Blangko Surat Pernyataan Kepemilikan Tanah Dan Surat Keterangan Kepemilikan Tanah 40 PDF
Blangko Surat Pernyataan Kepemilikan Tanah Dan Surat Keterangan Kepemilikan Tanah 40 PDF
N a m a : ........................................
U m ur : .......................................
A la m a t : ........................ ...............
NOP : ..................................................................................................................
K a b u p a te n /K o ta : ...................................................................................................................
L u a s (m 2) : ...................................................................................................................
M e n g e ta h u i: S ingaraja,
Materai
6 .0 0 0
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SURAT KETERANGAN KEPEMILXKAN TANAH
N o. : .....................................................................
T anggal : ....................................................................
Yang b erta n d a ta n g a n d ib a w ah i n i :
N am a : .....................................
A ia m a t : ......................................
N am a
A ia m a t
U m ur
N o m o rO b y e k P a ja k : .................................................................................................................................. ........
L o k asi : ...........................................................................................................................................
A p a b ila d ik em u d ian hari te rn y a ta p e rn y a taa n ini tid a k b en ar/ad a kesalah an , k am i bersed ia d itu n tu t
d i h a d a p a n p i h a k - p i h a k y a n g b e r w e n a n g b a ik s e c a r a p i d a n a m a u p u n p e r d a t a d a n
m em p ertan g g u n g jaw ab k an n y a di d e p an p e n g a d ila n se rta tid a k m e lib atk an P e m e rin ta h K ab u p aten
B u lelen g /B ad an K eu an g an D aerah K a b u p ate n B u lelen g
Y ang m en eran g k an
K e p ala D e sa / L u rah
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*) c o re t y a n g tid a k p e rlu