BADAN PERMUSYAWARATAN DESA (BPD)

DESA ..........
KECAMATAN .......... KABUPATEN ENREKANG
Alamat : Jl........................................

BERITA ACARA MUSYAWARAH

ATAS LAPORAN KETERANGAN PENYELENGGRAAN PEMERINTAHAN DESA
DESA .......... KECAMATAN ..........
TAHUN ANGGARAN 20.....

Nomor : ...../BPD/I/20........

---------- Pada hari ini .................... tanggal .......................... bulan Januari Tahun Dua
ribu ............, bertempat di Balai Desa .......... Kecamatan .......... Kabupaten Enrekang, kami
Badan Permustawaratan Desa (BPD) .......... telah mengadakan musyawarah Desa yang dihadiri
oleh kepala Desa, unsur perangkat Desa, BPD, wakil - wakil kelompok masyarakat, sebagaimana
daftar hadir terlampir. untuk membahas Laporan Keterangan Penyelenggaraan Pemerintahan Desa
.......... Tahun Anggaran 20....., yang disampaikan oleh Pemerintah Desa .......... kepada kami
tanggal ................................. ---------------------

---------- Setelah dilakukan pembahasan terhadap materi, selanjutnya seluruh peserta

musyawarah Desa menyepakati beberapa hal yang berketetapan menjadi catatan-catatan yang
terlampir di dalam berita acara ini untuk ditindaklanjuti oleh Pemerintah Desa, sebagai bentuk
evaluasi dan perbaikan untuk kemajuan Desa ...........-------------------

---------- Demikian Berita Acara ini dibuat dan disahkan dengan penuh tanggungjawab
agar dapat dipergunakan sebagaimana mestinya..---------------------

BADAN PERMUSYAWARATAN DESA ..........

1 ........................ Ketua (................................)

2 ........................ Wakil Ketua (................................)

3 ......................... Sekretaris (................................)

4 ........................ Anggota (................................)

5 ......................... Anggota (................................)

6 ......................... Anggota (................................)

7 ......................... Anggota (................................)

Disahkan di : ..........
pada tanggal : ...............................

Ketua BPD ..........

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

BADAN PERMUSYAWARATAN DESA (BPD)

DESA ..........
KECAMATAN .......... KABUPATEN ENREKANG
Alamat : Jl......................................................

CATATAN DAN REKOMENDASI

ATAS LAPORAN KETERANGAN PENYELENGGARAAN PEMERINTAHAN DESA ..........
TAHUN ANGGARAN 20........
A. Catatan atas Laporan Keterangan Penyelenggaraan Pemerintahan Desa
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B. Rekomendasi atas Laporan Keterangan Penyelenggaraan Pemerintahan Desa

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C. Kesimpulan
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BADAN PERMUSYAWARATAN DESA ..........

1 ........................ Ketua (................................)

2 ........................ Wakil Ketua (................................)

3 ......................... Sekretaris (................................)

4 ........................ Anggota (................................)

5 ......................... Anggota (................................)

6 ......................... Anggota (................................)

7 ......................... Anggota (................................)

DAFTAR HADIR MUSYAWARAH

PERUBAHAN APBDesa DESA .......... KECAMATAN .......... KABUPATEN ENREKANG
TAHUN ANGGARAN ..............

NO NAMA JABATAN TANDA TANGAN

1 2 3 4
..........,......,.............20.....
Ketua BPD ..........

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