PEMERINTAH KOTA SEMARANG

REKAPITULASI GAJI INDUK PNS/CPNS/PEJABAT NEGARA PER GOLONGAN

NAMA OPD

Form 1
POT.PAJAK
Jum.Pegawai TUNJ.STRUKTURAL
GAJI POKOK TUNJ.BERAS POT.THT
ISTRI TUNJ.UMUM
Bulan Golongan TUNJ.ISTRI TUNJ.PAJAK JUMLAH KOTOR POT.ASKES JUMLAH BERSIH
ANAK TUNJ.FUNGSIONAL
TUNJ.ANAK PEMBULATAN POT.TAPERUM
JIWA TUNJ.KHUSUS
JUMLAH POTONGAN

Jumlah

Semarang, ......................... 2018 

PENGGUNA ANGGARAN

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NIP. ...............................
 PEMERINTAH KOTA SEMARANG
REKAPITULASI BELANJA TPP/INSENTIF PUNGUT
NAMA OPD

Form 2

BULAN JUMLAH PEGAWAI JUMLAH TPP PPh21 JUMLAH BERSIH

JUMLAH

Semarang, ......................... 2018 

PENGGUNA ANGGARAN

...............................................
NIP. ...............................
 PEMERINTAH KOTA SEMARANG
REKAPITULASI BELANJA BANTUAN/HIBAH/RESTITUSI/TAK TERDUGA
NAMA OPD

Form 3
BULAN JUMLAH REALISASI SISA

JUMLAH

Semarang, ......................... 2018 

PENGGUNA ANGGARAN

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NIP. ...............................
 PEMERINTAH KOTA SEMARANG
REKAPITULASI SETORAN BPJS/PPH/TAPERUM
NAMA OPD

Form 4
CATATAN PEMINDAH
BULAN BPJS 2 % THT 8% PPH TAPERUM JKK JKM
BUKUAN/KOMPENSASI PAJAK

JUMLAH

Semarang, ......................... 2018 

PENGGUNA ANGGARAN

...............................................
NIP. ...............................
 BERITA ACARA REKONSILIASI BELANJA TIDAK LANGSUNG
PERIODE JANUARI SD JUNI 2018

NO URAIAN ADA/TIDAK ALASAN

1 Rekapitulasi Belanja Gaji dan Tunjangan
(PNS/CPNS/Pejabat Negara)

2 Rekapitulasi Belanja TPP (PNS/CPNS) /

Insentif Pungut

3 Rekapitulasi Belanja Bantuan/Hibah/ Tak

terduga/Restitusi

4 Rekapitulasi Setoran BPJS/PPh/

Taperum/JKK/JKM

5 Bukti Pelaporan Pajak atas potongan PPh

CATATAN : . ..........................................................................................................................................................................................
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Semarang , ..................................2018
Petugas OPD Petugas

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NIP. ..................................... NIP. .....................................