a. Ditandatangani Walikota.
WALIKOTA PEKALONGAN
Kepada
Yth. ............................................
...........................................
di -
............................
SURAT EDARAN
NOMOR ………………………………….
TENTANG
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WALIKOTA PEKALONGAN
tanda tangan
Jalan…...Nomor…....Kota..….Kode Pos.….Telepon…...Faksimile……e-mail…..Website.....
WALIKOTA PEKALONGAN
Kepada
Yth. ............................................
...........................................
di -
............................
SURAT EDARAN
NOMOR………………………………….
TENTANG
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WALIKOTA PEKALONGAN
WAKIL WALIKOTA
tanda tangan
Jalan…...Nomor…....Kota..….Kode Pos.….Telepon…...Faksimile……e-mail…..Website......
c. Ditandatangani Sekretaris Daerah atas nama Walikota.
Kepada
Yth. ............................................
...........................................
di -
............................
SURAT EDARAN
NOMOR………………………………….
TENTANG
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tanda tangan
NAMA PEJABAT
Pangkat
NIP
TEMBUSAN: (apabila ada)
1. ...............................
2. ...............................
3. dan seterusnya.
(diberi garis bawah sesuai tembusan terakhir)