KANTOR KEMENTERIAN AGAMA KABUPATEN SERDANG BEDAGAI

KANTOR URUSAN AGAMA KECAMATAN DOLOK MASIHUL

JL. PERINTIS KEMERDEKAAN NO. 002 KELURAHAN PEKAN DOLOK MASIHUL
Email : kuadolokmasihul@gmail.com Kode Pos : 20991

DATA TANAH WAKAF / HIBAH

Nama Kelurahan / Desa : .......................................................................................

Jumlah Dusun / Lingkungan : .......................................................................................

Nama Kepala Desa / Lurah : .......................................................................................

Peruntukan / Fungsi Tanah Wakaf : .......................................................................................

Lokasi Tanah Wakaf : .......................................................................................

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Nama Pewakaf : .......................................................................................

Nama Nazhir / Pengurus Wakaf : .......................................................................................

No. AIW / APAIW (Akta Pengganti AIW) : .......................................................................................

Tanggal AIW / APAIW : .......................................................................................

Luas AIW (Akta Ikrar Wakaf) : .......................................................................................

Nomor Sertifikat BPN : .......................................................................................

Tanggal Sertfikat BPN : .......................................................................................

Luas BPN : .......................................................................................

Kepala Desa / Lurah Nazhir / Pengurus Wakaf Penyuluh Agama Islam

.......................................... ................................................... H.Asnawi Rangkuti Lc, M.A