BERITA ACARA

MASJID DARUL’AMAL

Pada hari ini Minggu Tanggal Dua Puluh Bulan Juni Tahun Dua Ribu Dua Puluh Satu Pukul Dua
Puluh Satu s/d selesai bertempat di Masjid Darul ‘Amal Desa Sinar Rejeki Kecamatan Jati Agung
Kabupaten Lampung Selatan. Telah dilaksanakan acara Musyawarah yang dihadiri oleh Unsur :

1. …………………………………………………..
2. …………………………………………………..
3. …………………………………………………..
4. …………………………………………………..
5. …………………………………………………..
6. …………………………………………………..
Dll.

Daftar Hadir terlampir, telah mengadakan acara Musyawarah.

Materi atau topik yang dibahas dalam musyawarah ini serta yang bertindak selaku unsur pimpinan
rapat dan narasumber adalah :

A. Materi atau Topik

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

B. Unsur Pimpinan Rapat dan Narasumber

Pimpinan Rapat : .............................................................................................................................

Notulen : .............................................................................................................................
Narasumber : .............................................................................................................................
.............................................................................................................................
.............................................................................................................................

Setelah dilakukan pembahasan dan diskusi terhadap materi atau topik di atas selanjutnya seluruh
peserta Musyawarah menyetujui serta memutuskan beberapa hal yang berketetapan menjadi
Keputusan Akhir dari Musyawarah yaitu :
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................
...................................................................................................................................................................

Demikian berita acara ini dibuat dan disahkan dengan penuh tanggungjawab agar
dapat dipergunakan sebagaimana mestinya.
Sinar Rejeki, 20 Juni 2021

Pimpinan Musyawarah, Notulen

___________________________ ___________________________

Menyetujui / Menyepakati
Wakil Kelompok Masyarakat

NO NAMA DARI UNSUR TANDA TANGAN

1 1 2

2
3 3 4

4
5 5 6

6
7 7 8

8
9 9 10

10

DAFTAR HADIR

Hari / Tanggal : Ahad 20 Juni 2021 M. / 10 Dzul Qaidah 1442 H.

Tempat : Masjid DARUL ‘AMAL
Acara : Musyawarah

Jabatan/ Unsur
No Nama Alamat Tanda Tangan
dari
 1 1

2 2
3 3

4 4
5 5

6 6
7 7

8 8
9 9

10 10
11 11

12 12
13 13

14 14
15 15

16 16
17 17

18 18
19 19

20 20
21 21

22 22
23 23

24 24
25 25

26 26
27 27

28 28
29 29

30 30
31 31

32 32
33 33

34 34
35 35

36 36
37 37

38 38
39 39

40 40