0 0 1,932,480 185,000
Punjot K0 Wanita 3,160,900 3,160,900 316,090 0 3,476,990 185,000
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TUNJANGAN TUNJANGAN
Jumlah
BERAS KHUSUS Tunjangan Lain JML-BLN awal bln akhir bln Gaji Pokok Tunjangan Istri Tunjangan Anak
(22+22+23
SEBULAN SEBULAN (TPK)
348,800 300,000 12 1 12 47,126,400 4,712,640 1,885,056 53,724,096

69,760 300,000 12 1 12 45,687,600 0 0 45,687,600
279,040 300,000 12 1 12 44,293,200 4,429,320 1,771,728 50,494,248
279,040 300,000 12 1 12 42,940,800 4,294,080 1,717,632 48,952,512
279,040 300,000 12 1 12 42,940,800 4,294,080 1,717,632 48,952,512
279,040 300,000 12 1 12 42,940,800 4,294,080 1,717,632 48,952,512
279,040 300,000 12 1 12 42,940,800 4,294,080 1,717,632 48,952,512
69,760 300,000 12 1 12 42,940,800 0 0 42,940,800
279,040 300,000 12 1 12 42,940,800 4,294,080 1,717,632 48,952,512
209,280 300,000 12 1 12 42,940,800 0 1,717,632 44,658,432
209,280 300,000 12 1 12 42,940,800 4,294,080 858,816 48,093,696
279,040 300,000 12 1 12 42,940,800 4,294,080 1,717,632 48,952,512
279,040 300,000 12 1 12 40,358,400 4,035,840 1,614,336 46,008,576
209,280 300,000 12 1 12 41,629,200 0 1,665,168 43,294,368
279,040 300,000 12 1 12 41,629,200 4,162,920 1,665,168 47,457,288
279,040 300,000 12 1 12 41,629,200 4,162,920 1,665,168 47,457,288
69,760 300,000 12 1 12 41,629,200 0 0 41,629,200
279,040 300,000 12 1 12 44,293,200 4,429,320 1,771,728 50,494,248
279,040 300,000 12 1 12 42,495,600 4,249,560 1,699,824 48,444,984
279,040 300,000 12 1 12 44,293,200 4,429,320 1,771,728 50,494,248
279,040 300,000 12 1 12 42,495,600 4,249,560 1,699,824 48,444,984
209,280 300,000 12 1 12 42,940,800 0 1,717,632 44,658,432
279,040 300,000 12 1 12 42,940,800 4,294,080 1,717,632 48,952,512
279,040 300,000 12 1 12 41,629,200 4,162,920 1,665,168 47,457,288
279,040 300,000 12 1 12 41,629,200 4,162,920 1,665,168 47,457,288
279,040 300,000 12 1 12 42,064,800 4,206,480 1,682,592 47,953,872
69,760 300,000 12 1 12 40,358,400 0 0 40,358,400
69,760 300,000 12 1 12 40,358,400 0 0 40,358,400
279,040 300,000 12 1 12 40,358,400 4,035,840 1,614,336 46,008,576
69,760 300,000 12 1 12 40,358,400 0 0 40,358,400
139,520 300,000 12 1 12 40,358,400 4,035,840 807,168 45,201,408
279,040 300,000 12 1 12 39,126,000 3,912,600 1,565,040 44,603,640
279,040 300,000 12 1 12 39,525,600 3,952,560 1,581,024 45,059,184
69,760 300,000 12 1 12 39,525,600 0 0 39,525,600
69,760 300,000 12 1 12 39,525,600 0 0 39,525,600
279,040 300,000 12 1 12 40,358,400 4,035,840 1,614,336 46,008,576
279,040 300,000 12 1 12 40,358,400 4,035,840 1,614,336 46,008,576
279,040 300,000 12 1 12 40,358,400 4,035,840 1,614,336 46,008,576
279,040 300,000 12 1 12 39,126,000 3,912,600 1,565,040 44,603,640
279,040 300,000 12 1 12 35,649,600 3,564,960 1,425,984 40,640,544
69,760 300,000 12 1 12 40,358,400 0 0 40,358,400
209,280 300,000 12 1 12 36,772,800 3,677,280 735,456 41,185,536
279,040 300,000 12 1 12 35,280,000 3,528,000 1,411,200 40,219,200
69,760 300,000 12 1 12 36,772,800 0 0 36,772,800
209,280 300,000 12 1 12 36,772,800 3,677,280 735,456 41,185,536
279,040 300,000 12 1 12 35,280,000 3,528,000 1,411,200 40,219,200
139,520 300,000 12 1 12 34,203,600 0 684,072 34,887,672
279,040 300,000 12 1 12 37,538,400 3,753,840 1,501,536 42,793,776
139,520 300,000 12 1 12 30,522,000 3,052,200 0 33,574,200
69,760 300,000 12 1 12 34,203,600 0 0 34,203,600
69,760 300,000 12 1 12 36,391,200 0 0 36,391,200
209,280 300,000 12 1 12 35,280,000 3,528,000 705,600 39,513,600
69,760 300,000 12 1 12 34,203,600 0 0 34,203,600
279,040 300,000 12 1 12 30,206,400 3,020,640 1,208,256 34,435,296
209,280 300,000 12 1 12 30,842,400 3,084,240 616,848 34,543,488
69,760 300,000 12 1 12 30,842,400 0 0 30,842,400
69,760 300,000 12 1 12 30,842,400 0 0 30,842,400
279,040 300,000 7 1 7 17,991,400 1,799,140 719,656 20,510,196
69,760 300,000 12 1 12 36,014,400 0 0 36,014,400
279,040 300,000 12 1 12 33,498,000 3,349,800 1,339,920 38,187,720
279,040 300,000 12 1 12 32,815,200 3,281,520 1,312,608 37,409,328
209,280 300,000 12 1 12 33,848,400 3,384,840 676,968 37,910,208
209,280 300,000 12 1 12 32,815,200 0 1,312,608 34,127,808
69,760 300,000 12 1 12 30,522,000 0 0 30,522,000
69,760 300,000 12 1 12 30,522,000 0 0 30,522,000
279,040 300,000 12 1 12 31,813,200 3,181,320 1,272,528 36,267,048
279,040 300,000 12 1 12 31,813,200 3,181,320 1,272,528 36,267,048
279,040 300,000 12 1 12 31,813,200 3,181,320 1,272,528 36,267,048
279,040 300,000 12 1 12 31,813,200 3,181,320 1,272,528 36,267,048
279,040 300,000 12 1 12 31,813,200 3,181,320 1,272,528 36,267,048
209,280 300,000 12 1 12 33,848,400 3,384,840 676,968 37,910,208
69,760 300,000 12 1 12 32,815,200 0 0 32,815,200
69,760 300,000 12 1 12 33,848,400 0 0 33,848,400
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
69,760 300,000 12 1 12 31,813,200 0 0 31,813,200
279,040 300,000 12 1 12 31,813,200 3,181,320 1,272,528 36,267,048
209,280 300,000 12 1 12 27,522,000 2,752,200 550,440 30,824,640
69,760 300,000 12 1 12 32,475,600 0 0 32,475,600
139,520 300,000 12 1 12 32,475,600 3,247,560 0 35,723,160
279,040 300,000 12 1 12 35,641,200 3,564,120 1,425,648 40,630,968
279,040 300,000 12 1 12 32,475,600 3,247,560 1,299,024 37,022,184
69,760 300,000 12 1 12 35,641,200 0 0 35,641,200
69,760 300,000 12 1 12 31,483,200 0 0 31,483,200
279,040 300,000 12 1 12 29,283,600 2,928,360 1,171,344 33,383,304
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
279,040 300,000 12 1 12 32,475,600 3,247,560 1,299,024 37,022,184
279,040 300,000 12 1 12 32,475,600 3,247,560 1,299,024 37,022,184
209,280 300,000 12 1 12 32,475,600 3,247,560 649,512 36,372,672
279,040 300,000 12 1 12 32,475,600 3,247,560 1,299,024 37,022,184
209,280 300,000 12 1 12 32,475,600 3,247,560 649,512 36,372,672
69,760 300,000 12 1 12 34,552,800 0 0 34,552,800
279,040 300,000 12 1 12 34,552,800 3,455,280 1,382,112 39,390,192
279,040 300,000 12 1 12 27,237,600 2,723,760 1,089,504 31,050,864
69,760 300,000 12 1 12 30,522,000 0 0 30,522,000
279,040 300,000 12 1 12 29,283,600 2,928,360 1,171,344 33,383,304
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
69,760 300,000 12 1 12 31,483,200 0 0 31,483,200
279,040 300,000 12 1 12 32,475,600 3,247,560 1,299,024 37,022,184
69,760 300,000 12 1 12 32,475,600 0 0 32,475,600
279,040 300,000 12 1 12 32,475,600 3,247,560 1,299,024 37,022,184
279,040 300,000 12 1 12 32,475,600 3,247,560 1,299,024 37,022,184
279,040 300,000 12 1 12 32,475,600 3,247,560 1,299,024 37,022,184
279,040 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
139,520 300,000 12 1 12 31,483,200 3,148,320 0 34,631,520
279,040 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
209,280 300,000 12 1 12 30,522,000 3,052,200 610,440 34,184,640
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
209,280 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
279,040 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
279,040 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
279,040 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
69,760 300,000 12 1 12 30,522,000 0 0 30,522,000
279,040 300,000 12 1 12 31,813,200 3,181,320 1,272,528 36,267,048
209,280 300,000 12 1 12 30,522,000 3,052,200 610,440 34,184,640
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
139,520 300,000 12 1 12 30,522,000 0 610,440 31,132,440
69,760 300,000 12 1 12 30,522,000 0 0 30,522,000
69,760 300,000 12 1 12 30,522,000 0 0 30,522,000
209,280 300,000 12 1 12 30,522,000 3,052,200 610,440 34,184,640
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
279,040 300,000 12 1 12 29,283,600 2,928,360 1,171,344 33,383,304
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
69,760 300,000 12 1 12 30,522,000 0 0 30,522,000
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
69,760 300,000 12 1 12 27,522,000 0 0 27,522,000
279,040 300,000 12 1 12 30,522,000 3,052,200 1,220,880 34,795,080
209,280 300,000 12 1 12 30,522,000 3,052,200 610,440 34,184,640
279,040 300,000 12 1 12 31,813,200 3,181,320 1,272,528 36,267,048
69,760 300,000 12 1 12 27,522,000 0 0 27,522,000
209,280 300,000 12 1 12 27,522,000 2,752,200 550,440 30,824,640
209,280 300,000 12 1 12 28,687,200 2,868,720 573,744 32,129,664
139,520 300,000 12 1 12 27,522,000 2,752,200 0 30,274,200
209,280 300,000 12 1 12 29,283,600 2,928,360 585,672 32,797,632
209,280 300,000 12 1 12 27,522,000 2,752,200 550,440 30,824,640
279,040 300,000 12 1 12 27,522,000 2,752,200 1,100,880 31,375,080
69,760 300,000 12 1 12 27,522,000 0 0 27,522,000
209,280 300,000 12 1 12 27,522,000 2,752,200 550,440 30,824,640
209,280 300,000 12 1 12 27,522,000 2,752,200 550,440 30,824,640
279,040 300,000 12 1 12 27,522,000 2,752,200 1,100,880 31,375,080
69,760 300,000 12 1 12 27,522,000 0 0 27,522,000
69,760 300,000 12 1 12 28,687,200 0 0 28,687,200
279,040 300,000 12 1 12 27,522,000 2,752,200 1,100,880 31,375,080
279,040 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
69,760 300,000 12 1 12 29,283,600 0 0 29,283,600
279,040 300,000 12 1 12 29,283,600 2,928,360 1,171,344 33,383,304
209,280 300,000 12 1 12 25,599,600 2,559,960 1,023,984 29,183,544
279,040 300,000 12 1 12 28,389,600 2,838,960 1,135,584 32,364,144
69,760 300,000 12 1 12 28,980,000 0 0 28,980,000
69,760 300,000 12 1 12 26,406,000 0 0 26,406,000
279,040 300,000 12 1 12 27,522,000 2,752,200 1,100,880 31,375,080
139,520 300,000 12 1 12 27,522,000 2,752,200 0 30,274,200
69,760 300,000 12 1 12 28,389,600 0 0 28,389,600
279,040 300,000 12 1 12 33,498,000 3,349,800 1,339,920 38,187,720
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
139,520 300,000 12 1 12 30,834,000 3,083,400 0 33,917,400
279,040 300,000 12 1 12 31,804,800 3,180,480 1,272,192 36,257,472
69,760 300,000 12 1 12 31,804,800 0 0 31,804,800
209,280 300,000 12 1 12 30,834,000 0 1,233,360 32,067,360
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 30,206,400 3,020,640 1,208,256 34,435,296
279,040 300,000 12 1 12 30,206,400 3,020,640 1,208,256 34,435,296
279,040 300,000 12 1 12 30,206,400 3,020,640 1,208,256 34,435,296
279,040 300,000 12 1 12 24,817,200 2,481,720 992,688 28,291,608
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 33,498,000 3,349,800 1,339,920 38,187,720
69,760 300,000 12 1 12 30,834,000 0 0 30,834,000
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
69,760 300,000 12 1 12 30,834,000 0 0 30,834,000
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
69,760 300,000 12 1 12 30,834,000 0 0 30,834,000
209,280 300,000 12 1 12 32,138,400 3,213,840 642,768 35,995,008
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
69,760 300,000 12 1 12 27,804,000 0 0 27,804,000
69,760 300,000 12 1 12 32,138,400 0 0 32,138,400
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 27,516,000 2,751,600 1,100,640 31,368,240
69,760 300,000 12 1 12 30,842,400 0 0 30,842,400
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
69,760 300,000 12 1 12 31,804,800 0 0 31,804,800
279,040 300,000 12 1 12 33,151,200 3,315,120 1,326,048 37,792,368
279,040 300,000 12 1 12 31,804,800 3,180,480 1,272,192 36,257,472
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 31,804,800 3,180,480 1,272,192 36,257,472
69,760 300,000 12 1 12 31,804,800 0 0 31,804,800
69,760 300,000 12 1 12 31,804,800 0 0 31,804,800
279,040 300,000 12 1 12 31,804,800 3,180,480 1,272,192 36,257,472
279,040 300,000 12 1 12 28,980,000 2,898,000 1,159,200 33,037,200
279,040 300,000 12 1 12 27,804,000 2,780,400 1,112,160 31,696,560
69,760 300,000 12 1 12 26,954,400 0 0 26,954,400
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
69,760 300,000 12 1 12 32,138,400 0 0 32,138,400
279,040 300,000 12 1 12 28,980,000 2,898,000 1,159,200 33,037,200
279,040 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
69,760 300,000 12 1 12 29,582,400 0 0 29,582,400
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
69,760 300,000 12 1 12 31,804,800 0 0 31,804,800
209,280 300,000 12 1 12 26,954,400 2,695,440 539,088 30,188,928
69,760 300,000 12 1 12 30,834,000 0 0 30,834,000
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
69,760 300,000 12 1 12 32,138,400 0 0 32,138,400
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 32,138,400 3,213,840 1,285,536 36,637,776
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
279,040 300,000 12 1 12 30,834,000 3,083,400 1,233,360 35,150,760
69,760 300,000 12 1 12 30,834,000 0 0 30,834,000
209,280 300,000 12 1 12 32,138,400 3,213,840 642,768 35,995,008
279,040 300,000 12 1 12 31,483,200 3,148,320 1,259,328 35,890,848
279,040 300,000 12 1 12 31,156,800 3,115,680 1,246,272 35,518,752
209,280 300,000 12 1 12 31,483,200 3,148,320 629,664 35,261,184
279,040 300,000 12 1 12 31,156,800 3,115,680 1,246,272 35,518,752
279,040 300,000 12 1 12 28,980,000 2,898,000 1,159,200 33,037,200
209,280 300,000 12 1 12 31,483,200 3,148,320 629,664 35,261,184
209,280 300,000 12 1 12 31,156,800 3,115,680 623,136 34,895,616
139,520 300,000 12 1 12 27,804,000 2,780,400 0 30,584,400
69,760 300,000 12 1 12 28,980,000 0 0 28,980,000
209,280 300,000 12 1 12 28,980,000 2,898,000 579,600 32,457,600
279,040 300,000 12 1 12 29,893,200 2,989,320 1,195,728 34,078,248
279,040 300,000 12 1 12 28,980,000 2,898,000 1,159,200 33,037,200
279,040 300,000 12 1 12 29,893,200 2,989,320 1,195,728 34,078,248
279,040 300,000 12 1 12 29,893,200 2,989,320 1,195,728 34,078,248
69,760 300,000 12 1 12 27,804,000 0 0 27,804,000
279,040 300,000 12 1 12 29,893,200 2,989,320 1,195,728 34,078,248
69,760 300,000 12 1 12 28,980,000 0 0 28,980,000
69,760 300,000 12 1 12 28,980,000 0 0 28,980,000
279,040 300,000 12 1 12 27,804,000 2,780,400 1,112,160 31,696,560
279,040 300,000 12 1 12 31,156,800 3,115,680 1,246,272 35,518,752
139,520 300,000 12 1 12 28,980,000 2,898,000 0 31,878,000
209,280 300,000 12 1 12 28,095,600 2,809,560 561,912 31,467,072
69,760 300,000 12 1 12 27,522,000 0 0 27,522,000
279,040 300,000 12 1 12 28,095,600 2,809,560 1,123,824 32,028,984
69,760 300,000 12 1 12 28,095,600 0 0 28,095,600
279,040 300,000 12 1 12 28,095,600 2,809,560 1,123,824 32,028,984
69,760 300,000 12 1 12 26,954,400 0 0 26,954,400
139,520 300,000 12 1 12 26,954,400 2,695,440 0 29,649,840
279,040 300,000 12 1 12 26,132,400 2,613,240 1,045,296 29,790,936
279,040 300,000 12 1 12 26,132,400 2,613,240 1,045,296 29,790,936
69,760 300,000 12 1 12 25,071,600 0 0 25,071,600
279,040 300,000 12 1 12 27,237,600 2,723,760 1,089,504 31,050,864
279,040 300,000 12 1 12 25,599,600 2,559,960 1,023,984 29,183,544
279,040 300,000 12 1 12 27,237,600 2,723,760 1,089,504 31,050,864
139,520 300,000 12 1 12 27,237,600 2,723,760 0 29,961,360
209,280 300,000 12 1 12 27,237,600 2,723,760 544,752 30,506,112
279,040 300,000 12 1 12 26,132,400 2,613,240 1,045,296 29,790,936
279,040 300,000 12 1 12 26,954,400 2,695,440 1,078,176 30,728,016
139,520 300,000 12 1 12 26,132,400 2,613,240 0 28,745,640
209,280 300,000 12 1 12 27,237,600 2,723,760 544,752 30,506,112
279,040 300,000 12 1 12 27,522,000 2,752,200 1,100,880 31,375,080
279,040 300,000 12 1 12 24,560,400 2,456,040 982,416 27,998,856
209,280 300,000 12 1 12 23,810,400 2,381,040 476,208 26,667,648
209,280 300,000 12 1 12 23,810,400 2,381,040 476,208 26,667,648
279,040 300,000 12 1 12 23,810,400 2,381,040 952,416 27,143,856
139,520 300,000 12 1 12 23,810,400 0 476,208 24,286,608
279,040 300,000 12 1 12 23,810,400 2,381,040 952,416 27,143,856
279,040 300,000 12 1 12 29,276,400 2,927,640 1,171,056 33,375,096
279,040 300,000 12 1 12 24,048,000 2,404,800 961,920 27,414,720
209,280 300,000 12 1 12 25,071,600 2,507,160 501,432 28,080,192
209,280 300,000 12 1 12 24,306,000 2,430,600 486,120 27,222,720
69,760 300,000 12 1 12 21,685,200 0 0 21,685,200
209,280 300,000 12 1 12 22,832,400 2,283,240 456,648 25,572,288
209,280 300,000 12 1 12 32,475,600 3,247,560 649,512 36,372,672
279,040 300,000 12 1 12 28,687,200 2,868,720 1,147,488 32,703,408
69,760 300,000 12 1 12 27,522,000 0 0 27,522,000
69,760 300,000 12 1 12 32,815,200 0 0 32,815,200
209,280 300,000 12 1 12 27,522,000 2,752,200 550,440 30,824,640
279,040 300,000 12 1 12 23,810,400 2,381,040 952,416 27,143,856
279,040 300,000 12 1 12 30,842,400 3,084,240 1,233,696 35,160,336
279,040 300,000 12 1 12 27,522,000 2,752,200 1,100,880 31,375,080
209,280 300,000 12 1 12 27,522,000 2,752,200 550,440 30,824,640
69,760 300,000 12 1 12 25,599,600 0 0 25,599,600
209,280 300,000 12 1 12 42,940,800 4,294,080 1,717,632 48,952,512
209,280 300,000 12 1 12 37,158,000 3,715,800 743,160 41,616,960
139,520 300,000 12 1 12 32,146,800 3,214,680 0 35,361,480
209,280 300,000 4 9 12 8,224,640 822,464 164,492 9,211,596
69,760 300,000 4 9 12 7,973,440 0 0 7,973,440
69,760 300,000 4 9 12 7,973,440 0 0 7,973,440
69,760 300,000 4 9 12 7,973,440 0 0 7,973,440
69,760 300,000 4 9 12 7,973,440 0 0 7,973,440
69,760 300,000 4 9 12 7,973,440 0 0 7,973,440
69,760 300,000 4 9 12 7,729,920 0 0 7,729,920
139,520 300,000 12 1 12 37,930,800 3,793,080 0 41,723,880
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9,394,475,960 684,029,124 243,068,532 10,321,573,616
Ke 1770-S
Tunjangan
TUNJANGAN BRUTO
Jabatan/Fungsio Tujangan Beras Tunjangan lain Brutobantu TotBruto +gaji tunjangan 13 Iuran Pensiun
Khusus (26+27+28+29+30)
nal
6,000,000 4,185,600 3,600,000 0 67,509,696 0 71,436,896 2,551,895

6,000,000 837,120 3,600,000 0 56,124,720 0 59,815,820 2,170,161
6,000,000 3,348,480 3,600,000 0 63,442,728 0 67,133,828 2,398,477
6,000,000 3,348,480 3,600,000 0 61,900,992 0 65,479,392 2,325,244
6,000,000 3,348,480 3,600,000 0 61,900,992 0 65,479,392 2,325,244
6,000,000 3,348,480 3,600,000 0 61,900,992 0 65,479,392 2,325,244
6,000,000 3,348,480 3,600,000 0 61,900,992 0 65,479,392 2,325,244
6,000,000 837,120 3,600,000 0 53,377,920 0 56,956,320 2,039,688
6,000,000 3,348,480 3,600,000 0 61,900,992 0 65,479,392 2,325,244
6,000,000 2,511,360 3,600,000 0 56,769,792 0 60,348,192 2,121,276
6,000,000 2,511,360 3,600,000 0 60,205,056 0 63,783,456 2,284,451
6,000,000 3,348,480 3,600,000 0 61,900,992 0 65,370,092 2,325,244
6,000,000 3,348,480 3,600,000 0 58,957,056 0 62,320,256 2,185,407
7,200,000 2,511,360 3,600,000 0 56,605,728 0 60,074,828 2,056,482
6,000,000 3,348,480 3,600,000 0 60,405,768 0 63,874,868 2,254,221
6,000,000 3,348,480 3,600,000 0 60,405,768 0 63,874,868 2,254,221
6,000,000 837,120 3,600,000 0 52,066,320 0 55,535,420 1,977,387
6,000,000 3,348,480 3,600,000 0 63,442,728 0 67,021,128 2,398,477
6,000,000 3,348,480 3,600,000 0 61,393,464 0 64,934,764 2,301,137
6,000,000 3,348,480 3,600,000 0 63,442,728 0 67,133,828 2,398,477
6,000,000 3,348,480 3,600,000 0 61,393,464 0 64,934,764 2,301,137
6,000,000 2,511,360 3,600,000 0 56,769,792 0 60,348,192 2,121,276
6,000,000 3,348,480 3,600,000 0 61,900,992 0 65,370,092 2,325,244
6,000,000 3,348,480 3,600,000 0 60,405,768 0 63,874,868 2,254,221
6,000,000 3,348,480 3,600,000 0 60,405,768 0 63,874,868 2,254,221
10,200,000 3,348,480 3,600,000 0 65,102,352 0 68,607,752 2,277,809
7,200,000 837,120 3,600,000 0 51,995,520 0 55,358,720 1,917,024
6,000,000 837,120 3,600,000 0 50,795,520 0 54,056,020 1,917,024
6,000,000 3,348,480 3,600,000 0 58,957,056 0 62,320,256 2,185,407
6,000,000 837,120 3,600,000 0 50,795,520 0 54,158,720 1,917,024
6,000,000 1,674,240 3,600,000 0 56,475,648 0 59,838,848 2,147,067
6,000,000 3,348,480 3,600,000 0 57,552,120 0 60,812,620 2,118,673
3,180,000 3,348,480 3,600,000 0 55,187,664 0 58,481,464 2,140,311
3,180,000 837,120 3,600,000 0 47,142,720 0 50,436,520 1,877,466
3,180,000 837,120 3,600,000 0 47,142,720 0 50,436,520 1,877,466
6,000,000 3,348,480 3,600,000 0 58,957,056 0 62,320,256 2,185,407
6,000,000 3,348,480 3,600,000 0 58,957,056 0 62,320,256 2,185,407
6,000,000 3,348,480 3,600,000 0 58,957,056 0 62,085,256 2,185,407
6,000,000 3,348,480 3,600,000 0 57,552,120 0 60,713,020 2,118,673
6,480,000 3,348,480 3,600,000 0 54,069,024 0 57,039,824 1,930,426
7,200,000 837,120 3,600,000 0 51,995,520 0 55,358,720 1,917,024
7,200,000 2,511,360 3,600,000 0 54,496,896 0 57,436,896 1,956,313
6,000,000 3,348,480 3,600,000 0 53,167,680 0 56,017,980 1,910,412
6,000,000 837,120 3,600,000 0 47,209,920 0 50,274,320 1,746,708
6,000,000 2,511,360 3,600,000 0 53,296,896 0 56,236,896 1,956,313
9,000,000 3,348,480 3,600,000 0 56,167,680 0 59,107,680 1,910,412
6,480,000 1,674,240 3,600,000 0 46,641,912 0 49,405,212 1,657,164
6,000,000 3,348,480 3,600,000 0 55,742,256 0 58,774,856 2,032,704
2,220,000 1,674,240 3,600,000 0 41,068,440 0 43,611,940 1,594,775
6,000,000 837,120 3,600,000 0 44,640,720 0 47,491,020 1,624,671
6,000,000 837,120 3,600,000 0 46,828,320 0 49,768,320 1,728,582
6,000,000 2,511,360 3,600,000 0 51,624,960 0 54,475,260 1,876,896
6,000,000 837,120 3,600,000 0 44,640,720 0 47,491,020 1,624,671
2,880,000 3,348,480 3,600,000 0 44,263,776 0 46,780,976 1,635,677
3,600,000 2,511,360 3,600,000 0 44,254,848 0 46,825,048 1,640,816
2,220,000 837,120 3,600,000 0 37,499,520 0 40,069,720 1,465,014
3,600,000 837,120 3,600,000 0 38,879,520 0 41,449,720 1,465,014
2,100,000 1,953,280 2,100,000 0 26,663,476 0 29,233,676 139,176
3,180,000 837,120 3,600,000 0 43,631,520 0 46,632,720 1,710,684
2,880,000 3,348,480 3,600,000 0 48,016,200 0 50,807,700 1,813,917
3,180,000 3,348,480 3,600,000 0 47,537,808 0 50,272,408 1,776,943
3,180,000 2,511,360 3,600,000 0 47,201,568 0 50,022,268 1,800,735
3,180,000 2,511,360 3,600,000 0 43,419,168 0 46,153,768 1,621,071
3,180,000 837,120 3,600,000 0 38,139,120 0 40,682,620 1,449,795
2,880,000 837,120 3,600,000 0 37,839,120 0 40,382,620 1,449,795
3,180,000 3,348,480 3,600,000 0 46,395,528 0 48,861,428 1,722,685
3,180,000 3,348,480 3,600,000 0 46,395,528 0 48,939,028 1,722,685
3,180,000 3,348,480 3,600,000 0 46,395,528 0 48,786,128 1,722,685
2,880,000 3,348,480 3,600,000 0 46,095,528 0 48,746,628 1,722,685
3,180,000 3,348,480 3,600,000 0 46,395,528 0 49,046,628 1,722,685
3,180,000 2,511,360 3,600,000 0 47,201,568 0 50,022,268 1,800,735
3,180,000 837,120 3,600,000 0 40,432,320 0 43,055,920 1,558,722
3,180,000 837,120 3,600,000 0 41,465,520 0 44,286,220 1,607,799
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,467,060 1,652,766
2,880,000 3,348,480 3,600,000 0 44,623,560 0 47,167,060 1,652,766
3,180,000 837,120 3,600,000 0 39,430,320 0 41,973,820 1,511,127
3,180,000 3,348,480 3,600,000 0 46,395,528 0 49,046,628 1,722,685
2,880,000 2,511,360 3,600,000 0 39,816,000 0 42,109,500 1,464,170
3,600,000 837,120 3,600,000 0 40,512,720 0 43,219,020 1,542,591
3,180,000 1,674,240 3,600,000 0 44,177,400 0 46,883,700 1,696,850
3,180,000 3,348,480 3,600,000 0 50,759,448 0 53,729,548 1,929,971
3,180,000 3,348,480 3,600,000 0 47,150,664 0 49,856,964 1,758,554
3,180,000 837,120 3,600,000 0 43,258,320 0 46,228,420 1,692,957
2,880,000 837,120 3,600,000 0 38,800,320 0 41,423,920 1,495,452
2,880,000 3,348,480 3,600,000 0 43,211,784 0 45,505,284 1,585,707
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,467,060 1,652,766
3,180,000 3,348,480 3,600,000 0 47,150,664 0 49,856,964 1,758,554
3,180,000 3,348,480 3,600,000 0 47,150,664 0 49,856,964 1,758,554
3,180,000 2,511,360 3,600,000 0 45,664,032 0 48,370,332 1,727,702
3,180,000 3,348,480 3,600,000 0 47,150,664 0 49,856,964 1,758,554
3,180,000 2,511,360 3,600,000 0 45,664,032 0 48,370,332 1,727,702
3,180,000 837,120 3,600,000 0 42,169,920 0 45,049,320 1,641,258
3,180,000 3,348,480 3,600,000 0 49,518,672 0 52,398,072 1,871,034
2,880,000 3,348,480 3,600,000 0 40,879,344 0 43,149,144 1,474,916
2,880,000 837,120 3,600,000 0 37,839,120 0 40,382,620 1,449,795
2,880,000 3,348,480 3,600,000 0 43,211,784 0 45,652,084 1,585,707
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,467,060 1,652,766
2,880,000 3,348,480 3,600,000 0 44,623,560 0 47,063,860 1,652,766
2,880,000 837,120 3,600,000 0 38,800,320 0 41,343,820 1,495,452
3,180,000 3,348,480 3,600,000 0 47,150,664 0 49,856,964 1,758,554
3,180,000 837,120 3,600,000 0 40,092,720 0 42,799,020 1,542,591
3,180,000 3,348,480 3,600,000 0 47,150,664 0 49,856,964 1,758,554
3,180,000 3,348,480 3,600,000 0 47,150,664 0 49,856,964 1,758,554
3,180,000 3,348,480 3,600,000 0 47,150,664 0 49,856,964 1,758,554
3,180,000 3,348,480 3,600,000 0 46,019,328 0 48,642,928 1,704,815
2,880,000 1,674,240 3,600,000 0 42,785,760 0 45,302,960 1,644,997
3,180,000 3,348,480 3,600,000 0 46,019,328 0 48,642,928 1,704,815
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,467,060 1,652,766
2,880,000 2,511,360 3,600,000 0 43,176,000 0 45,616,300 1,623,770
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,467,060 1,652,766
3,180,000 2,511,360 3,600,000 0 45,182,208 0 47,805,808 1,704,815
2,880,000 3,348,480 3,600,000 0 45,719,328 0 48,342,928 1,704,815
3,180,000 3,348,480 3,600,000 0 46,019,328 0 48,642,928 1,704,815
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,363,860 1,652,766
2,880,000 3,348,480 3,600,000 0 45,719,328 0 48,262,828 1,704,815
3,180,000 837,120 3,600,000 0 38,139,120 0 40,682,620 1,449,795
2,220,000 3,348,480 3,600,000 0 45,435,528 0 47,979,028 1,722,685
2,880,000 2,511,360 3,600,000 0 43,176,000 0 45,616,300 1,623,770
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,467,060 1,652,766
2,880,000 3,348,480 3,600,000 0 44,623,560 0 47,063,860 1,652,766
3,180,000 1,674,240 3,600,000 0 39,586,680 0 42,026,980 1,478,791
2,880,000 837,120 3,600,000 0 37,839,120 0 40,279,420 1,449,795
3,180,000 837,120 3,600,000 0 38,139,120 0 40,682,620 1,449,795
2,880,000 2,511,360 3,600,000 0 43,176,000 0 45,616,300 1,623,770
2,880,000 3,348,480 3,600,000 0 44,623,560 0 47,063,860 1,652,766
2,880,000 3,348,480 3,600,000 0 43,211,784 0 45,652,084 1,585,707
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,467,060 1,652,766
2,880,000 3,348,480 3,600,000 0 44,623,560 0 47,063,860 1,652,766
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,467,060 1,652,766
3,180,000 837,120 3,600,000 0 38,139,120 0 40,682,620 1,449,795
2,880,000 3,348,480 3,600,000 0 44,623,560 0 47,063,860 1,652,766
2,880,000 837,120 3,600,000 0 34,839,120 0 37,132,620 1,307,295
3,180,000 3,348,480 3,600,000 0 44,923,560 0 47,363,860 1,652,766
2,880,000 2,511,360 3,600,000 0 43,176,000 0 45,616,300 1,623,770
3,600,000 3,348,480 3,600,000 0 46,815,528 0 49,359,028 1,722,685
2,880,000 837,120 3,600,000 0 34,839,120 0 37,132,620 1,307,295
2,880,000 2,511,360 3,600,000 0 39,816,000 0 42,109,500 1,464,170
3,600,000 2,511,360 3,600,000 0 41,841,024 0 44,231,624 1,526,159
2,880,000 1,674,240 3,600,000 0 38,428,440 0 40,721,940 1,438,025
2,880,000 2,511,360 3,600,000 0 41,788,992 0 44,229,292 1,557,888
2,880,000 2,511,360 3,600,000 0 39,816,000 0 42,109,500 1,464,170
2,880,000 3,348,480 3,600,000 0 41,203,560 0 43,497,060 1,490,316
2,880,000 837,120 3,600,000 0 34,839,120 0 37,132,620 1,307,295
2,880,000 2,511,360 3,600,000 0 39,816,000 0 42,109,500 1,464,170
2,880,000 2,511,360 3,600,000 0 39,816,000 0 42,109,500 1,464,170
2,880,000 3,348,480 3,600,000 0 41,203,560 0 43,497,060 1,490,316
2,880,000 837,120 3,600,000 0 34,839,120 0 37,132,620 1,307,295
3,600,000 837,120 3,600,000 0 36,724,320 0 39,114,920 1,362,642
2,880,000 3,348,480 3,600,000 0 41,203,560 0 43,497,060 1,490,316
2,880,000 3,348,480 3,600,000 0 45,719,328 0 48,236,528 1,704,815
2,160,000 837,120 3,600,000 0 35,880,720 0 38,222,020 1,390,971
2,880,000 3,348,480 3,600,000 0 43,211,784 0 45,652,084 1,585,707
2,880,000 2,511,360 3,600,000 0 38,174,904 0 40,308,204 1,386,218
2,880,000 3,348,480 3,600,000 0 42,192,624 0 44,558,424 1,537,297
2,880,000 837,120 3,600,000 0 36,297,120 0 38,712,120 1,376,550
2,880,000 837,120 3,600,000 0 33,723,120 0 35,923,620 1,254,285
2,880,000 3,348,480 3,600,000 0 41,203,560 0 43,497,060 1,490,316
2,880,000 1,674,240 3,600,000 0 38,428,440 0 40,561,740 1,438,025
2,880,000 837,120 3,600,000 0 35,706,720 0 38,072,520 1,348,506
3,180,000 3,348,480 3,600,000 0 48,316,200 0 51,107,700 1,813,917
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 1,674,240 3,600,000 0 42,071,640 0 44,562,740 1,611,077
2,880,000 3,348,480 3,600,000 0 46,085,952 0 48,736,352 1,722,230
2,880,000 837,120 3,600,000 0 39,121,920 0 41,772,320 1,510,728
2,880,000 2,511,360 3,600,000 0 41,058,720 0 43,628,220 1,523,200
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 3,348,480 3,600,000 0 44,263,776 0 46,780,976 1,635,677
2,880,000 3,348,480 3,600,000 0 44,263,776 0 46,780,976 1,635,677
2,880,000 3,348,480 3,600,000 0 44,263,776 0 46,780,976 1,635,677
2,880,000 3,348,480 3,600,000 0 38,120,088 0 40,461,388 1,343,851
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
3,180,000 3,348,480 3,600,000 0 48,316,200 0 50,807,300 1,813,917
2,880,000 837,120 3,600,000 0 38,151,120 0 40,642,220 1,464,615
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,880,000 837,120 3,600,000 0 38,151,120 0 40,720,620 1,464,615
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,035,756 1,740,294
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 837,120 3,600,000 0 38,151,120 0 40,720,620 1,464,615
2,880,000 2,511,360 3,600,000 0 44,986,368 0 47,664,568 1,709,763
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,160,000 837,120 3,600,000 0 34,401,120 0 36,647,320 1,320,690
2,880,000 837,120 3,600,000 0 39,455,520 0 42,133,720 1,526,574
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,160,000 3,348,480 3,600,000 0 40,476,720 0 42,769,720 1,489,991
3,600,000 837,120 3,600,000 0 38,879,520 0 41,449,720 1,465,014
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 837,120 3,600,000 0 39,121,920 0 41,772,320 1,510,728
2,880,000 3,348,480 3,600,000 0 47,620,848 0 50,299,048 1,795,137
2,880,000 3,348,480 3,600,000 0 46,085,952 0 48,655,452 1,722,230
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,035,756 1,740,294
2,880,000 3,348,480 3,600,000 0 46,085,952 0 48,736,352 1,722,230
2,880,000 837,120 3,600,000 0 39,121,920 0 41,772,320 1,510,728
2,880,000 837,120 3,600,000 0 39,121,920 0 41,772,320 1,510,728
2,880,000 3,348,480 3,600,000 0 46,085,952 0 48,736,352 1,722,230
2,880,000 3,348,480 3,600,000 0 42,865,680 0 45,206,980 1,569,267
2,880,000 3,348,480 3,600,000 0 41,525,040 0 43,771,240 1,505,587
2,160,000 837,120 3,600,000 0 33,551,520 0 35,729,220 1,280,334
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 837,120 3,600,000 0 39,455,520 0 42,025,020 1,526,574
2,640,000 3,348,480 3,600,000 0 42,625,680 0 44,966,980 1,569,267
3,600,000 3,348,480 3,600,000 0 46,439,328 0 49,062,928 1,704,815
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 837,120 3,600,000 0 36,899,520 0 39,289,520 1,405,164
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,470,340 1,669,661
2,880,000 837,120 3,600,000 0 39,121,920 0 41,772,320 1,510,728
2,160,000 2,511,360 3,600,000 0 38,460,288 0 40,706,488 1,433,974
2,880,000 837,120 3,600,000 0 38,151,120 0 40,720,620 1,464,615
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,880,000 837,120 3,600,000 0 39,455,520 0 42,025,020 1,526,574
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,160,000 3,348,480 3,600,000 0 44,259,240 0 46,750,340 1,669,661
2,880,000 3,348,480 3,600,000 0 46,466,256 0 49,144,456 1,740,294
2,160,000 3,348,480 3,600,000 0 44,259,240 0 46,750,340 1,669,661
2,880,000 3,348,480 3,600,000 0 44,979,240 0 47,548,740 1,669,661
2,880,000 837,120 3,600,000 0 38,151,120 0 40,720,620 1,464,615
2,880,000 2,511,360 3,600,000 0 44,986,368 0 47,555,868 1,709,763
2,220,000 3,348,480 3,600,000 0 45,059,328 0 47,602,828 1,704,815
2,880,000 3,348,480 3,600,000 0 45,347,232 0 47,838,332 1,687,141
3,600,000 2,511,360 3,600,000 0 44,972,544 0 47,516,044 1,674,906
2,160,000 3,348,480 3,600,000 0 44,627,232 0 47,118,332 1,687,141
2,880,000 3,348,480 3,600,000 0 42,865,680 0 45,206,980 1,569,267
3,600,000 2,511,360 3,600,000 0 44,972,544 0 47,516,044 1,674,906
2,880,000 2,511,360 3,600,000 0 43,886,976 0 46,378,076 1,657,542
2,880,000 1,674,240 3,600,000 0 38,738,640 0 40,984,840 1,452,759
2,160,000 837,120 3,600,000 0 35,577,120 0 37,992,120 1,376,550
2,880,000 2,511,360 3,600,000 0 41,448,960 0 43,863,960 1,541,736
2,880,000 3,348,480 3,600,000 0 43,906,728 0 46,397,828 1,618,717
2,880,000 3,348,480 3,600,000 0 42,865,680 0 45,206,980 1,569,267
2,880,000 3,348,480 3,600,000 0 43,906,728 0 46,397,828 1,618,717
2,880,000 3,348,480 3,600,000 0 43,906,728 0 46,397,828 1,618,717
2,160,000 837,120 3,600,000 0 34,401,120 0 36,718,120 1,320,690
2,160,000 3,348,480 3,600,000 0 43,186,728 0 45,601,728 1,618,717
2,880,000 837,120 3,600,000 0 36,297,120 0 38,712,120 1,376,550
2,880,000 837,120 3,600,000 0 36,297,120 0 38,712,120 1,376,550
2,160,000 3,348,480 3,600,000 0 40,805,040 0 43,122,040 1,505,587
2,880,000 3,348,480 3,600,000 0 45,347,232 0 47,943,632 1,687,141
2,880,000 1,674,240 3,600,000 0 40,032,240 0 42,278,440 1,514,205
2,880,000 2,511,360 3,600,000 0 40,458,432 0 42,799,732 1,494,686
2,880,000 837,120 3,600,000 0 34,839,120 0 37,132,620 1,307,295
2,880,000 3,348,480 3,600,000 0 41,857,464 0 44,127,264 1,521,377
2,880,000 837,120 3,600,000 0 35,412,720 0 37,729,720 1,334,541
2,880,000 3,348,480 3,600,000 0 41,857,464 0 44,127,264 1,521,377
2,160,000 837,120 3,600,000 0 33,551,520 0 35,729,220 1,280,334
2,880,000 1,674,240 3,600,000 0 37,804,080 0 39,981,780 1,408,367
2,160,000 3,348,480 3,600,000 0 38,899,416 0 41,077,116 1,415,069
2,160,000 3,348,480 3,600,000 0 38,899,416 0 41,077,116 1,415,069
2,160,000 837,120 3,600,000 0 31,668,720 0 33,758,020 1,190,901
2,880,000 3,348,480 3,600,000 0 40,879,344 0 43,057,044 1,474,916
2,880,000 3,348,480 3,600,000 0 39,012,024 0 41,058,724 1,386,218
2,880,000 3,348,480 3,600,000 0 40,879,344 0 43,149,144 1,474,916
2,880,000 1,674,240 3,600,000 0 38,115,600 0 40,385,400 1,423,165
2,880,000 2,511,360 3,600,000 0 39,497,472 0 41,767,272 1,449,040
2,160,000 3,348,480 3,600,000 0 38,899,416 0 41,010,616 1,415,069
2,160,000 3,348,480 3,600,000 0 39,836,496 0 42,014,196 1,459,581
2,160,000 1,674,240 3,600,000 0 36,179,880 0 38,357,580 1,365,418
2,880,000 2,511,360 3,600,000 0 39,497,472 0 41,767,272 1,449,040
2,880,000 3,348,480 3,600,000 0 41,203,560 0 43,497,060 1,490,316
2,880,000 3,348,480 3,600,000 0 37,827,336 0 39,874,036 1,329,946
2,880,000 2,511,360 3,600,000 0 35,659,008 0 37,643,208 1,266,713
2,640,000 2,511,360 3,600,000 0 35,419,008 0 37,403,208 1,266,713
2,880,000 3,348,480 3,600,000 0 36,972,336 0 38,956,536 1,289,333
2,880,000 1,674,240 3,600,000 0 32,440,848 0 34,425,048 1,153,614
2,640,000 3,348,480 3,600,000 0 36,732,336 0 38,716,536 1,289,333
2,160,000 3,348,480 3,600,000 0 42,483,576 0 44,923,276 1,585,317
2,100,000 3,348,480 3,600,000 0 36,463,200 0 38,467,200 1,302,199
2,160,000 2,511,360 3,600,000 0 36,351,552 0 38,440,852 1,333,809
2,160,000 2,511,360 3,600,000 0 35,494,080 0 37,519,580 1,293,079
2,100,000 837,120 3,600,000 0 28,222,320 0 30,029,420 1,030,047
2,100,000 2,511,360 3,600,000 0 33,783,648 0 35,686,348 1,214,684
3,180,000 2,511,360 3,600,000 0 45,664,032 0 48,370,332 1,727,702
2,880,000 3,348,480 3,600,000 0 42,531,888 0 44,825,388 1,553,412
2,880,000 837,120 3,600,000 0 34,839,120 0 37,132,620 1,307,295
3,180,000 837,120 3,600,000 0 40,432,320 0 43,166,920 1,558,722
2,880,000 2,511,360 3,600,000 0 39,816,000 0 42,109,500 1,464,170
2,640,000 3,348,480 3,600,000 0 36,732,336 0 38,716,536 1,289,333
3,600,000 3,348,480 3,600,000 0 45,708,816 0 48,279,016 1,670,116
2,880,000 3,348,480 3,600,000 0 41,203,560 0 43,497,060 1,490,316
2,880,000 2,511,360 3,600,000 0 39,816,000 0 42,109,500 1,464,170
2,880,000 837,120 3,600,000 0 32,916,720 0 35,050,020 1,215,981
6,480,000 2,511,360 3,600,000 0 61,543,872 0 65,122,272 2,325,244
6,480,000 2,511,360 3,600,000 0 54,208,320 0 57,304,820 1,976,806
2,220,000 1,674,240 3,600,000 0 42,855,720 0 45,534,620 1,679,670
740,000 837,120 1,200,000 0 11,988,716 0 11,988,716 109,388
740,000 279,040 1,200,000 0 10,192,480 0 10,192,480 94,685
740,000 279,040 1,200,000 0 10,192,480 0 10,192,480 94,685
740,000 279,040 1,200,000 0 10,192,480 0 10,192,480 94,685
740,000 279,040 1,200,000 0 10,192,480 0 10,192,480 94,685
740,000 279,040 1,200,000 0 10,192,480 0 10,192,480 94,685
740,000 279,040 1,200,000 0 9,948,960 0 9,948,960 91,793
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1,022,600,000 739,456,000 1,169,700,000 0 13,253,329,616 0 14,024,630,716 487,415,878
PENGURANG NETO12/disetahun
Biaya Jabatan NETO (33-37) PTKP PKP PEMBULATAN LB500
(34+36) kan
3,571,844 6,123,739 65,313,157 65,313,157 32,400,000 32,913,157 32,913,000 0

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697,226,482 1,184,642,361 12,759,888,690 12,830,682,814 8,494,875,000 4,346,820,088 4,346,646,000 0
BULAN BULAN
K500 K250 K50 PPH SETAHUN PPH PERBULAN
AWAL AKHIR
0 0 1,645,650 1,645,650 137,138 Januari Desember

0 0 947,600 947,600 78,967 Januari Desember
0 0 0 0 0 Januari Juli
0 0 0 0 0 September Desember
0 0 0 0 0 Januari Desember
0 0 217,332,300 217,332,300 18,111,025
SPT Masa
Departemen Pajak
Keuangan RI
Penghasilan X SPT Normal
Pasal 21 dan/atau
SPT Pembetulan Ke- ____
Direktorat Pasal 26
Formulir ini digunakan untuk melaporkan Tahun Kalender Formulir
Jenderal kewajiban Pemotongan Pajak Penghasilan
Pajak Pasal 21 dan/atau Pasal 26

2 0 1 1 1721
Bulan/Tahun
Masa Pajak 1 2 / 2 0 1 4
Bagian A – Informasi Identitas Wajib Pajak
1 NPWP 0 0 . 4 0 9 . 4 6 4 . 5 - 1 0 2 . 0 0 0
2 Nama WP DINAS KESEHATAN KABUPATEN BIREUEN
3 Alamat Jl. Sultan Iskandar Muda
4 Nomor Telepon 0644 21827 5 Alamat Email 0

Bagian Jumlah
B – Objek Pajak
Jumlah Jumlah
Golongan Penerima Penghasilan Bruto Pajak
No Penerima
Penghasilan Terutang
(Rp) (Rp)
(1) (2) (3)
Penghasilan (4) (5)
6 Pegawai Tetap 1,000 13,253,329,616 217,332,300

7 Penerima Pensiun Berkala
8 Pegawai Tidak Tetap atau Tenaga Kerja Lepas
9 Distributor MLM
10 Petugas Dinas Luar Asuransi
11 Penjaja Barang Dagangan
12 Tenaga Ahli
Anggota Dewan Komisaris atau Dewan Pengawas yang
13
tidak Merangkap sebagai Pegawai Tetap
Mantan Pegawai yang Menerima Jasa Produksi, Tantiem,
14
Bonus atau Imbalan Lain
15 Pegawai yang Melakukan Penarikan Dana Pensiun
16 Peserta Kegiatan
Bukan Pegawai yang Menerima Penghasilan yang
17
Bersifat Berkesinambungan
Bukan Pegawai yang Menerima Penghasilan yang Tidak
18
Bersifat Berkesinambungan
Pegawai atau Pemberi Jasa sebagai Wajib Pajak Luar
19
Negeri
Jumlah Bagian B
20 (Penjumlahan Angka 6 s.d. 1,000 13,253,329,616 217,332,300
19)
PPh Pasal 21 dan/atau Pasal 26 yang telah Disetor pada Masa Pajak Januari s.d. November
21
(Diisi hanya pada Masa Pajak Desember)
22 STP PPh Pasal 21 dan/atau Pasal 26 (hanya Pokok Pajak)
Kelebihan setor PPh Pasal 21 dan/atau Pasal 26 dari :
23 Masa Pajak Tahun Kalender

1 2 3 4 5 6 7 8 9 10 11 12
24 Jumlah (angka 21 + angka 22 + angka 23) -

25 PPh Pasal 21 dan/atau Pasal 26 yang Kurang (Lebih) Disetor (angka 20 – angka 24) 217,332,300
25a. Penyetoran dengan SSP PPh Pasal 21 Ditanggung Pemerintah
25b. Penyetoran dengan SSP
Jika SPT Pembetulan, maka dilanjutkan ke angka 26 dan 27

PPh Pasal 21 dan/atau Pasal 26 yang Kurang (Lebih) Disetor pada SPT yang Dibetulkan
26 (merupakan pindahan dari Bagian B Angka 25 dari SPT
yang Dibetulkan)
27 PPh Pasal 21 dan/atau Pasal 26 yang Kurang (Lebih) Disetor karena pembetulan (angka 25 – angka 26) 217,332,300
28 Kelebihan setor pada angka 25 atau angka 27 akan dikompensasikan ke Masa Pajak Tahun
Catatan:
Khusus Untuk Masa Pajak Desember, Jumlah Penghasilan Bruto (kolom 4) dan Jumlah Pajak Terutang (kolom 5) pada angka 6
sampai dengan angka 20 diisi jumlah kumulatif dalam Tahun Kalender yang bersangkutan
Bagian C – Objek
Jumlah Pajak – Final
Jumlah Jumlah
Golongan Penerima
No Penerima
Penghasilan Penghasilan Bruto Pajak Terutang
(Rp) (Rp)
(1) (2) (3) (4) (5)
Penghasilan
Penerima Uang Pesangon, Uang Manfaat Pensiun,
29 Tunjangan Hari Tua atau Jaminan Hari Tua, dan Pembayaran
Lain Sejenis yang Dibayarkan Sekaligus
Pejabat Negara, Pegawai Negeri Sipil, Anggota TNI/POLRI

30 dan Pensiunan yang Menerima Honorarium dan Imbalan Lain
yang Dibebankan Kepada Keuangan Negara/Daerah
Jumlah Bagian C
31
(Penjumlahan Angka 29 s.d 30) - - -
Bagian D – Lampiran
b) Surat Setoran Pajak PPh Pasal 21 DTP c) Surat Kuasa Khusus/Surat
a) Surat Setoran Paja lembar
Keterangan Kematian
d) Daftar Bukti Pemotongan Pajak e) Daftar Bukti Pemotongan Pajak f) Formulir 1721 – I
Penghasilan Tidak Final Penghasilan Final (Disampaikan hanya pada Masa
Pajak Desember)
g) Formulir 1721 – II h) Daftar Biaya untuk Wajib Pajak yang i) ……………………………

(Disampaikan hanya pada Masa Pajak Tidak Wajib Menyampaikan SPT
terjadi perubahan Pegawai Tetap) Tahunan PPh Badan (Disampaikan
hanya pada Masa Pajak Desember)
Bagian E – Pernyataan dan Tanda Tangan

Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi - sanksi sesuai dengan
ketentuan perundang-undangan yang berlaku, saya menyatakan bahwa apa yang telah saya Diisi oleh Petugas
beritahukan di atas beserta lampiran-lampirannya adalah benar, lengkap dan jelas.
PEMOTONG PAJAK (PIMPINAN) Kuasa Wajib Pajak SPT Masa Diterima :

Nama dr. AMIR ADDANI Langsung dari WP
NPWP 0 0 4 0 9 4 6 4 5 1 0 2 0 0 0 Melalui Pos

Tanda Tangan Tanggal (dd/mm/yyyy) Tanggal (dd/mm/yyyy) Tanda Tangan
3 0 0 1 2 0 1 5
___/___/_____
TARIF PPh PASAL 21 MENGGUNAKAN TARIF PASAL 17 UU PPh

Dalam ketentuan baru ini, tarif pemotongan PPh Pasal 21 adalah dengan menggunakan tarif Pasal 17 ayat (1) huruf a UU PPh atas
penghasilan yang diterima oleh:
1. Pegawai tetap.
2. Penerima pensiun yang dibayarkan secara bulanan.
3. Pegawai tidak tetap atau tenaga kerja lepas yang dibayarkan secara bulanan.
4. Pegawai tidak tetap atau tenaga kerja lepas berupa upah harian, upah mingguan, upah satuan, upah borongan dan uang
saku harian yang tidak dibayarkan secara bulanan.
5. Bukan pegawai yang menerima pembayaran yang bersifat tidak berkesinambungan.
6. Peserta kegiatan setiap kali menerima pembayaran yang bersifat utuh dan tidak dipecah.
7. Bukan pegawai yang menerima imbalan yang berkesinambungan.
8. Anggota dewan komisaris atau dewan pengawas yang tidak merangkap sebagai pegawai tetap yang menerima atau
memperoleh honorarium atau imbalan yang bersifat tidak teratur.
9. Mantan pegawai yang menerima atau memperoleh jasa produksi, tantiem, gratifikasi, bonus atau imbalan lain yang bersifat
tidak teratur.
10. Peserta program pensiun yang berstatus sebagai pegawai yang melakukan penarikan Dana Pensiun.
(Pasal 13, 14, 15 dan 16 PMK 252/PMK.03/2008)
PTKP BAGI PENERIMA PENGHASILAN BUKAN PEGAWAI

PTKP Bagi orang pribadi bukan Pegawai seperti petugas dinas luar asuransi yang tidak berstatus sebagai pegawai, distributor MLM atau direct
selling, penjaja barang dagangan yang tidak berstatus pegawai atau penerima penghasilan lainnya yang menerima penghasilan dari pemotong PPh
Pasal 21 secara berkesinambungan. Syarat bagi penerima penghasilan bukan pegawai untuk mendapatkan pengurangan PTKP yaitu orang pribadi
bukan pegawai penerima penghasilan tersebut harus memiliki NPWP (untuk wanita kawin, maka suaminya harus memiliki NPWP) dan memberikan
fotokopi kartu NPWP miliknya (atau milik suaminya, bagi wanita kawin) kepada pemotong PPh Pasal 21 (Pasal 12 PMK-252/PMK.03/2008).
BIAYA JABATAN
Biaya Jabatan ditetapkan sebesar 5% dari penghasilan bruto dengan jumlah setinggi-tingginya Rp 6.000.000,00 setahun atau Rp
500.000,00 sebulan.
Biaya Pensiun ditetapkan sebesar 5% dari penghasilan bruto dengan jumlah setinggi-tingginya Rp 2.400.000,00 setahun atau Rp
200.000,00 sebulan.
(Pasal 1 PMK 250/PMK.03/2008)
BATAS UPAH HARIAN YANG TIDAK DIPOTONG PPh PASAL 21

Batas penghasilan bruto yang diterima atau diperoleh pegawai harian, mingguan dan pegawai tidak tetap lainnya sampai dengan jumlah Rp 150.000,00 sehari tidak
dipotong PPh Pasal 21. Namun ketentuan ini tidak berlaku jika penghasilan bruto ini telah melebihi Rp 1.320.000,00 (jika upah harian tersebut diakumulasikan
selama sebulan) atau jika penghasilan upah harian ini dibayarkan secara bulanan. (Pasal 1 dan Pasal 2 PMK 254/PMK.03/2008).
PEMOTONGAN PPh PASAL 21 YANG TIDAK MEMILIKI NPWP

Atas penghasilan yang dibayarkan kepada pegawai dan bukan pegawai yang tidak memiliki NPWP, dikenakan Pemotongan PPh Pasal 21 dengan tarif yang lebih
tinggi 20% daripada tarif yang diterapkan dalam PPh Pasal 21, sehingga jumlah PPh yang dipotong tarifnya menjadi 120% dari jumlah PPh Pasal 21 yang seharusnya
dipotong. Pemotongan tersebut hanya berlaku untuk pemotongan PPh Pasal 21 yang bersifat tidak final.
(Pasal 20 PMK 252/PMK.03/2008).
Dilamp
DAFTAR BUKTI PEMOTONGAN PAJAK
1721 - I
Departemen PENGHASILAN
Keuangan RI PASAL 21
DAN/ATAU PASAL 26
Direktorat UNTUK PEGAWAI
TETAP DAN Tahun Kalender
Jenderal PENERIMA PENSIUN
BERKALA 2 0 1 4
Pajak
A. DAFTAR PEGAWAI TETAP DAN PENERIMA PENSIUN ATAU THT/JHT YANG PENGHASILAN NETONYA
MELEBIHI PENGHASILAN TIDAK KENA PAJAK (PTKP)
PPh Pasal 21
Penghasilan Bruto dan/atau Pasal 26
No NPWP Nama Wajib Pajak
(Rupiah) Terutang
(Rupiah)
(1) (2) (3) (4) (5)
1 69.118.007.9-104.000 TAUFIK HELMI, SKM - 1,645,650

2 69.118.008.7-104.000 ERLIZA,Amd.Keb - 1,517,700
3 69.118.017.8-104.000 FAUZI - 1,550,150
4 78.032.635.1-104.000 MAIMUN - 1,475,250
5 69.118.010.3-104.000 MARDIANI,SKM - 1,475,250
6 78.032.634.4-104.000 ISKANDAR - 1,475,250
7 69.118.018.6-104.000 ROZANNA, AMD.KEB. - 1,475,250
8 78.032.633.6-104.000 ARNIZA ZA - 1,388,400
9 69.118.009.5-104.000 ZALIKHA ALI - 1,475,250
10 69.118.012.9-104.000 JAMILAH - 1,342,950
11 89.210.338.3-104.000 M. DAUD, AMK - 1,497,950
12 77.751.803.6-104.000 RUKIAH - 1,470,050
13 77.751.802.8-101.000 ZAHARA - 1,332,150
14 68.964.069.6-104.000 NURHAYATI, AMD.KEB. - 1,333,200
15 68.964.065.4-104.000 BAHRIATI, AMD.KEB. - 1,402,550
16 69.118.014.5-104.000 ERNA SURYANI - 1,402,550
17 69.118.013.7-104.000 RAIHANI - 1,324,050
18 69.118.028.5-104.000 YUSRAWATI, SST - 1,544,800
19 69.118.024.4-104.000 ZAIFULLI - 1,450,550
20 69.118.025.1-104.000 NURBAITI, AMK - 1,550,150
A1. Pegawai tetap dan Penerima Pensiun atau THT/JHT yang
- 29,129,100
Penghasilan Netonya Melebihi PTKP (jumlah nomor 1 s.d. 20)
B. Pegawai Tetap dan Penerima Pensiun atau THT/JHT yang
-
Penghasilan Netonya tidak Melebihi PTKP orang
C. Jumlah (A1 + B) - 29,129,100
Halaman ke 1 dari 50 halaman
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI
KE MENU UTAMA
Departemen
Keuangan RI
1721 - II
Direktorat DAFTAR PERUBAHAN MASA PAJAK
PEGAWAI TETAP (Bulan/Tahun)
Jenderal
/ 2 0
Pajak
A. Pegawai Tetap yang Keluar
PPh Pasal 21
Penghasilan
Bruto dan/atau Pasal 26
(Rupiah) Terutang
(1) (2) (3) (4) (Rupiah)
(5)
1.
2.
3.
4.
5.
B. Pegawai Tetap yang Masuk
Status Karyawan
No NPWP Nama Wajib Pajak (TK, K, K/I, Jumlah
PH, HB) Tanggungan
(1) (2) (3) (4) (5)
1.
2.
3.
4.
5.
C. Pegawai yang Baru Memiliki NPWP
Tanggal
Terdaftar
(1) (2) (3) (4)
1.
2.
3.
4.
5.
Halaman ke dari halaman
ISIKAN NOMOR HALAMAN Ke Induk Hal 1
1
Departemen
Keuangan RI
DAFTAR PEGAWAI
1721 - T
Direktorat TETAP / MASA PAJAK
(Bulan/Tahun)
PENERIMA PENSIUN
Jenderal BERKALA 1 2 / 2 0 1 4
Pajak
Status Karyawan
No NPWP* Nama Wajib Pajak (TK, K, K/I, Jumlah
PH, HB) Tanggungan

(1) (2) (3) (4) (5)
1 69.118.007.9-104.000 TAUFIK HELMI, SKM K3 3
2 69.118.008.7-104.000 ERLIZA,Amd.Keb TK 0 0
3 69.118.017.8-104.000 FAUZI K2 2
4 78.032.635.1-104.000 MAIMUN K2 2
5 69.118.010.3-104.000 MARDIANI,SKM K2 2
6 78.032.634.4-104.000 ISKANDAR K2 2
7 69.118.018.6-104.000 ROZANNA, AMD.KEB. K2 2
8 78.032.633.6-104.000 ARNIZA ZA TK 0 0
9 69.118.009.5-104.000 ZALIKHA ALI K2 2
10 69.118.012.9-104.000 JAMILAH TK 2 2
11 89.210.338.3-104.000 M. DAUD, AMK K1 1
12 77.751.803.6-104.000 RUKIAH K2 2
13 77.751.802.8-101.000 ZAHARA K2 2
14 68.964.069.6-104.000 NURHAYATI, AMD.KEB. TK 2 2
15 68.964.065.4-104.000 BAHRIATI, AMD.KEB. K2 2
16 69.118.014.5-104.000 ERNA SURYANI K2 2
17 69.118.013.7-104.000 RAIHANI TK 0 0
18 69.118.028.5-104.000 YUSRAWATI, SST K2 2
19 69.118.024.4-104.000 ZAIFULLI K2 2
20 69.118.025.1-104.000 NURBAITI, AMK K2 2
* Untuk Pegawai yang tidak memiliki NPWP, maka kolom NPWP dikosongkan.
Halaman ke 1 dari 50 halaman
Dilampirkan hanya sekali setahun,
biasanya bulan Juli 2009
T
K
wan
ah
nggungan
(5)
2
UK INI
Ke 1770-SS Ke 1770-S
LAMPIRAN I - B 1. Lembar 1 untuk KPP
TAHUN TAKWIM
1721 - A2 2. Lembar 2 untuk Pemotong Pajak
FORMULIR
3. Le="mbar 3 untuk Pegawai"

SPT TAHUNAN PPH PASAL 21
2 0 1 4
• PENGHASILAN DAN PENGHITUNGAN PPh PASAL 21 PEGAWAI
DEPARTEMEN KEUANGAN RI NEGERI SIPIL, ANGGOTA TNI / POLRI, PEJABAT NEGARA DAN
DIREKTORAT JENDERAL PAJAK PENSIUNANNYA
PETUNJUK PEMAKAIAN :
KLIK BAGIAN YG DITUNJUK ANAK PANAH, kemudian pilih nomor dari nama yang di
NOMOR URUT : 299
NAMA INSTANSI / BADAN LAIN : DINAS KESEHATAN KABUPATEN BIREUEN
NPWP BENDAHARA : 00.409.464.5-102.000
NAMA BENDAHARA : AGUSTALANI, SKM
ALAMAT BENDAHARA : Jl. Sultan Iskandar Muda
NAMA PEGAWAI / PENSIUNAN : dr. Millati Amalia
NIP / NRP : 19870831 201406 2 001
NPWP PEGAWAI / PENSIUNAN : 71.991.382.4-104.000
ALAMAT PEGAWAI / PENSIUNAN :
PANGKAT / GOLONGAN : Penata Muda Tk.I / III.b

JABATAN :
STATUS DAN JENIS KELAMIN : KAWIN X TIDAK KAWIN LAKI-LAKI X PEREMPUAN
JUMLAH TANGGUNGAN KELUARGA UNTUK PTKP : K/ TK/ 0 HB/
MASA PEROLEHAN PENGHASILAN : 9 S.D 12
A. RINCIAN PENGHASILAN DAN PENGHITUNGAN PPh PASAL 21 SEBAGAI BERIKUT : RUPIAH

• PENGHASILAN BRUTO :
1. GAJI POKOK / PENSIUN 1 7,729,920
2. TUNJANGAN ISTERI 2 -
3. TUNJANGAN ANAK 3 -
4. JUMLAH GAJI DAN TUNJANGAN KELUARGA (1+2+3) 4 7,729,920
5. TUNJANGAN PERBAIKAN PENGHASILAN (GAJI 13) 5 -
6. TUNJANGAN STRUKTURAL / FUNGSIONAL 6 740,000
7. TUNJANGAN BERAS 7 279,040
8. TUNJANGAN KHUSUS 8 1,200,000
9. TUNJANGAN LAIN-LAIN 9 -
10. JUMLAH PENGHASILAN BRUTO (4 S.D. 9) 10 9,948,960
• PENGURANGAN :
11. BIAYA JABATAN / BIAYA PENSIUN 11 124,362
12. IURAN PENSIUN ATAU IURAN THT 12 91,793
13. JUMLAH PENGURANGAN (11 + 12) 13 216,155
• PENGHITUNGAN PPh PASAL 21 :
14. JUMLAH PENGHASILAN NETO (10 - 13) 14 9,732,805
15. JUMLAH PENGHASILAN NETO UNTUK PENGHITUNGAN PPh PASAL 21 (SETAHUN/DISETAHUNKAN) 15 9,084,341
16. PENGHASILAN TIDAK KENA PAJAK (PTKP) 16 24,300,000
17. PENGHASILAN KENA PAJAK SETAHUN / DISETAHUNKAN (15 - 16) 17 -
18. PPh PASAL 21 TERUTANG 18 -
19. PPh PASAL 21 YANG TELAH DIPOTONG 19 -
20. JUMLAH PPh PASAL 21 :
a. YANG KURANG DIPOTONG (18 - 19)
20 NIHIL
b. YANG LEBIH DIPOTONG (19 - 18)
B. • PEGAWAI TERSEBUT : DIPINDAHKAN PINDAHAN BARU PENSIUN
C. TANDA TANGAN BENDAHARA Bireuen 3 0 0 1 2 0 1 5

(tempat) TGL BLN THN
Tanda Tangan dan Cap
BENDAHARA DINAS KESEHATAN KABUPATEN BIREUEN
NAMA AGUSTALANI, SKM
NIP/NRP 197308021997031002
D.1.1.32.49
petun
klik yg
anak p
pilih n
yang d
SPT TAHUNAN
###
TAHUN PAJAK
1770 S PAJAK PENGHASILAN WAJIB PAJAK ORANG PRIBADI
FORMULIR
DEPARTEMEN KEUANGAN RI
MEMPUNYAI PENGHASILAN :
• DARI SATU ATAU LEBIH PEMBERI KERJA
2 0 1 4
DIREKTORAT JENDERAL PAJAK • DALAM NEGERI LAINNYA
• YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL
PERHATIAN • SEBELUM MENGISI BACA DAHULU BUKU PETUNJUK PENGISIAN • ISI DENGAN HURUF CETAK /DIKETIK DENGAN TINTA HITAM • BERI TANDA "X" PADA (KOTAK PILIHAN) YANG SESUAI
NPWP : 78.364.555.9-104.000
IDENTITAS
NAMA WAJIB PAJAK : DARMIATI,AMK

PEKERJAAN : Pegawai Negeri Sipil KLU : 9 5 0 0 1
NO. TELEPON : - NO. FAKS : -
PERUBAHAN DATA : LAMPIRAN TERSENDIRI TIDAK ADA
*) Pengisian kolom-kolom yang berisi nilai rupiah harus tanpa nilai desimal (contoh penulisan lihat buku petunjuk hal. 3) RUPIAH *)
1 PENGHASILAN NETO DALAM NEGERI SEHUBUNGAN DENGAN PEKERJAAN …….……………………………………………
[Diisi akumulasi jumlah penghasilan neto pada setiap Formulir 1721-A1 dan/atau 1721-A2 angka 14 yang dilampirkan]
1 45,605,562
2 PENGHASILAN NETO DALAM NEGERI LAINNYA …… ……………………………………………………………………………

[Diisi sesuai dengan Formulir 1770 S-I Jumlah Bagian A ]
2 0
A. PENGHASILAN NETO
3 PENGHASILAN NETO LUAR NEGERI ………………………………………………………………………………………………………………

3
[Apabila memiliki penghasilan dari luar negeri agar diisi dari Lampiran Tersendiri, lihat buku petunjuk]
0
4 JUMLAH PENGHASILAN NETO (1+2+3) ………………………………………………………………………………………

4 45,605,562
5 ZAKAT ATAS PENGHASILAN YANG MENJADI OBJEK PAJAK ………………………………………………………………………

5 0
6 JUMLAH PENGHASILAN NETO SETELAH PENGURANGAN ZAKAT ATAS PENGHASILAN (4-5) ………………..
6 45,605,562
B.PENGHASILAN
7 PENGHASILAN TIDAK KENA PAJAK TK/ K/ 2 K/I/ PH/ HB/

45,605,562
KENA PAJAK
8 PENGHASILAN KENA PAJAK (6-7) ……………………………………………………………………………………………. 8

0
9 PPh TERUTANG (TARIF PASAL 17 UU PPh x ANGKA 8) ……………………………………………………………………

9 761,500
C. PPh TERUTANG
10 PENGEMBALIAN / PENGURANGAN PPh PASAL 24 YANG TELAH DIKREDITKAN ………………………………………

10
11 JUMLAH PPh TERUTANG (9+10) ……………………………………………………………………………………………

11 761,500
12 PPh YANG DIPOTONG/DIPUNGUT PIHAK LAIN/DITANGGUNG PEMERINTAH DAN/ATAU KREDIT PAJAK LUAR
12 761,500
NEGERI DAN/ATAU TERUTANG DI LUAR NEGERI [Diisi dari Formulir 1770 S-I Jumlah Bagian C Kolom (7)]
13 a. PPh YANG HARUS DIBAYAR SENDIRI

(11-12) …………………………………………………….. 13 0
b. PPh YANG LEBIH DIPOTONG/DIPUNGUT
D. KREDIT PAJAK
14 PPh YANG DIBAYAR SENDIRI a. PPh PASAL 25 ………………………………………………………………………………

14a
b. TP PPh Pasal 25 (Hanya Pokok Pajak) ………………………………………………

14b
c. FISKAL LUAR NEGERI …………………………………………………………….

14c
15 JUMLAH KREDIT PAJAK (14a + 14b + 14c) ……………………………………………………………………….

15 0
E. PPh KURANG/LEBIH BAYAR
TGL LUNAS
16 a. PPh YANG KURANG DIBAYAR (PPh PASAL 29)

(13-15)
TGL BLN THN
16 0
b. PPh YANG LEBIH DIBAYAR (PPh PASAL 28 A)
17 PERMOHONAN : PPh Lebih Bayar pada 16b mohon a. DIRESTITUSIKAN
b. DIPERHITUNGKAN DENGAN UTANG PAJAK

PAJAK BERIKUTNYA
18 ANGSURAN PPh PASAL 25 TAHUN PAJAK BERIKUTNYA SEBESAR

……………………………………………………………………………………………………………………..
F. ANGSURAN PPh
PASAL 25 TAHUN
18
DIHITUNG BERDASARKAN
a. 1/12 x JUMLAH PADA ANGKA 13
b. PENGHITUNGAN DALAM LAMPIRAN TERSENDIRI
a. X Fotokopi Formulir 1721-A1 atau 1721-A2 atau Bukti Potong PPh Pasal 21 d. Perhitungan PPh Terutang Bagi Wajib Pajak Kawin Pisah Harta /mem
G. LAMPIRAN
punyai NPWP sendiri

b. Surat Setoran Pajak Lembar ke-3 PPh Pasal 29 e. …………………………………………………………..
c. Surat Kuasa Khusus (Bila dikuasakan)
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan peraturan TANDA TANGAN
perundang-undangan yang berlaku, saya menyatakan bahwa yang telah saya beritahukan diatas beserta lampiran-
lampirannya adalah benar, lengkap dan jelas.
x WAJIB PAJAK KUASA TANGGAL 3 0 0 1 2 0 1 2

TGL BLN THN
NAMA LENGKAP : DARMIATI,AMK

NPWP : 78.364.555.9-104.000
F.1.1.32.18
created by:kaka_060106529
LAMPIRAN - I
TAHUN PAJAK
1770 S - I
FORMULIR
SPT TAHUNAN PPh WAJIB PAJAK ORANG PRIBADI
DEPARTEMEN KEUANGAN RI
•
•
PENGHASILAN NETO DALAM NEGERI LAINNYA
PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK
2 0 1 4
DIREKTORAT JENDERAL PAJAK • DAFTAR PEMOTONGAN/PEMUNGUTAN PPh OLEH PIHAK LAIN DAN PPh YANG
DITANGGUNG PEMERINTAH
NPWP : 78.364.555.9-104.000
BAGIAN A : PENGHASILAN NETO DALAM NEGERI LAINNYA

(Tidak Termasuk Penghasilan Dikenakan PPh Final dan/atau Bersifat Final)
JUMLAH PENGHASILAN
NO. JENIS PENGHASILAN
(Rupiah)
(1) (2) (3)
1 Bunga -
2 Dividen -
-
3 Royalti
4 Sewa -
5 Penghargaan dan Hadiah -
6 Keuntungan dari Penjualan / Pengalihan Harta -
7 Penghasilan Lainnya -
JUMLAH BAGIAN A JBA -

Pindahkan Jumlah Bagian A ke Formulir Induk 1770 S Bagian
angka (2)
BAGIAN B : PENGHASILAN YANG TIDAK TERMASUK OBJEK PAJAK
JUMLAH PENGHASILAN
NO. JENIS PENGHASILAN
(Rupiah)
(1) (2) (3)
1 Bantuan / Sumbangan / Hibah

-
2 Warisan -
3 Bagian Laba Anggota Perseroan Komanditer Tidak Atas Saham, Persekutuan, -

Perkumpulan, Firma, Kongsi
4 Klaim Asuransi Kesehatan, Kecelakaan, Jiwa, Dwiguna, Beasiswa -
5 Beasiswa Dalam Negeri

-
6 Penghasilan Lainnya yang Tidak Termasuk Objek Pajak
JUMLAH BAGIAN B JBB -

BAGIAN C : DAFTAR PEMOTONGAN/PEMUNGUTAN PPh OLEH PIHAK LAIN
DAN PPh YANG DITANGGUNG PEMERINTAH
NAMA PEMOTONG/ NPWP PEMOTONG/ BUKTI PEMOTONGAN/ JENIS PAJAK : JUMLAH PPh YANG
NO PEMUNGUTAN PPh PASAL 21/
PEMUNGUT PAJAK PEMUNGUT PAJAK DIPOTONG / DIPUNGUT
NOMOR TANGGAL 22/23/24/26/DTP
(1) (2) (3) (4) (5) (6) (7)
DINAS KESEHATAN KABUPATEN
1 BIREUEN
00.409.464.5-102.000 20 27-01-2012 PPh Pasal 21 761,500
9
dst
JUMLAH BAGIAN C JBC 761,500
Catatan : Pindahkan Jumlah Bagian C ke Formulir Induk
*) - DTP : Ditanggung Pemerintah 1770 S Bagian D angka (12)
- Kolom (6) diisi dengan pilihan PPh Pasal 21/22/23/24/26/DTP (Contoh : ditulis 21, 22, 23, 24, 26, DTP)
- Jika terdapat kredit pajak PPh Pasal 24, maka jumlah yang diisi adalah maksimum yang dapat dikreditkan sesuai lampiran tersendiri
(lihat buku petunjuk tentang Lampiran I Bagian C dan Induk SPT angka 3)
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI Halaman ke- dari halaman Lampiran-I
LAMPIRAN - II
TAHUN PAJAK
1770 S - II
FORMULIR
SPT TAHUNAN PPh WAJIB PAJAK ORANG PRIBADI

DEPARTEMEN KEUANGAN RI • PENGHASILAN YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL
2 0 1 4
DIREKTORAT JENDERAL PAJAK • DAFTAR HARTA PADA AKHIR TAHUN
• DAFTAR KEWAJIBAN/UTANG PADA AKHIR TAHUN
NPWP : 78.364.555.9-104.000
NAMA WAJIB PAJA : DARMIATI,AMK
BAGIAN A : PENGHASILAN YANG DIKENAKAN PPh FINAL DAN/ATAU BERSIFAT FINAL

DASAR PENGENAAN PAJAK/ PPh TERUTANG
NO. SUMBER/JENIS PENGHASILAN
PENGHASILAN BRUTO (Rupiah)
(1) (2) (3) (4)
1 Bunga Deposito, Tabungan dan Diskonto SBI

- -
2 Bunga/Diskonto Obligasi yang Dilaporkan Perdagangannya di
Bursa Efek - -
3 Penjualan Saham di Bursa Efek - -
4 Hadiah Undian - -
5 Pesangon, Tunjangan Hari Tua dan Tebusan Pensiun yang
Dibayar Sekaligus - -
6 Honorarium atas Beban APBN/APBD - -
7 Pengalihan Hak atas Tanah dan/atau Bangunan

- -
8 Sewa atas Tanah dan/atau Bangunan - -
9 Bangunan yang Diterima Dalam Rangka Bangun Guna Serah
- -
Bunga Simpanan yg dibayarkan oleh Koperasi kepada
10 anggota koperasi
11 Penghasilan dari transaksi Derivatif - -
12 Dividen - -
13 Penghasilan Isteri dari Satu Pemberi Kerja - -
Penghasilan Lain yang dikenakan Pajak Final dan/atau
14 Bersifat Final - -
JUMLAH BAGIAN A JBA
-
BAGIAN B : DAFTAR HARTA PADA AKHIR TAHUN
TAHUN HARGA PEROLEHAN
KETERANGAN
NO. JENIS HARTA
PEROLEHAN (Rupiah)
(1) (2) (3) (4) (5)
1 - - - -
2
3
4
5
6
dst
JUMLAH BAGIAN B JBB
-
BAGIAN C : DAFTAR KEWAJIBAN/UTANG PADA AKHIR TAHUN
NAMA ALAMAT TAHUN
NO. JUMLAH
PEMBERI PINJAMAN PEMBERI PINJAMAN PEMINJAMAN
(1) (2) (3) (4) (5)
1 - - - -
2
3
4
5
6
dst
JUMLAH BAGIAN C JBC -
BAGIAN D : DAFTAR SUSUNAN KELUARGA

NAMA TANGGAL LAHIR HUBUNGAN
NO. KELUARGA PEKERJAAN
(1) (2) (3) (4) (5)

1 - - - -
2
3
4
5
JIKA FORMULIR INI TIDAK MENCUKUPI, DAPAT DIBUAT SENDIRI SESUAI DENGAN BENTUK INI Halaman ke- dari halaman Lampiran II
STAPLES HANYA PADA BAGIAN INI
KEMENTERIAN KEUANGAN RI
1770 SS
TAHUN PAJAK
DIREKTORAT JENDERAL PAJAK H.03 2 0
PERHATIAN :
SPT TAHUNAN
PAJAK PENGHASILAN DIISI OLEH PETUGAS KPP
▪ SEBELUM MENGISI BACA DAHULU PETUNJUK PENGISIAN
WAJIB PAJAK ORANG PRIBADI BARCODE DITEMPEL DISINI
▪ ISI DENGAN HURUF CETAK/DIKETIK DENGAN TINTA HITAM
▪ BERI TANDA 'X' PADA (KOTAK PILIHAN) YANG SESUAI H.01 SPT PEMBETULAN KE H.02 - ….
WAJIB PAJAK
IDENTITAS
NPWP I.01 : 78.364.555.9 - 104 - 000
NAMA WAJIB PAJAK I.02 : DARMIATI,AMK
Pengisian kolom-kolom yang berisi nilai rupiah harus tanpa nilai desimal
A. PAJAK PENGHASILAN
1 Penghasilan Bruto dalam Negeri Sehubungan dengan Pekerjaan dan Penghasilan Netto dalam Negeri Lainnya 1 A.01 49,856,964
2 Pengurangan
(Diisi jumlah pengurangan dari Formulir 1721-A1 angka 13 atau 1721-A2 angka 13)
2 A.02 4,251,402
TK/ K/ K/I/
3 Penghasilan Tidak Kena Pajak A.03 A.04
2
A.05 3 A.06 30,375,000
(Diisi jumlah PTKP dari Formulir 1721-A1 angka 17 atau 1721-A2 angka 16)
4 Penghasilan Kena Pajak ( 1 - 2 - 3 ) 4 A.07 15,230,562
5 Pajak Penghasilan Terutang 5 A.08 761,500
6 Pajak Penghasilan yang telah Dipotong oleh Pihak Lain 6 A.09 761,500
7 a. A.10 Pajak Penghasilan yang harus Dibayar Sendiri *

(5-6) 7 A.12 -
b. A.11 Pajak Penghasilan yang Lebih Dipotong
B PENGHASILAN YANG DIKENAKAN PPh FINAL DAN YANG DIKECUALIKAN DARI OBJEK PAJAK
8 Dasar Pengenaan Pajak/Penghasilan Bruto Pajak Penghasilan Final 8 B.01
9 Pajak Penghasilan Final Terutang 9 B.02
10 Penghasilan yang Dikecualikan dari Objek Pajak 10 B.03
C DAFTAR HARTA DAN KEWAJIBAN
11 Jumlah Keseluruhan Harta yang Dimiliki pada Akhir Tahun Pajak 11 C.01
12 Jumlah Keseluruhan Kewajiban/Utang pada Akhir Tahun Pajak 12 C.02
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan peraturan perundang-undangan yang berlaku
Saya menyatakan bahwa apa yang telah saya beritahukan di atas adalah benar, lengkap, jelas.
P.01 - -
dd mm yyyy
TANDA TANGAN
* Apabila terdapat Pajak Penghasilan yang harus dibayar sendiri, Wajib Pajak harus melampirkan asli SSP lembar ke-3
SPT TAHUNAN ###
1770 SS
TAHUN PAJAK
FORMULIR
PAJAK PENGHASILAN WAJIB PAJAK ORANG PRIBADI

DEPARTEMEN KEUANGAN RI YANG MEMPUNYAI PENGHASILAN DARI SATU PEMBERI KERJA
2 0 1 4
DIREKTORAT JENDERAL PAJAK DENGAN PENGHASILAN BRUTO TIDAK MELEBIHI Rp.60 JUTA
SETAHUN DAN TIDAK MEMPUNYAI PENGHASILAN LAINNYA KECUALI
BUNGA BANK DAN/ATAU BUNGA KOPERASI
PERHATIAN • BACA DAHULU PETUNJUK PENGISIAN PADA HALAMAN INI • BERI TANDA "X" PADA (KOTAK PILIHAN) YANG SESUAI
• LAMPIRKAN FOTO COPY FORMULIR 1721-A1 atau 1721-A2* • ISI DENGAN HURUF CETAK/ DIKETIK DENGAN TINTA HITAM
NPWP : 78.364.555.9-104.000

IDENTITAS
PEKERJAAN : Pegawai Negeri KLU :
NO. TELEPON : - NO. FAKSIMILI : -
PERUBAHAN DATA : LAMPIRAN TERSENDIRI TIDAK ADA
JUMLAH KESELURUHAN HARTA YANG DIMILIKI PADA AKHIR TAHUN ………………………….Ø Rp.
JUMLAH KESELURUHAN KEWAJIBAN/UTANG PADA AKHIR TAHUN …………………………Ø Rp.
PERNYATAAN
Dengan menyadari sepenuhnya akan segala akibatnya termasuk sanksi-sanksi sesuai dengan ketentuan peraturan TANDA TANGAN
perundang-undangan yang berlaku, saya menyatakan bahwa yang telah saya beritahukan diatas beserta lampiran-
lampirannya adalah benar,lengkap, jelas, dan bahwa saya tidak memperoleh penghasilan lain selain dari
satu pemberi kerja.
TANGGAL
TGL BLN THN
*) Foto copy Formulir 1721 A1 atau 1721 A2 wajib dilampirkan sebagai satu kesatuan yang tidak terpisahkan dari SPT 1770 SS
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SPT - 21 - Des - Bend - 2014 - pUSKESMAS pEUSANGAN

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IDENTITAS BENDAHARA

1 Masa Pajak (dua digit)*) : 0 1 Tahun Pajak (dua digit) : 1 4

NO NAMA NIP GOL PANGKAT JABATAN NPWP

Pante Pisang K3 Laki-laki 3,927,200 3,927,200 392,720 157,088 4,477,008 500,000

348,800 300,000 12 1 12 47,126,400 4,712,640 1,885,056 53,724,096

6,000,000 4,185,600 3,600,000 0 67,509,696 0 71,436,896 2,551,895

3,571,844 6,123,739 65,313,157 65,313,157 32,400,000 32,913,157 32,913,000 0

0 0 1,645,650 1,645,650 137,138 Januari Desember

Pajak Pasal 21 dan/atau Pasal 26

3 Alamat Jl. Sultan Iskandar Muda

4 Nomor Telepon 0644 21827 5 Alamat Email 0

6 Pegawai Tetap 1,000 13,253,329,616 217,332,300

Kelebihan setor PPh Pasal 21 dan/atau Pasal 26 dari :

23 Masa Pajak Tahun Kalender

24 Jumlah (angka 21 + angka 22 + angka 23) -

Jika SPT Pembetulan, maka dilanjutkan ke angka 26 dan 27

Pejabat Negara, Pegawai Negeri Sipil, Anggota TNI/POLRI

g) Formulir 1721 – II h) Daftar Biaya untuk Wajib Pajak yang i) ……………………………

Bagian E – Pernyataan dan Tanda Tangan

PEMOTONG PAJAK (PIMPINAN) Kuasa Wajib Pajak SPT Masa Diterima :

NPWP 0 0 4 0 9 4 6 4 5 1 0 2 0 0 0 Melalui Pos

TARIF PPh PASAL 21 MENGGUNAKAN TARIF PASAL 17 UU PPh

PTKP BAGI PENERIMA PENGHASILAN BUKAN PEGAWAI

BATAS UPAH HARIAN YANG TIDAK DIPOTONG PPh PASAL 21

PEMOTONGAN PPh PASAL 21 YANG TIDAK MEMILIKI NPWP

DAFTAR BUKTI PEMOTONGAN PAJAK

1 69.118.007.9-104.000 TAUFIK HELMI, SKM - 1,645,650

Halaman ke 1 dari 50 halaman

B. Pegawai Tetap yang Masuk

C. Pegawai yang Baru Memiliki NPWP

Halaman ke dari halaman

PH, HB) Tanggungan

1 69.118.007.9-104.000 TAUFIK HELMI, SKM K3 3

7 69.118.018.6-104.000 ROZANNA, AMD.KEB. K2 2

9 69.118.009.5-104.000 ZALIKHA ALI K2 2

11 89.210.338.3-104.000 M. DAUD, AMK K1 1

14 68.964.069.6-104.000 NURHAYATI, AMD.KEB. TK 2 2

15 68.964.065.4-104.000 BAHRIATI, AMD.KEB. K2 2

16 69.118.014.5-104.000 ERNA SURYANI K2 2

18 69.118.028.5-104.000 YUSRAWATI, SST K2 2

20 69.118.025.1-104.000 NURBAITI, AMK K2 2

LAMPIRAN I - B 1. Lembar 1 untuk KPP

3. Le="mbar 3 untuk Pegawai"

NPWP BENDAHARA : 00.409.464.5-102.000

NAMA BENDAHARA : AGUSTALANI, SKM

ALAMAT BENDAHARA : Jl. Sultan Iskandar Muda

NAMA PEGAWAI / PENSIUNAN : dr. Millati Amalia

NIP / NRP : 19870831 201406 2 001

NPWP PEGAWAI / PENSIUNAN : 71.991.382.4-104.000

ALAMAT PEGAWAI / PENSIUNAN :

PANGKAT / GOLONGAN : Penata Muda Tk.I / III.b

STATUS DAN JENIS KELAMIN : KAWIN X TIDAK KAWIN LAKI-LAKI X PEREMPUAN

JUMLAH TANGGUNGAN KELUARGA UNTUK PTKP : K/ TK/ 0 HB/

MASA PEROLEHAN PENGHASILAN : 9 S.D 12

A. RINCIAN PENGHASILAN DAN PENGHITUNGAN PPh PASAL 21 SEBAGAI BERIKUT : RUPIAH

B. • PEGAWAI TERSEBUT : DIPINDAHKAN PINDAHAN BARU PENSIUN

C. TANDA TANGAN BENDAHARA Bireuen 3 0 0 1 2 0 1 5

NAMA AGUSTALANI, SKM

NAMA WAJIB PAJAK : DARMIATI,AMK

PERUBAHAN DATA : LAMPIRAN TERSENDIRI TIDAK ADA

2 PENGHASILAN NETO DALAM NEGERI LAINNYA …… ……………………………………………………………………………

3 PENGHASILAN NETO LUAR NEGERI ………………………………………………………………………………………………………………

4 JUMLAH PENGHASILAN NETO (1+2+3) ………………………………………………………………………………………