APLIKASI - PINTAR 1721 A2 2020

NAMA KANTOR / INSTANSI : UPT PUSKESMAS JARAI

NAMA BENDAHARA INSTANSI : BEND. GAJI

NPWP BENDAHARA : 89 249 . 183 . 8 - 309 . 000

CETAK A2
TAHUN PAJAK : 2021

NPWP PRIBADI BENDAHARA : 89 249 . 183 . 8 - 309 . 000

NAMA PRIBADI BENDAHARA : NURWANINGSIH, Am.Kep
NIP PRIBADI BENDAHARA : 198404042008012004

TANGGAL PEMOTONGAN : 31 12 2021

NOMOR AWAL BUPOT : 1 . 2 . 12 - 21 - 1

KOTA PEMBUATAN : LAHAT

"APLIKASI NON RESMI, TIDAK UNTUK DIPERJUALBELIKAN, AKIBAT HUKUM AKIBAT SALAH PENGGUNAAN APLIKASI INI DITANGGUNG MASING MASING
PENGGUNA (USER) APLIKASI INI, DAN SAYA MENYUTUJUI PERNYATAAN DI ATAS"

✘ SETUJU
BADAN KEPEGAWAIAN & PENGEMBANGAN SUMBER DAYA MANUSIA
 CETAK A2

TANGGUNG MASING MASING

 DATA PEGAWAI UNTUK 1721 A2

PENGHASILAN SATU TAHUN (TERMASUK GAJI KE-13 DAN KE-14) Pengurangan

Jumlah
NIK
Jumlah
SKPD
NPWP NIP Status JUMLAH Jumlah
No Nama Pegawai Alamat Pegawai Pangkat Golongan Jenis Kelamin NIK
Kawin Tanggung Jabatan Masa Perolehan
Penghasilan Tunj Tunj Penghasilan Lain Yg
PENGHASILAN
Pengurang
Penghasilan PTKP Penghasilan
Kena Pajak
PPh 21
Terutang
an Tunj Istri / Tunj Jumlah Gaji & Tunj Tunj Tunj BRUTO 1 TAHUN iuran Netto
Gaji Pokok Suami Anak Tunj Keluarga Perbaikan Struktural / Beras Khusus Lainnnya
Teratur Terpisah Dari Biaya Jabatan
Penghasilan Fungsional Gaji Pensiun

Perumahan Bukit Sejahterah Poligon Blok bb no 10 Kelurahan Karang Jaya

1 DINAS KESEHATAN 361832975309000 198105112010012003 dr.Icah Paramitri, M.Kes III D P 1604015105810001 TK 0 Ka PUSKESMAS 0112 Rp 42,217,200 - - 42,217,200 - 9,000,000 869,040 - - - 52,086,240 2,604,312 2,005,317 4,609,629 47,476,611 54,000,000 - -
Kec Gandus Kota Palembang
Tebat baru Ilir RT 03 RW 01 Kel Tebat giri indah kec Pagaralam selatan
2 DINAS KESEHATAN 480628734309000 19681210199002202 Hernawati,Am.Keb III D P 1672025002680001 K 1 Kasubag 0112 Rp 50,850,000 - 1,017,000 51,867,000 - 5,880,000 1,738,080 - - - 59,485,080 2,974,254 2,463,682 5,437,936 54,047,144 63,000,000 - -
kota Pagaralam
3 DINAS KESEHATAN 144991973309000 196409121988031005 Nasrul Ilmin, Am.Kep Desa Lawang Agung Lama Kecamatan Muara Payang Kabupaten Lahat III D L 1604281209640001 K 2 Perawat 0112 Rp 54,103,200 5,410,320 - 60,595,584 - 6,000,000 1,738,080 - - - 68,333,664 3,416,683 2,878,290 6,294,973 62,038,691 67,500,000 - -

4 DINAS KESEHATAN 570296038309000 196710121990022001 Efrida, Am.Keb Desa Jarai Kecamatan Jarai Kabupaten Lahat III D P 1604066901670001 HD Bidan 0112 Rp 54,103,200 - - 52,450,800 - 6,000,000 869,040 - - - 59,319,840 2,965,992 2,491,413 5,457,405 53,862,435 - 53,862,435 3,079,365

5 DINAS KESEHATAN 570296079309000 196703161989032003 Ili Guspawati, Am.Keb Pagar Gading Pagaralam Utara III D P 1672015603670001 K 2 Bidan 0112 Rp 54,103,200 5,410,320 1,082,064 58,744,896 - 6,000,000 2,607,120 - - - 67,352,016 3,367,600 2,790,382 6,157,982 61,194,034 67,500,000 - -

6 DINAS KESEHATAN 570296145309000 197003021993032002 Hasmiani,Am.Keb Desa Jarai Kecamatan Jarai Kabupaten Lahat III D P 1604064203700003 K 1 Bidan 0112 Rp 50,850,000 5,085,000 - 54,226,920 - 6,000,000 1,738,080 - - - 61,965,000 3,098,250 2,575,778 5,674,028 56,290,972 63,000,000 - -

7 DINAS KESEHATAN 147995120309000 198106042006042009 Yenni Pariana, SKM Kel. Karang dalo RT 03 tw 02 kec. Dempo Tengah Pagar Alam III D P 1604174406810001 K 3 Sanitarian 0112 Rp 42,217,200 4,221,720 1,688,688 46,174,104 - 6,000,000 3,476,160 - - - 55,650,264 2,782,513 2,193,269 4,975,782 50,674,482 72,000,000 - -

8 DINAS KESEHATAN 691834394309000 197411252006042012 Juslaini, Am.Kep Desa Karang Caya Kecamatan Suka Merindu Kabupaten Lahat III D P 1604066511740001 K 3 Perawat 0112 Rp 46,332,000 4,633,200 1,853,280 49,127,616 - 6,000,000 3,476,160 - - - 58,603,776 2,930,188 2,333,561 5,263,749 53,340,027 72,000,000 - -

9 DINAS KESEHATAN 160688826307000 197502281997032004 Yurniati, Amd.Kes Desa Bandar Aji Kecamatan Jarai Kabupaten Lahat III C P 1671076802750007 K 2 Perawat Gigi 0112 Rp 45,852,000 4,585,200 917,040 49,785,792 - 6,000,000 2,607,120 - - - #REF! - 2,364,825 2,364,825 - 67,500,000 - -

10 DINAS KESEHATAN 151271731309000 197805252007012004 Rasnili, Am.Kep Desa Suka Nanti Kecamatan Jarai Kabupaten Lahat III C P 1604066505780003 K 2 Perawat 0112 Rp 44,451,600 4,445,160 889,032 48,265,728 - 6,000,000 2,607,120 - - - 56,872,848 2,843,642 2,292,622 5,136,264 51,736,584 67,500,000 - -

11 DINAS KESEHATAN 691834386309000 197407142006042011 Erida Eftika, Am.Keb Jl.Mangga No.170 Blok.C Prumnas Nendagung Pagaralam III B P 1672025407740003 HD Bidan 0112 Rp 45,376,800 - - 43,990,800 - 3,180,000 869,040 - - - 48,039,840 2,401,992 2,089,563 4,491,555 43,548,285 - 43,548,285 2,177,414

12 DINAS KESEHATAN 157299173309000 198206252007012003 Yesi Hutriani Jln. Perintis Gang Mawar 4 No 03 RT 014 RW 005 Pagar Alam III B P 1672016506820002 K Perawat 0112 Rp 41,163,600 - - 40,083,600 - 3,180,000 869,040 - - - 44,132,640 2,206,632 1,903,971 4,110,603 40,022,037 - 40,022,037 2,001,102

Desa Talang Pasai Kel.Dempo Makmur Kec.Pagaralm Utara

13 DINAS KESEHATAN 892491838309000 198404042008012004 Nurwaningsih, Am.Kep III B P 1672014404840004 K 3 Perawat 0112 Rp 38,859,600 3,885,960 1,554,384 44,299,944 - 3,180,000 3,476,160 - - - 50,956,104 2,547,805 2,104,247 4,652,052 46,304,052 72,000,000 - -
Kota.Pagaralam
Suka Maju No. 11 RT/RW 004/002 Desa Sukorejo, Kec Pagar Alam Utara,
14 DINAS KESEHATAN 737157339309000 198803092020122003 dr.Ervina III B P 1672014903880001 K 1 Dokter Umum 0112 Rp 25,809,600 2,580,960 516,192 28,390,560 - 2,220,000 2,607,120 - - - 33,217,680 1,660,884 1,348,551 3,009,435 30,208,245 63,000,000 - -
Kota Pagar Alam
JL. R. Sukamto No.32 RT.042 RW.008 Kelurahan 8 Ilir Kecamatan Ilir
15 DINAS KESEHATAN 944146264301000 199309022020122002 drg.Ranny Etnadiah III B P 1671064209930010 K 1 Dokter Gigi 0112 Rp 25,809,600 2,580,960 - 28,390,560 - 2,220,000 1,738,080 - - - 32,348,640 1,617,432 1,348,551 2,965,983 29,382,657 63,000,000 - -
Timur Tiga
Jl. Mangga Rt 06 Kel. Taba Jemekeh, Kec. Lubuk Linggau Timur I, Lubuk
16 DINAS KESEHATAN 847547072303000 199406272020122004 Kurniawati, S.Farm,APT III B P 1673016706940001 K Apoteker 0112 Rp 25,809,600 2,580,960 - 25,809,600 - 2,220,000 1,738,080 - - - 29,767,680 1,488,384 1,225,956 2,714,340 27,053,340 - 27,053,340 1,352,667
Linggau
17 DINAS KESEHATAN 148550288309000 197501272007012003 Emi Hariyanti, Am.Keb Desa Suka Merindu Kecamatan Suka Merindu Kabupaten Lahat III A P 1604126701750001 K Bidan 0112 Rp 43,534,800 - - 42,206,400 - 3,180,000 869,040 - - - 46,255,440 2,312,772 2,004,804 4,317,576 41,937,864 - 41,937,864 2,096,893

18 DINAS KESEHATAN 691773410309000 197905072008012007 Henny Susulawati, Am.Keb Desa Suka Nanti Kecamatan Jarai Kabupaten Lahat III A P 1604064706790003 K 3 Bidan 0112 Rp 40,917,600 4,091,760 1,636,704 46,646,064 - 3,180,000 3,476,160 - - - 53,302,224 2,665,111 2,215,688 4,880,799 48,421,425 72,000,000 - -

Tebat Baru Ulu RT 002 RW 002 No 02 Kel Tebat Giri Indah Kec Pagar
19 DINAS KESEHATAN 718492911309000 198110222014082002 Dian Puspitasari, Am.Kep III A P 1604106210810007 K 3 Perawat 0112 Rp 38,456,400 3,845,640 1,538,256 43,840,296 - 3,180,000 3,476,160 - - - 50,496,456 2,524,822 2,082,414 4,607,236 45,889,220 72,000,000 - -
Alam Selatan Kota Pagar Alam
Jl. Abikusno Cokrosuyoso Lr.Sabar No.94 RT.03 RW.01 Kel.Kemang
20 DINAS KESEHATAN 939482519306000 199705132020122002 Anisa Lestari, SKM III A P 1671135305970005 TK Promkes 0112 Rp 24,762,240 - - 24,762,240 - 2,220,000 869,040 - - - 27,851,280 1,392,564 1,176,206 2,568,770 25,282,510 - 25,282,510 1,264,126
Agung Kec. Kertapati Palembang
21 DINAS KESEHATAN 665253308309000 198305012017042004 Mika Erlisa, Am,Keb Desa Sadan Kecamatan Jarai Kabupaten Lahat II D P 1604064105830001 K Bidan 0112 Rp 35,769,600 - - 33,270,000 - 2,880,000 869,040 - - - 37,019,040 1,850,952 1,580,325 3,431,277 33,587,763 - 33,587,763 1,679,388

22 DINAS KESEHATAN 665252151309000 198708132017042010 Deka Astariani, Am.Keb Desa Tanjung Menang Kecamatan Jarai Kabupaten Lahat II D P 1604065308870002 K Bidan 0112 Rp 33,618,000 - - 32,253,600 - 2,880,000 869,040 - - - 36,002,640 1,800,132 1,532,046 3,332,178 32,670,462 - 32,670,462 1,633,523

l.H.Sanusi Lr.bilal 2 Rt.38 Rw.06 Lebong Siareng . Kel.Sukabangun

23 DINAS KESEHATAN 944440379307000 199804232020122003 Nurul Fadhilah, Amd.GZ II C P 1671076304980011 TK Petugas Gizi 0112 Rp 22,097,280 - - 22,097,280 - 2,160,000 869,040 - - - 25,126,320 1,256,316 1,049,620 2,305,936 22,820,384 - 22,820,384 1,141,019
Kec.Sukarami Palembang
26 DINAS KESEHATAN X - - - - - - -
27 DINAS KESEHATAN X - - - - - - -
28 DINAS KESEHATAN X - - - - - - -
29 DINAS KESEHATAN X - - - - - - -
30 DINAS KESEHATAN X - - - - - - -
31 DINAS KESEHATAN X - - - - - - -
32 DINAS KESEHATAN X - - - - - - -
33 DINAS KESEHATAN X - - - - - - -
34 DINAS KESEHATAN X - - - - - - -
35 DINAS KESEHATAN X - - - - - - -
36 DINAS KESEHATAN X - - - - - - -
37 DINAS KESEHATAN X - - - - - - -
38 DINAS KESEHATAN X - - - - - - -
39 DINAS KESEHATAN X - - - - - - -
40 DINAS KESEHATAN X - - - - - - -
41 DINAS KESEHATAN X - - - - - - -
42 DINAS KESEHATAN X - - - - - - -
43 DINAS KESEHATAN X - - - - - - -
44 DINAS KESEHATAN X - - - - - - -
45 DINAS KESEHATAN X - - - - - - -
46 DINAS KESEHATAN X - - - - - - -
47 DINAS KESEHATAN X - - - - - - -
48 DINAS KESEHATAN X - - - - - - -
49 DINAS KESEHATAN X - - - - - - -
50 DINAS KESEHATAN X - - - - - - -
51 DINAS KESEHATAN X - - - - - - -
52 DINAS KESEHATAN X - - - - - - -
53 DINAS KESEHATAN X - - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
- - - - - - -
 1,080,000
7,560,000
-
-
-
-
-
-
-
4,578,000
-
-
-
-
-
-
-
-
-
-
24,795,000
17,640,000
13,720,000
13,720,000
13,720,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
4,860,000
-
-
13,720,000
7,560,000
7,560,000
7,560,000
7,560,000
1,080,000
7,560,000
15,120,000
-
-
-
-
6,480,000
-
-
-
-
-
6,075,000
17,640,000
7,560,000
17,640,000
13,720,000
13,720,000
13,720,000
7,560,000
7,560,000
13,440,000
-
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
-
7,560,000
-
-
-
-
-
-
-
-
-
-
-
26,325,000
13,720,000
13,720,000
11,760,000
16,520,000
7,560,000
16,240,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
5,400,000
7,560,000
-
-
-
-
-
-
-
-
-
-
-
24,795,000
17,640,000
13,720,000
13,720,000
13,720,000
7,560,000
-
-
-
-
-
-
-
-
13,720,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
8,280,000
7,560,000
-
-
-
-
-
7,560,000
7,560,000
7,560,000
7,560,000
-
-
-
-
-
-
-
-
-
-
-
26,325,000
13,720,000
13,720,000
13,720,000
13,720,000
7,560,000
7,560,000
7,560,000
-
-
14,560,000
7,560,000
7,560,000
4,860,000
7,560,000
7,310,000
-
-
-
-
-
-
26,325,000
17,640,000
13,720,000
13,720,000
-
13,720,000
13,720,000
-
7,560,000
7,560,000
7,560,000
 7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
-
-
4,860,000
-
11,200,000
-
4,860,000
4,860,000
7,560,000
7,560,000
7,560,000
-
-
-
4,578,000
-
5,400,000
-
-
7,280,000
2,100,000
4,900,000
-
-
16,800,000
16,800,000
16,800,000
16,800,000
-
16,800,000
16,800,000
13,720,000
7,000,000
11,900,000
11,900,000
11,900,000
11,900,000
11,900,000
11,900,000
16,800,000
12,750,000
16,800,000
16,800,000
16,800,000
11,900,000
16,800,000
13,720,000
7,560,000
7,560,000
3,710,000
7,000,000
7,000,000
-
7,000,000
7,000,000
-
7,000,000
7,000,000
7,000,000
4,550,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
7,000,000
10,500,000
10,500,000
10,500,000
7,000,000
7,000,000
7,000,000
7,000,000
8,400,000
7,000,000
10,500,000
10,500,000
8,400,000
7,000,000
8,250,000
10,500,000
-
-
8,400,000
7,000,000
10,920,000
-
10,500,000
10,500,000
8,400,000
6,000,000
10,500,000
8,400,000
17,640,000
13,720,000
13,720,000
7,560,000
7,560,000
7,560,000
7,980,000
7,560,000
-
2,160,000
-
-
-
10,500,000
-
-
7,000,000
7,000,000
7,000,000
2,650,000
7,000,000
-
7,000,000
7,000,000
7,000,000
7,000,000
-
7,000,000
7,000,000
14,560,000
7,000,000
7,000,000
4,885,000
7,000,000
7,000,000
7,000,000
3,710,000
7,000,000
5,355,000
2,650,000
3,710,000
7,000,000
10,920,000
3,710,000
4,005,000
7,000,000
7,000,000
-
-
7,000,000
10,570,000
3,710,000
3,710,000
7,000,000
7,000,000
3,710,000
10,500,000
10,500,000
10,500,000
3,710,000
2,450,000
8,400,000
13,440,000
-
14,000,000
3,710,000
7,000,000
-
-
4,550,000
8,400,000
5,700,000
10,500,000
10,190,000
-
-
-
-
-
-
3,360,000
3,710,000
-
8,400,000
3,710,000
3,710,000
3,710,000
3,710,000
-
3,710,000
3,710,000
3,710,000
3,710,000
3,710,000
3,710,000
4,200,000
3,710,000
3,710,000
3,710,000
3,710,000
-
3,710,000
3,710,000
3,710,000
3,710,000
3,710,000
3,710,000
3,710,000
3,710,000
3,710,000
3,710,000
6,300,000
3,710,000
3,710,000
-
-
3,710,000
4,200,000
-
6,300,000
3,710,000
3,710,000
6,300,000
6,300,000
3,710,000
10,878,000
6,300,000
2,650,000
3,710,000
7,560,000
-
-
-
3,710,000
3,710,000
3,710,000
3,710,000
3,535,000
3,535,000
3,245,000
3,710,000
3,535,000
-
-
-
3,385,000
3,535,000
3,535,000
3,710,000
3,710,000
3,710,000
3,385,000
-
-
3,710,000
3,710,000
-
7,560,000
-
3,360,000
-
3,360,000
-
-
-
-
-
-
-
-
3,360,000
-
-
-
-
-
-
-
-
-
-
-
-
-
-
24,795,000
17,640,000
13,720,000
13,720,000
13,720,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
-
-
-
10,640,000
7,560,000
2,700,000
7,560,000
4,860,000
-
-
-
-
-
6,480,000
7,560,000
-
-
-
-
26,325,000
17,640,000
13,720,000
12,840,000
13,720,000
13,720,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
4,860,000
7,560,000
7,560,000
4,860,000
-
-
-
-
-
-
-
2,700,000
-
 -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
24,795,000
17,080,000
12,840,000
7,560,000
-
13,720,000
13,720,000
13,720,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
1,080,000
-
7,560,000
5,400,000
6,960,000
7,560,000
-
-
-
-
-
-
-
-
-
-
26,325,000
14,280,000
13,720,000
7,560,000
-
13,720,000
13,720,000
5,740,000
4,860,000
7,560,000
7,560,000
7,560,000
-
-
-
7,560,000
7,560,000
4,860,000
7,560,000
7,035,000
4,860,000
7,560,000
7,560,000
7,560,000
-
-
-
-
-
-
-
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5,446,000
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5,446,000
5,446,000
4,578,000
4,578,000
4,578,000
4,578,000
4,578,000
4,578,000
4,578,000
5,446,000
5,446,000
5,446,000
5,446,000
5,930,000
5,446,000
4,578,000
4,578,000
-
4,045,000
4,578,000
-
-
5,446,000
5,446,000
5,446,000
4,578,000
4,578,000
4,578,000
4,578,000
4,578,000
-
18,032,000
5,446,000
6,090,000
4,578,000
4,578,000
4,578,000
4,578,000
4,045,000
6,300,000
4,578,000
-
-
5,446,000
5,446,000
4,578,000
4,578,000
4,004,000
7,140,000
5,446,000
4,578,000
4,578,000
4,578,000
4,004,000
4,888,000
4,578,000
4,578,000
6,090,000
4,578,000
4,578,000
4,578,000
4,578,000
5,446,000
5,446,000
6,090,000
4,578,000
4,578,000
4,004,000
-
4,578,000
4,578,000
-
4,004,000
-
6,090,000
4,578,000
8,582,000
4,004,000
4,004,000
7,140,000
-
5,446,000
7,140,000
4,578,000
2,289,000
6,090,000
4,578,000
4,578,000
2,616,000
4,578,000
4,578,000
4,004,000
4,004,000
-
-
5,446,000
4,578,000
4,578,000
-
4,004,000
6,090,000
4,578,000
4,578,000
4,578,000
-
-
4,888,000
4,578,000
4,578,000
4,578,000
4,578,000
5,446,000
7,140,000
4,578,000
4,578,000
4,578,000
7,140,000
4,578,000
4,578,000
4,578,000
4,578,000
4,578,000
4,004,000
4,004,000
7,140,000
4,578,000
4,578,000
4,578,000
-
5,446,000
7,140,000
4,578,000
-
4,004,000
5,446,000
5,446,000
6,090,000
4,578,000
8,582,000
7,140,000
4,578,000
4,578,000
7,140,000
5,446,000
4,578,000
4,578,000
4,578,000
5,446,000
4,578,000
4,004,000
8,582,000
-
4,004,000
-
-
6,090,000
4,578,000
7,140,000
4,578,000
4,578,000
4,578,000
9,156,000
4,578,000
4,578,000
4,578,000
4,578,000
-
5,446,000
4,578,000
4,578,000
4,578,000
7,140,000
4,578,000
4,578,000
7,140,000
4,578,000
4,578,000
4,578,000
4,578,000
4,004,000
6,090,000
4,578,000
4,004,000
12,586,000
4,578,000
4,578,000
4,578,000
8,582,000
4,578,000
4,578,000
4,578,000
4,578,000
-
4,004,000
17,640,000
13,720,000
7,560,000
7,560,000
7,560,000
7,560,000
7,360,000
6,860,000
-
980,000
-
-
-
-
-
13,720,000
17,640,000
7,560,000
7,560,000
7,560,000
-
15,120,000
4,860,000
6,860,000
6,860,000
-
-
-
-
-
-
-
-
-
-
-
24,795,000
13,720,000
-
-
5,880,000
-
15,120,000
13,720,000
8,440,000
13,720,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
-
-
-
-
-
-
-
-
-
-
 -
-
-
-
-
-
-
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
7,560,000
-
-
-
-
6,860,000
-
-
-
-
-
-
-
-
-
-
-
-
-
7,560,000
7,560,000
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
5,446,000
5,446,000
5,446,000
5,446,000
5,446,000
5,930,000
4,578,000
4,578,000
4,578,000
4,578,000
-
11,966,000
7,140,000
5,446,000
4,578,000
4,578,000
4,578,000
4,578,000
4,086,000
7,140,000
4,888,000
4,826,000
4,578,000
4,578,000
4,578,000
4,004,000
5,930,000
4,888,000
5,446,000
5,446,000
4,578,000
4,578,000
4,578,000
327,000
-
5,446,000
10,892,000
7,140,000
5,446,000
-
4,578,000
4,578,000
4,578,000
-
5,446,000
5,446,000
4,578,000
4,578,000
4,578,000
4,578,000
-
5,446,000
5,446,000
5,446,000
5,446,000
7,140,000
5,446,000
4,578,000
4,578,000
5,446,000
5,446,000
5,446,000
5,446,000
5,446,000
5,446,000
4,826,000
5,446,000
4,578,000
5,010,000
5,446,000
5,446,000
5,446,000
5,446,000
5,446,000
7,840,000
5,446,000
5,446,000
5,446,000
5,446,000
5,446,000
5,446,000
4,578,000
4,578,000
4,578,000
4,578,000
5,040,000
4,578,000
4,578,000
4,578,000
4,578,000
4,578,000
9,978,000
4,578,000
5,446,000
7,156,000
4,578,000
4,578,000
11,438,000
4,578,000
4,578,000
-
2,616,000
4,578,000
-
-
4,004,000
5,446,000
5,446,000
5,446,000
4,578,000
4,578,000
-
-
7,140,000
5,446,000
4,578,000
4,578,000
4,578,000
-
-
4,578,000
4,578,000
4,578,000
-
7,140,000
4,578,000
9,438,000
4,578,000
-
-
4,578,000
4,578,000
4,578,000
2,520,000
-
4,578,000
7,020,000
-
-
-
area staples

BUKTI PEMOTONGAN PAJAK PENGHASILAN PASAL 21

BAGI PEGAWAI NEGERI SIPIL ATAU ANGGOTA FORMULIR 1721 - A2
TENTARA NASIONAL INDONESIA ATAU ANGGOTA Lembar 1 : Untuk Penerima Penghasilan
POLISI REPUBLIK INDONESIA ATAU PEJABAT NEGARA Lembar 2 : Untuk Pemotong

###
ATAU PENSIUNNYA MASA PEROLEHAN
KEMENTERIAN KEUANGAN RI PENGHASILAN [mm - mm]
DIREKTORAT JENDERAL PAJAK
NOMOR : H.01 1 . 2 - 12 - 21 - 1 H.02
01
- 12

NAMA INSTANSI/
UPT PUSKESMAS JARAI
BADAN LAIN : H.03 NPWP BENDAHARA : H.05
NAMA
BENDAHARA BEND. GAJI 89.249.183.8 309 000
: H.04 - -

A. IDENTITAS PENERIMA PENGHASILAN YANG DIPOTONG

1 NPWP : A.01 36.183.297.5.309.000 6 JENIS KELAMIN : A.07 LAKI-LAKI A.08 X PEREMPUAN
NIP/ : 7 NIK : A.09 1604015105810001
2 198105112010012003
NRP A.02
3 NAMA : A.03 dr.Icah Paramitri, M.Kes 8 STATUS/JUMLAH TANGGUNGAN KELUARGA UNTUK PTKP
4 PANGKAT/ A.10 A.11 A.12
GOLONGAN III D K/ TK / 0 HB /
: A.04 A.05

5 ALAMAT PERUMAHAN BUKIT SEJAHTERAH POLIGON BLOK NAMA JABATAN A.13 KA PUSKESMAS
: A.06 9
###
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 42,217,200
2. TUNJANGAN ISTERI -
3. TUNJANGAN ANAK -
4. JUMLAH GAJI DAN TUNJANGAN KELUARGA (1 S.D. 3) 42,217,200
5. TUNJANGAN PERBAIKAN PENGHASILAN -
6. TUNJANGAN STRUKTURAL/FUNGSIONAL 9,000,000
7. TUNJANGAN BERAS 869,040
8. TUNJANGAN KHUSUS -
9. TUNJANGAN LAIN-LAIN -
PENGHASILAN TETAP DAN TERATUR LAINNYA YANG PEMBAYARANNYA TERPISAH DARI
10.
PEMBAYARAN GAJI
-
11. JUMLAH PENGHASILAN BRUTO (4 S.D. 10) 52,086,240
PENGURANGAN
12. BIAYA JABATAN/BIAYA PENSIUN 2,604,312
13. IURAN PENSIUN ATAU IURAN THT/JHT 2,005,317
14. JUMLAH PENGURANGAN ( 12 S.D. 14) 4,609,629
PENGHITUNGAN PPh PASAL 21
15. JUMLAH PENGHASILAN NETTO (11 - 14) 47,476,611
16. PENGHASILAN NETO MASA PAJAK SEBELUMNYA -
17. JUMLAH PENGHASILAN NETO UNTUK PENGHITUNGAN PPh PASAL 21 (SETAHUN/DISETAHUNKAN) 47,476,611
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 PAJAK SEBELUMNYA -
22. PPh PASAL 21 TERUTANG -
23. PPh PASAL 21 YANG TELAH DIPOTONG DAN DILUNASI
23A. ATAS GAJI DAN TUNJANGAN -
ATAS PENGHASILAN TETAP DAN TERATUR LAINNYA YANG PEMBAYARANNYA TERPISAH
23B.
DARI PEMBAYARAN GAJI
-

C. PEGAWAI TERSEBUT : C.01 DIPINDAHKAN C.02 PINDAHAN C.03 BARU C.03 PENSIUN
D. TANDA TANGAN BENDAHARA
1. NPWP : D.01 89.249.183.8-309.000 3. TANGGAL & TANDA TANGAN STEMPEL & TANDA TANGAN

D.02 NURWANINGSIH, Am.Kep C.03 31/12/2021

2. NAMA :
[dd - mm - yyyy]
D.02 198404042008012004
3. NIP/NRP :
 THANKS TO
-

semua pihak yang telah membantu terbentuknya aplikasi ini d

disebutkan namanya di sini atas saran, kritik, motivasi, dan araha

FURTHER UPDATE & BUG FIX

- akomodasi WP dengan penghasilan tidak full Jan - Des karena pindah keluar
- akomodasi WP dengan penghasilan tidak full karena pensiun
- akomodasi WP dengan penghasilan tidak full karena pindah masuk
- akomodasi WP dengan status HB
- akomodasi WP dengan penghasilan tidak full karena baru CPNS
-
-

LAST ACTION

- Button Print Selected Pages

- Button Print Yes Continue Print or Cancel Print
- Lock Y2 In Sheet Data Pegawai
ANKS TO

nya aplikasi ini dan pihak pihak yang tidak bisa

tivasi, dan arahan terutama mengenai VB coding.

TE & BUG FIX

TAHUN PAJAK PTKTP RUPIAH MASA BULAN

2018 TK0 54,000,000 1 01

2019 TK1 58,500,000 2 02
2020 TK2 63,000,000 3 03
2021 TK3 67,500,000 4 04
2022 K0 58,500,000 5 05
2023 K1 63,000,000 6 06
K2 67,500,000 7 07
K3 72,000,000 8 08
9 09
10 10
11 11
12 12
HARI TANGGAL

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