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    PENGADILAN AGAMA KLATEN

    JL. KH. Samanhudi, No.9. ℡ dan Fax 0272 321513


    E-mail samanhudi9@gmail.com Website www.pa-klaten.go.id
    aten.go.id
    KLATEN 57416

    FORMULI
    LIR PENGADUAN MASYARAK
    KAT
    Nomor:
    r: ...............................................................
    .........

    Nama : ...................................................................................................
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    Alamat : ...................................................................................................
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    Nomor Telepon/Hp : ...................................................................................................
    Pekerjaan : ...................................................................................................
    ...................................................................................................
    Hal yang diadukan : ...................................................................................................
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    Klaten, .......................................201
    .....................201..
    Pengadu,

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