Surat Kuasa
Surat Kuasa
Nama : ..........................................................................................................
Tempat / Tgl. Lahir : ..........................................................................................................
Pekerjaan : ..........................................................................................................
Alamat : ..........................................................................................................
..........................................................................................................
KTP. No. : ..........................................................................................................
Nama : ..........................................................................................................
Tempat / Tgl. Lahir : ..........................................................................................................
Pekerjaan : ..........................................................................................................
Alamat : ..........................................................................................................
..........................................................................................................
KTP. No. : ..........................................................................................................
Untuk pengurusan Pembuatan / Penerbitan Akta Kelahiran atas nama anak saya :
........................................................................................
........................................................................................
dan
........................................................................................
Demikian Surat Kuasa ini kami buat dengan sebenarnya untuk dijadikan bahan
pertimbangan selanjutnya.
......................, ......................................
Yang Memberi Kuasa Yang menerima Kuasa
Materai
6000
........................................... ...........................................