Kop Surat Opd Lambang Daerah

PEMERINTAH KABUPATEN BATU BARA
SEKRETARIAT DAERAH
Jln. PERINTIS KEMERDEKAAN NO. 164 TELP. (0622) - 96782
LIMA PULUH – 21255
Lima Puluh,
Nomor : Kepada :
Sifat : ................................................. Yth. 1. .................................................;
Lampiran : ................................................. 2. .................................................;
Hal : .................................................. 3. .................................................;
4. .................................................;
5. .................................................;
6. ..................................................
di-
Tempat.
a.n. BUPATI BATU BARA

SEKRETARIS DAERAH
H. SAKTI ALAM SIREGAR, SH

PEMBINA UTAMA MADYA
NIP. 19630301 198602 1 002
Tembusan :
1. .................
2. ..............
SEKRETARIAT DAERAH
Jln. PERINTIS KEMERDEKAAN NO. 164 TELP. (0622) - 96782
LIMA PULUH – 21255
Lima Puluh,
Nomor : Kepada :
Sifat : ................................................. Yth. 1. .................................................;
Lampiran : ................................................. 2. .................................................;
Hal : .................................................. 3. .................................................;
4. .................................................;
5. .................................................;
6. ..................................................
di-
Tempat.
a.n. BUPATI BATU BARA

SEKRETARIS DAERAH
u.b.
ASISTEN .....................................
..................................................
..................................................
NIP. ..................................................
Tembusan :
1. .................
2. .................
NAMA PERANGKAT DAERAH
Jln. .................... NO. .......... TELP. (..........) - ............... FAX. (..........) - .........
WEBSITE ......... E-MAIL ......... KODE POS ..........
..................., ..........................
Nomor : Kepada :
Sifat : ................................................. Yth. 1. .................................................;
Lampiran : ................................................. 2. .................................................;
Hal : .................................................. 3. .................................................;
4. .................................................;
5. .................................................;
6. ..................................................
di-
Tempat.
KEPALA DINAS/ BADAN ..............

KABUPATEN BATU BARA
..................................................
..................................................
NIP. ..................................................
Tembusan :
1. .................
2. .................
KECAMATAN .............................
Jln. .................... NO. .......... TELP. (..........) - ............... FAX. (..........) - .........
..................., ..........................
Nomor : Kepada :
Sifat : ................................................. Yth. 1. .................................................;
Lampiran : ................................................. 2. .................................................;
Hal : .................................................. 3. .................................................;
4. .................................................;
5. .................................................;
6. ..................................................
di-
Tempat.
CAMAT...............................
..................................................
..................................................
NIP. ..................................................
Tembusan :
1. .................
2. ................
KECAMATAN ...............................
KELURAHAN ..............................
Jln. .................... NO. .......... TELP. (..........) - ............... FAX. (..........) - .........
..................., ..........................
Nomor : Kepada :
Sifat : ................................................. Yth. 1. .................................................;
Lampiran : ................................................. 2. .................................................;
Hal : .................................................. 3. .................................................;
4. .................................................;
5. .................................................;
6. ..................................................
di-
Tempat.
LURAH.....................................
..................................................
..................................................
NIP. ..................................................
Tembusan :
1. .................
2. .................
NAMA PERANGKAT DAERAH
UPTD ......................................
Jln. .................... NO. .......... TELP. (..........) - ............... FAX. (..........) - .........
..................., ..........................
Nomor : Kepada :
Sifat : ................................................. Yth. 1. .................................................;
Lampiran : ................................................. 2. .................................................;
Hal : .................................................. 3. .................................................;
4. .................................................;
5. .................................................;
6. ..................................................
di-
Tempat.
KEPALA UPTD .....................................
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..................................................
NIP. ..................................................
Tembusan :
1. .................
2. .................

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PEMERINTAH KABUPATEN BATU BARA

a.n. BUPATI BATU BARA

H. SAKTI ALAM SIREGAR, SH

a.n. BUPATI BATU BARA

KEPALA DINAS/ BADAN ..............

KEPALA UPTD .....................................

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