Lembar ke : ...............
Kode No : ...............
Nomor : 800/......../2022
Dikeluarkan di : Kedungwuni
Pada tanggal : 7 Juli 2022
Kepala SMP Negeri 2 Kedungwuni
Kabupaten Pekalongan
kepala
kepala
V. CATATAN LAIN-LAIN
VI. PERHATIAN
Pejabat yang berwenang menerbitkan SPPD, pegawai yang melakukan perjalanan dinas,
para pejabat yang mengesahkan tanggal berangkat/tiba serta Bendaharawan bertanggung
jawab berdasarkan peraturan-peraturan Keuangan Negara apabila Negara mendapat rugi
akibat kesalahan, kelalaian, kealpaannya.
1. Nama Kegiatan
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
2. Hari / Tanggal
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
3. Tempat
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
4. Uraian Kegiatan
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
…………………………………………………………………………………........................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
Pelapor
SAMSUDIN, S.Kom
NIP. 19870613 20222 1 010