BERITA ACARA

MUSYAWARAH DUSUN
DALAM RANGKA PENYUSUNAN RPJM DESA
TAHUN 2022 – 2028
Berkaitan dengan pelaksanaan kegiatan Pengkajian Keadaan Desa, di Desa Lumpoknyo Kecamatan
Luwuk Kabupaten Banggai Provinsi Sulawesi Tengah dalam rangka Penyusunan RPJM Desa Tahun
2022– 2028, maka pada hari ini:

Hari dan Tanggal : ………………………………………

Jam : 08.00 s/d Selesai
Tempat : Balai Desa Lumpoknyo

telah diadakan kegiatan kegiatan musyawarah dusun/kelompok, yang telah dihadiri oleh wakil-wakil
kelompok, dusun dan tokoh masyarakat, serta unsur lain yang terkait Desa sebagaimana tercantum
dalam daftar hadir terlampir.

Materi yang dibahas, serta yang bertindak selaku unsur pimpinan rapat dan narasumber dalam
membahas kegiatan pengkajian keadaan Desa (PKD) melalui musyawarah dusun/kelompok adalah:

A. Materi
1. Pemetaan Potensi dan masalah;
2. Pengkajian dan Pemeringkatan Tindakan Potensi dan Masalah; dan
3. Serap aspirasi/gagasan masyarakat.

B. Unsur Pimpinan Rapat dan Narasumber

Pemimpin Musyawarah : …..……………………........................................ dari ..........
Notulen : …..……………………........................................ dari ..........
Narasumber : 1. …..…………………….................................... dari ..........
2. …..…………………….................................... dari ..........
3. …..…………………….................................... dari ..........
4. …..…………………….................................... dari ..........
Setelah dilakukan pembahasan dan diskusi terhadap materi, selanjutnya seluruh peserta musyawarah
dusun/kelompok menyepakati beberapa hal yang berketetapan menjadi kesepakatan akhir dari
musyawarah dusun/kelompok yaitu:

1. ………………………………………………………...................................……….....
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Keputusan diambil secara musyawarah mufakat/aklamasi dan pemungutan suara/voting.

Demikian Berita Acara ini dibuat dan disahkan dengan penuh tanggungjawab agar dapat dipergunakan
sebagaimana mestinya.

Mengetahui, Lumpoknyo, ....................... 2023

Kepala Dusun 1 Ketua Tim Penyusun RPJM Desa

JUFRI MOINTI RAFLI ISWANTO MOINTI, S.H

Mengetahui dan Menyetujui

Kepala Desa Wakil Masyarakat

MOH. AMIRULLAH LENGKAS AMIR NDEJA

 NOTULENSI

Agenda Kegiatan : Musyawarah Dusun 1

Hari dan Tanggal : 2023
Jam : 08.00 s.d. selesai
Notulen:
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Lumpoknyo, 2023
 Notulis,

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 DAFTAR HADIR
MUSYAWARAH DUSUN
DALAM RANGKA PENYUSUNAN RPJM DESA
TAHUN 2022 – 2028

Hari/Tanggal : ............., ....................... 2022

Jam : .................... WIB
Tempat : ................................................
Jumlah Peserta : .............. orang
Laki-laki : ................ orang, Perempuan : ................ orang
JABATAN/
NO NAMA L/P ALAMAT TANDA TANGAN
UNSUR
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 JABATAN/
NO NAMA L/P ALAMAT TANDA TANGAN
UNSUR
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Mengetahui, ....nama desa, ....................... 20....
Kepala Dusun Ketua Tim Penyusun RPJM Desa

.......................................... RAFLI ISWANTO MOINTI, S.H