PEMERINTAH KABUPATEN LEBAK

DINAS PENDIDIKAN DAN KEBUDAYAAN

SMP NEGERI 4 CIKULUR
Jl. Tajur – Pasirmalati Km. 05 Desa. Cigoong Selatan Kec. Cikulur Kab. Lebak - Banten

SURAT KETERANGAN SEKOLAH

NOMOR: 421.3\038-SMPN4 CKL\I\2020

Yang bertanda tangan dibawah ini, saya :

Nama : ASEP SUKANA, S.Pd.

NIP : 19660323 198803 1 009
Jabatan : Kepala SMP Negeri 4 Cikulur

Dengan menerangkan bahwa nama – nama tersebut dibawah ini, adalah benar Pesrta Didik SMP
Negeri 4 Cikulur dan yang bersangkutan sebagai penerima Program Indonesia Pintar (PIP) 2019.

No Nama Peserta Didik Kelas Nomor rekening / Akun Virtual NISN

1 AJIS 7 008001170673505 921620614528070003AS 0068029058

2 ALDI 7 008001186456501 922420614528070001AI 0074160227
3 EKA SUSILAWATI 7 008001182146502 922020614528070001EI 0082099119
4 ELKI PERDIAWAN 7 008001179867509 921720614528070001EN 0066800926
5 FADLI HAFIDZ 7 008001183135504 922020614528070002FZ 0066681296
6 HERUL ARDIANSYAH 7 008001181643501 922020614528070003HH 0074885160
7 INTAN TRIYANI 7 008001183117506 922020614528070004II 0072160784
8 ITA ROSITA 7 008001182918501 922020614528070005IA 0058564383
9 JULPIAH 7 008001184926500 922420614528070002JH 0076437686
10 JUWITA MINGKASARI 7 008001170829504 921620614528070007JI 0073603615
11 LIDIA 7 008001181912502 922020614528070006LA 0079399243
12 LUVIYANI 7 008001182133509 922020614528070007LI 0082140876
13 M. RIZWAN 7 008001171183503 921620614528070008MN 0064723808
14 MULYANI 7 008001182921504 922020614528070008MI 0053616897
15 NIHAYAH 7 008001181752504 922020614528070009NH 0075622315
16 NIKO SOHIB 7 008001181731508 922020614528070010NB 0071324097
17 NURLELI 7 008001171003509 921620614528070016NI 0063098642
18 OTI ULYAWATI 7 008001183050500 922020614528070011OI 0072149744
19 PUPUT MAHDALENA 7 008001186397503 922420614528070003PA 0076676575
20 RASTI 7 008001184996505 922420614528070004RI 0073159558
21 RENDI 7 008001182863502 922020614528070012RI 0062125236
22 RENO 7 008001183665509 922420614528070005RO 0065216388
23 RESTI 7 008001182943506 922020614528070013RI 0064198940
24 RIAN 7 008001182314503 922020614528070014RN 0074140684
25 RISMA 7 008001184290501 922420614528070006RA 0063396526
26 RODIAH 7 008001184381506 922420614528070007RH 0078365099
27 ROYA ANDRA 7 008001182119505 922020614528070015RA 0075793191

1
 PRATAMA
28 RUDINI 7 008001187950508 922420614528070008RI 0077866563
29 SELVIANNA 7 008001182129500 922020614528070016SA 0073339989
30 SENDI FERDIANSYAH 7 008001171166501 921620614528070018SH 0067182721
31 SITI ALIAWATI 7 008001187601507 922420614528070009SI 0081491963
32 SUHANIYAH 7 008001171261505 921620614528070022SH 0087956475
33 SULISTIANI 7 008001182769504 922020614528070017SI 0076429843
34 SUPRIATNA 7 008001183616500 922420614528070010SA 0071909194
35 WIDIYA ASTUTI 7 008001182900508 922020614528070018WI 0077452771
36 ADAH 8 008001182640506 922020614528080019AH 0074161170
37 AMALIA 8 008001188017507 922320614528080001AA 0062785900
38 ANDRI 8 008001188704502 922320614528080002AI 0059654870
39 ASEP MAULANA 8 008001189793504 922320614528080003AA 0059272526
40 HELMAHADI 8 008001182254509 922020614528080020HI 0066912417
41 INDRA SAPUTRA 8 008001176879507 921120614528080001IA 0044912938
42 JOSE 8 008001190190503 922320614528080004JE 0059310022
43 JUHETI 8 008001181776508 922020614528080021JI 0077702640
44 KHOIRUN NISA 8 008001185583509 922420614528080011KA 0069481184
MUHAMAD GERI
45 8 008001183468509 922020614528080022MA 0064355140
TENGGANG SENTOSA
46 POPI ADEA NENGSIH 8 008001184880500 922420614528080012PH 0064249979
47 RANI RASWATI 8 008001182896505 922020614528080023RI 0069914831
48 RIAN 8 008001186980500 922420614528080013RN 0051286392
49 RIYANTI 8 008001185477504 922420614528080014RI 0061700446
50 SITI AMALIA 8 008001188136505 922320614528080005SA 0069313166
51 SUENDI 8 008001183357504 922020614528080024SI 0051055253
52 USDI 8 008001182958501 922020614528080025UI 0061716583
53 ZIKI MAULANA 8 008001190364500 922320614528080006ZA 0062291454
54 ARIS MAULANA 9 008001183213506 922020614528090026AA 0042851687
55 DIKI PATAWI 9 008001181788505 922020614528090027DI 3046432190
56 ELI ADHADIAWAN 9 008001189549507 922320614528090007EN 0051356851
57 FAOJIAH 9 008001184680502 922420614528090015FH 0059276121
HAMDAN
58 9 008001183083503 922020614528090028HH 3053340135
FERDIANSYAH
59 HERA WAHYUNI 9 008001181747509 922020614528090029HI 0044023640
60 MOH. BAEHAKI 9 008001184018501 922420614528090016MI 0048143086
NURUL ANISA
61 9 008001189262503 922320614528090008NH 0058616648
MUTOHAROH
REHAN MUTAMAM
62 9 008001184828508 922420614528090017RI 0041848812
HASANI
63 RINAD MAULANA 9 008001183363505 922020614528090030RA 0060039098
64 SILVIA SARI 9 008001187106507 922420614528090018SI 3057654861
65 SITI ROHMAH 9 008001181766503 922020614528090031SH 0049006646
66 SUNARTO 9 008001181960505 922020614528090032SO 0048217563
67 SUSILAWATI 9 008001181572506 922020614528090033SI 0051486964
2
 68 TIA ANGGARA 9 008001182841500 922020614528090034TA 0055248810
69 WAWAN SETIAWAN 9 008001188806508 922320614528090009WN 0032503439
70 YANTO 9 008001190255507 922320614528090010YO 0045966924
71 YEYET ATMIYATI 9 008001189458502 922420614528090019YI 0055792064
72 YUNITA SARI 9 008001189869509 922320614528090011YI 0056017248
73 MARDI 7 008001095370509 921620614528070009MI 0078085647
MUHAMAD IRFA
74 7 483201002155505 921620614528070013MH 0077027699
ARDIANSYAH
75 AAM AMALIA 7 008001116873503 921620614528070001AA 0077658112
76 MADRIPAN 7 008001168643506 920520614528070002MN 0051565232
77 UTIS ADITIA 9 008001168434509 920120614528080084UA 0053871021

Demikian surat keterangan ini dibuat untuk digunakan sebagai salah satu persyaratan untuk mencairkan
dana PIP di lembaga penyalur.

Cikulur, 23 Januari 2020

Kepala Sekolah,

ASEP SUKANA, S.Pd.

NIP. 19660323 198803 1 009