Alamat : ....................................................................
SURAT PENUGASAN
Nomor : ............... / ...................... 2018
Nama : ...........................................................
NIP : ...........................................................
Pangkat / Gol. Ruang : ...........................................................
Jabatan : ...........................................................
Unit Kerja : ...........................................................
Nama : .............................................................
Jabatan : .............................................................
E-Mail : .............................................................
Telp/HP : .............................................................
Unit Kerja : .............................................................
Demikian surat penugasan ini dikeluarkan untuk dapat dilaksanakan dengan baik
dan penuh rasa tanggung jawab.
................................................
NIP. ..................................................