Excel Bukti Pajak Tahun 2022 Asn-Rohman

IDENTITAS PEMOTONG
NPWP INSTANSI PEMERINTAH 0 0 1 3 5 5 5 8 5 4
NAMA INSTANSI PEMERINTAH DINAS PENDIDIKAN PROVINSI JAWA BARAT
ID SUBUNIT ORGANISASI
TAHUN PAJAK 2022
NAMA BENDAHARA MOCH ROCHMAT FARMANSJAH, SE
NIP BENDAHARA 197104252010011001
NPWP BENDAHARA 0 0 1 3 5 5 5 8 5 4
TANGGAL BUKTI POTONG 31/01/2023
NIK PEMOTONG/BENDAHARA
Langkah-langkah Pengisian
2 8 0 0 0
1. Buka dan isi identitas Pegawai dalam Sheet PEGAWAI
2. Buka dan isi jumlah penghasilan per bulan dalam Sheet PENGHASILAN
3. Silakan Print Bukti Potong 1721 A2 dalam Sheet 1721 A2
3. Anda dapat memanfaatkan fasilitas impor xls ke SPT Unifikasi Instansi Pemer
4. Pembuatan Bukti Potong PPh Pasal 21 Final di Sheet PENGHASILAN FINAL
2 8 0 0 0
Sheet PENGHASILAN
SPT Unifikasi Instansi Pemerintah di Sheet A2 Unifikasi
heet PENGHASILAN FINAL

NO NAMA NPWP NIK
2 3 4
1 ROHMAN SOFYAN, ST 9537768669130223 3215090512900001
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
NIP PANGKAT / GOLONGAN JENIS KELAMIN
5 6 7
199012052022211010 PENATA MUDA / IIIA LAKI-LAKI
JUMLAH
JABATAN STATUS PERNIKAHAN STATUS PTKP
ANAK
8 9 10 11
GURU AHLI PERTAMA MENIKAH 2 TK/0
MASA MASA JUMLAH
STATUS
ALAMAT PEROLEHAN PEROLEHAN TUNJANGAN BERAS
PEGAWAI
AWAL AKHIR PER BULAN
12 13 14 15 16
Perum Grand Mutiara Blok E 07 12 BARU 289,680
LAMA
BEKERJA
17
7
TABEL PTKP 2016
Status Setahun Sebulan
TK/0 54,000,000 4,500,000

TK/1 58,500,000 4,875,000
TK/2 63,000,000 5,250,000
TK/3 67,500,000 5,625,000
K/0 58,500,000 4,875,000
K/1 63,000,000 5,250,000
K/2 67,500,000 5,625,000
K/3 72,000,000 6,000,000
K/I/0 112,500,000 9,375,000
K/I/1 117,000,000 9,750,000
K/I/2 121,500,000 10,125,000
K/I/3 126,000,000 10,500,000
! PERHATIAN
PTKP Terbaru sesuai dengan
Peraturan Menteri Keuangan yaitu PMK No. 101/PMK.010/2016 dan
PMK No. 102/PMK.010/2016
No Masa Perolehan AwalMasa Perolehan AkhiTgl Pemotongan (dd/MM/yyyy
2 3 4
1 1 12 31/01/2023
2 1 12 31/01/2023
3 1 12 31/01/2023
4 1 12 31/01/2023
5 1 12 31/01/2023
6 1 12 31/01/2023
7 1 12 31/01/2023
8 1 12 31/01/2023
9 1 12 31/01/2023
10 1 12 31/01/2023
11 1 12 31/01/2023
12 1 12 31/01/2023
13 1 12 31/01/2023
14 1 12 31/01/2023
15 1 12 31/01/2023
16 1 12 31/01/2023
17 1 12 31/01/2023
18 1 12 31/01/2023
19 1 12 31/01/2023
20 1 12 31/01/2023
21 1 12 31/01/2023
22 1 12 31/01/2023
23 1 12 31/01/2023
24 1 12 31/01/2023
25 1 12 31/01/2023
26 1 12 31/01/2023
27 1 12 31/01/2023
28 1 12 31/01/2023
29 1 12 31/01/2023
30 1 12 31/01/2023
31 1 12 31/01/2023
32 1 12 31/01/2023
33 1 12 31/01/2023
34 1 12 31/01/2023
35 1 12 31/01/2023
36 1 12 31/01/2023
37 1 12 31/01/2023
38 1 12 31/01/2023
39 1 12 31/01/2023
40 1 12 31/01/2023
41 1 12 31/01/2023
42 1 12 31/01/2023
43 1 12 31/01/2023
44 12 31/01/2023
45 12 31/01/2023
46 12
47 12
48 12
49 12
50 12
51 12
52 12
53 12
54 12
55 12
56 12
57 12
58 12
59 12
60 12
61 12
62 12
63 12
64 12
65 12
66 12
67 12
68 12
69 12
70 12
71 12
72 12
73 12
74 12
75 12
76 12
77 12
78 12
79 12
80 12
81 12
82 12
83 12
84 12
85 12
86 12
87 12
88 12
89 12
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
250
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
Penerima Penghasilan (NPWP/NINPWP (tanpa format/tanda bac
5 6
NPWP 092714419433000
NPWP 26.673.540.6-408.000
NPWP 09.280.372.5-408.000
NPWP 09.277.869.5-408.000
NPWP 09.272.650.4-408.000
NPWP 24.213.471.6-408.000
NPWP 09.279.315.7-408.000
NPWP 09.278.074.1-408.000
NPWP 25.872.070.5-412.000
NPWP 47.215.375.8-435.000
NPWP 35.728.767.1-433.000
NPWP 25.359.696.9-008.000
NPWP 35.724.240.3-414.000
NPWP 25.471.408.2.433.000
NPWP 25.144.349.5-433.000
NPWP 25.434.448.4-408.000
NPWP 24.194.715.9-413.000
NPWP 68.773.845.0-425.000
NPWP 09.273.875.6-408.000
NPWP 34.667.413.8-408.000
NPWP 24.999.100.1-433.000
NPWP 09.274.651.0-408.000
NPWP 09.276.733.4-408.000
NPWP 09.278.245.7-408.000
NPWP 25.479.414.2-433.000
NPWP 25.383.633.2-433.000
NPWP 09.282.005.9-408.000
NPWP 25.554.287.0-413.000
NPWP 26.657.825.1-408.000
NPWP 34.480.435.6-414.000
NPWP 09.281.859.0-408.000
NPWP 89.264.132.5-408.000
NPWP 44.984.002.4.408.000
NPWP 35.737.062.6-433.000
NPWP 09.279.859.4.408.000
NPWP 55.455.611.8-408.000
NPWP 34.327.413.0-408.000
NPWP 44.653.404.2-408.000
NPWP 26.738.443.6.408.000
NPWP 70.631.432.5-524.000
NPWP 72.358.570.9-401.000
NPWP 90.651.741.2-525.000
NPWP 85.109.47.4-408.000
NPWP 46.750.023.7-408.000
NPWP 55.406.426.1-408.000
NPWP 55.412.412.3-408.000
NPWP 09.276.785.4-408.000
NPWP 0
NPWP 66.718.937.7-433.000
NPWP 75.226.639.5-408.000
NPWP 44.179.062.3-408-000
NPWP 59.216.298.6-433.000
NPWP 43.258.672.5-408.000
NPWP 68.088.756.9-003.000
NPWP 95.496.572.9-433.000
NPWP 65.631.618.9-408.000
NPWP 73.988.719.8-433.000
NPWP 90.406.618.0-433.000
26.975.026.1-408.000
55.412.310.9-408.000
74.118.849.4-433.000
44.919.177.4-408.000
76.802.744.3-433000
80.026.788.2-408.000
75.455.843.5-433.000
26.718.932.2-408.999
59.952.151.5-451.000
76.098.893.1-433.000
25.217.341-4.414.000
45.442.308.8-408.000
34.327.410.6-408.000
66.399.730.2-408.000
26.720.921.1-408.000
60.001.029.2-408.000
84.373.914.5-501.000
75.148.145.8-442.000
83.099.433.1-445.000
76.123.221.4-433.000
77.008.084.4-408.000
72.344.820.5-437.000
70.519.971.9-408.000
90.268.264.0-433.000
57.832.360.2-408.000
09.280.245.3-408.000
65.602.599.6-408.000
91.462.341.8-433.000
0
66.159.414.3-433.000
72.520.229.5-408.000
73.293.937.6-432.000
0
66.946.122.0-408.000
65.642.514.7-408.000
26.671.979.8-408.000
66.339.175.3-408.000
66.369.847.2-408.000
Nama Penerima Penghasilan (QQ) NIK (tanpa format/tanda baca)
7 8
ROHMAN SOFYAN, ST 3215090512900001
Nama Penerima Penghasilan Sesuai NIP (tanpa format/tanda bacaJenis Kelamin (L/P)
9 10 11
ROHMAN SOFYAN, ST 199012052022211010 L
Nama Jabatan Status PTKP Pangkat Golongan
12 13 14
GURU AHLI PERTAMA 2 TK/0 PENATA MUDA/IIIa
Status Pegawai (Dipindahkan/Pindahan/Baru/PenPenandatangan Menggunakan NPWP/N
15 16
BARU NPWP
NPWP Penandatangan (tanpa format/tanda bNIK Penandatangan (tanpa format/tanda b
17 18
738570126408000 0
Nama Penandatangan Sesuai NKode Objek Pajak Gaji Pokok/ Pensiunan PER BUL
19 20 21
MOCH ROCHMAT FARMANSJAH, SE 21-100-01 2,966,500
Lama Kerja dalam SetahuGaji Pokok/ Pensiunan SETAHUN Tunjangan Istri/Suami
22 23 24
7 35,598,000 296650
Tunjangan Anak Jumlah Gaji dan Tunjangan Keluarga Tunjangan Perbaikan Penghasil
25 26 27
118660 36,013,310 0
Tunjangan Struktural/FungsionTunjangan Beras Jumlah Penghasilan Bruto
28 29 30
2,289,000 2,027,760 40,330,070
Tunjangan Lain-lainPenghasilan tetap dan teratur lain
31 32
0
Jumlah Penghasilan Bruto Setahun/ disetahunkan Biaya Jabatan/Biaya Pensiu
33 34
40,330,070 0
Iuran Pensiun atau Iuran THT/J Jumlah Pengurangan Jumlah Penghasilan Nett
35 36 37
0 704,965 39,625,105
Penghasilan Neto masa pajak sebelumnya
38
0
Penghasilan Netto setahun/disetahunkan Penghasilan Tidak Kena Pajak (PTKP)
39 40
0 54,000,000
Penghasilan Kena Pajak setahun/ disetahu PPh Pasal 21 setahun/ disetahun
41 42
-54,000,000 5%
PPh Pasal 21 yang telah dipotong masa pajak sebe PPh Pasal 21 Terutan
43 44
-2700000 5%
PPh Pasal 21 atas Gaji dan Tunjan PPh Pasal 21 atas Penghasilan tetap dan teratur lainnya
45 46
5% 0
.
teratur lainnya
MASA PEMOTONGAN
Masa Masa Penerima

Tgl Pemotongan NPWP (tanpa
No Perolehan Perolehan Penghasilan
(dd/MM/yyyy) format/tanda baca)
Awal Akhir (NPWP/NIK)
2 3 4 5 6
1 07 12 31/01/2023 NPWP 9537768669130223
2 0 0 31/01/2023 NPWP 0
3 0 0 31/01/2023 NPWP 0
4 0 0 31/01/2023 NPWP 0
5 0 0 31/01/2023 NPWP 0
6 0 0 31/01/2023 NPWP 0
7 0 0 31/01/2023 NPWP 0
8 0 0 31/01/2023 NPWP 0
9 0 0 31/01/2023 NPWP 0
10 0 0 31/01/2023 NPWP 0
11 0 0 31/01/2023 NPWP 0
12 0 0 31/01/2023 NPWP 0
13 0 0 31/01/2023 NPWP 0
14 0 0 31/01/2023 NPWP 0
15 0 0 31/01/2023 NPWP 0
16 0 0 31/01/2023 NPWP 0
17 0 0 31/01/2023 NPWP 0
18 0 0 31/01/2023 NPWP 0
19 0 0 31/01/2023 NPWP 0
20 0 0 31/01/2023 NPWP 0
21 0 0 31/01/2023 NPWP 0
22 0 0 31/01/2023 NPWP 0
23 0 0 31/01/2023 NPWP 0
24 0 0 31/01/2023 NPWP 0
25 0 0 31/01/2023 NPWP 0
26 0 0 31/01/2023 NPWP 0
27 0 0 31/01/2023 NPWP 0
28 0 0 31/01/2023 NPWP 0
29 0 0 31/01/2023 NPWP 0
30 0 0 31/01/2023 NPWP 0
31 0 0 31/01/2023 NPWP 0
32 0 0 31/01/2023 NPWP 0
48 0 0 NPWP 0
49 0 0 NPWP 0
50 0 0 NPWP 0
51 0 0 NPWP 0
52 0 0 NPWP 0
53 0 0 NPWP 0
54 0 0 NPWP 0
55 0 0 NPWP 0
56 0 0 NPWP 0
57 0 0 NPWP 0
58 0 0 NPWP 0
59 0 0 NPWP 0
60 0 0 NPWP 0
61 0 0 NPWP 0
62 0 0 NPWP 0
63 0 0 NPWP 0
64 0 0 NPWP 0
65 0 0 NPWP 0
66 0 0 NPWP 0
67 0 0 NPWP 0
68 0 0 NPWP 0
69 0 0 NPWP 0
70 0 0 NPWP 0
71 0 0 NPWP 0
72 0 0 NPWP 0
73 0 0 NPWP 0
74 0 0 NPWP 0
75 0 0 NPWP 0
76 0 0 NPWP 0
77 0 0 NPWP 0
78 0 0 NPWP 0
79 0 0 NPWP 0
80 0 0 NPWP 0
81 0 0 NPWP 0
82 0 0 NPWP 0
83 0 0 NPWP 0
84 0 0 NPWP 0
85 0 0 NPWP 0
86 0 0 NPWP 0
87 0 0 NPWP 0
88 0 0 NPWP 0
89 0 0 NPWP 0
90 0 0 NPWP 0
91 0 0 NPWP 0
92 0 0 NPWP 0
93 0 0 NPWP 0
94 0 0 NPWP 0
95 0 0 NPWP 0
96 0 0 NPWP 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
IDENTITAS PENERIMAN PENGHASILAN
Nama Penerima
Nama Penerima Penghasilan NIK (tanpa NIP (tanpa
Penghasilan
(QQ) format/tanda baca) format/tanda baca)
Sesuai NIK
7 8 9 10
ROHMAN SOFYAN, ST 3215090512900001 ROHMAN SOFYAN, S199012052022211010
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
N PENGHASILAN
Jenis
Status
Kelamin Nama Jabatan Pangkat Golongan
PTKP
(L/P)
11 12 13 14
L GURU AHLI PERTAMA TK/0 PENATA MUDA / IIIA
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
P 0 0 0
IDENTITAS PEMOTONG
Status Pegawai Penandatangan

NPWP Penandatangan
(Dipindahkan/Pindaha Menggunakan
(tanpa format/tanda baca)
n/Baru/Pensiun) NPWP/NIK
15 16 17
BARU NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
0 NPWP 001355585428000
IDENTITAS PEMOTONG
NIK Penandatangan (tanpa

Nama Penandatangan Sesuai NIK Kode Objek Pajak
format/tanda baca)
18 19 20
197104252010011001 MOCH ROCHMAT FARMANSJAH, SE 21-100-01
Gaji Pokok/ Lama Kerja Gaji Pokok/
Tunjangan
Pensiunan PER dalam Pensiunan Tunjangan Anak
Istri/Suami
BULAN Setahun SETAHUN
21 22 23 24 25
3,839,000 6 23,034,000 2,303,400 921,360
5,052,300 1 5,052,300 - -
1 - - -
5,052,300 1 5,052,300 - -
4,898,100 1 4,898,100 - -
1 - - -
1 - - -
5,000,000 1 5,000,000 - -
4,847,300 1 4,847,300 - -
1 - - -
1 - - -
4,912,400 1 4,912,400 - -
4,463,000.00 1 4,463,000 - -
4,416,700.00 1 4,416,700 - -
4,024,400.00 1 4,024,400 - -
4,024,400.00 1 4,024,400 - -
1 - - -
3,743,100.00 1 3,743,100 - -
3,743,100.00 1 3,743,100 - -
3,743,100.00 1 3,743,100 - -
3,743,100.00 1 3,743,100 - -
4,108,100.00 1 4,108,100 - -
3,743,100.00 1 3,743,100 - -
1 - - -
3,743,100.00 1 3,743,100 - -
3,861,000.00 1 3,861,000 - -
3,518,500.00 1 3,518,500 - -
3,375,300.00 1 3,375,300 - -
3,861,000.00 1 3,861,000 - -
3,375,300.00 1 3,375,300 - -
3,518,100.00 1 3,518,100 - -
3,272,200.00 1 3,272,200 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
2,966,500.00 1 2,966,500 - -
PENGHASILAN BRUTO SETAHUN
Jumlah Gaji dan Tunjangan Tunjangan Jumlah

Tunjangan
Tunjangan Perbaikan Struktural/Fungs Penghasilan
Beras
Keluarga Penghasilan ional Bruto
26 27 28 29 30
26,258,760 - 13,680,000 2,027,760 41,966,520
5,052,300 8,420 4,668,000 - 9,728,720
- - -
5,052,300 8,419 4,668,000 - 9,728,719
4,898,100 8,422 4,668,000 - 9,574,522
- - - -
- - - -
5,000,000 - 4,668,000 - 9,668,000
4,847,300 - 4,668,000 - 9,515,300
- - - -
- - - -
4,912,400 8,429 4,668,000 - 9,588,829
4,463,000 8,432 4,668,000 - 9,139,432
4,416,700 8,431 4,668,000 - 9,093,131
4,024,400 8,433 4,668,000 - 8,700,833
4,024,400 - 4,668,000 - 8,692,400
- - - -
3,743,100 8,443 3,924,000 - 7,675,543
3,743,100 8,442 3,924,000 - 7,675,542
3,743,100 8,441 3,924,000 - 7,675,541
3,743,100 8,440 3,924,000 - 7,675,540
4,108,100 8,437 3,924,000 - 8,040,537
3,743,100 8,445 3,924,000 - 7,675,545
- - - -
3,743,100 8,446 3,924,000 - 7,675,546
3,861,000 8,439 3,924,000 - 7,793,439
3,518,500 - 3,924,000 - 7,442,500
3,375,300 8,451 4,069,800 - 7,453,551
3,861,000 8,449 3,924,000 - 7,793,449
3,375,300 8,453 3,924,000 - 7,307,753
3,518,100 - - 3,518,100
3,272,200 8,452 3,924,000 - 7,204,652
2,966,500 - - 2,966,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 289,000 - 3,255,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - - 2,966,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - - 2,966,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
2,966,500 - 3,924,000 - 6,890,500
PENGURANGAN
Jumlah
Penghasilan Biaya Iuran Pensiun
Tunjangan Lain- Penghasilan
tetap dan Jabatan/Biaya atau Iuran
lain Bruto Setahun/
teratur lainnya Pensiun THT/JHT
disetahunkan
31 32 33 34 35
- - 41,966,520 2,098,326 1,247,291
1,302 5,526,800 15,256,822 762,841 239,984
- 50,000 50,000 2,500 -
- 6,438,400 16,167,119 808,356 239,984
1,218 5,921,800 15,497,540 774,877 232,659
- - - - -
- - - - -
- 5,461,500 15,129,500 756,475 237,500
- 5,890,779 15,406,079 770,304 230,246
- - - - -
- - - - -
1,148 5,401,900 14,991,877 749,594 233,339
42 5,611,200 14,750,674 737,534 211,992
518 5,382,300 14,475,949 723,797 209,793
490 4,485,900 13,187,223 659,361 191,159
1,134 4,485,900 13,179,434 658,972 191,159
- - - - -
448 4,736,600 12,412,591 620,630 177,797
448 4,736,600 12,412,590 620,630 177,797
1,218 4,883,900 12,560,659 628,033 177,797
1,218 4,883,900 12,560,658 628,033 177,797
1,316 4,507,600 12,549,453 627,473 195,134
812 4,883,900 12,560,257 628,013 177,797
- - - - -
336 4,883,900 12,559,782 627,989 177,797
- 4,719,000 12,512,439 625,622 183,397
266 4,203,100 11,645,866 582,293 167,128
- - 7,453,551 372,678 160,326
1,092 5,018,300 12,812,841 640,642 183,397
- 4,464,600 11,772,353 588,618 160,326
- - 3,518,100 175,905 167,109
644 4,347,000 11,552,296 577,615 155,429
- - 2,966,500 148,325 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,998,497 10,888,997 544,450 140,908
- - 3,255,500 162,775 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,998,497 10,888,997 544,450 140,908
- 3,851,500 10,742,000 537,100 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,735,054 10,625,554 531,278 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,998,497 10,888,997 544,450 140,908
- 3,365,946 10,256,446 512,822 140,908
- 3,998,497 10,888,997 544,450 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,998,497 10,888,997 544,450 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,629,490 10,519,990 526,000 140,908
- 3,998,497 10,888,997 544,450 140,908
- 3,866,776 10,757,276 537,864 140,908
- 3,998,497 10,888,997 544,450 140,908
- 3,365,946 10,256,446 512,822 140,908
- - 2,966,500 148,325 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 2,966,500 148,325 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
- - 6,890,500 344,525 140,908
URANGAN PENGHITUNGAN PP
Penghasilan
Jumlah Penghasilan Penghasilan
Jumlah Netto
Penghasilan Neto masa pajak Tidak Kena Pajak
Pengurangan setahun/disetah
Netto sebelumnya (PTKP)
unkan
36 37 38 39 40
3,345,617 38,620,903 - 38,620,903 54,000,000
1,002,825 14,253,997 - 14,253,997 -
2,500 47,500 - 47,500 -
1,048,340 15,118,779 - 15,118,779 -
1,007,536 14,490,004 - 14,490,004 -
- - - - -
- - - - -
993,975 14,135,525 - 14,135,525 -
1,000,550 14,405,529 - 14,405,529 -
- - - - -
- - - - -
982,933 14,008,944 - 14,008,944 -
949,526 13,801,148 - 13,801,148 -
933,590 13,542,359 - 13,542,359 -
850,520 12,336,703 - 12,336,703 -
850,131 12,329,303 - 12,329,303 -
- - - - -
798,427 11,614,164 - 11,614,164 -
798,427 11,614,164 - 11,614,164 -
805,830 11,754,829 - 11,754,829 -
805,830 11,754,828 - 11,754,828 -
822,607 11,726,846 - 11,726,846 -
805,810 11,754,447 - 11,754,447 -
- - - - -
805,786 11,753,996 - 11,753,996 -
809,019 11,703,420 - 11,703,420 -
749,421 10,896,445 - 10,896,445 -
533,004 6,920,547 - 6,920,547 -
824,039 11,988,802 - 11,988,802 -
748,944 11,023,409 - 11,023,409 -
343,014 3,175,086 - 3,175,086 -
733,044 10,819,252 - 10,819,252 -
289,233 2,677,267 - 2,677,267 -
678,772 10,078,504 - 10,078,504 -
685,358 10,203,639 - 10,203,639 -
303,683 2,951,817 - 2,951,817 -
678,772 10,078,504 - 10,078,504 -
685,358 10,203,639 - 10,203,639 -
678,008 10,063,992 - 10,063,992 -
678,772 10,078,504 - 10,078,504 -
672,186 9,953,368 - 9,953,368 -
678,772 10,078,504 - 10,078,504 -
685,358 10,203,639 - 10,203,639 -
653,730 9,602,716 - 9,602,716 -
685,358 10,203,639 - 10,203,639 -
678,772 10,078,504 - 10,078,504 -
685,358 10,203,639 - 10,203,639 -
678,772 10,078,504 - 10,078,504 -
678,772 10,078,504 - 10,078,504 -
678,772 10,078,504 - 10,078,504 -
666,908 9,853,083 - 9,853,083 -
685,358 10,203,639 - 10,203,639 -
678,772 10,078,504 - 10,078,504 -
685,358 10,203,639 - 10,203,639 -
653,730 9,602,716 - 9,602,716 -
289,233 2,677,267 - 2,677,267 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
289,233 2,677,267 - 2,677,267 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
485,433 6,405,067 - 6,405,067 -
PENGHITUNGAN PPh PASAL 21
PPh Pasal 21
Penghasilan
PPh Pasal 21 yang telah PPh Pasal 21
Kena Pajak PPh Pasal 21
setahun/ dipotong masa atas Gaji dan
setahun/ Terutang
disetahunkan pajak Tunjangan
disetahunkan
sebelumnya
41 42 43 44 45
- - - - -
14,253,000 712,650 - 712,650 712,650
47,000 2,350 - 2,350 2,350
15,118,000 755,900 - 755,900 755,900
14,490,000 724,500 - 724,500 724,500
- - - - -
- - - - -
14,135,000 706,750 - 706,750 706,750
14,405,000 720,250 - 720,250 720,250
- - - - -
- - - - -
14,008,000 700,400 - 700,400 700,400
13,801,000 690,050 - 690,050 690,050
13,542,000 677,100 - 677,100 677,100
12,336,000 616,800 - 616,800 616,800
12,329,000 616,450 - 616,450 616,450
- - - - -
11,614,000 580,700 - 580,700 580,700
11,614,000 580,700 - 580,700 580,700
11,754,000 587,700 - 587,700 587,700
11,754,000 587,700 - 587,700 587,700
11,726,000 586,300 - 586,300 586,300
11,754,000 587,700 - 587,700 587,700
- - - - -
11,753,000 587,650 - 587,650 587,650
11,703,000 585,150 - 585,150 585,150
10,896,000 544,800 - 544,800 544,800
6,920,000 346,000 - 346,000 346,000
11,988,000 599,400 - 599,400 599,400
11,023,000 551,150 - 551,150 551,150
3,175,000 158,750 - 158,750 158,750
10,819,000 540,950 - 540,950 540,950
2,677,000 133,850 - 133,850 133,850
10,078,000 503,900 - 503,900 503,900
10,203,000 510,150 - 510,150 510,150
2,951,000 147,550 - 147,550 147,550
10,078,000 503,900 - 503,900 503,900
10,203,000 510,150 - 510,150 510,150
10,063,000 503,150 - 503,150 503,150
10,078,000 503,900 - 503,900 503,900
9,953,000 497,650 - 497,650 497,650
10,078,000 503,900 - 503,900 503,900
10,203,000 510,150 - 510,150 510,150
9,602,000 480,100 - 480,100 480,100
10,203,000 510,150 - 510,150 510,150
10,078,000 503,900 - 503,900 503,900
10,203,000 510,150 - 510,150 510,150
10,078,000 503,900 - 503,900 503,900
10,078,000 503,900 - 503,900 503,900
10,078,000 503,900 - 503,900 503,900
9,853,000 492,650 - 492,650 492,650
10,203,000 510,150 - 510,150 510,150
10,078,000 503,900 - 503,900 503,900
10,203,000 510,150 - 510,150 510,150
9,602,000 480,100 - 480,100 480,100
2,677,000 133,850 - 133,850 133,850
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
2,677,000 133,850 - 133,850 133,850
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
6,405,000 320,250 - 320,250 320,250
PPh Pasal 21
atas Penghasilan
tetap dan
teratur lainnya
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area staples
BUKTI PEMOTONGAN PAJAK PENGHASILAN

PASAL 21 BAGI PEGAWAI NEGERI SIPIL ATAU FORMULIR 1721 - A2
ANGGOTA TENTARA NASIONAL INDONESIA Lembar ke-1 : untuk Penerima Penghasilan
ATAU ANGGOTA POLISI REPUBLIK INDONESIA Lembar ke-2 : untuk Pemotong
ATAU PEJABAT NEGARA ATAU PENSIUNANNYA
MASA PEROLEHAN
KEMENTERIAN KEUANGAN RI PENGHASILAN [mm - mm]
DIREKTORAT JENDERAL PAJAK NOMOR : H.01 1 . 2 - 12 . 22 - 0000001 H.02 07 - 12
NAMA INSTANSI/ NPWP

BADAN LAIN : H.03 DINAS PENDIDIKAN PROVINSI JAWA BARAT BENDAHARA : H.05
NAMA
BENDAHARA : H.04
MOCH ROCHMAT FARMANSJAH, SE 00.135.558.5 - 428 . 000 ###
A. IDENTITAS PENERIMA PENGHASILAN YANG DIPOTONG
1. NPWP : 953776866-913.223 6. JENIS KELAMIN : A.07 X LAKI-LAKI A.09 - PEREMPUAN

A.01
2. NIP/ 199012052022211010 7. NIK : A.09 3215090512900001

NRP : A.02
3. NAMA : A.03 ROHMAN SOFYAN, ST 8. STATUS / JUMLAH TANGGUNGAN KELUARGA UNTUK PTKP
4. PANGKAT/
GOLONGAN : A.04
PENATA MUDA / IIIA
A.05
IIIA K/ - TK / 0 HB /
A.10 A.11 A.12
5. ALAMAT Perum Grand Mutiara Blok E 10 No 14 9. NAMA JABATAN : A.13 GURU AHLI PERTAMA
: A.06
B. RINCIAN PENGHASILAN DAN PENGHITUNGAN PPh PASAL 21

URAIAN JUMLAH (Rp)
KODE OBJEK PAJAK : X 21-100-01 21-100-02
PENGHASILAN BRUTO :
1. GAJI POKOK/PENSIUN 23,034,000###

2. TUNJANGAN ISTERI 2,303,400###
3. TUNJANGAN ANAK 921,360###
4. JUMLAH GAJI DAN TUNJANGAN KELUARGA (1 S.D. 3) 26,258,760###
5. TUNJANGAN PERBAIKAN PENGHASILAN ###
-
6. TUNJANGAN STRUKTURAL/FUNGSIONAL 13,680,000###
7. TUNJANGAN BERAS 2,027,760###
8. TUNJANGAN KHUSUS ###
-
9. TUNJANGAN LAIN-LAIN ###
-
10. PENGHASILAN TETAP DAN TERATUR LAINNYA YANG PEMBAYARANNYA TERPISAH DARI PEMBAYARAN GAJI ###
-
11. JUMLAH PENGHASILAN BRUTO (4 S.D. 10) 41,966,520###
PENGURANGAN :
12. BIAYA JABATAN/ BIAYA PENSIUN 2,098,326###

13. IURAN PENSIUN ATAU IURAN THT 1,247,291###
14. JUMLAH PENGURANGAN (12 S.D 14) 3,345,617###
PENGHITUNGAN PPh PASAL 21 :
15. JUMLAH PENGHASILAN NETO (11 - 14) 38,620,903###

16. JUMLAH PENGHASILAN NETO MASA SEBELUMNYA ###
-
17. JUMLAH PENGHASILAN NETO UNTUK PENGHITUNGAN PPh PASAL 21 (SETAHUN/DISETAHUNKAN) 38,620,903###
18. PENGHASILAN TIDAK KENA PAJAK (PTKP) 54,000,000###
19. PENGHASILAN KENA PAJAK SETAHUN/DISETAHUNKAN (17 - 18) ###
-
20. PPh PASAL 21 ATAS PENGHASILAN KENA PAJAK SETAHUN/DISETAHUNKAN ###
-
21. PPh PASAL 21 YANG TELAH DIPOTONG MASA SEBELUMNYA ###
-
22. PPh PASAL 21 TERUTANG ###
-
23. PPh PASAL 21 YANG TELAH DIPOTONG DAN DILUNASI -
23A. ATAS GAJI DAN TUNJANGAN ###
-
23B ATAS PENGHASILAN TETAP DAN TERATUR LAINNYA YANG PEMBAYARANNYA TERPISAH DARI PEMBAYARAN GAJI -
###
C. PEGAWAI TERSEBUT : C.01 - DIPINDAHKAN C.02 - PINDAHAN C.03 X BARU C.04 - PENSIUN
D. TANDA TANGAN BENDAHARA
1. NPWP : D.01 00.135.558.5 - 428 . 000 4. TANGGAL & TANDA TANGAN
2. NAMA : D.02 MOCH ROCHMAT FARMANSJAH, SE D.04 31 - 01 - 2023

[dd - mm - yyyy]
3. NIP/NRP : D.03 197104252010011001
No Masa Masa Tgl Penerima NPWP (tanpa
Perolehan Perolehan Pemotongan Penghasilan? format/tanda baca)
Awal Akhir (dd/MM/yyyy) (NPWP/NIK)
2 3 4 5 6
1 07 12 31/01/2023 NPWP 9537768669130223
2 0 0 31/01/2023 NPWP 0
3 0 0 31/01/2023 NPWP 0
4 0 0 31/01/2023 NPWP 0
5 0 0 31/01/2023 NPWP 0
6 0 0 31/01/2023 NPWP 0
7 0 0 31/01/2023 NPWP 0
8 0 0 31/01/2023 NPWP 0
9 0 0 31/01/2023 NPWP 0
10 0 0 31/01/2023 NPWP 0
11 0 0 31/01/2023 NPWP 0
12 0 0 31/01/2023 NPWP 0
13 0 0 31/01/2023 NPWP 0
14 0 0 31/01/2023 NPWP 0
15 0 0 31/01/2023 NPWP 0
16 0 0 31/01/2023 NPWP 0
17 0 0 31/01/2023 NPWP 0
18 0 0 31/01/2023 NPWP 0
19 0 0 31/01/2023 NPWP 0
20 0 0 31/01/2023 NPWP 0
21 0 0 31/01/2023 NPWP 0
22 0 0 31/01/2023 NPWP 0
23 0 0 31/01/2023 NPWP 0
24 0 0 31/01/2023 NPWP 0
25 0 0 31/01/2023 NPWP 0
26 0 0 31/01/2023 NPWP 0
27 0 0 31/01/2023 NPWP 0
28 0 0 31/01/2023 NPWP 0
29 0 0 31/01/2023 NPWP 0
30 0 0 31/01/2023 NPWP 0
31 0 0 31/01/2023 NPWP 0
32 0 0 31/01/2023 NPWP 0
33 0 0 31/01/2023 NPWP 0
34 0 0 31/01/2023 NPWP 0
35 0 0 31/01/2023 NPWP 0
36 0 0 31/01/2023 NPWP 0
37 0 0 31/01/2023 NPWP 0
38 0 0 31/01/2023 NPWP 0
39 0 0 31/01/2023 NPWP 0
40 0 0 31/01/2023 NPWP 0
41 0 0 31/01/2023 NPWP 0
42 0 0 31/01/2023 NPWP 0
43 0 0 31/01/2023 NPWP 0
44 0 0 31/01/2023 NPWP 0
45 0 0 31/01/2023 NPWP 0
46 0 0 0 NPWP 0
47 0 0 0 NPWP 0
48 0 0 0 NPWP 0
49 0 0 0 NPWP 0
50 0 0 0 NPWP 0
51 0 0 0 NPWP 0
52 0 0 0 NPWP 0
53 0 0 0 NPWP 0
54 0 0 0 NPWP 0
55 0 0 0 NPWP 0
56 0 0 0 NPWP 0
57 0 0 0 NPWP 0
58 0 0 0 NPWP 0
59 0 0 0 NPWP 0
60 0 0 0 NPWP 0
61 0 0 0 NPWP 0
62 0 0 0 NPWP 0
63 0 0 0 NPWP 0
64 0 0 0 NPWP 0
65 0 0 0 NPWP 0
66 0 0 0 NPWP 0
67 0 0 0 NPWP 0
68 0 0 0 NPWP 0
69 0 0 0 NPWP 0
70 0 0 0 NPWP 0
71 0 0 0 NPWP 0
72 0 0 0 NPWP 0
73 0 0 0 NPWP 0
74 0 0 0 NPWP 0
75 0 0 0 NPWP 0
76 0 0 0 NPWP 0
77 0 0 0 NPWP 0
78 0 0 0 NPWP 0
79 0 0 0 NPWP 0
80 0 0 0 NPWP 0
81 0 0 0 NPWP 0
82 0 0 0 NPWP 0
83 0 0 0 NPWP 0
84 0 0 0 NPWP 0
85 0 0 0 NPWP 0
86 0 0 0 NPWP 0
87 0 0 0 NPWP 0
88 0 0 0 NPWP 0
89 0 0 0 NPWP 0
90 0 0 NPWP 0
91 0 0 NPWP 0
92 0 0 NPWP 0
93 0 0 NPWP 0
94 0 0 NPWP 0
95 0 0 NPWP 0
96 0 0 NPWP 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Nama Penerima Penghasilan (QQ) NIK (tanpa Nama Penerima
format/tanda baca) Penghasilan Sesuai
NIK
7 8 9
ROHMAN SOFYAN, ST 3215090512900001 ROHMAN SOFYAN, ST
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0
NIP (tanpa Jenis Nama Jabatan Status
format/tanda baca) Kelamin PTKP
(L/P)
10 11 12 13
199012052022211010 L GURU AHLI PERTAMA TK/0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
0P 0 0
Pangkat Golongan Status Pegawai Penandatangan NPWP Penandatangan
(Dipindahkan/Pindah Menggunakan (tanpa format/tanda
an/Baru/Pensiun) NPWP/NIK ? baca)
14 15 16 17
PENATA MUDA / IIIA BARU NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
0 0 NPWP 001355585428000
NIK Penandatangan Nama Kode Objek Pajak Jumlah 1
(tanpa format/tanda Penandatangan (21-100-01/ 21-
baca) Sesuai NIK 100-02)
18 19 20 23
197104252010011001 MOCH ROCHMAT FARMA 21-100-01 23034000
Jumlah 2 Jumlah 3 Jumlah 4 Jumlah 5 Jumlah 6
24 25 26 27 28
2303400 921360 26258760 0 13680000
0 0 5052300 8420 4668000
0 0 0 0 0
0 0 5052300 8419 4668000
0 0 4898100 8422 4668000
0 0 0 0 0
0 0 0 0 0
0 0 5000000 0 4668000
0 0 4847300 0 4668000
0 0 0 0 0
0 0 0 0 0
0 0 4912400 8429 4668000
0 0 4463000 8432 4668000
0 0 4416700 8431 4668000
0 0 4024400 8433 4668000
0 0 4024400 0 4668000
0 0 0 0 0
0 0 3743100 8443 3924000
0 0 3743100 8442 3924000
0 0 3743100 8441 3924000
0 0 3743100 8440 3924000
0 0 4108100 8437 3924000
0 0 3743100 8445 3924000
0 0 0 0 0
0 0 3743100 8446 3924000
0 0 3861000 8439 3924000
0 0 3518500 0 3924000
0 0 3375300 8451 4069800
0 0 3861000 8449 3924000
0 0 3375300 8453 3924000
0 0 3518100 0 0
0 0 3272200 8452 3924000
0 0 3554000 8459 3924000
0 0 3665900 8456 3924000
0 0 3554000 8457 3924000
0 0 3554000 8460 3924000
0 0 3554000 8458 3924000
0 0 3554000 8461 3924000
0 0 3665900 8455 3924000
0 0 2950600 8463 3924
0 0 2950600 8464 3924000
0 0 0 0 0
0 0 2579400 24164 3924000
0 0 2966500 0 3924000
0 0 2966500 33 3924000
0 0 2966500 451 3924000
0 0 2632400 8466 0
0 0 2966500 0 0
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 289000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 0
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 0
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
0 0 2966500 0 3924000
29 30 31 32 33
2027760 41966520 0 0 41966520
0 9728720 1302 5526800 15256822
0 0 0 50000 50000
0 9728719 0 6438400 16167119
0 9574522 1218 5921800 15497540
0 0 0 0 0
0 0 0 0 0
0 9668000 0 5461500 15129500
0 9515300 0 5890779 15406079
0 0 0 0 0
0 0 0 0 0
0 9588829 1148 5401900 14991877
0 9139432 42 5611200 14750674
0 9093131 518 5382300 14475949
0 8700833 490 4485900 13187223
0 8692400 1134 4485900 13179434
0 0 0 0 0
0 7675543 448 4736600 12412591
0 7675542 448 4736600 12412590
0 7675541 1218 4883900 12560659
0 7675540 1218 4883900 12560658
0 8040537 1316 4507600 12549453
0 7675545 812 4883900 12560257
0 0 0 0 0
0 7675546 336 4883900 12559782
0 7793439 0 4719000 12512439
0 7442500 266 4203100 11645866
0 7453551 0 0 7453551
0 7793449 1092 5018300 12812841
0 7307753 0 4464600 11772353
0 3518100 0 0 3518100
0 7204652 644 4347000 11552296
0 7486459 0 3845000 11331459
0 7598356 700 4065000 11664056
0 7486457 168 4403300 11889925
0 7486460 0 3953500 11439960
0 7486458 560 4261900 11748918
0 7486461 0 3845000 11331461
0 7598355 154 4668300 12266809
0 2962987 28 3844000 6807015
0 6883064 28 3714900 10597992
0 0 0 0 0
0 6527564 698 2978900 9507162
0 6890500 0 3735000 10625500
0 6890533 77 3735000 10625610
0 6890951 396 3735000 10626347
0 2640866 952 3470700 6112518
0 2966500 0 0 2966500
0 6890500 0 3866776 10757276
0 6890500 0 3998497 10888997
0 3255500 0 0 3255500
0 6890500 0 3866776 10757276
0 6890500 0 3998497 10888997
0 6890500 0 3851500 10742000
0 6890500 0 3866776 10757276
0 6890500 0 3735054 10625554
0 6890500 0 3866776 10757276
0 6890500 0 3998497 10888997
0 6890500 0 3365946 10256446
0 6890500 0 3998497 10888997
0 6890500 0 3866776 10757276
0 6890500 0 3998497 10888997
0 6890500 0 3866776 10757276
0 6890500 0 3866776 10757276
0 6890500 0 3866776 10757276
0 6890500 0 3629490 10519990
0 6890500 0 3998497 10888997
0 6890500 0 3866776 10757276
0 6890500 0 3998497 10888997
0 6890500 0 3365946 10256446
0 2966500 0 0 2966500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 2966500 0 0 2966500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
0 6890500 0 0 6890500
34 35 36 37 38
2098326 1247291 3345617 38620903 0
762841 239984 1002825 14253997 0
2500 0 2500 47500 0
808356 239984 1048340 15118779 0
774877 232659 1007536 14490004 0
0 0 0 0 0
0 0 0 0 0
756475 237500 993975 14135525 0
770304 230246 1000550 14405529 0
0 0 0 0 0
0 0 0 0 0
749594 233339 982933 14008944 0
737534 211992 949526 13801148 0
723797 209793 933590 13542359 0
659361 191159 850520 12336703 0
658972 191159 850131 12329303 0
0 0 0 0 0
620630 177797 798427 11614164 0
620630 177797 798427 11614164 0
628033 177797 805830 11754829 0
628033 177797 805830 11754828 0
627473 195134 822607 11726846 0
628013 177797 805810 11754447 0
0 0 0 0 0
627989 177797 805786 11753996 0
625622 183397 809019 11703420 0
582293 167128 749421 10896445 0
372678 160326 533004 6920547 0
640642 183397 824039 11988802 0
588618 160326 748944 11023409 0
175905 167109 343014 3175086 0
577615 155429 733044 10819252 0
566573 168815 735388 10596071 0
583203 174130 757333 10906723 0
594496 168815 763311 11126614 0
571998 168815 740813 10699147 0
587446 168815 756261 10992657 0
566573 168815 735388 10596073 0
613340 174130 787470 11479339 0
340351 140153 480504 6326511 0
529900 140153 670053 9927939 0
0 0 0 0 0
475358 122521 597879 8909283 0
531275 140908 672183 9953317 0
531281 140908 672189 9953422 0
531317 140908 672225 9954122 0
305626 125039 430665 5681853 0
148325 140908 289233 2677267 0
537864 140908 678772 10078504 0
544450 140908 685358 10203639 0
162775 140908 303683 2951817 0
537864 140908 678772 10078504 0
544450 140908 685358 10203639 0
537100 140908 678008 10063992 0
537864 140908 678772 10078504 0
531278 140908 672186 9953368 0
537864 140908 678772 10078504 0
544450 140908 685358 10203639 0
512822 140908 653730 9602716 0
544450 140908 685358 10203639 0
537864 140908 678772 10078504 0
544450 140908 685358 10203639 0
537864 140908 678772 10078504 0
537864 140908 678772 10078504 0
537864 140908 678772 10078504 0
526000 140908 666908 9853083 0
544450 140908 685358 10203639 0
537864 140908 678772 10078504 0
544450 140908 685358 10203639 0
512822 140908 653730 9602716 0
148325 140908 289233 2677267 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
148325 140908 289233 2677267 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
344525 140908 485433 6405067 0
39 40 41 42 43
38620903 54000000 0 0 0
14253997 0 14253000 712650 0
47500 0 47000 2350 0
15118779 0 15118000 755900 0
14490004 0 14490000 724500 0
0 0 0 0 0
0 0 0 0 0
14135525 0 14135000 706750 0
14405529 0 14405000 720250 0
0 0 0 0 0
0 0 0 0 0
14008944 0 14008000 700400 0
13801148 0 13801000 690050 0
13542359 0 13542000 677100 0
12336703 0 12336000 616800 0
12329303 0 12329000 616450 0
0 0 0 0 0
11614164 0 11614000 580700 0
11614164 0 11614000 580700 0
11754829 0 11754000 587700 0
11754828 0 11754000 587700 0
11726846 0 11726000 586300 0
11754447 0 11754000 587700 0
0 0 0 0 0
11753996 0 11753000 587650 0
11703420 0 11703000 585150 0
10896445 0 10896000 544800 0
6920547 0 6920000 346000 0
11988802 0 11988000 599400 0
11023409 0 11023000 551150 0
3175086 0 3175000 158750 0
10819252 0 10819000 540950 0
10596071 0 10596000 529800 0
10906723 0 10906000 545300 0
11126614 0 11126000 556300 0
10699147 0 10699000 534950 0
10992657 0 0 0 0
10596073 0 10596000 529800 0
11479339 0 11479000 573950 0
6326511 0 6326000 316300 0
9927939 0 9927000 496350 0
0 0 0 0 0
8909283 0 8909000 445450 0
9953317 0 9953000 497650 0
9953422 0 9953000 497650 0
9954122 0 9954000 497700 0
5681853 0 5681000 284050 0
2677267 0 2677000 133850 0
10078504 0 10078000 503900 0
10203639 0 10203000 510150 0
2951817 0 2951000 147550 0
10078504 0 10078000 503900 0
10203639 0 10203000 510150 0
10063992 0 10063000 503150 0
10078504 0 10078000 503900 0
9953368 0 9953000 497650 0
10078504 0 10078000 503900 0
10203639 0 10203000 510150 0
9602716 0 9602000 480100 0
10203639 0 10203000 510150 0
10078504 0 10078000 503900 0
10203639 0 10203000 510150 0
10078504 0 10078000 503900 0
10078504 0 10078000 503900 0
10078504 0 10078000 503900 0
9853083 0 9853000 492650 0
10203639 0 10203000 510150 0
10078504 0 10078000 503900 0
10203639 0 10203000 510150 0
9602716 0 9602000 480100 0
2677267 0 2677000 133850 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
2677267 0 2677000 133850 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
6405067 0 6405000 320250 0
Jumlah 22 Jumlah 23a Jumlah 23b
44 45 46
0 0 0
712650 712650 0
2350 2350 0
755900 755900 0
724500 724500 0
0 0 0
0 0 0
706750 706750 0
720250 720250 0
0 0 0
0 0 0
700400 700400 0
690050 690050 0
677100 677100 0
616800 616800 0
616450 616450 0
0 0 0
580700 580700 0
580700 580700 0
587700 587700 0
587700 587700 0
586300 586300 0
587700 587700 0
0 0 0
587650 587650 0
585150 585150 0
544800 544800 0
346000 346000 0
599400 599400 0
551150 551150 0
158750 158750 0
540950 540950 0
529800 529800 0
545300 545300 0
556300 556300 0
534950 534950 0
0 0 0
529800 529800 0
573950 573950 0
316300 316300 0
496350 496350 0
0 0 0
445450 445450 0
497650 497650 0
497650 497650 0
497700 497700 0
284050 284050 0
133850 133850 0
503900 503900 0
510150 510150 0
147550 147550 0
503900 503900 0
510150 510150 0
503150 503150 0
503900 503900 0
497650 497650 0
503900 503900 0
510150 510150 0
480100 480100 0
510150 510150 0
503900 503900 0
510150 510150 0
503900 503900 0
503900 503900 0
503900 503900 0
492650 492650 0
510150 510150 0
503900 503900 0
510150 510150 0
480100 480100 0
133850 133850 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
133850 133850 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
320250 320250 0
Masa Tahun Masa Perolehan Masa Perolehan
Pembetulan Nomor Bukti Potong
Pajak Pajak Awal Akhir
12 2022 0 1.2-12.22-0000001 07 12
0 2022 0 1.2-12.22-0000002 0 0
0 2022 0 1.2-12.22-0000003 0 0
0 2022 0 1.2-12.22-0000004 0 0
0 2022 0 1.2-12.22-0000005 0 0
0 2022 0 1.2-12.22-0000006 0 0
0 2022 0 1.2-12.22-0000007 0 0
0 2022 0 1.2-12.22-0000008 0 0
0 2022 0 1.2-12.22-0000009 0 0
0 2022 0 1.2-12.22-0000010 0 0
0 2022 0 1.2-12.22-0000011 0 0
0 2022 0 1.2-12.22-0000012 0 0
0 2022 1.2-12.22-0000013 0 0
0 2022 1.2-12.22-0000014 0 0
0 2022 1.2-12.22-0000015 0 0
0 2022 1.2-12.22-0000016 0 0
0 2022 1.2-12.22-0000017 0 0
0 2022 1.2-12.22-0000018 0 0
0 2022 1.2-12.22-0000019 0 0
0 2022 1.2-12.22-0000020 0 0
0 2022 1.2-12.22-0000021 0 0
0 2022 1.2-12.22-0000022 0 0
0 2022 1.2-12.22-0000023 0 0
0 2022 1.2-12.22-0000024 0 0
0 2022 1.2-12.22-0000025 0 0
0 2022 1.2-12.22-0000026 0 0
0 2022 1.2-12.22-0000027 0 0
0 2022 1.2-12.22-0000028 0 0
0 2022 1.2-12.22-0000029 0 0
0 2022 1.2-12.22-0000030 0 0
0 2022 1.2-12.22-0000031 0 0
0 2022 1.2-12.22-0000032 0 0
0 2022 1.2-12.22-0000033 0 0
0 2022 1.2-12.22-0000034 0 0
0 2022 1.2-12.22-0000035 0 0
0 2022 1.2-12.22-0000036 0 0
0 2022 1.2-12.22-0000037 0 0
0 2022 1.2-12.22-0000038 0 0
0 2022 1.2-12.22-0000039 0 0
0 2022 1.2-12.22-0000040 0 0
0 2022 1.2-12.22-0000041 0 0
0 2022 1.2-12.22-0000042 0 0
0 2022 1.2-12.22-0000043 0 0
0 2022 1.2-12.22-0000044 0 0
0 2022 1.2-12.22-0000045 0 0
0 2022 1.2-12.22-0000046 0 0
0 2022 1.2-12.22-0000047 0 0
0 2022 1.2-12.22-0000048 0 0
0 2022 1.2-12.22-0000049 0 0
0 2022 1.2-12.22-0000050 0 0
0 2022 1.2-12.22-0000051 0 0
0 2022 1.2-12.22-0000052 0 0
0 2022 1.2-12.22-0000053 0 0
0 2022 1.2-12.22-0000054 0 0
0 2022 1.2-12.22-0000055 0 0
0 2022 1.2-12.22-0000056 0 0
0 2022 1.2-12.22-0000057 0 0
0 2022 1.2-12.22-0000058 0 0
0 2022 1.2-12.22-0000059 0 0
0 2022 1.2-12.22-0000060 0 0
0 2022 1.2-12.22-0000061 0 0
0 2022 1.2-12.22-0000062 0 0
0 2022 1.2-12.22-0000063 0 0
0 2022 1.2-12.22-0000064 0 0
0 2022 1.2-12.22-0000065 0 0
0 2022 1.2-12.22-0000066 0 0
0 2022 1.2-12.22-0000067 0 0
0 2022 1.2-12.22-0000068 0 0
0 2022 1.2-12.22-0000069 0 0
0 2022 1.2-12.22-0000070 0 0
0 2022 1.2-12.22-0000071 0 0
0 2022 1.2-12.22-0000072 0 0
0 2022 1.2-12.22-0000073 0 0
0 2022 1.2-12.22-0000074 0 0
0 2022 1.2-12.22-0000075 0 0
0 2022 1.2-12.22-0000076 0 0
0 2022 1.2-12.22-0000077 0 0
0 2022 1.2-12.22-0000078 0 0
0 2022 1.2-12.22-0000079 0 0
0 2022 1.2-12.22-0000080 0 0
0 2022 1.2-12.22-0000081 0 0
0 2022 1.2-12.22-0000082 0 0
0 2022 1.2-12.22-0000083 0 0
0 2022 1.2-12.22-0000084 0 0
0 2022 1.2-12.22-0000085 0 0
0 2022 1.2-12.22-0000086 0 0
0 2022 1.2-12.22-0000087 0 0
0 2022 1.2-12.22-0000088 0 0
0 2022 1.2-12.22-0000089 0 0
0 2022 1.2-12.22-0000090 0 0
0 2022 1.2-12.22-0000091 0 0
0 2022 1.2-12.22-0000092 0 0
0 2022 1.2-12.22-0000093 0 0
0 2022 1.2-12.22-0000094 0 0
0 2022 1.2-12.22-0000095 0 0
0 2022 1.2-12.22-0000096 0 0
0 2022 1.2-12.22-0000000 0 0
0 2022 1.2-12.22-0000000 0 0
0 2022 1.2-12.22-0000000 0 0
0 2022 1.2-12.22-0000000 0 0
0 2022 1.2-12.22-0000000 0 0
0 2022 1.2-12.22-0000000 0 0
0 2022 1.2-12.22-0000000 0 0
NPWP NIP Nama Pangkat Golongan
9537768669130223199012052022211010 ROHMAN SOFYAN,

PENATA MUDA / IIIA IIIA
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
0 0 0 0 #N/A
Alamat Jenis Kelamin NIK Status PTKP Jumlah Tanggungan
Perum Grand Mu M 3215090512900001 TK 0

0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK 0
0 F 0 TK
0 F 0 TK
0 F 0 TK
0 F 0 TK
0 F 0 TK
0 F 0 TK
0 F 0 TK
Nama Jabatan Kode Pajak Jumlah 1 Jumlah 2 Jumlah 3 Jumlah 4
GURU AHLI PERTAMA 21-100-01 23034000 2303400 921360 26258760

0 21-100-01 5052300 0 0 5052300
0 21-100-01 0 0 0 0
0 21-100-01 5052300 0 0 5052300
0 21-100-01 4898100 0 0 4898100
0 21-100-01 0 0 0 0
0 21-100-01 0 0 0 0
0 21-100-01 5000000 0 0 5000000
0 21-100-01 4847300 0 0 4847300
0 21-100-01 0 0 0 0
0 21-100-01 0 0 0 0
0 21-100-01 4912400 0 0 4912400
0 21-100-01 4463000 0 0 4463000
0 21-100-01 4416700 0 0 4416700
0 21-100-01 4024400 0 0 4024400
0 21-100-01 4024400 0 0 4024400
0 21-100-01 0 0 0 0
0 21-100-01 3743100 0 0 3743100
0 21-100-01 3743100 0 0 3743100
0 21-100-01 3743100 0 0 3743100
0 21-100-01 3743100 0 0 3743100
0 21-100-01 4108100 0 0 4108100
0 21-100-01 3743100 0 0 3743100
0 21-100-01 0 0 0 0
0 21-100-01 3743100 0 0 3743100
0 21-100-01 3861000 0 0 3861000
0 21-100-01 3518500 0 0 3518500
0 21-100-01 3375300 0 0 3375300
0 21-100-01 3861000 0 0 3861000
0 21-100-01 3375300 0 0 3375300
0 21-100-01 3518100 0 0 3518100
0 21-100-01 3272200 0 0 3272200
0 21-100-01 3554000 0 0 3554000
0 21-100-01 3665900 0 0 3665900
0 21-100-01 3554000 0 0 3554000
0 21-100-01 3554000 0 0 3554000
0 21-100-01 3554000 0 0 3554000
0 21-100-01 3554000 0 0 3554000
0 21-100-01 3665900 0 0 3665900
0 21-100-01 2950600 0 0 2950600
0 21-100-01 2950600 0 0 2950600
0 21-100-01 0 0 0 0
0 21-100-01 2579400 0 0 2579400
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2632400 0 0 2632400
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 21-100-01 2966500 0 0 2966500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
Jumlah 5 Jumlah 6 Jumlah 7 Jumlah 8 Jumlah 9 Jumlah 10 Jumlah 11
0 13680000 2027760 0 41966520 0 41966520

8420 4668000 0 0 9728720 5526800 15256822
0 0 0 0 0 50000 50000
8419 4668000 0 0 9728719 6438400 16167119
8422 4668000 0 0 9574522 5921800 15497540
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 4668000 0 0 9668000 5461500 15129500
0 4668000 0 0 9515300 5890779 15406079
0 0 0 0 0 0 0
0 0 0 0 0 0 0
8429 4668000 0 0 9588829 5401900 14991877
8432 4668000 0 9139432 5611200 14750674
8431 4668000 0 9093131 5382300 14475949
8433 4668000 0 8700833 4485900 13187223
0 4668000 0 8692400 4485900 13179434
0 0 0 0 0 0
8443 3924000 0 7675543 4736600 12412591
8442 3924000 0 7675542 4736600 12412590
8441 3924000 0 7675541 4883900 12560659
8440 3924000 0 7675540 4883900 12560658
8437 3924000 0 8040537 4507600 12549453
8445 3924000 0 7675545 4883900 12560257
0 0 0 0 0 0
8446 3924000 0 7675546 4883900 12559782
8439 3924000 0 7793439 4719000 12512439
0 3924000 0 7442500 4203100 11645866
8451 4069800 0 7453551 0 7453551
8449 3924000 0 7793449 5018300 12812841
8453 3924000 0 7307753 4464600 11772353
0 0 0 3518100 0 3518100
8452 3924000 0 7204652 4347000 11552296
8459 3924000 0 7486459 3845000 11331459
8456 3924000 0 7598356 4065000 11664056
8457 3924000 0 7486457 4403300 11889925
8460 3924000 0 7486460 3953500 11439960
8458 3924000 0 7486458 4261900 11748918
8461 3924000 0 7486461 3845000 11331461
8455 3924000 0 7598355 4668300 12266809
8463 3924 0 2962987 3844000 6807015
8464 3924000 0 6883064 3714900 10597992
0 0 0 0 0 0
24164 3924000 0 6527564 2978900 9507162
0 3924000 0 6890500 3735000 10625500
33 3924000 0 6890533 3735000 10625610
451 3924000 0 6890951 3735000 10626347
8466 0 0 2640866 3470700 6112518
0 0 0 2966500 0 2966500
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3998497 10888997
0 289000 0 3255500 0 3255500
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3998497 10888997
0 3924000 0 6890500 3851500 10742000
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3735054 10625554
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3998497 10888997
0 3924000 0 6890500 3365946 10256446
0 3924000 0 6890500 3998497 10888997
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3998497 10888997
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3629490 10519990
0 3924000 0 6890500 3998497 10888997
0 3924000 0 6890500 3866776 10757276
0 3924000 0 6890500 3998497 10888997
0 3924000 0 6890500 3365946 10256446
0 0 0 2966500 0 2966500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 0 0 2966500 0 2966500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 3924000 0 6890500 0 6890500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
Jumlah 12 Jumlah 13 Jumlah 14 Jumlah 15 Jumlah 16 Jumlah 17 Jumlah 18
2098326 1247291 3345617 38620903 0 38620903 54000000

762841.1 239984 1002825.1 14253996.9 0 14253996.9 0
2500 0 2500 47500 0 47500 0
808355.95 239984 1048339.95 15118779.05 0 15118779.05 0
774877 232659 1007536 14490004 0 14490004 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
756475 237500 993975 14135525 0 14135525 0
770303.95 230246 1000549.95 14405529.05 0 14405529.05 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
749593.85 233339 982932.85 14008944.15 0 14008944.15 0
737533.7 211992 949525.7 13801148.3 0 13801148.3 0
723797.45 209793 933590.45 13542358.55 0 13542358.55 0
659361.15 191159 850520.15 12336702.85 0 12336702.85 0
658971.7 191159 850130.7 12329303.3 0 12329303.3 0
0 0 0 0 0 0 0
620629.55 177797 798426.55 11614164.45 0 11614164.45 0
620629.5 177797 798426.5 11614163.5 0 11614163.5 0
628032.95 177797 805829.95 11754829.05 0 11754829.05 0
628032.9 177797 805829.9 11754828.1 0 11754828.1 0
627472.65 195134 822606.65 11726846.35 0 11726846.35 0
628012.85 177797 805809.85 11754447.15 0 11754447.15 0
0 0 0 0 0 0 0
627989.1 177797 805786.1 11753995.9 0 11753995.9 0
625621.95 183397 809018.95 11703420.05 0 11703420.05 0
582293.3 167128 749421.3 10896444.7 0 10896444.7 0
372677.55 160326 533003.55 6920547.45 0 6920547.45 0
640642.05 183397 824039.05 11988801.95 0 11988801.95 0
588617.65 160326 748943.65 11023409.35 0 11023409.35 0
175905 167109 343014 3175086 0 3175086 0
577614.8 155429 733043.8 10819252.2 0 10819252.2 0
566572.95 168815 735387.95 10596071.05 0 10596071.05 0
583202.8 174130 757332.8 10906723.2 0 10906723.2 0
594496.25 168815 763311.25 11126613.75 0 11126613.75 0
571998 168815 740813 10699147 0 10699147 0
587445.9 168815 756260.9 10992657.1 0 10992657.1 0
566573.05 168815 735388.05 10596072.95 0 10596072.95 0
613340.45 174130 787470.45 11479338.55 0 11479338.55 0
340350.75 140153 480503.75 6326511.25 0 6326511.25 0
529899.6 140153 670052.6 9927939.4 0 9927939.4 0
0 0 0 0 0 0 0
475358.1 122521 597879.1 8909282.9 0 8909282.9 0
531275 140908 672183 9953317 0 9953317 0
531280.5 140908 672188.5 9953421.5 0 9953421.5 0
531317.35 140908 672225.35 9954121.65 0 9954121.65 0
305625.9 125039 430664.9 5681853.1 0 5681853.1 0
148325 140908 289233 2677267 0 2677267 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
544449.85 140908 685357.85 10203639.15 0 10203639.15 0
162775 140908 303683 2951817 0 2951817 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
544449.85 140908 685357.85 10203639.15 0 10203639.15 0
537100 140908 678008 10063992 0 10063992 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
531277.7 140908 672185.7 9953368.3 0 9953368.3 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
544449.85 140908 685357.85 10203639.15 0 10203639.15 0
512822.3 140908 653730.3 9602715.7 0 9602715.7 0
544449.85 140908 685357.85 10203639.15 0 10203639.15 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
544449.85 140908 685357.85 10203639.15 0 10203639.15 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
525999.5 140908 666907.5 9853082.5 0 9853082.5 0
544449.85 140908 685357.85 10203639.15 0 10203639.15 0
537863.8 140908 678771.8 10078504.2 0 10078504.2 0
544449.85 140908 685357.85 10203639.15 0 10203639.15 0
512822.3 140908 653730.3 9602715.7 0 9602715.7 0
148325 140908 289233 2677267 0 2677267 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
148325 140908 289233 2677267 0 2677267 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
344525 140908 485433 6405067 0 6405067 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
Jumlah 19 Jumlah 20 Jumlah 21 Jumlah 22 Jumlah 23 Jumlah 23a Jumlah 23b
0 0 0 0 0 0 0
14253000 712650 0 712650 712650 712650 0
47000 2350 0 2350 2350 2350 0
15118000 755900 0 755900 755900 755900 0
14490000 724500 0 724500 724500 724500 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
14135000 706750 0 706750 706750 706750 0
14405000 720250 0 720250 720250 720250 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
14008000 700400 0 700400 700400 700400 0
13801000 690050 0 690050 690050 690050 0
13542000 677100 0 677100 677100 677100 0
12336000 616800 0 616800 616800 616800 0
12329000 616450 0 616450 616450 616450 0
0 0 0 0 0 0 0
11614000 580700 0 580700 580700 580700 0
11614000 580700 0 580700 580700 580700 0
11754000 587700 0 587700 587700 587700 0
11754000 587700 0 587700 587700 587700 0
11726000 586300 0 586300 586300 586300 0
11754000 587700 0 587700 587700 587700 0
0 0 0 0 0 0 0
11753000 587650 0 587650 587650 587650 0
11703000 585150 0 585150 585150 585150 0
10896000 544800 0 544800 544800 544800 0
6920000 346000 0 346000 346000 346000 0
11988000 599400 0 599400 599400 599400 0
11023000 551150 0 551150 551150 551150 0
3175000 158750 0 158750 158750 158750 0
10819000 540950 0 540950 540950 540950 0
10596000 529800 0 529800 529800 529800 0
10906000 545300 0 545300 545300 545300 0
11126000 556300 0 556300 556300 556300 0
10699000 534950 0 534950 534950 534950 0
0 0 0 0 0 0 0
10596000 529800 0 529800 529800 529800 0
11479000 573950 0 573950 573950 573950 0
6326000 316300 0 316300 316300 316300 0
9927000 496350 0 496350 496350 496350 0
0 0 0 0 0 0 0
8909000 445450 0 445450 445450 445450 0
9953000 497650 0 497650 497650 497650 0
9953000 497650 0 497650 497650 497650 0
9954000 497700 0 497700 497700 497700 0
5681000 284050 0 284050 284050 284050 0
2677000 133850 0 133850 133850 133850 0
10078000 503900 0 503900 503900 503900 0
10203000 510150 0 510150 510150 510150 0
2951000 147550 0 147550 147550 147550 0
10078000 503900 0 503900 503900 503900 0
10203000 510150 0 510150 510150 510150 0
10063000 503150 0 503150 503150 503150 0
10078000 503900 0 503900 503900 503900 0
9953000 497650 0 497650 497650 497650 0
10078000 503900 0 503900 503900 503900 0
10203000 510150 0 510150 510150 510150 0
9602000 480100 0 480100 480100 480100 0
10203000 510150 0 510150 510150 510150 0
10078000 503900 0 503900 503900 503900 0
10203000 510150 0 510150 510150 510150 0
10078000 503900 0 503900 503900 503900 0
10078000 503900 0 503900 503900 503900 0
10078000 503900 0 503900 503900 503900 0
9853000 492650 0 492650 492650 492650 0
10203000 510150 0 510150 510150 510150 0
10078000 503900 0 503900 503900 503900 0
10203000 510150 0 510150 510150 510150 0
9602000 480100 0 480100 480100 480100 0
2677000 133850 0 133850 133850 133850 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
2677000 133850 0 133850 133850 133850 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
6405000 320250 0 320250 320250 320250 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
Status Pindah NPWP Pemotong Nama Pemotong Tanggal Bukti Potong
001355585428000 MOCH ROCHMAT FARM

31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
31/01/2023
001355585428000 MOCH ROCHMAT FARM 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
Instansi Pemotong NIP Pemotong
DINAS PENDIDIKAN PROVINSI JAWA BARAT 197104252010011001

Penerima
No Tgl Pemotongan Penghasilan? NPWP (tanpa Nama Penerima
(dd/MM/yyyy) format/tanda baca) Penghasilan (QQ)
(NPWP/NIK)
1 31/01/2023 NPWP 9537768669130223 ROHMAN SOFYAN, ST

2 31/01/2023 NPWP 0 0
3 31/01/2023 NPWP 0 0
4 31/01/2023 NPWP 0 0
5 31/01/2023 NPWP 0 0
6 31/01/2023 NPWP 0 0
7 31/01/2023 NPWP 0 0
8 31/01/2023 NPWP 0 0
9 31/01/2023 NPWP 0 0
10 31/01/2023 NPWP 0 0
11 31/01/2023 NPWP 0 0
12 31/01/2023 NPWP 0 0
13 31/01/2023 NPWP 0 0
14 31/01/2023 NPWP 0 0
15 31/01/2023 NPWP 0 0
16 31/01/2023 NPWP 0 0
17 31/01/2023 NPWP 0 0
18 31/01/2023 NPWP 0 0
19 31/01/2023 NPWP 0 0
20 31/01/2023 NPWP 0 0
21 31/01/2023 NPWP 0 0
22 31/01/2023 NPWP 0 0
23 31/01/2023 NPWP 0 0
24 31/01/2023 NPWP 0 0
25 31/01/2023 NPWP 0 0
26 31/01/2023 NPWP 0 0
27 31/01/2023 NPWP 0 0
28 31/01/2023 NPWP 0 0
29 31/01/2023 NPWP 0 0
30 31/01/2023 NPWP 0 0
31 31/01/2023 NPWP 0 0
32 31/01/2023 NPWP 0 0
33 31/01/2023 NPWP 0 0
34 31/01/2023 NPWP 0 0
35 31/01/2023 NPWP 0 0
36 31/01/2023 NPWP 0 0
37 31/01/2023 NPWP 0 0
38 31/01/2023 NPWP 0 0
39 31/01/2023 NPWP 0 0
40 31/01/2023 NPWP 0 0
41 31/01/2023 NPWP 0 0
42 31/01/2023 NPWP 0 0
43 31/01/2023 NPWP 0 0
44 31/01/2023 NPWP 0 0
45 31/01/2023 NPWP 0 0
46 31/01/2023 NPWP 0 0
47 31/01/2023 NPWP 0 0
48 31/01/2023 NPWP 0 0
49 31/01/2023 NPWP 0 0
50 31/01/2023 NPWP 0 0
51 31/01/2023 NPWP 0 0
52 31/01/2023 NPWP 0 0
53 31/01/2023 NPWP 0 0
54 31/01/2023 NPWP 0 0
55 31/01/2023 NPWP 0 0
56 31/01/2023 NPWP 0 0
57 31/01/2023 NPWP 0 0
58 31/01/2023 NPWP 0 0
59 31/01/2023 NPWP 0 0
60 31/01/2023 NPWP 0 0
61 31/01/2023 NPWP 0 0
62 31/01/2023 NPWP 0 0
63 31/01/2023 NPWP 0 0
64 31/01/2023 NPWP 0 0
65 31/01/2023 NPWP 0 0
66 31/01/2023 NPWP 0 0
67 31/01/2023 NPWP 0 0
68 31/01/2023 NPWP 0 0
69 31/01/2023 NPWP 0 0
70 31/01/2023 NPWP 0 0
71 31/01/2023 NPWP 0 0
72 31/01/2023 NPWP 0 0
73 31/01/2023 NPWP 0 0
74 31/01/2023 NPWP 0 0
75 31/01/2023 NPWP 0 0
76 31/01/2023 NPWP 0 0
77 31/01/2023 NPWP 0 0
78 31/01/2023 NPWP 0 0
79 31/01/2023 NPWP 0 0
80 31/01/2023 NPWP 0 0
81 31/01/2023 NPWP 0 0
82 31/01/2023 NPWP 0 0
83 31/01/2023 NPWP 0 0
84 31/01/2023 NPWP 0 0
85 31/01/2023 NPWP 0 0
86 31/01/2023 NPWP 0 0
87 31/01/2023 NPWP 0 0
88 31/01/2023 NPWP 0 0
89 31/01/2023 NPWP 0 0
90 31/01/2023 NPWP 0 0
91 31/01/2023 NPWP 0 0
92 31/01/2023 NPWP 0 0
93 31/01/2023 NPWP 0 0
94 31/01/2023 NPWP 0 0
95 31/01/2023 NPWP 0 0
96 31/01/2023 NPWP 0 0
0 31/01/2023 NPWP 0 0
0 31/01/2023 NPWP 0 0
0 31/01/2023 NPWP 0 0
0 31/01/2023 NPWP 0 0
Penandatangan
NIK (tanpa Nama Penerima Kode Objek Pajak Menggunakan
format/tanda baca) Penghasilan Sesuai NIK
NPWP/NIK ?
199012052022211010 ROHMAN SOFYAN, ST 21-402-01 NPWP

0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
NPWP Penandatangan NIK Penandatangan
(tanpa format/tanda (tanpa format/tanda Nama Penandatangan Sesuai NIK
baca) baca)
17 0 MOCH ROCHMAT FARMANSJAH, SE

Penghasilan Bruto Dasar Pengenaan Pajak Tarif (%) PPh Dipotong DTP
10,000,000 10,000,000 5 500,000

9,000,000 9,000,000 #N/A #N/A
8,000,000 8,000,000 #N/A #N/A
7,000,000 7,000,000 #N/A #N/A
6,000,000 6,000,000 #N/A #N/A
5,000,000 5,000,000 #N/A #N/A
4,000,000 4,000,000 #N/A #N/A
4,000,000 4,000,000 #N/A #N/A
4,000,000 4,000,000 #N/A #N/A
4,000,000 4,000,000 #N/A #N/A
4,000,000 4,000,000 #N/A #N/A
4,000,000 4,000,000 #N/A #N/A
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
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- -
- -
- -
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- -
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- -
- -
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- -
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- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
Mendapatkan Fasilitas ? Nomor SKB Nomor Surat DTP
(N/SKB/DTP/Lainnya)
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
Fasilitas PPh Tarif PPh Berdasarkan
Lainnya Fas. PPh Lainnya
area staples
BUKTI PEMOTONGAN PAJAK

PENGHASILAN PASAL 21
(FINAL) FORMULIR 1721 - VII
Lembar ke-1 : untuk Penerima Penghasilan
Lembar ke-2 : untuk Pemotong
KEMENTERIAN KEUANGAN RI
DIREKTORAT JENDERAL PAJAK NOMOR : 1 . 4 - 12 . 22 - 0000004
H.01
A. IDENTITAS PENERIMA PENGHASILAN YANG DIPOTONG
1. NPWP : A.01 0 - . 0 2. NIK / NO. PASPOR : A.02 0
2. NAMA : A.03 0
3. ALAMAT : A.04 0
B. PPh PASAL 21 YANG DIPOTONG

JUMLAH
TARIF PPh DIPOTONG
KODE OBJEK PAJAK PENGHASILAN BRUTO (%) (RP)
(Rp)
(1) (2) (3) (4)
21 - 402 - 01 7,000,000 #N/A #N/A
C. IDENTITAS PEMOTONG
1. NPWP : C.01 00.135.558.5 - 428 . 000 3. TANGGAL & TANDA TANGAN
2. NAMA : C.02 DINAS PENDIDIKAN PROVINSI JAWA BARAT C.03 31 - 01 - 2023

[dd - mm - yyyy]
KODE OBJEK PAJAK PENGHASILAN PASAL 21 ( FINAL)
1. 21-401-01 Uang Pesangon yang Dibayarkan Sekaligus

2. 21-401-02 Uang Manfaat Pensiun, Tunjangan Hari Tua, atau Jaminan Hari Tua yang Dibayarkan Sekaligus
3. 21-402-01 Honor dan Imbalan Lain yang Dibebankan kepada APBN atau APBD yang Diterima oleh PNS, Anggota TNI/POLRI, Pejabat
Negara dan Pensiunannya
4. 21-499-99 Objek PPh Pasal 21 Final Lainnya
No Tgl Pemotongan Penerima NPWP (tanpa Nama Penerima
(dd/MM/yyyy) Penghasilan? format/tanda baca) Penghasilan (QQ)
(NPWP/NIK)
1 31/01/2023 NPWP 9537768669130223 ROHMAN SOFYAN, ST

2 31/01/2023 NPWP 0 0
3 31/01/2023 NPWP 0 0
4 31/01/2023 NPWP 0 0
5 31/01/2023 NPWP 0 0
6 31/01/2023 NPWP 0 0
7 31/01/2023 NPWP 0 0
8 31/01/2023 NPWP 0 0
9 31/01/2023 NPWP 0 0
10 31/01/2023 NPWP 0 0
11 31/01/2023 NPWP 0 0
12 31/01/2023 NPWP 0 0
NIK (tanpa Nama Penerima Kode Objek Pajak Penandatangan
format/tanda baca) Penghasilan Sesuai NIK Menggunakan
NPWP/NIK ?
199012052022211010 ROHMAN SOFYAN, ST 21-402-01 NPWP

0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
0 0 21-402-01 NPWP
NPWP Penandatangan NIK Penandatangan Nama Penandatangan Penghasilan Bruto
(tanpa format/tanda baca) (tanpa format/tanda Sesuai NIK
baca)
17 0 MOCH ROCHMAT FARMANS 10000000

Dasar Pengenaan Tarif (%) PPh Dipotong DTP Mendapatkan Fasilitas ?
Pajak (N/SKB/DTP/Lainnya)
10000000 5 500000 N
9000000 #N/A #N/A N
8000000 #N/A #N/A N
7000000 #N/A #N/A N
6000000 #N/A #N/A N
5000000 #N/A #N/A N
4000000 #N/A #N/A N
4000000 #N/A #N/A N
4000000 #N/A #N/A N
4000000 #N/A #N/A N
4000000 #N/A #N/A N
4000000 #N/A #N/A N
Nomor SKB Nomor Surat DTP Fasilitas PPh Lainnya
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
Tarif PPh Berdasarkan
Fas. PPh Lainnya
0
0
0
0
0
0
0
0
0
0
0
0
Kode Objek Pajak
21-401-01
21-401-02
21-402-01
21-499-99
21-100-03
21-100-07
21-100-08
21-100-09
21-100-10
21-100-11
21-100-12
21-100-13
21-100-99
27-100-99
21-100-01
21-100-02
Nama Objek Pajak
Uang Pesangon yang Dibayarkan Sekaligus
Uang Manfaat Pensiun, Tunjangan Hari Tua, atau Jaminan Hari Tua yang Dibayarkan Sekaligus
Honor dan Imbalan Lain yang Dibebankan kepada APBN atau APBD yang Diterima oleh PNS, Anggota TNI/POLRI, Pejabat Nega
Objek PPh Pasal 21 Final Lainnya
Upah Pegawai Tidak Tetap atau Tenaga Kerja Lepas
Imbalan Kepada Tenaga Ahli
Imbalan Kepada Bukan Pegawai yang Menerima Penghasilan yang Bersifat Berkesinambungan
Imbalan Kepada Bukan Pegawai yang Menerima Penghasilan yang Tidak Bersifat Berkesinambungan
Honorarium atau Imbalan Kepada Anggota Dewan Komisaris atau Dewan Pengawas yang tidak Merangkap sebagai Pegawai Te
Jasa Produksi, Tantiem, Bonus atau Imbalan Kepada Mantan Pegawai
Penarikan Dana Pensiun oleh Pegawai
Imbalan Kepada Peserta Kegiatan
Objek PPh Pasal 21 Tidak Final Lainnya PPh Pasal 26
Imbalan sehubungan dengan jasa, pekerjaan dan kegiatan, hadiah dan penghargaan, pensiun dan pembayaran berkala lainnya
Pegawai Tetap
Penerima Pensiun Berkala
KAP KJS KETERANGAN
411121 401 FINAL
411121 401 FINAL
411121 402 FINAL
411121 499 FINAL
411121 100 TIDAK FINAL
https://youtu.be/zXS6XTIP0fs
https://youtu.be/aTcjmIkEAwg
fs

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IDENTITAS PEMOTONG

NPWP INSTANSI PEMERINTAH 0 0 1 3 5 5 5 8 5 4

NAMA INSTANSI PEMERINTAH DINAS PENDIDIKAN PROVINSI JAWA BARAT

TAHUN PAJAK 2022

NAMA BENDAHARA MOCH ROCHMAT FARMANSJAH, SE

NIP BENDAHARA 197104252010011001

TANGGAL BUKTI POTONG 31/01/2023

3. Silakan Print Bukti Potong 1721 A2 dalam Sheet 1721 A2

4. Pembuatan Bukti Potong PPh Pasal 21 Final di Sheet PENGHASILAN FINAL

SPT Unifikasi Instansi Pemerintah di Sheet A2 Unifikasi

heet PENGHASILAN FINAL

Status Setahun Sebulan

TK/0 54,000,000 4,500,000

Masa Masa Penerima

Status Pegawai Penandatangan

NIK Penandatangan (tanpa

Jumlah Gaji dan Tunjangan Tunjangan Jumlah

BUKTI PEMOTONGAN PAJAK PENGHASILAN

DIREKTORAT JENDERAL PAJAK NOMOR : H.01 1 . 2 - 12 . 22 - 0000001 H.02 07 - 12

NAMA INSTANSI/ NPWP

A. IDENTITAS PENERIMA PENGHASILAN YANG DIPOTONG

1. NPWP : 953776866-913.223 6. JENIS KELAMIN : A.07 X LAKI-LAKI A.09 - PEREMPUAN

2. NIP/ 199012052022211010 7. NIK : A.09 3215090512900001

B. RINCIAN PENGHASILAN DAN PENGHITUNGAN PPh PASAL 21

KODE OBJEK PAJAK : X 21-100-01 21-100-02

1. GAJI POKOK/PENSIUN 23,034,000###

12. BIAYA JABATAN/ BIAYA PENSIUN 2,098,326###

15. JUMLAH PENGHASILAN NETO (11 - 14) 38,620,903###

D. TANDA TANGAN BENDAHARA

1. NPWP : D.01 00.135.558.5 - 428 . 000 4. TANGGAL & TANDA TANGAN

2. NAMA : D.02 MOCH ROCHMAT FARMANSJAH, SE D.04 31 - 01 - 2023

9537768669130223199012052022211010 ROHMAN SOFYAN,

Perum Grand Mu M 3215090512900001 TK 0

GURU AHLI PERTAMA 21-100-01 23034000 2303400 921360 26258760

0 13680000 2027760 0 41966520 0 41966520

2098326 1247291 3345617 38620903 0 38620903 54000000

001355585428000 MOCH ROCHMAT FARM

DINAS PENDIDIKAN PROVINSI JAWA BARAT 197104252010011001

1 31/01/2023 NPWP 9537768669130223 ROHMAN SOFYAN, ST

199012052022211010 ROHMAN SOFYAN, ST 21-402-01 NPWP

17 0 MOCH ROCHMAT FARMANSJAH, SE

10,000,000 10,000,000 5 500,000

BUKTI PEMOTONGAN PAJAK

A. IDENTITAS PENERIMA PENGHASILAN YANG DIPOTONG

1. NPWP : A.01 0 - . 0 2. NIK / NO. PASPOR : A.02 0

B. PPh PASAL 21 YANG DIPOTONG

(1) (2) (3) (4)

21 - 402 - 01 7,000,000 #N/A #N/A

1. NPWP : C.01 00.135.558.5 - 428 . 000 3. TANGGAL & TANDA TANGAN

2. NAMA : C.02 DINAS PENDIDIKAN PROVINSI JAWA BARAT C.03 31 - 01 - 2023

KODE OBJEK PAJAK PENGHASILAN PASAL 21 ( FINAL)

1. 21-401-01 Uang Pesangon yang Dibayarkan Sekaligus

1 31/01/2023 NPWP 9537768669130223 ROHMAN SOFYAN, ST

199012052022211010 ROHMAN SOFYAN, ST 21-402-01 NPWP

17 0 MOCH ROCHMAT FARMANS 10000000

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