PEMERINTAH KABUPATENBOGOR

NAMA PERANGKATDAERAH
Jalan ..........................KodePos ..............
Telepon. ............................. Faks. .........................
Email:..............,Website:........................................

Cibinong,${tanggal_naskah}

Nomor : ${nomor_naskah} Kepada

Sifat : ${sifat} Yth. ${jabatan_tujuan}
Lampiran : - di-
Perihal : ${hal}. ...........................

Uji coba...........................................................................................
..........................................................................................

Hari : ................................................

Tanggal : ................................................

Pukul : ................................................

Tempat : ................................................

Acara : ................................................

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

KEPALA,

${ttd_pengirim}

${nama_pengirim}
NIP.${nip_pengirim}
Tembusan :

1.Yth...........................................
2. Yth...........................................
1. dst.