KEMENTERIAN AGAMA

KELOMPOK KERJA PENGAWAS PAI (POKJAWAS PAI)
KANTOR KABUPATEN CILACAP
Alamat : Jalan DI. Panjaitan No.44 Telp. (0282)531155 Cilacap
PEMANTAUAN DANA BOS REGULER DAN BOS BUKU
SEMESTER I (Bulan Januari s.d. Juni)

NAMA SEKOLAH/MADRASAH
ALAMAT SEKOLAH/MADRASAH
MAMA RESPONDEN
JABATAN RESPONDEN
HARI, TANGGAL MONITORING

:
:
:
:
:

..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................

A. BOS REGULER
1. Jumlah Siswa Penerima
= .......................
2. Jumlah Dana BOS yang diterima
3. Jumlah Dana BOS yang dikeluarkan
4. Saldo Dana BOS per Juni ................
5. Administrasi Keuangan Dana BOS
a. Buku Kas Umum
b. Buku Kas Tunai
c. Buku BAnk
d. Buku Pajak
e. Buku Pembelian Barang
f. SPJ Dana BOS
6. Pajak
7. Penggunaan Dana BOS
8. Temuan/saran-saran

:

L = ...................

P= ...................

:
:
:

Rp ........................................................
Rp ........................................................
Rp ........................................................

:
:
:
:
:
:
:
:
:

Ada / Tidak
Baik / Cukup / Kurang
Ada / Tidak
Baik / Cukup / Kurang
Ada / Tidak
Baik / Cukup / Kurang
Ada / Tidak
Baik / Cukup / Kurang
Ada / Tidak
Baik / Cukup / Kurang
Sudah Dikerjakan / Dalam Proses / Belum
Ada / Tidak
Sudah dibayar / Belum
Tepat Sasaran / Kurang Tepat / Tidak Tepat

Jml

B. BOS BUKU
1. Jumlah Siswa Penerima
: L = ..................P= ....................
Jml = .......................
2. Jumlah Dana BOS yang diterima
: Rp .................................................
3. Jumlah Dana BOS yang dikeluarkan : Rp .................................................
4. Saldo Dana BOS per Juni ........
: Rp .................................................
5. Jumlah Buku yang dibeli
: .................................................
6. Judul Buku yang dibeli
: .................................................
7. Temuan/saran-saran
: .................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................

Cilacap, ............................................
RESPONDEN

Pengawas RA/Madrasah Ibtidaiyah

______________________________
NIP: .............................................

....................................................
NIP: ........................................................

KEMENTERIAN AGAMA
KELOMPOK KERJA PENGAWAS PAI (POKJAWAS PAI)
KANTOR KABUPATEN CILACAP
Alamat : Jalan DI. Panjaitan No.44 Telp. (0282)531155 Cilacap
PEMANTAUAN DANA BOS REGULER DAN BOS BUKU
SEMESTER II (Juli Januari s.d. Desember)

NAMA SEKOLAH/MADRASAH
ALAMAT SEKOLAH/MADRASAH
MAMA RESPONDEN
JABATAN RESPONDEN
HARI, TANGGAL MONITORING

:
:
:
:
:

..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................
..................................................................................................

A. BOS REGULER
1. Jumlah Siswa Penerima
: L = ................ P=......................
Jml
=..............................
2. Jumlah Dana BOS yang diterima
: Rp .........................................................
3. Jumlah Dana BOS yang dikeluarkan : Rp .........................................................
4. Saldo Dana BOS per Desember ........ : Rp .........................................................
5. Administrasi Keuangan Dana BOS
a. Buku Kas Umum
: Ada / Tidak
Baik / Cukup / Kurang
b. Buku Kas Tunai
: Ada / Tidak
Baik / Cukup / Kurang
c. Buku BAnk
: Ada / Tidak
Baik / Cukup / Kurang
d. Buku Pajak
: Ada / Tidak
Baik / Cukup / Kurang
e. Buku Pembelian Barang
: Ada / Tidak
Baik / Cukup / Kurang
f. SPJ Dana BOS
: Sudah Dikerjakan / Dalam Proses / Belum
6. Pajak
: Ada / Tidak
Sudah dibayar / Belum
7. Penggunaan Dana BOS
: Tepat Sasaran / Kurang Tepat / Tidak Tepat
8. Temuan/saran-saran
:
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
B. BOS BUKU
1. Jumlah Siswa Penerima
: L = ............... P=....................
Jml =...........................
2. Jumlah Dana BOS yang diterima
: Rp .........................................................
3. Jumlah Dana BOS yang dikeluarkan : Rp .........................................................
4. Saldo Dana BOS per Desember........ : Rp .........................................................
5. Jumlah Buku yang dibeli
: .........................................................
6. Judul Buku yang dibeli
: .........................................................
7. Temuan/saran-saran
: .........................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................

Cilacap, ............................................
RESPONDEN

Pengawas RA/Madrasah Ibtidaiyah

______________________________
NIP: .............................................

.....................................................
NIP: ........................................................

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