TANDA TERIMA TANDA TERIMA

BANTUAN AIR BERSIH DARI BANTUAN AIR BERSIH DARI

WONOGIRI MOUNTAIN BIKE (WMTB) WONOGIRI MOUNTAIN BIKE (WMTB)

Telah terima dari : WONOGIRI MOUNTAIN BIKE (WMTB) Telah terima dari : WONOGIRI MOUNTAIN BIKE (WMTB)

Air Bersih sebanyak : .................................................................. Air Bersih sebanyak : ..................................................................

Kepada : .................................................................. Kepada : ..................................................................

Alamat : Dusun ....................................................... Alamat : Dusun .......................................................

Desa/Kel ............................Rt / Rw............ Desa/Kel ............................Rt / Rw............

Kecamatan ................................................. Kecamatan .................................................

Giritontro, ............................ Giritontro, ............................

Mengetahui Penerima Mengetahui Penerima

Ketua RT / RW......................... Ketua RT / RW.........................

......................................... ......................................... ......................................... .........................................