Sumedang, ..............................................
Kepada Yth. :
Ketua BAZNAS Kabupaten Sumedang
di
SUMEDANG
SURAT PENGANTAR
Nomor : ..................................................................
No URAIAN BANYAKNYA KETERANGAN
Sumedang, ...................................................
Kepala Dinas/Instansi/Sekolah/Lembaga
..................................................................
....................................................................................
Kop Surat Sekolah / Madrasah
2. Pelaksana Harian :
Ketua : ......................................................
Sekretaris : ......................................................
Bendahara : ......................................................
Anggota : 1. ......................................................
2. ......................................................
Sumedang, ...................................................
....................................................................................