KECAMATAN XXXXXXXXXXXXXX
Alamat : Jln. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Kepada
SURAT PENGANTAR
Nomor : .................................
. Camat Xxxxxxxxxxxxxxx,
XXXXXXXXXXXXXXXXXXX
PEMERINTAH KABUPATEN KOTABARU
KECAMATAN XXXXXXXXXXXXXX
DESA XXXXXXXXXX
Alamat : Jln. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Kepada
SURAT PENGANTAR
Nomor : .................................
. Camat Xxxxxxxxxxxxxxx,
XXXXXXXXXXXXXXXXXXX
Tanda Terima RKP Desa :
Tanggal : ...........................................
Nama Penerima : ...........................................
Tandatangan : ...........................................
Tandatangan : ...........................................