KEMENTERIAN AGAMA

UNIVERSITAS ISLAM NEGERI

SULTAN MAULANA HASANUDDIN BANTEN
FAKULTAS SYARIAH
Jl. Jend. Sudirman No. 30 Serang 42118 Telp. 0254-2000323 Fax. 0254-200022 e-mail: syariah@uinbanten.ac.id.

Nomor : Istimewa/Un.17/F.II/PP.00.9/..../20....
Lampiran : 2 (Dua) Lembar
Perihal : Pengajuan Judul

Kepada Yth.
Dekan Fakultas Syariah
c.q. Ketua Jurusan/Program Studi Hukum Tata Negara (Siyasah)
UIN SMH Banten

Assalamu’alaikum Wr.Wb
Yang bertanda tangan dibawah ini, saya
Nama :...........................................
NIM :...........................................
Semester :...........................................
Fak/Jur/Kls : Fakultas Syariah / HTN /.......
Dengan ini saya mohon kiranya bapak/ibu menyetujui salah satu judul yang saya
ajukan di bawah ini:

1 ..................................................................................................................................
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2 ..................................................................................................................................
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3 ..................................................................................................................................
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4 ..................................................................................................................................
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5 ..................................................................................................................................
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Demikian, atas perhatian bapak ibu saya sampaikan terimakasih.

Wassalamualaikum Wr. Wb
Serang. ................................ 20...

Menyetujui. Hormat saya,

Dosen Pembimbing Akademik

............................................................... ........................................................
NIP. NIM.
 PERTIMBANGAN PENGAJUAN JUDUL

1. NAMA MAHASISWA :...................................................

2. NOMOR INDUK MAHASISWA : ...................................................
3. FAKULTAS/JURUSAN/KELAS : ...................................................
4. PERTIMBANGAN PERTIMBANGAN
A. Pertimbangan Akademik
1) Sampai dengan semester ..............masih punya hutang....................sks
2) Kukerta : Sudah / Belum
3) Praktikum Profesi : Sudah / Belum

B. Bidang Administrasi dan Keuangan

1) Her Registasi SPP T.A ........./.......... dan Lain-lain : Lunas/belum 
2) Her Registasi SPP T.A ........./.......... dan Lain-lain : Lunas/belum 
3) ...............................................................................................................
4) ...............................................................................................................

Serang, .............................
Kasubbag Akademik Fakultas

Ina Nurdiana, S.Pd.I., M.Pd.I.

NIP. 19820731 200912 2 005

5. REKOMENDASI SEKRETARIS JURUSAN

A. Judul layak dibahas sesuai dengan jurusan
B. Judul telah diteliti dari arsip dan belum ada pembahas
C. .................................................................................................................
Serang, .............................
Sekretaris Jurusan HTN

Arif Rahman, M.H.

NIP. 19870912 201903 1 009

6. PERSETUJUAN KETUA JURUSAN

Setuju Untuk dibahas Judul Nomor.................................Dengan Catatan
A. .....................................................................................................................
B. .....................................................................................................................
C. .....................................................................................................................
Serang, .............................
Ketua Jurusan HTN

Atu Karomah, S.H.,M.Si.

NIP. 19690214 199903 2 001


Coret Yang tidak Sesuai




Nomor : Istimewa/Un.17/F.II/PP.00.9/...../20....
Lampiran : 1 (Satu) Bundel
Perihal : Mohon Persetujuan Pembimbing

Kepada Yth.
Dekan Fakultas Syariah
c.q. Wakil Dekan Bidang Akademik
UIN SMH Banten

Assalamualaikum Wr.Wb.
Dengan ini kami ajukan proposal skripsi mahasiswa untuk mendapatkan ketetapan
Sebagai berikut:
1. Nama :...............................................
2. NIM :...............................................
3. Fakultas/Jurusan/Kelas : Syari’ah /HTN/......
4. Judul Skripsi :.....................................................................................
.....................................................................................
.....................................................................................
.....................................................................................
5. Nama Calon Pembimbing Skripsi
1) .............................................................................
2) .............................................................................
3) .............................................................................
4) .............................................................................

Demikian Untuk Maklum Adanya.

Wassalamualaikum Wr. Wb.

Serang, .............................
Ketua Jurusan HTN

Atu Karomah, S.H.,M.Si.

NIP. 19690214 199903 2 001

6. Persetujuan Pembimbing, An. Dekan

Serang, .............................
Wakil Dekan Bidang Akademik,

7.

Dr. H. Muhammad Ishom, M.A.

NIP. 19760623 200604 1 002