D Hasil Provinsi

BERITA ACARA DAN SERTIFIKAT REKAPITULASI HASIL PENGHITUNGAN PEROLEHAN SUARA MODEL
PARTAI POLITIK DAN CALON ANGGOTA DEWAN PERWAKILAN RAKYAT PROVINSI D. HASIL KECAMATAN-
DARI SETIAP TPS DALAM WILAYAH KECAMATAN DPRD PROV
PEMILIHAN UMUM TAHUN 2024 HALAMAN 1
KECAMATAN/........... *) : CIGUDEG
KABUPATEN/KOTA : BOGOR
PROVINSI : JAWA BARAT
DAERAH PEMILIHAN : JAWA BARAT 6
Pada hari ini ……………….............. tanggal ………………........................ bulan ……………..........…............ tahun dua ribu ........................................................, Panitia Pemilihan Kecamatan (PPK)
Kecamatan / .................. *) ………………...................................... telah melaksanakan kegiatan rekapitulasi hasil penghitungan perolehan suara di tingkat kecamatan atau nama lain dalam wilayah kerja
PPK pada Pemilihan Umum Tahun 2024 bertempat di:
............................................................................................................................................................................................................................................
Pelaksanaan rekapitulasi hasil penghitungan perolehan suara Partai Politik dan Calon Anggota Dewan Perwakilan Rakyat Provinsi disaksikan oleh Saksi Partai Politik, serta diawasi oleh Panitia
Pengawas Pemilu Kecamatan untuk melaksanakan rekapitulasi hasil penghitungan suara Pemilihan Umum Calon Anggota Dewan Perwakilan Rakyat Provinsi.
Pada rapat rekapitulasi hasil penghitungan perolehan suara, PPK menyusun rekapitulasi hasil penghitungan perolehan suara tingkat kecamatan berdasarkan formulir Model C.HASIL-DPRD PROV dari
seluruh TPS dalam wilayah kecamatan atau nama lain.
Kecamatan/ .............. *) ............................... dalam rekapitulasi hasil penghitungan perolehan suara Partai Politik dan Calon Anggota Dewan Perwakilan Rakyat Provinsi ada/tidak ada *) kejadian
khusus dan/atau keberatan saksi sesuai dengan yang tercatat dalam formulir Model D.Kejadian Khusus dan/atau Keberatan Saksi-KPU tingkat kecamatan atau nama lain.
Demikian Berita Acara dan Sertifikat ini dibuat dalam …….. (……………) rangkap dan masing-masing rangkap ditandatangani oleh Ketua dan Anggota PPK serta Saksi Partai Politik yang hadir dilampiri
hasil perolehan suara di TPS.
NAMA DAN TANDA TANGAN PANITIA PEMILIHAN KECAMATAN

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

NAMA DAN TANDA TANGAN SAKSI PARTAI POLITIK
1. Partai Kebangkitan Bangsa 2. Partai Gerakan Indonesia Raya 3. Partai Demokrasi Indonesia Perjuangan 4. Partai Golongan Karya 5. Partai NasDem
6. Partai Buruh 7. Partai Gelombang Rakyat Indonesia 8. Partai Keadilan Sejahtera 9. Partai Kebangkitan Nusantara 10. Partai Hati Nurani Rakyat
11. Partai Garda Republik Indonesia 12. Partai Amanat Nasional 13. Partai Bulan Bintang 14. Partai Demokrat 15. Partai Solidaritas Indonesia
16. PARTAI PERINDO 17. Partai Persatuan Pembangunan 24. Partai Ummat
b0419d42-3ba4-4873-b9d5-58c895ebb1ed-pemilu(0)-2024-02-26-061752
table class="main-table">
MODEL
D. HASIL KECAMATAN-DPRD PROV
Halaman 2 - 1
REKAPITULASI TINGKAT KECAMATAN
NO. URAIAN
JUMLAH
I DATA PEMILIH DAN PENGGUNAAN HAK PILIH
1 2 3 4
A DATA PEMILIH
LK 50.307
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 45.310
JML 95.617
B PENGGUNA HAK PILIH
LK 38.877
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 38.799
JML 77.676
LK 53
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 52
JML 105
LK 207
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 202
JML 409
LK 39.137
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 39.053
JML 78.190
NO. URAIAN
JUMLAH
II DATA PENGGUNAAN SURAT SUARA
1 2 3
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 97.820
2 Jumlah surat suara yang digunakan 78.190
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 76
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 19.554
NO. URAIAN
JUMLAH
III DATA PEMILIH DISABILITAS
1 2 3 4
LK 23
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 36
JML 59
MODEL
Halaman 2 - 2 - 1
NO. URAIAN
JUMLAH
IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON
1 2 3
NOMOR, NAMA PARTAI DAN CALON
A.1 1. Partai Kebangkitan Bangsa 2.454
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 2.616
2. DINDIN ABDULLAH GHOZALI 314
3. H. AMIR AMIRULOH, S.H. 300
4. NAFIZUL ALHAFIZRANA 132
5. BAGUS DJATI KUSUMA 196
6. SHOLEHATUN NASIHA, S.Kom. 72
7. Ir. AAN SURYA PRIYANA 110
8. AGUS MULYADI, S.Pd. 58
9. ROSALINDA RAMDHANIAH, S.Ag. 30
10. TEGUH YULIANTO, S.T. 15
11. RISMA PUJI RIANTI 57
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 6.354
A.1 2. Partai Gerakan Indonesia Raya 4.195

A.2 1. H. RICKY KURNIAWAN, Lc. 1.772
1.701
2. Ir. PRASETYAWATI, M.M.
3. UDI SUHANDORO 396

4. H. CECEP GOGOM, S.Ag., M.Pd. 734
5. YORDA IMAM SUTOMO, S.H. 240
6. NIAR YUNIAR 272
7. Dr. AGUS SUHENDI, M.Pd. 185
8. SUTIYA ANJANI 136
9. TOTING SUPRIATNA 42
10. YANTI TARYATI 90
11. CAHYO FITRIADI 39
MODEL
Halaman 2 - 2 - 2
NO. URAIAN
JUMLAH
1 2 3
A.1 3. Partai Demokrasi Indonesia Perjuangan 1.991
A.2 1. Hj. ASYANTI ROZANA, S.E. 914
2. DONI MARADONA HUTABARAT, S.H. 1.459
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 317
4. Hj. DIAN ROSITA 293
5. THARIQ HALILINTAR 191
6. H. AGUS RIADI 76
7. IRAWATY OCTORA, S.E., M.Si. 42
8. MANGONTANG SIMANJUNTAK 20
9. BAMBANG SUMANTRI, S.Sos. 31
10. EUGINIA NATANIA PUTRI 37
11. ALUN HIMAWAN 12
A.1 4. Partai Golongan Karya 3.287

A.2 1. SAMSUL HIDAYAT, S.H. 3.407
2. H. KUSNADI, S.I.P. 860
3. KURNIAWATYNINGSIH, S.E. 343
4. ADI RESTU PERMADI 365
5. KHAERUL ANAM, S.Pi., M.Si. 216
6. LINDA OCTAVIA 167
7. H. HELMI BUSTOMI 218
8. MUNAWARAH SUNUSI, S.E., M.Si. 76
9. RENO ANGGARA MUKTI, S.ST.Par. 1.771
10. FAJAR SETIAWAN 94
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 40
MODEL
Halaman 2 - 2 - 3
NO. URAIAN
JUMLAH
1 2 3
A.1 5. Partai NasDem 849
A.2 1. M. RIZKY 1.538
2. DONDY DWIGUNTIA 1.314
3. VICA FITHRI NOER AZIZAH 52
4. MELIHASRAT JAYA ZAI, S.E. 28
5. DELLA PUSPITA 97
6. AJID, S.Ag. 34
7. UMMI NURAENI, S.H. 28
8. AHMAD ROUF, S.I.P., M.Si. 39
9. MUHAMAD RIDWAN 53
10. AWALUDDIN, S.T. 18
11. ARIFIN, S.Hut. 1.106
A.1 6. Partai Buruh 215

A.2 1. Komarudin 80
2. Krisdianto, S.H. 27
3. Mira Sari La Puppung, S.E. 15

4. Agus Sarjanto, S.H. 14
5. Sugiarta 10
6. Lilis Minarni 26
7. Abdul Oir, S.H. 7
8. Ade Yuswandi 6
9. Rinda Ayu Pratiwi, S.Sos. 6
10. SAHRUL BAHRI 3
11. Eva Pusvita Sari, S.Kom. 7
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 416
MODEL
Halaman 2 - 2 - 4
NO. URAIAN
JUMLAH
1 2 3
A.1 7. Partai Gelombang Rakyat Indonesia 362
A.2 1. WIWID PURWAWAN 113
2. Hj. LULU MASLUCHAH, Lc. 80
3. NASRUDDIN 62
4. NAFIZA 37
5. FERRY ARDIAN AR. 18
6. ANDON TEGAR PRIBADI 8
7. RIZKY RADIANTO FAJRI 34
8. LINA KADARMINI 12
9. ISLAM RAHIMI HUSAIN, S.T. 6
10. ADE SAEPUL, S.Ag. 6
11. MUHTADIN 9
A.1 8. Partai Keadilan Sejahtera 1.091

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 784
2. DEDI AROZA, S.Ag., M.Si. 262
3. Dra. IIN SUPRIHATIN 202
4. MOCHAMAD ICHSAN M., S.T. 346
5. NUR LAELA TUROHMAH, S.E. 73
6. SOPIAN APIP, S.E. 59
7. ZULFIKAR MAHBUB ROBBANI 265
8. ABDURROKHIM, S.Pt. 134
9. DEWI RACHMAWATI, S.E. 47
10. MURDOKO, S.H. 39
11. RETNO UMMY ASTHASARI, S.T.P. 76
MODEL
Halaman 2 - 2 - 5
NO. URAIAN
JUMLAH
1 2 3
A.1 9. Partai Kebangkitan Nusantara 160
A.2 1. Neneng Rohimah 17
2. Irwan Yani 10
3. JAN ADOLF HUKUBUN 7
4. FRANSISKA DWI KESDIATIK 6
5. Imam Fauzi 7
6. Sri Rosmaryati 3
7. ALI MUNAJIB 4
8. Aprizal Hamid 0
9. Nadya Oktafiani 17
A.1 10. Partai Hati Nurani Rakyat 123

A.2 1. ELIA 57
2. R. AGUNG CAHYA GUNARDI 44
3. ARIEF BUDIMAN 42
4. HERVINA LESTARI 17
5. ANDREAS KURNIAWAN E 13
6. DHEMAS PRADITYA 7
7. YASMIN INAYAH NATA BUWANA 10
8. NIRWAN PRATAMA PUTRA 1
9. RD. MOCH. FARIEDHAN 5
MODEL
Halaman 2 - 2 - 6
NO. URAIAN
JUMLAH
1 2 3
A.1 11. Partai Garda Republik Indonesia 160
A.2 1. A. KHALIK 34
2. YULIANTI BILAKONGA 21
A.1 12. Partai Amanat Nasional 1.796

A.2 1. H. SUPONO 655
2. H. PERMADI DALUNG, S.E., M.M. 4.824
3. SARASWATI 338
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 1.726
5. CEPI AL HAKIM, S.T.P., M.Si. 106
6. ASTRI SARTIKA 131
7. REGIVAL PUTRA ADRIAN 56
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 102
9. MERRY APRIYANTI 38
10. IIM SOLIHATI 24
11. ANI NURMAYANTI 49
MODEL
Halaman 2 - 2 - 7
NO. URAIAN
JUMLAH
1 2 3
A.1 13. Partai Bulan Bintang 290
A.2 1. SOLAHUDDIN, S.H., M.H. 258
2. AGUS SUKARNA WIJAYA 43
3. FITRIASARI 43
4. DJUMHAWAN R PERMANA 17
5. Deni Rusydiana, S.H.I. 5
6. YANI SURYANI FIKRIAH 10
7. WAWANG HUSNAWATI 3
8. Sanusi Permana 4
9. Mochammad Muzaqi 8
10. MOCHAMAD MORO ASIH 4
A.1 14. Partai Demokrat 819

A.2 1. DEDE CANDRA SASMITA, S.Ag. 1.716
2. MANATAP P SIMANJUNTAK 147
3. ANDRIYANTI WIJAYA 120
4. SAIFUL 91
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 74

6. ARNY NURANI SANGAJI 33
7. REDIKA SEGARA, S.E. 25
8. KARDAN 11
9. HARKES WOROWATI W. A. 84
10. NAUFAL ANDHIKA IRAWAN 28
11. ENDAH HENDRAWASIH 29
MODEL
Halaman 2 - 2 - 8
NO. URAIAN
JUMLAH
1 2 3
A.1 15. Partai Solidaritas Indonesia 311
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 154
2. FEBRY CITRA, S.T., M.A.B. 162
3. SIANA RIA, S.E., M.M. 47
4. MUHAMMAD ADE ALIYUDIN, S.H. 134
5. JASIMAN SITORUS, S.Kom., M.M. 25
6. DIAH WINARSIH 16
7. GUNADI, M.Ag. 25
8. DESI FITRI DIANA 20
A.1 16. PARTAI PERINDO 164

A.2 1. RESITA KANIYA 211
2. AGUS WINARNO 51
3. Drs. SUMARWAN SASTRA 37
4. NENDEN BANURIAH, S.Pd. 19
5. AMARENS MANUHUTU 7
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 18
7. YURIZAL, S.E., M.M. 68

8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 13
9. ELLY MARYANTI 24
10. RAHMAT HIDAYAT 11
11. MOHAMAD SATIBI 8
MODEL
Halaman 2 - 2 - 9
NO. URAIAN
JUMLAH
1 2 3
A.1 17. Partai Persatuan Pembangunan 1.745
A.2 1. H. MUHAMAD ROMLI, A.Md. 1.540
2. JUHANTA, S.T. 248
3. DWI ARYANTI, S.E. 703
4. IRFAN DARAJAT 900
5. FERRY PERDIAN 280
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 97
7. YENTI NASHI HATUL UMMAH 137
8. ABDUL ROHIM, S.Si., Apt. 69
9. GUNAWAN 72
10. RIA ANWAR 35
11. RIKE ISKANDAR 28
A.1 24. Partai Ummat 104

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 100
2. SELLY AFRIDA OLTAR, S.I.P. 22
3. H. SUMIRAT SAPTA HADI, S.Ag. 14
4. Drs. H. ASRI AL JUFRI, M.Si. 8
5. RITA HERLINA, S.E. 10
6. Drs. MOCH ZAENAL AL AQILI 7
7. FAUZIAH TABRIYANI 3
8. HERRY SUKARTA, S.E. 9
9. JAKA JATI NUR ALAM 11
MODEL
Halaman 2 - 3
NO. URAIAN
JUMLAH
V DATA SUARA SAH DAN TIDAK SAH
1 2 3
A. JUMLAH SELURUH SUARA SAH 64.219
B. JUMLAH SUARA TIDAK SAH 13.971
C. JUMLAH SELURUH SUARA SAH DAN SUARA TIDAK SAH (V.A + V.B) 78.190

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1
REKAPITULASI HASIL PEROLEHAN SUARA TPS

KELURAHAN/DESA …......................: SUKAMAJU
NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 TPS 014 TPS 015 JUMLAH PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 140 97 123 147 155 163 157 159 127 148 165 140 150 115 154 2.140
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 137 86 116 137 119 136 142 140 120 151 135 117 138 111 144 1.929
JML 277 183 239 284 274 299 299 299 247 299 300 257 288 226 298 4.069
LK 115 69 82 100 114 133 140 96 97 128 117 107 146 98 118 1.660
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 117 80 95 109 108 114 128 113 102 137 111 98 136 97 129 1.674
JML 232 149 177 209 222 247 268 209 199 265 228 205 282 195 247 3.334
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
JML 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
LK 0 0 3 0 0 0 0 0 0 1 0 0 4 2 0 10
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 0 0 2 0 0 0 0 0 0 0 0 1 2 0 0 5
JML 0 0 5 0 0 0 0 0 0 1 0 1 6 2 0 15
LK 115 69 85 100 114 133 140 96 97 129 117 107 150 100 118 1.670
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 117 80 97 109 108 114 129 113 102 137 111 99 138 97 129 1.680
JML 232 149 182 209 222 247 269 209 199 266 228 206 288 197 247 3.350
NO. URAIAN RINCIAN

TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS JUMLAH
001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 283 187 244 290 280 305 305 305 252 305 306 263 294 232 304 4.155
2 Jumlah surat suara yang digunakan 232 149 182 209 222 247 269 209 199 266 228 206 288 197 247 3.350
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 2
Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara
4 51 38 62 81 58 58 36 96 53 38 78 57 6 34 57 803
cadangan
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 TPS 014 TPS 015 JUMLAH PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 TPS 027 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A DATA PEMILIH
LK 2.140 149 139 136 146 148 151 155 144 123 110 148 103 3.792
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 1.929 126 141 121 127 143 113 130 126 98 101 146 94 3.395
JML 4.069 275 280 257 273 291 264 285 270 221 211 294 197 7.187
LK 1.660 113 97 98 102 123 127 114 106 89 88 118 70 2.905
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.674 100 111 98 112 123 101 110 98 67 84 129 82 2.889
JML 3.334 213 208 196 214 246 228 224 204 156 172 247 152 5.794
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 1 0 0 0 0 0 0 0 0 0 0 0 0 1
JML 1 0 0 0 0 0 0 0 0 0 0 0 0 1
LK 10 0 0 0 0 0 0 2 0 0 0 0 0 12
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 5 0 0 0 0 0 0 3 0 0 0 0 0 8
JML 15 0 0 0 0 0 0 5 0 0 0 0 0 20
LK 1.670 113 97 98 102 123 127 116 106 89 88 118 70 2.917
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.680 100 111 98 112 123 101 113 98 67 84 129 82 2.898
JML 3.350 213 208 196 214 246 228 229 204 156 172 247 152 5.815
NO. URAIAN RINCIAN

JUMLAH TPS TPS TPS TPS TPS TPS TPS TPS TPS
II DATA PENGGUNAAN SURAT SUARA TPS 025 TPS 026 TPS 027 JUMLAH AKHIR
PINDAHAN 016 017 018 019 020 021 022 023 024
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 4.155 281 288 263 279 297 270 290 276 226 216 300 200 7.341
2 Jumlah surat suara yang digunakan 3.350 213 208 196 214 246 228 229 204 156 172 247 152 5.815
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 2 0 0 0 0 0 0 0 0 1 0 0 0 3
4 803 68 80 67 65 51 42 61 72 69 44 53 48 1.523
cadangan
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 TPS 027 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
LK 0 0 0 0 0 0 0 0 0 0 0 1 0 1
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 0 0 0 0 0 0 0 0 0 0 0 2 0 2
JML 0 0 0 0 0 0 0 0 0 0 0 3 0 3
LAMPIRAN MODEL
Halaman 2 - 1 Lembar 1

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 TPS 014 TPS 015 JUMLAH PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 1. Partai Kebangkitan Bangsa 3 3 2 7 8 4 1 11 1 10 22 12 5 10 11 110
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 1 0 5 21 6 71 132 37 11 22 14 15 11 3 46 395
2. DINDIN ABDULLAH GHOZALI 0 0 1 1 1 0 2 2 0 1 0 0 0 2 1 11
3. H. AMIR AMIRULOH, S.H. 2 0 0 0 6 0 0 0 2 1 0 1 0 1 1 14
4. NAFIZUL ALHAFIZRANA 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
5. BAGUS DJATI KUSUMA 0 0 2 0 0 1 0 0 2 0 0 0 0 0 0 5
6. SHOLEHATUN NASIHA, S.Kom. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
7. Ir. AAN SURYA PRIYANA 1 0 0 2 0 1 0 1 1 1 1 0 0 0 0 8
8. AGUS MULYADI, S.Pd. 0 0 1 0 0 1 0 0 0 0 1 0 2 0 0 5
9. ROSALINDA RAMDHANIAH, S.Ag. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
10. TEGUH YULIANTO, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RISMA PUJI RIANTI 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 3
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 8 3 11 31 21 78 135 51 18 35 40 30 18 16 59 554
A.1 2. Partai Gerakan Indonesia Raya 14 9 10 12 15 9 14 13 9 10 14 7 13 11 15 175

A.2 1. H. RICKY KURNIAWAN, Lc. 9 2 4 6 7 5 3 3 10 7 5 4 9 5 3 82
2. Ir. PRASETYAWATI, M.M. 5 22 8 5 2 21 7 21 3 9 30 3 3 0 16 155

3. UDI SUHANDORO 2 2 1 3 1 3 1 1 0 1 0 1 0 2 1 19
4. H. CECEP GOGOM, S.Ag., M.Pd. 2 1 10 9 5 4 1 1 1 5 1 0 0 0 2 42
5. YORDA IMAM SUTOMO, S.H. 1 0 0 0 1 3 0 0 2 0 1 1 1 0 0 10
6. NIAR YUNIAR 0 0 5 2 3 4 2 0 2 0 1 0 0 1 0 20
7. Dr. AGUS SUHENDI, M.Pd. 1 1 1 0 2 0 0 0 1 2 0 0 1 1 0 10
8. SUTIYA ANJANI 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 3
9. TOTING SUPRIATNA 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2
10. YANTI TARYATI 2 0 1 0 1 0 0 0 0 0 0 0 1 0 0 5
11. CAHYO FITRIADI 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 TPS 027 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 1. Partai Kebangkitan Bangsa 110 10 3 5 9 13 3 5 2 7 12 4 2 185
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 395 38 14 9 21 11 121 24 31 14 52 33 7 770
2. DINDIN ABDULLAH GHOZALI 11 3 0 0 2 4 2 0 1 0 1 0 2 26
3. H. AMIR AMIRULOH, S.H. 14 0 2 1 1 2 0 1 1 0 0 0 0 22
4. NAFIZUL ALHAFIZRANA 1 0 0 0 2 0 1 0 0 1 0 1 0 6
5. BAGUS DJATI KUSUMA 5 0 0 0 0 0 0 0 0 0 0 0 0 5
6. SHOLEHATUN NASIHA, S.Kom. 1 0 0 1 0 0 1 0 0 0 1 0 0 4
7. Ir. AAN SURYA PRIYANA 8 0 1 0 0 0 0 0 0 0 0 1 1 11
8. AGUS MULYADI, S.Pd. 5 0 0 0 0 1 1 1 0 0 1 1 0 10
9. ROSALINDA RAMDHANIAH, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
10. TEGUH YULIANTO, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RISMA PUJI RIANTI 3 0 0 0 0 0 0 0 0 0 0 0 0 3
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 554 51 20 16 35 31 129 31 35 22 67 40 12 1.043
A.1 2. Partai Gerakan Indonesia Raya 175 15 13 9 13 18 3 16 16 9 7 6 6 306

A.2 1. H. RICKY KURNIAWAN, Lc. 82 7 7 8 8 3 5 9 2 4 1 7 6 149
2. Ir. PRASETYAWATI, M.M. 155 8 3 9 4 2 4 3 3 4 4 1 2 202

3. UDI SUHANDORO 19 0 3 1 1 0 0 2 2 1 0 2 1 32
4. H. CECEP GOGOM, S.Ag., M.Pd. 42 2 6 1 3 1 0 16 7 13 2 3 1 97
5. YORDA IMAM SUTOMO, S.H. 10 1 0 2 2 0 0 0 2 1 0 0 1 19
6. NIAR YUNIAR 20 2 2 1 2 1 1 1 1 1 2 2 4 40
7. Dr. AGUS SUHENDI, M.Pd. 10 1 1 1 0 0 2 1 2 1 0 1 1 21
8. SUTIYA ANJANI 3 0 1 1 0 0 1 1 2 1 2 2 0 14
9. TOTING SUPRIATNA 2 0 0 0 0 0 0 0 0 0 0 1 1 4
10. YANTI TARYATI 5 0 0 0 0 1 0 0 0 0 0 1 1 8
11. CAHYO FITRIADI 4 0 0 0 0 0 0 0 0 0 0 0 0 4
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 527 36 36 33 33 26 16 49 37 35 18 26 24 896
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 3. Partai Demokrasi Indonesia Perjuangan 7 7 0 4 5 6 4 12 5 9 0 4 11 8 4 86
A.2 1. Hj. ASYANTI ROZANA, S.E. 3 4 0 2 2 1 3 0 2 2 0 1 3 3 2 28
2. DONI MARADONA HUTABARAT, S.H. 26 4 0 0 0 1 1 0 3 1 1 0 18 0 0 55
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 0 0 0 0 0 0 0 1 1 1 0 0 12 0 1 16
4. Hj. DIAN ROSITA 1 1 0 0 1 0 1 0 0 0 0 0 0 1 0 5
5. THARIQ HALILINTAR 1 0 0 0 0 2 3 0 2 0 0 0 0 1 0 9
6. H. AGUS RIADI 0 0 0 0 1 1 2 0 0 2 0 0 0 0 1 7
7. IRAWATY OCTORA, S.E., M.Si. 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
8. MANGONTANG SIMANJUNTAK 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
9. BAMBANG SUMANTRI, S.Sos. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
10. EUGINIA NATANIA PUTRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 4. Partai Golongan Karya 12 3 7 5 10 7 3 16 12 17 3 10 5 11 8 129

A.2 1. SAMSUL HIDAYAT, S.H. 18 2 6 17 4 7 8 3 37 35 3 13 9 5 5 172
2. H. KUSNADI, S.I.P. 3 0 0 2 1 2 2 2 1 4 2 7 1 0 4 31
3. KURNIAWATYNINGSIH, S.E. 1 1 0 2 0 2 1 2 1 3 0 3 0 0 1 17
4. ADI RESTU PERMADI 2 0 0 0 1 1 0 2 1 1 1 2 0 0 0 11
5. KHAERUL ANAM, S.Pi., M.Si. 3 1 2 0 0 0 2 0 0 0 0 0 2 1 0 11
6. LINDA OCTAVIA 0 1 3 0 1 0 0 0 0 0 0 3 0 0 1 9
7. H. HELMI BUSTOMI 0 0 2 1 0 0 1 0 0 0 2 1 0 1 0 8
8. MUNAWARAH SUNUSI, S.E., M.Si. 0 0 0 1 0 1 0 0 0 1 0 0 0 1 1 5
9. RENO ANGGARA MUKTI, S.ST.Par. 0 14 1 5 1 0 1 1 1 4 0 1 2 8 3 42
10. FAJAR SETIAWAN 0 0 0 2 0 0 0 0 0 0 0 1 0 0 0 3
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 3. Partai Demokrasi Indonesia Perjuangan 86 1 6 1 6 19 0 1 4 0 0 1 1 126
A.2 1. Hj. ASYANTI ROZANA, S.E. 28 2 0 2 2 0 1 1 2 1 2 2 1 44
2. DONI MARADONA HUTABARAT, S.H. 55 5 0 0 3 5 13 0 0 0 0 2 1 84
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 16 0 0 0 1 1 0 0 4 0 0 0 0 22
4. Hj. DIAN ROSITA 5 1 1 0 1 0 1 1 0 0 0 2 0 12
5. THARIQ HALILINTAR 9 0 2 1 0 1 0 0 1 0 0 1 0 15
6. H. AGUS RIADI 7 1 0 0 0 2 0 0 0 0 1 0 0 11
7. IRAWATY OCTORA, S.E., M.Si. 2 0 0 1 0 0 0 0 1 0 0 0 1 5
8. MANGONTANG SIMANJUNTAK 1 0 0 0 0 0 0 0 0 0 0 0 0 1
9. BAMBANG SUMANTRI, S.Sos. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
10. EUGINIA NATANIA PUTRI 0 0 0 0 0 0 0 1 0 0 0 0 0 1
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 4. Partai Golongan Karya 129 10 11 12 4 8 1 11 6 5 5 9 14 225

A.2 1. SAMSUL HIDAYAT, S.H. 172 9 15 14 1 15 3 12 6 15 6 43 14 325
2. H. KUSNADI, S.I.P. 31 11 5 1 1 0 3 2 0 2 0 5 4 65
3. KURNIAWATYNINGSIH, S.E. 17 1 1 1 3 0 0 0 1 2 0 1 1 28
4. ADI RESTU PERMADI 11 1 1 1 3 1 0 0 1 1 0 3 1 24
5. KHAERUL ANAM, S.Pi., M.Si. 11 0 0 0 0 0 0 1 1 2 1 2 0 18
6. LINDA OCTAVIA 9 1 1 1 0 0 0 0 0 0 0 3 0 15
7. H. HELMI BUSTOMI 8 1 0 0 0 0 0 0 1 2 1 0 0 13
8. MUNAWARAH SUNUSI, S.E., M.Si. 5 0 0 0 0 0 0 0 1 0 0 1 0 7
9. RENO ANGGARA MUKTI, S.ST.Par. 42 1 0 1 0 2 3 0 1 0 0 0 1 51
10. FAJAR SETIAWAN 3 0 0 0 0 0 0 0 0 0 1 0 0 4
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 1 0 0 0 0 0 0 0 0 0 0 0 1 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 1 2 1 0 0 2 0 3 1 1 1 0 1 3 5 21
A.2 1. M. RIZKY 0 4 0 0 0 41 13 0 4 9 0 2 0 21 28 122
2. DONDY DWIGUNTIA 4 0 0 0 0 0 4 3 7 0 3 0 0 0 0 21
3. VICA FITHRI NOER AZIZAH 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 2
4. MELIHASRAT JAYA ZAI, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. DELLA PUSPITA 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 3
6. AJID, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. AHMAD ROUF, S.I.P., M.Si. 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 2
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
A.1 6. Partai Buruh 1 0 4 1 0 0 0 1 0 3 1 0 0 1 2 14

A.2 1. Komarudin 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 3
2. Krisdianto, S.H. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
3. Mira Sari La Puppung, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 3
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 5. Partai NasDem 21 2 0 4 2 0 0 1 1 2 1 3 0 37
A.2 1. M. RIZKY 122 0 2 4 1 1 0 1 1 1 0 1 2 136
2. DONDY DWIGUNTIA 21 2 0 0 1 0 0 1 2 0 0 2 0 29
3. VICA FITHRI NOER AZIZAH 2 0 1 0 0 1 0 1 0 0 0 0 0 5
4. MELIHASRAT JAYA ZAI, S.E. 0 0 0 0 0 0 0 0 1 0 0 0 0 1
5. DELLA PUSPITA 3 0 2 1 0 0 0 0 0 0 0 0 0 6
6. AJID, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 1 0 2
7. UMMI NURAENI, S.H. 0 0 0 1 0 0 0 0 0 0 0 0 0 1
8. AHMAD ROUF, S.I.P., M.Si. 2 0 0 0 0 0 0 0 1 0 0 0 0 3
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 0 1 0 2 3
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
A.1 6. Partai Buruh 14 1 4 6 1 2 0 4 9 3 3 5 3 55

A.2 1. Komarudin 3 0 0 0 0 0 0 1 1 0 0 0 2 7
2. Krisdianto, S.H. 1 1 2 0 0 1 0 0 1 0 0 0 0 6
3. Mira Sari La Puppung, S.E. 0 0 0 0 0 1 0 0 0 0 0 1 0 2
4. Agus Sarjanto, S.H. 0 1 0 0 0 0 0 0 0 0 0 0 0 1
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 3 1 0 0 0 0 0 0 0 1 0 0 0 5
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 7. Partai Gelombang Rakyat Indonesia 1 1 1 2 3 2 1 1 0 0 1 4 0 2 3 22
A.2 1. WIWID PURWAWAN 0 0 1 0 0 3 0 0 0 0 0 0 0 0 1 5
2. Hj. LULU MASLUCHAH, Lc. 0 0 0 1 0 1 0 0 0 0 0 1 0 1 0 4
3. NASRUDDIN 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 2
4. NAFIZA 0 0 6 0 0 2 1 0 0 0 0 0 0 1 5 15
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
6. ANDON TEGAR PRIBADI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
7. RIZKY RADIANTO FAJRI 0 0 0 0 1 1 0 0 0 1 1 1 0 3 0 8
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
9. ISLAM RAHIMI HUSAIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 4 1 4 10 5 6 8 11 2 3 6 6 3 2 3 74

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 4 2 4 12 9 5 2 3 2 0 2 5 0 3 3 56
2. DEDI AROZA, S.Ag., M.Si. 1 0 0 1 3 2 2 2 0 2 0 1 1 0 2 17
3. Dra. IIN SUPRIHATIN 2 0 0 1 1 4 6 4 0 1 1 0 0 0 0 20
4. MOCHAMAD ICHSAN M., S.T. 0 1 2 7 6 3 2 0 1 1 0 1 0 0 7 31
5. NUR LAELA TUROHMAH, S.E. 0 1 0 0 1 1 0 0 0 0 0 1 0 1 1 6
6. SOPIAN APIP, S.E. 1 0 2 0 1 0 1 0 0 0 0 2 0 0 2 9
7. ZULFIKAR MAHBUB ROBBANI 1 2 0 9 0 1 4 0 0 1 0 3 1 5 2 29
8. ABDURROKHIM, S.Pt. 0 0 1 4 0 1 1 2 1 0 0 0 0 0 3 13
9. DEWI RACHMAWATI, S.E. 0 0 0 0 0 0 0 2 0 0 0 1 0 0 0 3
10. MURDOKO, S.H. 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
11. RETNO UMMY ASTHASARI, S.T.P. 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 7. Partai Gelombang Rakyat Indonesia 22 0 3 0 3 0 0 0 1 0 0 0 0 29
A.2 1. WIWID PURWAWAN 5 0 0 0 0 0 0 0 0 0 0 2 0 7
2. Hj. LULU MASLUCHAH, Lc. 4 0 0 0 0 0 0 0 0 0 0 0 0 4
3. NASRUDDIN 2 0 0 0 0 0 1 0 0 0 0 0 0 3
4. NAFIZA 15 1 0 0 0 0 0 0 2 0 0 0 0 18
5. FERRY ARDIAN AR. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
6. ANDON TEGAR PRIBADI 1 0 0 0 0 0 0 0 0 0 0 0 0 1
7. RIZKY RADIANTO FAJRI 8 0 1 0 0 0 0 0 0 0 0 0 1 10
8. LINA KADARMINI 1 0 0 0 0 0 0 0 0 0 0 0 0 1
9. ISLAM RAHIMI HUSAIN, S.T. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 74 3 3 8 3 1 0 9 5 2 4 8 4 124

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 56 2 0 5 2 1 0 9 3 0 1 4 0 83
2. DEDI AROZA, S.Ag., M.Si. 17 2 1 1 3 1 0 1 1 0 0 3 0 30
3. Dra. IIN SUPRIHATIN 20 1 8 18 14 0 0 1 2 0 0 0 1 65
4. MOCHAMAD ICHSAN M., S.T. 31 2 0 2 1 0 1 3 5 0 1 1 1 48
5. NUR LAELA TUROHMAH, S.E. 6 0 1 0 0 0 0 0 0 0 0 0 0 7
6. SOPIAN APIP, S.E. 9 0 0 0 0 1 0 0 0 0 0 0 0 10
7. ZULFIKAR MAHBUB ROBBANI 29 1 1 1 3 0 0 1 0 0 0 2 0 38
8. ABDURROKHIM, S.Pt. 13 1 1 1 0 0 0 1 1 0 1 0 0 19
9. DEWI RACHMAWATI, S.E. 3 0 2 0 0 0 0 1 0 0 0 0 0 6
10. MURDOKO, S.H. 2 0 0 0 0 0 0 0 0 0 0 0 0 2
11. RETNO UMMY ASTHASARI, S.T.P. 2 0 0 0 0 0 0 1 2 0 0 0 0 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 9. Partai Kebangkitan Nusantara 0 2 0 0 0 0 0 0 0 0 0 1 3 0 0 6
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. JAN ADOLF HUKUBUN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. FRANSISKA DWI KESDIATIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 10. Partai Hati Nurani Rakyat 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 3

A.2 1. ELIA 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
2. R. AGUNG CAHYA GUNARDI
3. ARIEF BUDIMAN 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
4. HERVINA LESTARI 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 2
5. ANDREAS KURNIAWAN E 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. YASMIN INAYAH NATA BUWANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 9. Partai Kebangkitan Nusantara 6 0 0 0 0 2 0 0 0 0 0 0 0 8
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. JAN ADOLF HUKUBUN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. FRANSISKA DWI KESDIATIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 10. Partai Hati Nurani Rakyat 3 0 0 0 0 0 0 1 0 0 0 0 0 4

A.2 1. ELIA 2 0 1 0 0 0 0 0 0 0 0 0 0 3
2 0 0 0 0 1 0 0 0 0 0 0 1 4
3. ARIEF BUDIMAN 1 0 0 0 0 0 0 0 0 0 0 0 0 1
4. HERVINA LESTARI 2 0 0 0 0 0 0 0 0 0 0 0 0 2
5. ANDREAS KURNIAWAN E 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. YASMIN INAYAH NATA BUWANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 11. Partai Garda Republik Indonesia 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 3
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. YULIANTI BILAKONGA 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
A.1 12. Partai Amanat Nasional 11 0 1 3 7 1 0 7 5 4 3 6 4 2 2 56

A.2 1. H. SUPONO 1 1 2 1 4 0 0 0 0 2 2 1 4 2 1 21
2. H. PERMADI DALUNG, S.E., M.M. 2 1 1 1 0 1 0 1 0 0 1 1 12 1 1 23
3. SARASWATI 2 0 0 1 3 0 1 0 0 0 0 0 0 1 0 8
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 17 0 0 0 1 0 1 2 2 0 0 2 0 0 0 25
5. CEPI AL HAKIM, S.T.P., M.Si. 0 2 0 0 0 0 0 1 0 0 1 1 0 0 0 5
6. ASTRI SARTIKA 2 1 2 1 2 0 0 1 0 0 0 0 0 0 0 9
7. REGIVAL PUTRA ADRIAN 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 2
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 0 0 0 0 3 0 0 1 0 0 0 0 0 0 0 4
9. MERRY APRIYANTI 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
10. IIM SOLIHATI 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 11. Partai Garda Republik Indonesia 3 0 1 1 0 0 0 0 0 1 0 0 0 6
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. YULIANTI BILAKONGA 1 0 0 0 0 0 0 0 0 0 0 0 1 2
A.1 12. Partai Amanat Nasional 56 4 4 1 1 16 3 2 1 1 5 1 3 98

A.2 1. H. SUPONO 21 7 2 1 0 2 6 2 3 2 12 2 3 63
2. H. PERMADI DALUNG, S.E., M.M. 23 9 10 4 3 34 13 0 0 1 2 0 1 100
3. SARASWATI 8 0 1 3 0 1 2 1 0 1 0 1 1 19
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 25 1 1 0 0 0 1 1 0 1 1 1 1 33
5. CEPI AL HAKIM, S.T.P., M.Si. 5 0 0 1 0 0 1 0 0 0 0 0 0 7
6. ASTRI SARTIKA 9 0 0 1 0 0 0 0 0 1 0 0 0 11
7. REGIVAL PUTRA ADRIAN 2 0 1 0 0 0 0 0 0 0 0 0 0 3
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 4 0 0 1 1 0 1 0 0 0 1 0 0 8
9. MERRY APRIYANTI 1 0 0 0 0 1 0 0 0 0 0 0 0 2
10. IIM SOLIHATI 1 0 0 0 0 0 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 1 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 13. Partai Bulan Bintang 1 0 2 0 0 0 1 2 0 0 1 0 0 1 0 8
A.2 1. SOLAHUDDIN, S.H., M.H. 0 0 0 0 0 0 0 0 3 0 0 1 1 0 0 5
2. AGUS SUKARNA WIJAYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. FITRIASARI 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 2
4. DJUMHAWAN R PERMANA 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. WAWANG HUSNAWATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Mochammad Muzaqi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. MOCHAMAD MORO ASIH 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 2
A.1 14. Partai Demokrat 2 4 1 1 0 0 0 1 1 2 2 2 3 2 1 22

A.2 1. DEDE CANDRA SASMITA, S.Ag. 0 1 0 2 3 1 0 1 3 0 4 0 1 1 5 22
2. MANATAP P SIMANJUNTAK 0 1 0 0 0 0 1 0 0 1 0 1 0 0 0 4
3. ANDRIYANTI WIJAYA 1 0 0 0 0 0 0 1 0 1 0 0 1 0 0 4
4. SAIFUL 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 3
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 3
6. ARNY NURANI SANGAJI 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. HARKES WOROWATI W. A. 0 0 0 0 0 0 0 0 0 0 0 1 3 0 0 4
10. NAUFAL ANDHIKA IRAWAN 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
11. ENDAH HENDRAWASIH 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 13. Partai Bulan Bintang 8 1 1 2 0 0 0 2 0 1 0 0 0 15
A.2 1. SOLAHUDDIN, S.H., M.H. 5 1 2 0 0 0 0 1 0 0 0 0 0 9
2. AGUS SUKARNA WIJAYA 0 0 1 0 0 0 0 0 0 0 0 0 0 1
3. FITRIASARI 2 0 0 0 1 0 0 0 0 0 0 1 0 4
4. DJUMHAWAN R PERMANA 1 0 0 0 0 0 0 0 0 0 0 0 0 1
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. WAWANG HUSNAWATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Mochammad Muzaqi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. MOCHAMAD MORO ASIH 2 0 0 0 0 0 0 0 0 0 0 0 0 2
A.1 14. Partai Demokrat 22 0 0 0 1 3 0 1 0 2 0 2 0 31

A.2 1. DEDE CANDRA SASMITA, S.Ag. 22 1 1 0 0 0 3 0 7 0 0 0 0 34
2. MANATAP P SIMANJUNTAK 4 0 0 0 0 0 0 0 0 0 0 1 0 5
3. ANDRIYANTI WIJAYA 4 0 1 0 0 0 1 1 0 0 0 2 1 10
4. SAIFUL 3 0 0 0 0 0 0 0 0 0 0 2 0 5
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 3 0 1 0 0 0 0 0 0 0 0 1 0 5
6. ARNY NURANI SANGAJI 1 0 0 0 0 0 0 0 1 0 0 2 0 4
7. REDIKA SEGARA, S.E. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. HARKES WOROWATI W. A. 4 0 0 0 0 3 1 0 0 0 0 3 3 14
10. NAUFAL ANDHIKA IRAWAN 1 0 0 0 0 0 0 0 0 0 0 3 0 4
11. ENDAH HENDRAWASIH 1 0 0 0 0 0 0 0 0 0 0 0 1 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 15. Partai Solidaritas Indonesia 2 0 0 0 2 0 0 0 0 1 0 1 0 0 0 6
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 5
2. FEBRY CITRA, S.T., M.A.B. 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 3
3. SIANA RIA, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
4. MUHAMMAD ADE ALIYUDIN, S.H. 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 3
5. JASIMAN SITORUS, S.Kom., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DIAH WINARSIH 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 3

A.2 1. RESITA KANIYA 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
2. AGUS WINARNO 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 2
3. Drs. SUMARWAN SASTRA 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 4
4. NENDEN BANURIAH, S.Pd. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. AMARENS MANUHUTU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 7
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 15. Partai Solidaritas Indonesia 6 0 1 2 1 0 0 1 2 0 0 1 0 14
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 5 0 0 0 1 0 0 0 0 0 0 0 0 6
2. FEBRY CITRA, S.T., M.A.B. 3 0 0 0 0 0 0 1 0 0 0 0 0 4
3. SIANA RIA, S.E., M.M. 1 1 0 0 0 0 0 1 1 0 0 0 0 4
4. MUHAMMAD ADE ALIYUDIN, S.H. 3 0 0 1 0 0 0 1 0 0 0 0 0 5
5. JASIMAN SITORUS, S.Kom., M.M. 0 1 0 0 0 0 0 0 0 0 0 0 0 1
6. DIAH WINARSIH 2 0 0 0 0 0 0 0 1 0 0 0 0 3
7. GUNADI, M.Ag. 1 0 0 0 1 0 0 0 0 0 0 0 0 2
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 3 0 0 1 0 0 0 1 0 0 0 0 1 6

A.2 1. RESITA KANIYA 1 0 0 0 1 1 0 0 1 0 0 0 0 4
2. AGUS WINARNO 2 0 0 0 0 0 0 0 0 0 0 0 0 2
3. Drs. SUMARWAN SASTRA 4 0 0 0 0 1 0 0 0 0 0 0 0 5
4. NENDEN BANURIAH, S.Pd. 0 0 0 0 0 1 0 0 0 0 0 0 0 1
5. AMARENS MANUHUTU 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. YURIZAL, S.E., M.M. 7 0 0 0 0 0 0 0 0 0 0 0 0 7
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 1 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 17. Partai Persatuan Pembangunan 0 1 2 5 6 1 0 2 2 10 3 3 1 5 5 46
A.2 1. H. MUHAMAD ROMLI, A.Md. 7 0 0 1 7 4 1 1 1 2 1 1 0 0 1 27
2. JUHANTA, S.T. 0 0 2 0 0 1 0 0 0 0 1 0 0 0 1 5
3. DWI ARYANTI, S.E. 2 4 1 1 12 0 0 2 0 1 0 3 3 3 0 32
4. IRFAN DARAJAT 2 12 6 3 8 1 4 3 20 24 0 21 3 13 3 123
5. FERRY PERDIAN 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 2
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 2
7. YENTI NASHI HATUL UMMAH 0 0 2 1 3 0 0 1 0 0 0 0 1 1 0 9
8. ABDUL ROHIM, S.Si., Apt. 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 4
9. GUNAWAN 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 2
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 4

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 1 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3
2. SELLY AFRIDA OLTAR, S.I.P. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
3. H. SUMIRAT SAPTA HADI, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Drs. H. ASRI AL JUFRI, M.Si. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. RITA HERLINA, S.E. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
6. Drs. MOCH ZAENAL AL AQILI 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
9. JAKA JATI NUR ALAM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 17. Partai Persatuan Pembangunan 46 4 11 3 3 4 0 1 2 2 1 2 3 82
A.2 1. H. MUHAMAD ROMLI, A.Md. 27 0 12 5 10 2 0 0 0 0 0 0 3 59
2. JUHANTA, S.T. 5 0 0 0 0 1 1 0 0 0 0 0 0 7
3. DWI ARYANTI, S.E. 32 1 1 2 3 0 1 1 0 0 0 1 2 44
4. IRFAN DARAJAT 123 0 0 1 15 0 0 0 5 2 4 2 0 152
5. FERRY PERDIAN 2 0 0 0 0 0 0 0 0 0 0 0 0 2
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 2 0 0 0 0 0 0 0 0 0 0 0 0 2
7. YENTI NASHI HATUL UMMAH 9 0 0 0 0 0 0 0 0 0 0 0 0 9
8. ABDUL ROHIM, S.Si., Apt. 4 0 0 0 0 0 0 0 0 0 0 0 0 4
9. GUNAWAN 2 0 0 0 1 0 0 0 0 0 0 0 0 3
10. RIA ANWAR 1 0 0 0 0 1 0 0 0 0 0 0 0 2
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 4 0 1 0 0 0 0 0 0 0 0 1 0 6

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 3 1 0 0 0 0 0 0 0 0 0 0 0 4
2. SELLY AFRIDA OLTAR, S.I.P. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
3. H. SUMIRAT SAPTA HADI, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Drs. H. ASRI AL JUFRI, M.Si. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. RITA HERLINA, S.E. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
6. Drs. MOCH ZAENAL AL AQILI 1 0 0 0 0 0 0 0 0 0 0 0 0 1
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
9. JAKA JATI NUR ALAM 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
Halaman 3 - Lembar 1
NO. URAIAN RINCIAN
V DATA SUARA SAH DAN TIDAK SAH TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 TPS 014 TPS 015 JUMLAH PINDAHAN
A. JUMLAH SELURUH SUARA SAH 202 129 130 180 186 247 258 198 169 227 144 176 182 163 219 2.810
B. JUMLAH SUARA TIDAK SAH 30 20 52 29 36 0 11 11 30 39 84 30 106 34 28 540
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 232 149 182 209 222 247 269 209 199 266 228 206 288 197 247 3.350
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 TPS 027 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.810 185 185 167 171 195 206 165 165 111 140 203 117 4.820
B. JUMLAH SUARA TIDAK SAH 540 28 23 29 43 51 22 64 39 45 32 44 35 995
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.350 213 208 196 214 246 228 229 204 156 172 247 152 5.815

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: CIGUDEG
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 144 137 115 122 121 105 109 131 146 139 144 147 152 152 152 2.016
JML 299 262 216 243 258 198 205 269 297 270 284 297 297 295 293 3.983
LK 106 109 88 87 90 89 85 107 119 107 119 111 123 135 125 1.600
JML 226 208 172 196 210 169 161 228 252 220 238 240 243 253 251 3.267
LK 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
JML 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
LK 1 2 1 0 1 0 0 0 0 0 0 2 4 0 0 11
JML 6 3 1 0 2 0 0 0 0 1 0 2 4 0 0 19
LK 107 111 89 87 91 89 85 107 119 107 119 114 127 135 125 1.612
JML 232 211 173 196 212 169 161 228 252 221 238 243 247 253 251 3.287
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 73 58 51 53 52 33 49 47 51 65 52 60 56 48 48 796
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
JML 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 4
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

JUMLAH TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS JUMLAH
PINDAHAN 016 017 018 019 020 021 022 023 024 025 026 027 028 029 030 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
A DATA PEMILIH
LK 2.016 114 111 142 102 145 135 119 128 145 135 102 100 151 153 162 3.960
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 1.967 102 102 141 91 126 128 97 117 120 113 91 103 131 137 123 3.689
JML 3.983 216 213 283 193 271 263 216 245 265 248 193 203 282 290 285 7.649
LK 1.600 94 103 118 86 114 102 98 110 113 103 76 81 111 101 119 3.129
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.667 94 98 129 79 108 107 86 105 110 98 81 80 110 123 112 3.187
JML 3.267 188 201 247 165 222 209 184 215 223 201 157 161 221 224 231 6.316
LK 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan
PR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(DPTb)
JML 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
LK 11 0 0 1 0 0 0 2 0 1 0 0 1 0 0 0 16
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus
PR 8 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 11
(DPK)
JML 19 0 0 1 0 0 0 2 1 2 0 0 2 0 0 0 27
LK 1.612 94 103 119 86 114 102 100 110 114 103 76 82 111 101 119 3.146
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.675 94 98 129 79 108 107 86 106 111 98 81 81 110 123 112 3.198
JML 3.287 188 201 248 165 222 209 186 216 225 201 157 163 221 224 231 6.344
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 4.083 221 218 289 196 277 269 221 250 271 253 197 207 288 296 291 7.827
2 Jumlah surat suara yang digunakan 3.287 188 201 248 165 222 209 186 216 225 201 157 163 221 224 231 6.344
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat
4 796 33 17 41 31 55 60 35 34 46 52 40 44 67 72 60 1.483
suara cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
LK 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2
Jumlah seluruh Pemilih disabilitas yang menggunakan hak
PR 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
pilih
JML 4 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 5
LAMPIRAN MODEL
Halaman 1 Lembar 3

NO. URAIAN RINCIAN

PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042 043 044 045 AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
A DATA PEMILIH
LK 3.960 148 114 131 136 123 154 133 155 110 130 111 92 97 126 104 5.824
JML 7.649 262 212 247 259 245 286 255 282 210 242 205 169 182 230 206 11.141
LK 3.129 103 82 94 116 98 131 105 110 103 98 85 79 75 97 72 4.577
JML 6.316 204 164 192 228 202 242 207 215 181 196 167 149 150 184 162 9.159
LK 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
PR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(DPTb)
JML 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
LK 16 0 0 1 0 0 0 2 0 0 0 3 0 0 1 0 23
PR 11 0 0 1 0 0 0 5 0 0 0 5 0 0 0 0 22
(DPK)
JML 27 0 0 2 0 0 0 7 0 0 0 8 0 0 1 0 45
LK 3.146 103 82 95 116 98 131 107 110 103 98 88 79 75 98 72 4.601
JML 6.344 204 164 194 228 202 242 214 215 181 196 175 149 150 185 162 9.205
NO. URAIAN RINCIAN

PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042 043 044 045 AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
4 1.483 64 53 58 38 48 50 47 73 35 49 34 25 36 50 51 2.194
suara cadangan
NO. URAIAN RINCIAN

PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042 043 044 045 AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
LK 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
PR 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
pilih
JML 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 4


3. UDI SUHANDORO 0 0 0 2 0 1 0 1 0 4 0 0 1 2 0 11
6. NIAR YUNIAR 1 0 0 0 1 0 2 1 1 1 0 1 4 1 3 16
8. SUTIYA ANJANI 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
10. YANTI TARYATI 0 1 1 0 0 1 0 1 0 1 0 0 0 0 1 6
11. CAHYO FITRIADI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA JUMLAH TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS JUMLAH
IV
CALON PINDAHAN 016 017 018 019 020 021 022 023 024 025 026 027 028 029 030 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 1. Partai Kebangkitan Bangsa 57 5 4 4 5 7 3 7 8 5 3 7 12 20 13 19 179
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 111 7 3 5 3 5 3 6 0 3 10 1 3 11 7 6 184
2. DINDIN ABDULLAH GHOZALI 16 0 0 1 0 1 2 0 0 0 0 0 1 1 1 1 24
3. H. AMIR AMIRULOH, S.H. 4 2 2 1 0 0 0 0 1 1 0 3 0 1 4 3 22
4. NAFIZUL ALHAFIZRANA 3 1 0 0 0 0 0 0 1 0 2 1 0 3 0 1 12
5. BAGUS DJATI KUSUMA 17 2 1 6 0 3 0 0 1 0 0 0 0 0 0 0 30
6. SHOLEHATUN NASIHA, S.Kom. 4 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 6
7. Ir. AAN SURYA PRIYANA 11 0 0 1 0 0 0 0 1 0 0 0 1 0 0 3 17
8. AGUS MULYADI, S.Pd. 4 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 7
9. ROSALINDA RAMDHANIAH, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2
10. TEGUH YULIANTO, S.T. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. RISMA PUJI RIANTI 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6
JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 +
B 234 17 10 18 8 17 8 13 12 9 15 12 18 38 25 36 490
A.2)
A.1 2. Partai Gerakan Indonesia Raya 144 2 5 4 6 6 12 12 9 5 8 12 7 7 5 19 263

A.2 1. H. RICKY KURNIAWAN, Lc. 69 5 1 2 1 7 7 1 1 4 7 5 4 8 5 9 136
2. Ir. PRASETYAWATI, M.M. 63 0 2 2 1 11 1 5 4 1 36 3 3 3 2 4 141

3. UDI SUHANDORO 11 0 0 0 0 0 0 0 1 0 0 4 4 0 0 3 23
4. H. CECEP GOGOM, S.Ag., M.Pd. 34 1 1 0 0 2 0 0 1 2 6 0 2 0 0 4 53
5. YORDA IMAM SUTOMO, S.H. 10 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 13
6. NIAR YUNIAR 16 0 0 1 0 0 2 0 2 1 1 0 0 0 0 2 25
7. Dr. AGUS SUHENDI, M.Pd. 18 0 0 0 0 2 1 0 0 0 0 0 0 0 0 1 22
8. SUTIYA ANJANI 1 0 0 0 1 0 0 1 0 1 0 0 0 0 1 1 6
9. TOTING SUPRIATNA 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
10. YANTI TARYATI 6 0 0 0 0 1 0 0 0 1 1 0 0 1 2 0 12
11. CAHYO FITRIADI 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 2
B 373 8 9 9 9 29 23 19 18 15 59 26 20 20 17 43 697
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA JUMLAH TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS
IV TPS 043 TPS 044 TPS 045 JUMLAH AKHIR
CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
8. AGUS MULYADI, S.Pd. 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 490 28 15 11 21 13 13 10 6 15 10 6 8 9 14 22 691


3. UDI SUHANDORO 23 2 1 1 0 0 1 2 1 0 0 0 1 0 9 3 44
6. NIAR YUNIAR 25 0 0 2 0 0 1 0 2 0 1 1 2 2 1 1 38
8. SUTIYA ANJANI 6 0 1 1 0 0 0 0 0 1 1 0 1 0 1 0 12
10. YANTI TARYATI 12 0 2 0 0 1 0 0 0 1 0 0 1 0 0 0 17
11. CAHYO FITRIADI 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 697 30 45 51 15 12 18 13 18 17 22 27 35 27 35 20 1.082
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 8 2 0 0 5 1 1 0 1 0 1 16 10 1 4 50
6. H. AGUS RIADI 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 2
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2. H. KUSNADI, S.I.P. 6 10 3 5 5 1 7 5 3 10 3 2 4 1 2 67
6. LINDA OCTAVIA 1 0 0 4 0 1 0 1 0 0 0 3 2 1 0 13
7. H. HELMI BUSTOMI 3 6 0 2 0 4 0 2 2 3 2 3 4 1 0 32
10. FAJAR SETIAWAN 3 1 0 1 0 0 0 1 0 2 0 0 0 1 2 11
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 3. Partai Demokrasi Indonesia Perjuangan 45 4 3 2 3 3 0 1 5 2 2 5 5 3 3 3 89
A.2 1. Hj. ASYANTI ROZANA, S.E. 23 0 1 2 1 1 3 3 2 0 2 1 1 3 1 2 46
2. DONI MARADONA HUTABARAT, S.H. 29 0 0 1 2 3 0 1 1 0 1 0 0 4 0 2 44
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 11 0 1 2 0 1 0 0 1 0 1 1 0 0 3 1 22
4. Hj. DIAN ROSITA 50 14 5 7 19 5 6 1 0 0 1 2 0 0 0 0 110
5. THARIQ HALILINTAR 23 2 0 1 0 0 0 0 0 1 0 1 0 1 1 0 30
6. H. AGUS RIADI 2 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 5
7. IRAWATY OCTORA, S.E., M.Si. 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 3
8. MANGONTANG SIMANJUNTAK 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
9. BAMBANG SUMANTRI, S.Sos. 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2
10. EUGINIA NATANIA PUTRI 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
B 190 21 10 16 25 14 9 6 9 3 7 10 6 13 8 9 356
A.2)
A.1 4. Partai Golongan Karya 236 22 7 27 19 19 22 32 23 57 4 3 2 10 8 10 501

A.2 1. SAMSUL HIDAYAT, S.H. 277 71 122 115 23 21 25 38 35 84 18 0 6 11 4 7 857
2. H. KUSNADI, S.I.P. 67 1 1 1 2 4 1 3 1 6 7 3 1 3 1 3 105
3. KURNIAWATYNINGSIH, S.E. 20 2 1 0 2 1 2 4 0 1 0 1 1 1 1 2 39
4. ADI RESTU PERMADI 32 2 0 3 0 2 2 4 1 1 4 0 0 0 1 1 53
5. KHAERUL ANAM, S.Pi., M.Si. 16 0 2 2 0 1 0 0 2 2 3 2 0 0 0 0 30
6. LINDA OCTAVIA 13 1 1 0 0 1 0 1 1 1 3 0 1 0 0 1 24
7. H. HELMI BUSTOMI 32 1 1 0 2 0 3 1 1 0 2 0 0 0 0 0 43
8. MUNAWARAH SUNUSI, S.E., M.Si. 5 2 0 1 1 0 0 0 0 0 0 0 0 0 0 0 9
9. RENO ANGGARA MUKTI, S.ST.Par. 70 0 0 1 0 0 1 1 0 0 2 0 1 0 3 0 79
10. FAJAR SETIAWAN 11 1 1 0 3 0 0 0 0 0 2 0 0 0 0 0 18
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
B 782 103 136 150 52 49 56 84 64 152 45 9 12 25 18 24 1.761
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
4. Hj. DIAN ROSITA 110 0 0 2 0 0 1 1 0 0 0 0 6 2 1 0 123
6. H. AGUS RIADI 5 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 6
11. ALUN HIMAWAN 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2

2. H. KUSNADI, S.I.P. 105 3 0 0 2 0 1 0 2 0 4 10 1 4 2 0 134
6. LINDA OCTAVIA 24 0 0 1 1 0 0 0 1 1 1 2 0 0 0 1 32
7. H. HELMI BUSTOMI 43 1 0 0 0 1 0 0 4 0 0 2 1 1 0 0 53
10. FAJAR SETIAWAN 18 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 20
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 1.761 44 8 9 38 71 8 2 47 16 28 43 33 42 3 8 2.161
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 5 1 1 2 3 1 5 1 4 1 3 0 2 2 4 35
A.2 1. M. RIZKY 2 5 6 2 6 0 3 0 3 0 7 4 9 67 55 169
2. DONDY DWIGUNTIA 8 7 2 3 7 0 7 6 6 6 2 3 0 0 1 58
5. DELLA PUSPITA 0 0 0 1 1 0 0 1 0 0 1 1 0 2 0 7
6. AJID, S.Ag. 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 3
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
9. MUHAMAD RIDWAN 2 0 0 0 0 0 1 0 1 0 1 0 0 0 0 5
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 0 1 13 0 0 1 1 0 0 19 21 0 0 0 0 56
A.1 6. Partai Buruh 0 0 1 1 1 0 0 0 0 0 0 3 2 0 3 11

A.2 1. Komarudin 0 1 0 0 0 0 0 1 0 0 0 0 1 1 1 5
2. Krisdianto, S.H. 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 3
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 5. Partai NasDem 35 1 0 1 2 3 3 2 0 1 0 0 3 1 2 1 55
A.2 1. M. RIZKY 169 1 2 1 22 7 4 1 0 0 3 2 0 7 5 3 227
2. DONDY DWIGUNTIA 58 0 10 5 2 4 6 10 2 2 1 2 1 1 1 8 113
3. VICA FITHRI NOER AZIZAH 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 5
4. MELIHASRAT JAYA ZAI, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
5. DELLA PUSPITA 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
6. AJID, S.Ag. 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4
7. UMMI NURAENI, S.H. 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 3
8. AHMAD ROUF, S.I.P., M.Si. 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
9. MUHAMAD RIDWAN 5 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 6
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 3
11. ARIFIN, S.Hut. 56 0 0 0 0 0 1 0 0 0 0 0 0 2 4 18 81
B 343 2 12 7 26 16 15 14 2 3 5 4 6 11 13 32 511
A.2)
A.1 6. Partai Buruh 11 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 13

A.2 1. Komarudin 5 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 8
2. Krisdianto, S.H. 3 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 4
3. Mira Sari La Puppung, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 21 0 0 0 0 2 1 0 0 0 0 1 0 2 0 0 27
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 5. Partai NasDem 55 2 0 3 4 0 0 2 3 0 3 3 1 0 3 3 82
A.2 1. M. RIZKY 227 0 2 2 0 0 3 0 0 0 1 2 0 0 7 1 245
2. DONDY DWIGUNTIA 113 3 2 3 0 4 0 2 3 0 1 2 9 0 0 4 146
5. DELLA PUSPITA 7 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 8
6. AJID, S.Ag. 4 0 1 0 0 0 2 0 0 0 0 0 0 1 0 0 8
7. UMMI NURAENI, S.H. 3 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 5
9. MUHAMAD RIDWAN 6 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 8
10. AWALUDDIN, S.T. 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
11. ARIFIN, S.Hut. 81 5 0 0 0 0 0 0 4 0 3 1 0 0 0 0 94
A.1 6. Partai Buruh 13 0 0 0 1 0 0 0 0 0 1 3 0 0 0 1 19

A.2 1. Komarudin 8 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 9
2. Krisdianto, S.H. 4 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
6. Lilis Minarni 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
7. Abdul Oir, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 0 0 0 0 0 2 1 0 1 0 0 0 0 4
3. NASRUDDIN 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 2
4. NAFIZA 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 1 0 0 1 0 0 1 1 0 4
8. ABDURROKHIM, S.Pt. 1 0 0 0 0 0 0 0 0 1 2 1 1 0 0 6
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 3 0 0 1 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 7. Partai Gelombang Rakyat Indonesia 6 0 0 1 1 2 0 0 1 0 0 1 0 0 2 1 15
A.2 1. WIWID PURWAWAN 4 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 7
2. Hj. LULU MASLUCHAH, Lc. 6 0 0 0 0 0 1 0 1 0 0 0 0 1 0 0 9
3. NASRUDDIN 2 0 0 2 0 0 0 0 0 0 0 0 0 4 5 2 15
4. NAFIZA 2 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 3
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
6. ANDON TEGAR PRIBADI 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
7. RIZKY RADIANTO FAJRI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. LINA KADARMINI 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
9. ISLAM RAHIMI HUSAIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
B 23 0 0 4 1 2 2 0 3 0 0 1 0 7 8 4 55
A.2)
A.1 8. Partai Keadilan Sejahtera 113 2 2 5 0 3 6 0 0 2 1 2 4 0 5 3 148

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 63 3 1 2 0 5 5 0 2 3 1 3 2 7 2 4 103
2. DEDI AROZA, S.Ag., M.Si. 25 0 0 1 0 0 2 0 0 1 0 0 2 0 0 2 33
3. Dra. IIN SUPRIHATIN 19 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 21
4. MOCHAMAD ICHSAN M., S.T. 16 0 0 0 0 1 1 1 1 1 1 1 2 0 0 1 26
5. NUR LAELA TUROHMAH, S.E. 7 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 9
6. SOPIAN APIP, S.E. 4 0 0 0 0 0 3 0 0 0 0 1 0 0 0 0 8
7. ZULFIKAR MAHBUB ROBBANI 8 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 11
8. ABDURROKHIM, S.Pt. 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
9. DEWI RACHMAWATI, S.E. 1 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 4
10. MURDOKO, S.H. 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
11. RETNO UMMY ASTHASARI, S.T.P. 2 0 0 0 0 0 23 1 0 0 0 0 0 0 0 0 26
B 268 5 3 8 1 12 41 2 3 8 3 7 10 9 7 12 399
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. WIWID PURWAWAN 7 0 0 3 1 1 0 0 1 0 0 0 1 0 0 0 14
3. NASRUDDIN 15 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17
4. NAFIZA 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
5. FERRY ARDIAN AR. 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2
8. LINA KADARMINI 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1

6. SOPIAN APIP, S.E. 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9
8. ABDURROKHIM, S.Pt. 6 0 1 0 1 0 0 0 1 0 0 1 1 0 0 0 11
10. MURDOKO, S.H. 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. ELIA 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. ARIEF BUDIMAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 9. Partai Kebangkitan Nusantara 1 0 0 0 0 2 0 0 1 0 0 1 0 0 0 0 5
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 2 0 0 0 1 0 3
2. Irwan Yani 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
3. JAN ADOLF HUKUBUN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. FRANSISKA DWI KESDIATIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 2 0 0 0 0 2 0 0 1 0 2 1 0 0 1 0 9
A.2)
A.1 10. Partai Hati Nurani Rakyat 4 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 8

A.2 1. ELIA 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 3
0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 2
3. ARIEF BUDIMAN 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. ANDREAS KURNIAWAN E 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. YASMIN INAYAH NATA BUWANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 5 0 0 0 1 0 2 1 0 0 0 1 0 0 4 0 14
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. Neneng Rohimah 3 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 4
2. Irwan Yani 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. ELIA 3 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 5
2 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 4
3. ARIEF BUDIMAN 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 1 1 0 0 0 0 0 1 0 0 1 0 0 1 5

A.2 1. H. SUPONO 2 1 0 1 2 0 1 1 0 0 0 3 2 2 4 19
3. SARASWATI 2 0 0 0 0 1 0 0 0 0 1 2 0 0 2 8
6. ASTRI SARTIKA 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 4
9. MERRY APRIYANTI 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ANI NURMAYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 11. Partai Garda Republik Indonesia 6 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7
A.2 1. A. KHALIK 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
2. YULIANTI BILAKONGA 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
B 12 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13
A.2)
A.1 12. Partai Amanat Nasional 29 0 0 2 0 2 2 0 3 1 4 3 3 4 1 2 56

A.2 1. H. SUPONO 19 1 0 0 4 2 5 4 5 0 3 0 6 1 1 0 51
2. H. PERMADI DALUNG, S.E., M.M. 79 0 0 0 0 2 1 1 23 0 0 5 6 3 3 7 130
3. SARASWATI 8 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 12
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 19 0 0 0 0 0 0 2 0 1 2 10 16 5 2 8 65
5. CEPI AL HAKIM, S.T.P., M.Si. 3 1 0 0 0 1 0 0 0 0 0 0 1 0 0 0 6
6. ASTRI SARTIKA 4 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 6
7. REGIVAL PUTRA ADRIAN 2 0 0 0 0 1 1 0 1 0 1 1 0 0 0 0 7
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 5 1 0 0 0 2 0 0 0 0 0 0 0 1 0 0 9
9. MERRY APRIYANTI 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ANI NURMAYANTI 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
B 169 3 0 2 4 10 10 8 33 2 10 20 32 17 7 18 345
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. A. KHALIK 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5

A.2 1. H. SUPONO 51 0 1 1 1 1 0 1 2 1 2 2 3 0 3 2 71
3. SARASWATI 12 0 0 0 1 4 1 1 2 1 2 0 0 0 0 0 24
6. ASTRI SARTIKA 6 1 1 1 0 0 0 0 0 0 1 0 1 0 0 2 13
9. MERRY APRIYANTI 2 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 3
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ANI NURMAYANTI 1 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 2
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
7. REDIKA SEGARA, S.E. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 13. Partai Bulan Bintang 2 0 0 0 2 0 0 0 0 0 0 0 1 0 0 3 8
A.2 1. SOLAHUDDIN, S.H., M.H. 7 0 3 0 0 0 0 0 0 0 5 1 0 1 1 1 19
2. AGUS SUKARNA WIJAYA 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
3. FITRIASARI 2 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 5
4. DJUMHAWAN R PERMANA 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
7. WAWANG HUSNAWATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Mochammad Muzaqi 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
10. MOCHAMAD MORO ASIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 17 0 3 0 2 0 0 0 0 0 5 4 1 1 1 4 38
A.2)
A.1 14. Partai Demokrat 39 0 0 1 4 1 0 2 0 6 0 2 4 2 9 2 72

A.2 1. DEDE CANDRA SASMITA, S.Ag. 104 1 0 1 2 4 2 3 1 2 1 3 9 11 18 8 170
2. MANATAP P SIMANJUNTAK 3 0 0 0 0 0 1 0 1 0 0 0 2 1 0 0 8
3. ANDRIYANTI WIJAYA 4 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 7
4. SAIFUL 1 0 0 0 0 1 2 0 1 0 1 1 2 0 0 0 9
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 4 0 0 0 1 1 0 0 0 1 0 0 2 0 1 1 11
6. ARNY NURANI SANGAJI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
7. REDIKA SEGARA, S.E. 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 3
8. KARDAN 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 2
9. HARKES WOROWATI W. A. 2 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 3
10. NAUFAL ANDHIKA IRAWAN 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
11. ENDAH HENDRAWASIH 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
B 163 1 0 2 8 8 6 5 4 9 3 7 20 15 29 11 291
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
3. FITRIASARI 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 6
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 9 0 2 0 0 0 0 0 1 0 1 0 0 0 0 0 13
7. REDIKA SEGARA, S.E. 3 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 5
8. KARDAN 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 0 0 0 1 0 0 0 0 0 0 0 0 1 2 0 4

A.2 1. RESITA KANIYA 3 0 0 0 1 0 0 0 0 0 0 1 5 6 3 19
2. AGUS WINARNO 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 2
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 3
10. RAHMAT HIDAYAT 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 15. Partai Solidaritas Indonesia 15 0 0 0 0 0 2 0 0 1 0 3 1 0 1 1 24
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 5 0 0 0 0 0 1 0 0 0 0 0 0 0 2 0 8
2. FEBRY CITRA, S.T., M.A.B. 7 0 0 0 0 1 0 0 1 0 0 1 0 0 1 0 11
3. SIANA RIA, S.E., M.M. 0 0 0 0 0 1 0 0 0 0 0 0 0 2 0 0 3
4. MUHAMMAD ADE ALIYUDIN, S.H. 2 1 0 0 0 0 0 0 0 0 0 0 2 0 0 0 5
5. JASIMAN SITORUS, S.Kom., M.M. 3 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 4
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 33 1 0 0 0 2 3 0 1 1 0 5 3 2 4 1 56
A.2)
A.1 16. PARTAI PERINDO 4 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 5

A.2 1. RESITA KANIYA 19 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 21
2. AGUS WINARNO 2 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 5
3. Drs. SUMARWAN SASTRA 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
4. NENDEN BANURIAH, S.Pd. 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
5. AMARENS MANUHUTU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
9. ELLY MARYANTI 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
10. RAHMAT HIDAYAT 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. MOHAMAD SATIBI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
B 43 0 0 1 1 0 1 1 0 0 0 0 1 0 1 0 49
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
3. SIANA RIA, S.E., M.M. 3 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 4
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 2
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 5 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 7

A.2 1. RESITA KANIYA 21 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 22
2. AGUS WINARNO 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 3 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 5
10. RAHMAT HIDAYAT 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. MOHAMAD SATIBI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 0 2 0 0 0 0 0 1 0 0 0 1 0 0 1 5
3. DWI ARYANTI, S.E. 1 1 1 0 0 1 1 1 3 1 3 2 0 1 1 17
4. IRFAN DARAJAT 5 13 1 11 9 2 3 0 0 0 0 0 0 0 1 45
5. FERRY PERDIAN 0 1 0 0 0 0 1 0 0 0 0 1 1 0 0 4
9. GUNAWAN 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 3

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 4
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 17. Partai Persatuan Pembangunan 34 1 1 2 1 7 2 2 4 1 3 8 5 2 4 2 79
A.2 1. H. MUHAMAD ROMLI, A.Md. 62 5 0 2 3 15 4 0 2 1 2 5 4 2 4 3 114
2. JUHANTA, S.T. 5 0 0 0 1 1 0 0 1 0 0 0 3 0 0 3 14
3. DWI ARYANTI, S.E. 17 0 1 2 2 11 1 1 4 1 2 3 4 0 0 0 49
4. IRFAN DARAJAT 45 1 0 2 0 0 0 0 29 1 12 0 0 0 0 0 90
5. FERRY PERDIAN 4 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 6
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 7 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 10
7. YENTI NASHI HATUL UMMAH 5 1 0 1 0 0 1 0 2 3 0 1 0 2 0 1 17
8. ABDUL ROHIM, S.Si., Apt. 3 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 5
9. GUNAWAN 1 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 3
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
11. RIKE ISKANDAR 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
B 183 8 2 9 8 34 9 4 42 9 19 21 18 6 8 9 389
A.2)
A.1 24. Partai Ummat 3 0 0 1 0 0 0 0 0 0 0 2 0 0 0 0 6

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 2 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 3
2. SELLY AFRIDA OLTAR, S.I.P. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. H. SUMIRAT SAPTA HADI, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2
4. Drs. H. ASRI AL JUFRI, M.Si. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. RITA HERLINA, S.E. 4 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 5
6. Drs. MOCH ZAENAL AL AQILI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. JAKA JATI NUR ALAM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 11 0 0 1 0 0 0 0 0 0 0 2 3 0 0 0 17
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

CALON PINDAHAN 031 032 033 034 035 036 037 038 039 040 041 042
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
2. JUHANTA, S.T. 14 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 15
3. DWI ARYANTI, S.E. 49 1 1 0 2 1 3 1 2 2 1 0 1 4 2 0 70
4. IRFAN DARAJAT 90 0 0 0 0 0 1 1 0 0 0 1 3 9 1 0 106
5. FERRY PERDIAN 6 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 8
9. GUNAWAN 3 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5
10. RIA ANWAR 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 3
11. RIKE ISKANDAR 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2
A.1 24. Partai Ummat 6 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 9

5. RITA HERLINA, S.E. 5 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 6
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 TPS 027 TPS 028 TPS 029 TPS 030 JUMLAH PINDAHAN
A. JUMLAH SELURUH SUARA SAH 2.872 169 185 227 146 197 186 157 192 211 173 131 150 166 152 203 5.517
B. JUMLAH SUARA TIDAK SAH 415 19 16 21 19 25 23 29 24 14 28 26 13 55 72 28 827
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.287 188 201 248 165 222 209 186 216 225 201 157 163 221 224 231 6.344
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 031 TPS 032 TPS 033 TPS 034 TPS 035 TPS 036 TPS 037 TPS 038 TPS 039 TPS 040 TPS 041 TPS 042 TPS 043 TPS 044 TPS 045 JUMLAH AKHIR
B. JUMLAH SUARA TIDAK SAH 827 34 26 45 42 23 40 25 29 39 16 26 17 26 34 30 1.279

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: BUNAR
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 144 142 154 134 148 153 148 154 159 142 157 154 140 145 133 2.207
JML 280 277 285 271 273 286 286 288 284 270 292 289 265 282 242 4.170
LK 103 113 114 99 113 103 98 114 119 111 124 116 103 116 110 1.656
JML 217 228 228 217 221 205 218 227 231 222 237 235 218 239 212 3.355
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 3
LK 0 0 0 0 0 2 0 0 1 2 0 1 1 0 0 7
JML 2 2 0 2 0 5 0 0 2 2 0 1 4 0 0 20
LK 103 113 114 99 113 105 98 114 120 113 124 117 104 116 110 1.663
JML 219 230 228 219 221 210 219 228 233 225 237 236 222 239 212 3.378
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 67 0 63 58 58 82 74 66 57 51 61 59 49 49 35 829
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 3
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14
A DATA PEMILIH
LK 2.207 137 141 135 110 109 112 138 148 119 3.356
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 1.963 137 144 132 111 120 108 143 117 113 3.088
JML 4.170 274 285 267 221 229 220 281 265 232 6.444
LK 1.656 104 111 100 75 81 91 113 117 109 2.557
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.699 122 124 112 86 99 94 128 109 95 2.668
JML 3.355 226 235 212 161 180 185 241 226 204 5.225
LK 0 0 0 0 0 0 0 0 0 0 0
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 3 0 0 0 0 0 0 0 0 0 3
JML 3 0 0 0 0 0 0 0 0 0 3
LK 7 4 0 0 0 0 1 0 0 2 14
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 13 3 2 0 1 0 0 0 0 1 20
JML 20 7 2 0 1 0 1 0 0 3 34
LK 1.663 108 111 100 75 81 92 113 117 111 2.571
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.715 125 126 112 87 99 94 128 109 96 2.691
JML 3.378 233 237 212 162 180 186 241 226 207 5.262
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 4.259 280 287 274 226 233 225 285 271 237 6.577
2 Jumlah surat suara yang digunakan 3.378 233 237 212 162 180 186 241 226 207 5.262
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 52 1 0 0 0 0 0 0 1 0 54
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 829 46 50 62 64 53 39 44 44 30 1.261
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14
LK 0 1 0 0 0 0 0 0 0 0 1
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 3 0 1 0 0 0 0 1 0 0 5
JML 3 1 1 0 0 0 0 1 0 0 6
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 3


3. UDI SUHANDORO 0 1 2 1 0 0 0 1 1 1 2 0 2 1 0 12
6. NIAR YUNIAR 1 0 1 1 1 0 1 0 2 1 1 0 1 0 0 10
8. SUTIYA ANJANI 0 0 0 0 0 1 0 0 0 1 2 0 0 0 0 4
10. YANTI TARYATI 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 2
11. CAHYO FITRIADI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 1. Partai Kebangkitan Bangsa 53 3 2 7 3 0 1 5 3 1 78
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 133 1 1 4 3 2 1 7 31 1 184
2. DINDIN ABDULLAH GHOZALI 10 4 0 4 0 0 1 1 1 0 21
3. H. AMIR AMIRULOH, S.H. 11 0 1 2 0 0 1 1 0 2 18
4. NAFIZUL ALHAFIZRANA 8 1 1 0 0 0 0 1 0 1 12
5. BAGUS DJATI KUSUMA 20 0 2 0 2 1 0 3 2 3 33
6. SHOLEHATUN NASIHA, S.Kom. 5 0 0 0 0 0 0 0 0 0 5
7. Ir. AAN SURYA PRIYANA 12 1 0 1 1 0 0 1 0 0 16
8. AGUS MULYADI, S.Pd. 3 0 0 0 0 0 0 0 0 0 3
9. ROSALINDA RAMDHANIAH, S.Ag. 1 0 0 0 0 0 0 0 1 0 2
10. TEGUH YULIANTO, S.T. 1 1 1 0 0 0 0 0 0 0 3
11. RISMA PUJI RIANTI 1 0 0 1 0 0 0 0 0 0 2
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 258 11 8 19 9 3 4 19 38 8 377
A.1 2. Partai Gerakan Indonesia Raya 120 9 2 7 12 10 16 1 2 7 186

A.2 1. H. RICKY KURNIAWAN, Lc. 62 8 5 4 7 8 10 3 1 0 108
2. Ir. PRASETYAWATI, M.M. 70 11 5 7 55 30 94 0 1 2 275

3. UDI SUHANDORO 12 3 2 0 2 2 0 0 1 0 22
4. H. CECEP GOGOM, S.Ag., M.Pd. 65 6 0 0 1 1 1 0 7 2 83
5. YORDA IMAM SUTOMO, S.H. 82 0 1 1 0 0 0 0 0 0 84
6. NIAR YUNIAR 10 0 0 0 3 1 2 0 0 0 16
7. Dr. AGUS SUHENDI, M.Pd. 17 0 0 0 1 2 1 0 0 1 22
8. SUTIYA ANJANI 4 0 0 1 0 0 0 0 0 0 5
9. TOTING SUPRIATNA 1 0 0 0 0 0 0 0 0 1 2
10. YANTI TARYATI 2 0 0 0 2 1 0 0 0 0 5
11. CAHYO FITRIADI 0 1 1 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 2 0 0 2 0 0 0 0 0 1 1 1 2 0 9
6. H. AGUS RIADI 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 3
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1

2. H. KUSNADI, S.I.P. 3 7 6 4 7 4 8 7 6 6 5 2 1 1 1 68
6. LINDA OCTAVIA 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 3
7. H. HELMI BUSTOMI 3 2 1 0 3 0 0 1 1 0 0 2 0 0 1 14
10. FAJAR SETIAWAN 0 2 1 0 0 0 0 0 1 1 0 0 0 0 0 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 3. Partai Demokrasi Indonesia Perjuangan 69 0 5 2 0 5 5 10 6 4 106
A.2 1. Hj. ASYANTI ROZANA, S.E. 34 0 0 1 2 2 4 3 0 3 49
2. DONI MARADONA HUTABARAT, S.H. 212 6 3 19 7 9 11 17 5 3 292
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 13 1 0 0 0 1 0 2 0 0 17
4. Hj. DIAN ROSITA 9 0 2 0 1 2 0 2 1 0 17
5. THARIQ HALILINTAR 11 0 1 1 0 0 0 0 0 0 13
6. H. AGUS RIADI 3 0 0 1 0 1 0 0 1 1 7
7. IRAWATY OCTORA, S.E., M.Si. 4 0 0 0 0 1 0 0 0 0 5
8. MANGONTANG SIMANJUNTAK 1 0 0 0 0 0 0 0 0 0 1
9. BAMBANG SUMANTRI, S.Sos. 1 0 0 0 0 0 0 0 0 0 1
10. EUGINIA NATANIA PUTRI 1 0 0 0 0 1 0 0 0 1 3
11. ALUN HIMAWAN 1 0 0 0 0 0 0 0 0 0 1
A.1 4. Partai Golongan Karya 134 3 6 7 0 6 1 1 2 1 161

A.2 1. SAMSUL HIDAYAT, S.H. 57 7 3 2 1 2 2 2 1 0 77
2. H. KUSNADI, S.I.P. 68 4 0 1 0 0 0 1 2 1 77
3. KURNIAWATYNINGSIH, S.E. 22 1 0 1 0 0 0 0 1 0 25
4. ADI RESTU PERMADI 24 3 1 2 1 0 1 2 1 1 36
5. KHAERUL ANAM, S.Pi., M.Si. 14 0 1 0 0 0 0 0 1 0 16
6. LINDA OCTAVIA 3 1 0 0 0 1 0 0 0 0 5
7. H. HELMI BUSTOMI 14 0 1 2 0 1 1 1 0 0 20
8. MUNAWARAH SUNUSI, S.E., M.Si. 7 0 0 0 0 1 0 0 1 0 9
9. RENO ANGGARA MUKTI, S.ST.Par. 176 34 19 14 20 18 4 8 5 6 304
10. FAJAR SETIAWAN 5 0 0 0 0 0 0 0 0 0 5
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 1 0 1 0 0 1 0 0 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 3 3 1 1 0 3 0 1 6 1 3 2 0 1 0 25
A.2 1. M. RIZKY 1 3 0 1 0 1 2 5 2 3 4 3 0 0 0 25
2. DONDY DWIGUNTIA 0 1 1 0 2 0 3 2 5 0 0 2 10 2 2 30
5. DELLA PUSPITA 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 2
6. AJID, S.Ag. 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
7. UMMI NURAENI, S.H. 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 2
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 0 0 0 0 0 0 0 0 0 1 0 0 0 6 0 7
A.1 6. Partai Buruh 0 1 2 0 0 1 0 0 1 0 0 0 2 0 2 9

A.2 1. Komarudin 0 0 0 2 0 1 1 0 1 0 0 0 0 0 0 5
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 5. Partai NasDem 25 1 3 2 0 2 0 0 0 1 34
A.2 1. M. RIZKY 25 10 3 1 1 0 0 1 2 0 43
2. DONDY DWIGUNTIA 30 9 2 0 2 0 0 0 1 0 44
3. VICA FITHRI NOER AZIZAH 2 0 0 0 0 0 0 0 0 0 2
4. MELIHASRAT JAYA ZAI, S.E. 0 0 0 1 0 0 0 0 0 0 1
5. DELLA PUSPITA 2 0 0 2 0 0 2 0 1 0 7
6. AJID, S.Ag. 1 0 0 0 0 0 0 0 0 0 1
7. UMMI NURAENI, S.H. 2 0 0 0 0 0 0 0 0 0 2
8. AHMAD ROUF, S.I.P., M.Si. 0 1 1 0 0 0 0 2 0 0 4
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 0 0
10. AWALUDDIN, S.T. 0 0 0 0 0 1 0 0 0 0 1
11. ARIFIN, S.Hut. 7 0 30 1 0 0 0 0 0 0 38
A.1 6. Partai Buruh 9 0 0 3 1 0 0 0 0 0 13

A.2 1. Komarudin 5 0 0 1 0 2 0 1 0 0 9
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0
3. Mira Sari La Puppung, S.E. 1 0 1 0 0 0 0 0 0 0 2
4. Agus Sarjanto, S.H. 1 0 0 0 0 0 0 0 0 0 1
5. Sugiarta 0 0 0 0 0 0 0 1 0 0 1
6. Lilis Minarni 1 0 0 0 0 0 0 0 0 0 1
7. Abdul Oir, S.H. 1 0 0 0 0 0 0 0 0 0 1
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 1 0 0 0 0 0 0 0 0 0 1
11. Eva Pusvita Sari, S.Kom. 1 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 0 0 0 0 0 1 0 0 1 0 3 0 0 5
3. NASRUDDIN 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 2
4. NAFIZA 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 2
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 3
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 2 0 0 0 1 0 1 1 0 0 0 0 0 0 5
8. ABDURROKHIM, S.Pt. 2 1 0 0 0 0 0 0 0 0 1 1 0 1 0 6
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 7. Partai Gelombang Rakyat Indonesia 15 1 1 3 3 1 0 3 3 1 31
A.2 1. WIWID PURWAWAN 5 0 0 0 0 0 0 0 1 0 6
2. Hj. LULU MASLUCHAH, Lc. 2 0 2 0 0 1 0 1 1 0 7
3. NASRUDDIN 2 0 0 0 0 0 0 0 0 0 2
4. NAFIZA 2 0 0 0 0 0 0 0 0 0 2
5. FERRY ARDIAN AR. 3 0 0 1 0 0 0 0 0 0 4
6. ANDON TEGAR PRIBADI 0 0 0 0 0 0 0 0 0 0 0
7. RIZKY RADIANTO FAJRI 3 0 0 0 0 1 0 0 0 0 4
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0
9. ISLAM RAHIMI HUSAIN, S.T. 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 55 1 5 5 2 11 2 8 17 7 113

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 52 4 4 2 1 1 0 17 8 5 94
2. DEDI AROZA, S.Ag., M.Si. 15 1 0 1 0 1 1 3 6 2 30
3. Dra. IIN SUPRIHATIN 15 2 1 1 0 1 1 3 4 0 28
4. MOCHAMAD ICHSAN M., S.T. 21 1 0 2 0 2 0 57 13 27 123
5. NUR LAELA TUROHMAH, S.E. 4 2 1 1 0 1 0 1 0 0 10
6. SOPIAN APIP, S.E. 5 0 0 2 0 0 1 0 1 1 10
7. ZULFIKAR MAHBUB ROBBANI 25 0 3 0 1 5 1 2 13 4 54
8. ABDURROKHIM, S.Pt. 6 1 1 0 1 2 2 7 4 2 26
9. DEWI RACHMAWATI, S.E. 5 0 2 0 0 0 0 0 0 0 7
10. MURDOKO, S.H. 2 0 0 0 0 0 0 0 0 0 2
11. RETNO UMMY ASTHASARI, S.T.P. 1 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2

A.2 1. ELIA 0 0 0 1 1 0 1 0 0 0 0 1 0 0 0 4
0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 3
3. ARIEF BUDIMAN 1 0 0 0 1 0 0 0 0 1 0 2 0 0 0 5
4. HERVINA LESTARI 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 2
6. DHEMAS PRADITYA 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 9. Partai Kebangkitan Nusantara 4 0 0 1 1 0 0 0 0 0 6
A.2 1. Neneng Rohimah 0 0 0 0 0 1 0 0 0 0 1
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0
3. JAN ADOLF HUKUBUN 0 0 0 0 0 0 0 0 0 0 0
4. FRANSISKA DWI KESDIATIK 1 0 0 0 0 0 0 0 0 0 1
5. Imam Fauzi 1 0 0 0 0 0 0 0 0 0 1
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 1 0 0 0 0 0 1
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 2 0 0 0 0 0 0 0 0 0 2
A.1 10. Partai Hati Nurani Rakyat 14 1 0 0 0 0 0 0 0 0 15

A.2 1. ELIA 4 0 0 0 1 1 0 1 0 0 7
3 0 0 0 0 0 0 0 0 0 3
3. ARIEF BUDIMAN 5 0 1 0 0 0 0 0 0 0 6
4. HERVINA LESTARI 2 0 0 0 0 0 0 0 0 0 2
5. ANDREAS KURNIAWAN E 3 0 0 0 1 0 0 0 1 0 5
6. DHEMAS PRADITYA 2 0 0 0 0 0 0 0 0 0 2
7. YASMIN INAYAH NATA BUWANA 1 0 0 0 0 0 0 0 0 0 1
8. NIRWAN PRATAMA PUTRA 1 0 0 0 0 0 0 0 0 0 1
9. RD. MOCH. FARIEDHAN 3 0 0 0 0 0 0 0 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 1 2 0 0 0 3

A.2 1. H. SUPONO 1 0 0 0 1 1 0 1 3 1 2 1 0 1 0 12
3. SARASWATI 0 1 1 1 0 2 1 4 2 1 0 1 0 1 0 15
6. ASTRI SARTIKA 0 0 0 0 0 0 0 1 2 0 1 0 0 0 0 4
9. MERRY APRIYANTI 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
10. IIM SOLIHATI 0 0 1 0 1 1 1 0 0 0 1 0 0 0 0 5
11. ANI NURMAYANTI 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 11. Partai Garda Republik Indonesia 5 0 2 0 0 0 0 0 1 0 8
A.2 1. A. KHALIK 3 0 0 0 0 0 0 0 0 1 4
2. YULIANTI BILAKONGA 1 0 0 0 0 0 0 0 0 0 1
A.1 12. Partai Amanat Nasional 74 5 8 8 0 0 0 4 4 4 107

A.2 1. H. SUPONO 12 3 5 3 1 0 0 0 2 0 26
2. H. PERMADI DALUNG, S.E., M.M. 238 20 39 33 4 2 0 26 35 91 488
3. SARASWATI 15 0 2 1 0 0 0 1 1 1 21
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 11 3 4 0 0 0 0 0 2 1 21
5. CEPI AL HAKIM, S.T.P., M.Si. 5 0 1 1 0 0 0 1 0 0 8
6. ASTRI SARTIKA 4 0 0 0 0 0 0 0 1 0 5
7. REGIVAL PUTRA ADRIAN 3 1 0 0 1 0 0 2 0 0 7
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 6 0 0 0 1 0 0 0 1 0 8
9. MERRY APRIYANTI 1 0 0 0 0 1 0 0 0 0 2
10. IIM SOLIHATI 5 1 1 1 0 0 0 0 0 0 8
11. ANI NURMAYANTI 2 0 1 1 0 0 0 0 0 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 3
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 0 0 0 0 2 0 0 1 1 0 1 2 1 1 0 9
7. REDIKA SEGARA, S.E. 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 3
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 13. Partai Bulan Bintang 4 0 0 0 0 1 0 0 0 0 5
A.2 1. SOLAHUDDIN, S.H., M.H. 6 0 0 0 0 0 0 0 0 0 6
2. AGUS SUKARNA WIJAYA 0 0 0 0 0 0 0 0 0 0 0
3. FITRIASARI 3 0 0 0 0 0 0 0 0 0 3
4. DJUMHAWAN R PERMANA 1 0 0 0 0 0 0 0 0 0 1
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 0 0 0 0 0 0 0 0 0 0 0
7. WAWANG HUSNAWATI 0 0 0 0 0 0 0 0 0 0 0
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0
9. Mochammad Muzaqi 1 0 0 0 0 0 0 0 0 0 1
10. MOCHAMAD MORO ASIH 1 0 0 0 0 0 0 0 0 0 1
A.1 14. Partai Demokrat 29 5 1 1 0 3 0 2 0 0 41

A.2 1. DEDE CANDRA SASMITA, S.Ag. 55 24 4 2 1 0 1 1 1 1 90
2. MANATAP P SIMANJUNTAK 5 0 1 0 0 0 1 0 0 0 7
3. ANDRIYANTI WIJAYA 5 0 0 0 0 1 0 0 0 0 6
4. SAIFUL 9 1 0 0 0 0 0 0 0 0 10
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 5 0 1 1 0 0 0 0 0 0 7
6. ARNY NURANI SANGAJI 1 0 0 0 0 0 0 0 0 0 1
7. REDIKA SEGARA, S.E. 3 0 0 0 0 0 0 0 0 0 3
8. KARDAN 1 0 0 0 0 0 0 0 0 0 1
9. HARKES WOROWATI W. A. 12 0 0 0 0 0 0 0 1 0 13
10. NAUFAL ANDHIKA IRAWAN 2 0 0 0 0 0 0 0 0 0 2
11. ENDAH HENDRAWASIH 0 0 0 0 1 0 0 0 1 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 2
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 0 2 0 0 1 1 0 1 1 0 0 1 0 0 0 7
8. DESI FITRI DIANA 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 3
A.1 16. PARTAI PERINDO 1 0 0 1 0 0 1 0 0 0 0 0 1 0 0 4

A.2 1. RESITA KANIYA 0 0 1 0 0 0 1 1 0 0 0 1 0 0 0 4
2. AGUS WINARNO 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 15. Partai Solidaritas Indonesia 14 0 1 1 0 0 0 0 0 0 16
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 4 0 0 1 1 0 0 0 2 0 8
2. FEBRY CITRA, S.T., M.A.B. 7 0 1 0 0 0 0 0 0 0 8
3. SIANA RIA, S.E., M.M. 2 0 0 0 0 0 0 0 0 0 2
4. MUHAMMAD ADE ALIYUDIN, S.H. 11 0 1 0 0 3 0 0 1 0 16
5. JASIMAN SITORUS, S.Kom., M.M. 2 0 0 0 0 0 0 0 0 0 2
6. DIAH WINARSIH 0 1 0 0 0 0 0 0 0 0 1
7. GUNADI, M.Ag. 7 0 0 1 0 0 0 0 0 0 8
8. DESI FITRI DIANA 3 0 0 0 0 0 0 0 0 0 3
A.1 16. PARTAI PERINDO 4 1 0 0 0 0 0 0 0 0 5

A.2 1. RESITA KANIYA 4 0 0 0 0 0 0 0 0 0 4
2. AGUS WINARNO 1 0 0 0 0 0 0 0 0 0 1
3. Drs. SUMARWAN SASTRA 1 0 0 0 0 0 0 0 0 0 1
4. NENDEN BANURIAH, S.Pd. 0 1 0 0 0 0 0 0 0 0 1
5. AMARENS MANUHUTU 0 0 0 0 0 0 0 0 0 0 0
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 0 0 0 0 0 0 0 0 0 0 0
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 0 0 0 0 0 2 0 0 0 0 2
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 2 0 0 0 0 0 0 0 1 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 3
3. DWI ARYANTI, S.E. 2 5 0 1 2 3 0 3 0 3 0 2 0 0 0 21
4. IRFAN DARAJAT 0 1 1 6 25 9 7 1 0 0 0 0 0 0 0 50
5. FERRY PERDIAN 0 3 3 0 4 6 1 1 0 3 2 2 0 0 0 25
9. GUNAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 17. Partai Persatuan Pembangunan 41 0 0 1 0 4 0 1 0 1 48
A.2 1. H. MUHAMAD ROMLI, A.Md. 70 2 3 3 0 2 0 0 1 0 81
2. JUHANTA, S.T. 3 0 0 1 0 0 0 0 0 0 4
3. DWI ARYANTI, S.E. 21 3 0 1 1 1 0 0 0 0 27
4. IRFAN DARAJAT 50 0 1 0 0 1 0 1 0 0 53
5. FERRY PERDIAN 25 1 3 4 0 0 0 0 2 3 38
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 2 0 0 0 0 0 0 0 0 0 2
7. YENTI NASHI HATUL UMMAH 5 1 0 1 0 0 0 0 0 0 7
8. ABDUL ROHIM, S.Si., Apt. 9 1 0 0 0 1 0 0 0 0 11
9. GUNAWAN 0 0 0 0 0 0 0 0 0 0 0
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 0 0 0 0 0 0 0 0 0 0 0

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 0 0 0 1 0 0 0 0 0 0 1
2. SELLY AFRIDA OLTAR, S.I.P. 0 0 0 0 0 0 0 0 0 0 0
3. H. SUMIRAT SAPTA HADI, S.Ag. 0 0 0 0 0 0 0 0 0 0 0
4. Drs. H. ASRI AL JUFRI, M.Si. 1 0 0 0 0 0 0 0 0 0 1
5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 1 0 0 1
6. Drs. MOCH ZAENAL AL AQILI 0 0 0 0 0 0 0 0 0 0 0
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 1 0 0 0 0 0 0 0 0 0 1
9. JAKA JATI NUR ALAM 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.803 218 208 189 151 166 169 220 210 195 4.529
B. JUMLAH SUARA TIDAK SAH 575 15 29 23 11 14 17 21 16 12 733
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.378 233 237 212 162 180 186 241 226 207 5.262

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: BANYURESMI
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 126 92 144 143 136 107 104 145 152 112 88 121 114 139 105 1.828
JML 238 191 275 285 274 198 208 289 288 220 174 221 203 240 197 3.501
LK 104 79 124 111 104 85 87 102 130 85 69 100 101 105 75 1.461
JML 202 164 239 230 221 169 168 210 255 176 144 188 182 182 152 2.882
LK 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
JML 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
LK 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 2
JML 0 0 0 1 0 0 0 2 0 1 1 0 0 0 0 5
LK 104 79 124 111 104 85 87 103 131 86 69 100 101 105 75 1.464
JML 202 164 239 231 221 169 168 212 256 177 145 188 182 182 152 2.888
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 41 32 42 60 59 34 45 83 38 48 33 38 26 62 49 690
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
JML 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12
A DATA PEMILIH
LK 1.828 139 132 93 109 130 93 104 2.628
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 1.673 113 127 83 84 126 90 87 2.383
JML 3.501 252 259 176 193 256 183 191 5.011
LK 1.461 112 98 79 80 85 80 84 2.079
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.421 100 104 71 68 90 80 69 2.003
JML 2.882 212 202 150 148 175 160 153 4.082
LK 1 0 0 0 1 0 0 0 2
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 0 0 0 0 0 0 0 0 0
JML 1 0 0 0 1 0 0 0 2
LK 2 0 0 0 1 0 0 0 3
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 3 0 0 0 0 0 0 0 3
JML 5 0 0 0 1 0 0 0 6
LK 1.464 112 98 79 82 85 80 84 2.084
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.424 100 104 71 68 90 80 69 2.006
JML 2.888 212 202 150 150 175 160 153 4.090
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 3.578 258 265 199 197 262 187 195 5.141
2 Jumlah surat suara yang digunakan 2.888 212 202 150 150 175 160 153 4.090
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 0 0 0 0 0 0 0 0 0
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 690 46 63 49 47 87 27 42 1.051
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12
LK 1 0 0 0 0 0 0 0 1
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 0 0 0 0 0 0 0 0 0
JML 1 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 2


3. UDI SUHANDORO 1 1 1 0 1 0 0 0 1 0 1 6 2 1 1 16
6. NIAR YUNIAR 0 1 0 1 2 0 0 0 0 0 0 1 0 0 2 7
8. SUTIYA ANJANI 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 5
10. YANTI TARYATI 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 3
11. CAHYO FITRIADI 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11
A.1 1. Partai Kebangkitan Bangsa 131 16 10 3 5 8 17 15 205
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 85 3 5 12 1 2 5 2 115
2. DINDIN ABDULLAH GHOZALI 13 1 1 0 0 0 0 0 15
3. H. AMIR AMIRULOH, S.H. 10 0 3 0 1 0 0 0 14
4. NAFIZUL ALHAFIZRANA 3 0 0 0 0 1 0 1 5
5. BAGUS DJATI KUSUMA 24 1 0 0 1 0 0 0 26
6. SHOLEHATUN NASIHA, S.Kom. 5 0 0 0 1 0 0 0 6
7. Ir. AAN SURYA PRIYANA 3 0 1 0 1 0 0 0 5
8. AGUS MULYADI, S.Pd. 2 0 0 0 0 0 0 0 2
9. ROSALINDA RAMDHANIAH, S.Ag. 2 0 0 0 0 0 0 0 2
10. TEGUH YULIANTO, S.T. 1 0 0 0 0 0 0 0 1
11. RISMA PUJI RIANTI 6 1 0 0 0 0 1 4 12
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 285 22 20 15 10 11 23 22 408
A.1 2. Partai Gerakan Indonesia Raya 180 30 12 7 21 25 8 17 300

A.2 1. H. RICKY KURNIAWAN, Lc. 52 7 8 3 5 4 12 6 97
2. Ir. PRASETYAWATI, M.M. 35 5 1 2 3 0 1 5 52

3. UDI SUHANDORO 16 4 1 0 0 1 1 0 23
4. H. CECEP GOGOM, S.Ag., M.Pd. 88 24 0 2 0 1 0 3 118
5. YORDA IMAM SUTOMO, S.H. 7 0 0 0 0 0 1 2 10
6. NIAR YUNIAR 7 1 0 1 0 0 1 1 11
7. Dr. AGUS SUHENDI, M.Pd. 2 0 0 0 0 0 0 0 2
8. SUTIYA ANJANI 5 1 0 0 0 0 0 0 6
9. TOTING SUPRIATNA 2 0 0 0 0 0 0 0 2
10. YANTI TARYATI 3 2 0 0 1 0 0 0 6
11. CAHYO FITRIADI 2 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 2 1 0 2 0 0 1 1 1 0 1 0 0 0 9
6. H. AGUS RIADI 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 2
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2. H. KUSNADI, S.I.P. 5 7 8 8 6 5 3 1 2 0 1 1 1 1 2 51
6. LINDA OCTAVIA 2 1 1 0 0 0 0 0 0 0 0 1 0 1 0 6
7. H. HELMI BUSTOMI 1 0 0 1 1 0 0 1 0 0 1 0 0 1 0 6
10. FAJAR SETIAWAN 1 1 3 0 1 0 0 1 0 1 0 0 0 0 0 8
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 3. Partai Demokrasi Indonesia Perjuangan 98 5 5 8 6 4 0 7 133
A.2 1. Hj. ASYANTI ROZANA, S.E. 19 0 2 4 1 1 2 2 31
2. DONI MARADONA HUTABARAT, S.H. 37 5 0 2 2 2 1 2 51
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 15 0 3 0 0 0 1 2 21
4. Hj. DIAN ROSITA 9 0 0 1 0 2 0 0 12
5. THARIQ HALILINTAR 2 0 0 0 0 0 0 0 2
6. H. AGUS RIADI 2 0 0 0 0 0 0 0 2
7. IRAWATY OCTORA, S.E., M.Si. 0 0 0 0 0 0 0 1 1
8. MANGONTANG SIMANJUNTAK 0 0 0 0 0 0 0 0 0
9. BAMBANG SUMANTRI, S.Sos. 3 0 0 0 0 0 0 0 3
10. EUGINIA NATANIA PUTRI 1 0 0 0 0 0 0 0 1
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0
A.1 4. Partai Golongan Karya 251 4 15 20 7 10 9 12 328

A.2 1. SAMSUL HIDAYAT, S.H. 180 2 4 4 5 0 10 5 210
2. H. KUSNADI, S.I.P. 51 0 3 1 1 2 1 0 59
3. KURNIAWATYNINGSIH, S.E. 18 1 0 1 1 0 1 2 24
4. ADI RESTU PERMADI 19 1 0 1 2 0 1 0 24
5. KHAERUL ANAM, S.Pi., M.Si. 7 1 0 0 0 1 0 0 9
6. LINDA OCTAVIA 6 2 1 3 0 1 0 1 14
7. H. HELMI BUSTOMI 6 0 1 1 1 0 0 0 9
8. MUNAWARAH SUNUSI, S.E., M.Si. 2 0 1 1 0 0 0 0 4
9. RENO ANGGARA MUKTI, S.ST.Par. 127 1 2 17 5 4 0 2 158
10. FAJAR SETIAWAN 8 0 0 3 0 0 0 0 11
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 2 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 1 0 3 0 6 5 2 14 7 8 7 12 4 4 2 75
A.2 1. M. RIZKY 0 1 1 5 11 3 1 6 22 4 9 2 7 2 1 75
2. DONDY DWIGUNTIA 1 0 0 0 1 0 0 32 30 23 12 28 11 2 19 159
5. DELLA PUSPITA 0 0 1 0 1 0 0 0 2 0 1 0 1 0 0 6
6. AJID, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. MUHAMAD RIDWAN 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
10. AWALUDDIN, S.T. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
11. ARIFIN, S.Hut. 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2
A.1 6. Partai Buruh 0 0 0 0 2 0 1 1 1 0 0 0 0 1 0 6

A.2 1. Komarudin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 5. Partai NasDem 75 0 2 1 4 5 6 5 98
A.2 1. M. RIZKY 75 1 0 1 4 8 29 4 122
2. DONDY DWIGUNTIA 159 0 0 0 0 0 1 0 160
3. VICA FITHRI NOER AZIZAH 1 0 0 0 0 0 0 0 1
4. MELIHASRAT JAYA ZAI, S.E. 1 0 0 0 0 1 0 0 2
5. DELLA PUSPITA 6 0 0 0 1 0 1 0 8
6. AJID, S.Ag. 1 0 0 0 0 0 0 0 1
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0
8. AHMAD ROUF, S.I.P., M.Si. 3 0 0 0 0 0 0 0 3
9. MUHAMAD RIDWAN 1 0 1 0 0 0 0 0 2
10. AWALUDDIN, S.T. 1 0 0 0 0 0 0 0 1
11. ARIFIN, S.Hut. 2 0 0 0 0 0 0 0 2
A.1 6. Partai Buruh 6 1 0 0 0 0 0 0 7

A.2 1. Komarudin 0 0 0 0 0 0 0 1 1
2. Krisdianto, S.H. 0 0 0 0 0 0 1 0 1
3. Mira Sari La Puppung, S.E. 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 1 0 0 0 0 0 0 0 1
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 1 0 0 0 0 0 0 1 2
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
3. NASRUDDIN 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 2
4. NAFIZA 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. ABDURROKHIM, S.Pt. 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 7. Partai Gelombang Rakyat Indonesia 9 0 2 0 3 1 1 0 16
A.2 1. WIWID PURWAWAN 1 0 0 0 0 0 1 0 2
2. Hj. LULU MASLUCHAH, Lc. 2 0 0 0 0 0 0 0 2
3. NASRUDDIN 2 1 0 0 0 0 0 0 3
4. NAFIZA 1 0 0 0 0 0 0 0 1
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0
6. ANDON TEGAR PRIBADI 0 0 0 0 0 0 0 0 0
7. RIZKY RADIANTO FAJRI 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 1 0 0 0 0 0 0 0 1
9. ISLAM RAHIMI HUSAIN, S.T. 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 28 4 2 4 2 1 2 3 46

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 14 0 2 0 1 0 0 2 19
2. DEDI AROZA, S.Ag., M.Si. 3 0 0 1 0 0 0 0 4
3. Dra. IIN SUPRIHATIN 6 1 2 0 1 0 0 0 10
4. MOCHAMAD ICHSAN M., S.T. 2 0 0 0 0 0 0 0 2
5. NUR LAELA TUROHMAH, S.E. 0 0 0 0 0 0 0 0 0
6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 0
7. ZULFIKAR MAHBUB ROBBANI 2 0 0 2 0 0 0 0 4
8. ABDURROKHIM, S.Pt. 1 1 0 1 0 0 0 0 3
9. DEWI RACHMAWATI, S.E. 0 0 0 0 0 0 0 0 0
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0
11. RETNO UMMY ASTHASARI, S.T.P. 1 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 2
2. Irwan Yani 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. ELIA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 3
3. ARIEF BUDIMAN 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 9. Partai Kebangkitan Nusantara 21 0 0 3 0 1 0 0 25
A.2 1. Neneng Rohimah 2 0 0 0 0 0 0 0 2
2. Irwan Yani 1 0 0 0 0 0 0 0 1
3. JAN ADOLF HUKUBUN 0 0 0 0 0 0 0 0 0
4. FRANSISKA DWI KESDIATIK 1 0 0 0 0 0 0 0 1
5. Imam Fauzi 0 0 0 0 0 0 1 0 1
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0
A.1 10. Partai Hati Nurani Rakyat 5 5 0 0 0 0 0 0 10

A.2 1. ELIA 0 1 0 0 0 0 1 0 2
3 1 0 0 0 0 0 0 4
3. ARIEF BUDIMAN 1 0 0 0 1 0 0 0 2
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0
5. ANDREAS KURNIAWAN E 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0
7. YASMIN INAYAH NATA BUWANA 0 0 0 0 0 1 0 0 1
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. H. SUPONO 2 0 2 0 0 0 0 0 1 1 1 0 2 3 1 13
3. SARASWATI 0 2 2 1 0 0 0 2 6 0 3 2 2 0 0 20
6. ASTRI SARTIKA 0 1 0 1 0 1 0 0 0 0 1 1 0 0 0 5
9. MERRY APRIYANTI 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
10. IIM SOLIHATI 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 11. Partai Garda Republik Indonesia 7 0 0 0 0 0 0 0 7
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0
2. YULIANTI BILAKONGA 2 0 0 0 0 0 0 0 2
A.1 12. Partai Amanat Nasional 66 8 2 3 4 4 2 1 90

A.2 1. H. SUPONO 13 3 0 0 1 2 1 1 21
2. H. PERMADI DALUNG, S.E., M.M. 55 1 0 0 1 10 0 0 67
3. SARASWATI 20 0 1 0 0 1 0 1 23
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 20 10 0 1 0 0 0 1 32
5. CEPI AL HAKIM, S.T.P., M.Si. 6 0 0 0 0 0 0 0 6
6. ASTRI SARTIKA 5 0 0 0 0 0 0 1 6
7. REGIVAL PUTRA ADRIAN 0 0 0 0 0 1 0 0 1
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 0 0 0 0 0 0 0 0 0
9. MERRY APRIYANTI 1 0 0 0 0 1 0 0 2
10. IIM SOLIHATI 1 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 2
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 2
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 13. Partai Bulan Bintang 29 11 5 3 3 5 9 1 66
A.2 1. SOLAHUDDIN, S.H., M.H. 28 1 7 1 4 2 1 2 46
2. AGUS SUKARNA WIJAYA 3 0 0 0 0 1 0 1 5
3. FITRIASARI 2 0 1 0 0 0 0 0 3
4. DJUMHAWAN R PERMANA 1 0 0 0 0 0 0 1 2
5. Deni Rusydiana, S.H.I. 2 0 0 0 0 0 0 0 2
6. YANI SURYANI FIKRIAH 0 0 0 0 1 0 0 0 1
7. WAWANG HUSNAWATI 2 0 0 0 0 0 0 0 2
8. Sanusi Permana 0 0 0 0 0 0 0 0 0
9. Mochammad Muzaqi 1 0 0 0 0 0 0 0 1
10. MOCHAMAD MORO ASIH 0 0 0 0 0 0 0 0 0
A.1 14. Partai Demokrat 24 2 4 2 1 1 2 1 37

A.2 1. DEDE CANDRA SASMITA, S.Ag. 22 0 0 1 1 1 2 2 29
2. MANATAP P SIMANJUNTAK 1 0 0 0 0 0 1 0 2
3. ANDRIYANTI WIJAYA 4 0 0 0 0 0 0 0 4
4. SAIFUL 2 0 0 0 0 0 0 0 2
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 1 0 0 0 0 0 0 0 1
6. ARNY NURANI SANGAJI 1 0 0 0 0 0 0 0 1
7. REDIKA SEGARA, S.E. 1 0 0 0 0 0 0 0 1
8. KARDAN 0 0 0 0 0 0 0 1 1
9. HARKES WOROWATI W. A. 3 0 0 0 0 0 0 0 3
10. NAUFAL ANDHIKA IRAWAN 0 0 0 0 0 0 0 0 0
11. ENDAH HENDRAWASIH 1 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 2 1 1 0 2 2 1 0 0 0 0 0 0 0 0 9

A.2 1. RESITA KANIYA 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 3
2. AGUS WINARNO 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 2
7. YURIZAL, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
9. ELLY MARYANTI 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 3
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 15. Partai Solidaritas Indonesia 11 1 0 1 0 1 0 0 14
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 5 0 1 1 0 0 0 1 8
2. FEBRY CITRA, S.T., M.A.B. 1 0 0 1 0 0 0 0 2
3. SIANA RIA, S.E., M.M. 0 0 0 0 0 0 0 0 0
4. MUHAMMAD ADE ALIYUDIN, S.H. 1 0 0 0 0 0 0 0 1
5. JASIMAN SITORUS, S.Kom., M.M. 1 0 0 0 0 0 0 0 1
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 9 0 1 0 0 0 0 0 10

A.2 1. RESITA KANIYA 3 0 1 0 1 0 0 0 5
2. AGUS WINARNO 2 0 1 0 0 0 0 1 4
3. Drs. SUMARWAN SASTRA 1 1 0 0 1 0 0 0 3
4. NENDEN BANURIAH, S.Pd. 0 0 0 0 0 0 0 0 0
5. AMARENS MANUHUTU 1 0 0 0 0 0 0 0 1
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 1 0 0 0 0 0 0 0 1
7. YURIZAL, S.E., M.M. 1 0 0 0 0 0 0 0 1
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 3 0 0 0 0 0 0 0 3
10. RAHMAT HIDAYAT 0 0 0 0 1 0 0 0 1
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 0 0 0 1 0 0 0 1 1 0 0 0 0 0 1 4
3. DWI ARYANTI, S.E. 2 3 2 3 1 1 0 4 0 0 0 2 1 0 0 19
4. IRFAN DARAJAT 0 1 0 0 0 0 3 0 1 0 0 0 0 0 0 5
5. FERRY PERDIAN 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 2
9. GUNAWAN 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RIKE ISKANDAR 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 2
A.1 24. Partai Ummat 0 0 1 0 0 0 0 0 1 1 0 0 0 1 0 4

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 17. Partai Persatuan Pembangunan 65 10 11 3 5 7 4 5 110
A.2 1. H. MUHAMAD ROMLI, A.Md. 37 11 9 6 1 0 1 1 66
2. JUHANTA, S.T. 4 3 1 1 1 1 0 1 12
3. DWI ARYANTI, S.E. 19 0 3 0 0 2 1 1 26
4. IRFAN DARAJAT 5 0 0 0 1 0 0 0 6
5. FERRY PERDIAN 2 0 0 0 0 0 0 0 2
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 1 0 0 1 0 0 1 0 3
7. YENTI NASHI HATUL UMMAH 3 0 0 0 0 1 0 0 4
8. ABDUL ROHIM, S.Si., Apt. 0 0 0 0 1 0 0 0 1
9. GUNAWAN 1 0 0 0 0 0 0 0 1
10. RIA ANWAR 0 0 0 0 0 0 0 0 0
11. RIKE ISKANDAR 2 0 0 0 0 0 0 0 2
A.1 24. Partai Ummat 4 0 0 0 1 0 1 0 6

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 1 0 0 0 0 1 0 0 2
2. SELLY AFRIDA OLTAR, S.I.P. 0 0 0 0 0 0 0 0 0
3. H. SUMIRAT SAPTA HADI, S.Ag. 1 0 0 0 0 0 0 0 1
4. Drs. H. ASRI AL JUFRI, M.Si. 1 0 0 0 0 0 0 0 1
5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0
6. Drs. MOCH ZAENAL AL AQILI 0 0 0 0 0 0 0 0 0
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 2 0 0 0 0 0 0 0 2
9. JAKA JATI NUR ALAM 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.499 196 138 135 117 129 143 132 3.489
B. JUMLAH SUARA TIDAK SAH 389 16 64 15 33 46 17 21 601
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 2.888 212 202 150 150 175 160 153 4.090

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: CINTAMANIK
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 146 157 160 152 164 165 155 126 138 162 152 165 135 163 141 2.281
JML 295 299 297 300 299 299 292 251 260 299 290 300 267 299 252 4.299
LK 100 94 97 106 107 100 90 64 87 100 107 112 101 120 103 1.488
JML 227 190 198 226 212 209 195 148 186 209 219 227 208 236 203 3.093
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
LK 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 3
JML 0 0 0 0 1 0 0 0 0 0 1 1 0 2 0 5
LK 100 94 97 106 108 100 90 64 87 100 108 113 101 120 104 1.492
JML 227 190 198 226 213 209 195 148 186 209 220 228 208 238 204 3.099
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 73 115 108 80 90 96 103 109 80 96 76 78 65 66 54 1.289
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 2 0 0 0 0 0 1 0 0 0 0 0 0 0 0 3
JML 3 0 0 0 0 0 1 0 0 0 0 0 0 0 0 4
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A DATA PEMILIH
LK 2.281 148 118 136 159 128 151 163 155 158 121 109 3.827
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 2.018 123 99 128 138 105 137 136 139 141 110 104 3.378
JML 4.299 271 217 264 297 233 288 299 294 299 231 213 7.205
LK 1.488 88 64 93 96 78 96 100 109 92 87 78 2.469
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.605 93 74 100 107 85 114 90 102 94 88 79 2.631
JML 3.093 181 138 193 203 163 210 190 211 186 175 157 5.100
LK 1 0 0 0 0 0 0 0 0 0 0 0 1
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 1 0 0 0 0 0 0 0 0 0 0 0 1
LK 3 0 0 0 0 4 0 0 2 0 0 0 9
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 2 0 0 0 0 0 0 0 2 0 0 0 4
JML 5 0 0 0 0 4 0 0 4 0 0 0 13
LK 1.492 88 64 93 96 82 96 100 111 92 87 78 2.479
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.607 93 74 100 107 85 114 90 104 94 88 79 2.635
JML 3.099 181 138 193 203 167 210 190 215 186 175 157 5.114
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 4.391 277 222 270 303 238 294 305 300 305 236 218 7.359
2 Jumlah surat suara yang digunakan 3.099 181 138 193 203 167 210 190 215 186 175 157 5.114
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 3 1 0 0 0 0 0 0 0 0 0 0 4
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 1.289 95 84 77 100 71 84 115 85 119 61 61 2.241
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
LK 3 0 0 0 0 0 0 0 0 0 0 0 3
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 1 0 0 0 0 1 0 0 0 0 0 0 2
JML 4 0 0 0 0 1 0 0 0 0 0 0 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1


3. UDI SUHANDORO 1 0 5 3 3 4 1 0 0 3 4 4 4 4 1 37
6. NIAR YUNIAR 1 0 0 1 1 1 2 0 0 0 0 0 1 3 1 11
8. SUTIYA ANJANI 1 4 1 5 3 1 2 4 0 0 5 5 0 3 1 35
10. YANTI TARYATI 0 0 0 0 1 0 0 0 0 1 0 1 2 0 0 5
11. CAHYO FITRIADI 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 1. Partai Kebangkitan Bangsa 148 10 9 10 11 7 14 15 17 10 13 9 273
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 89 11 2 21 5 1 3 14 9 6 3 3 167
2. DINDIN ABDULLAH GHOZALI 7 0 0 0 3 0 1 0 0 1 0 1 13
3. H. AMIR AMIRULOH, S.H. 15 0 0 0 3 1 1 1 3 2 1 0 27
4. NAFIZUL ALHAFIZRANA 12 0 0 0 0 0 0 1 0 2 1 0 16
5. BAGUS DJATI KUSUMA 1 0 0 0 0 0 0 0 0 0 0 0 1
6. SHOLEHATUN NASIHA, S.Kom. 6 0 0 0 0 0 0 0 1 0 0 0 7
7. Ir. AAN SURYA PRIYANA 4 0 0 1 0 0 0 0 0 0 0 0 5
8. AGUS MULYADI, S.Pd. 1 2 0 0 0 0 0 0 0 0 0 0 3
9. ROSALINDA RAMDHANIAH, S.Ag. 4 0 0 0 0 0 0 0 1 0 0 0 5
10. TEGUH YULIANTO, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RISMA PUJI RIANTI 2 0 1 0 0 0 0 1 0 0 0 0 4
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 289 23 12 32 22 9 19 32 31 21 18 13 521
A.1 2. Partai Gerakan Indonesia Raya 244 17 12 9 13 11 20 34 39 37 28 21 485

A.2 1. H. RICKY KURNIAWAN, Lc. 115 5 3 11 26 4 19 6 5 4 2 7 207
2. Ir. PRASETYAWATI, M.M. 92 5 9 6 2 8 7 5 1 3 3 0 141

3. UDI SUHANDORO 37 2 4 1 2 3 0 3 2 4 1 4 63
4. H. CECEP GOGOM, S.Ag., M.Pd. 43 2 1 1 3 0 2 0 5 1 0 1 59
5. YORDA IMAM SUTOMO, S.H. 9 1 0 0 0 0 2 0 1 1 0 0 14
6. NIAR YUNIAR 11 0 0 0 3 1 0 3 0 3 1 2 24
7. Dr. AGUS SUHENDI, M.Pd. 7 0 0 0 0 0 1 0 0 0 0 0 8
8. SUTIYA ANJANI 35 2 1 0 1 0 1 0 0 0 0 0 40
9. TOTING SUPRIATNA 4 0 0 0 0 0 0 0 0 0 1 0 5
10. YANTI TARYATI 5 0 1 1 1 0 0 0 0 0 0 0 8
11. CAHYO FITRIADI 1 0 0 0 1 0 0 0 0 0 0 0 2
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 603 34 31 29 52 27 52 51 53 53 36 35 1.056
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 1 0 0 0 0 0 1 1 0 1 1 0 1 1 7
6. H. AGUS RIADI 0 0 0 0 0 1 0 0 1 0 0 1 0 1 0 4
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1

2. H. KUSNADI, S.I.P. 1 0 0 2 0 0 0 0 0 0 0 0 1 2 0 6
6. LINDA OCTAVIA 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 2
7. H. HELMI BUSTOMI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. FAJAR SETIAWAN 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 3. Partai Demokrasi Indonesia Perjuangan 177 7 7 9 18 9 10 24 8 3 5 3 280
A.2 1. Hj. ASYANTI ROZANA, S.E. 278 12 15 12 2 10 8 1 2 1 0 0 341
2. DONI MARADONA HUTABARAT, S.H. 30 3 1 3 1 7 7 0 0 0 0 0 52
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 19 1 1 1 4 2 2 1 1 0 1 1 34
4. Hj. DIAN ROSITA 7 2 0 0 0 0 0 0 0 0 0 0 9
5. THARIQ HALILINTAR 7 0 0 0 0 0 0 0 0 0 0 0 7
6. H. AGUS RIADI 4 0 0 0 0 0 0 0 0 0 0 0 4
7. IRAWATY OCTORA, S.E., M.Si. 0 0 0 0 0 0 2 0 0 0 0 0 2
8. MANGONTANG SIMANJUNTAK 5 0 0 1 0 0 0 0 0 0 0 0 6
9. BAMBANG SUMANTRI, S.Sos. 0 0 0 0 0 0 0 0 0 0 0 0 0
10. EUGINIA NATANIA PUTRI 1 0 0 0 0 0 1 0 0 0 0 0 2
11. ALUN HIMAWAN 1 0 0 0 0 0 0 0 0 0 0 0 1
A.1 4. Partai Golongan Karya 46 3 1 2 6 1 4 7 26 25 16 11 148

A.2 1. SAMSUL HIDAYAT, S.H. 17 5 0 2 0 0 1 2 4 6 3 1 41
2. H. KUSNADI, S.I.P. 6 2 1 2 1 0 0 1 1 0 3 0 17
3. KURNIAWATYNINGSIH, S.E. 5 0 0 1 0 1 0 0 1 0 0 0 8
4. ADI RESTU PERMADI 3 0 0 0 0 0 0 1 2 1 0 1 8
5. KHAERUL ANAM, S.Pi., M.Si. 0 0 0 0 0 0 0 1 0 0 0 0 1
6. LINDA OCTAVIA 2 0 0 0 0 1 0 0 0 0 0 0 3
7. H. HELMI BUSTOMI 0 0 0 0 1 0 0 0 0 0 0 0 1
8. MUNAWARAH SUNUSI, S.E., M.Si. 1 0 0 0 0 0 0 0 0 0 0 0 1
9. RENO ANGGARA MUKTI, S.ST.Par. 6 0 0 0 9 6 1 0 0 3 2 0 27
10. FAJAR SETIAWAN 2 0 0 0 0 0 0 0 0 0 0 0 2
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 1 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 6 1 1 1 1 5 3 1 0 2 2 1 1 0 0 25
A.2 1. M. RIZKY 3 1 2 0 0 0 1 0 0 2 0 3 0 1 1 14
2. DONDY DWIGUNTIA 2 0 1 0 1 0 0 1 0 3 0 1 3 0 0 12
5. DELLA PUSPITA 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 2
6. AJID, S.Ag. 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 2
7. UMMI NURAENI, S.H. 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 2
9. MUHAMAD RIDWAN 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 3
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 14 0 0 0 1 5 1 0 0 0 2 6 0 0 0 29
A.1 6. Partai Buruh 2 0 0 0 0 0 1 1 0 2 1 1 0 1 1 10

A.2 1. Komarudin 0 0 2 1 0 0 1 1 0 1 0 1 1 2 1 11
2. Krisdianto, S.H. 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 2 0 0 0 0 0 0 0 0 0 0 0 1 0 0 3
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 5. Partai NasDem 25 2 0 4 3 0 1 0 2 3 4 0 44
A.2 1. M. RIZKY 14 0 2 0 1 0 1 0 0 0 0 0 18
2. DONDY DWIGUNTIA 12 1 1 2 0 3 0 0 0 0 0 0 19
3. VICA FITHRI NOER AZIZAH 3 0 0 0 0 0 0 0 0 0 0 0 3
4. MELIHASRAT JAYA ZAI, S.E. 1 0 0 0 0 0 0 0 0 0 0 0 1
5. DELLA PUSPITA 2 0 1 0 0 0 0 0 0 0 0 0 3
6. AJID, S.Ag. 2 0 0 0 0 0 0 0 0 0 0 0 2
7. UMMI NURAENI, S.H. 2 0 0 0 0 0 0 0 0 0 0 0 2
8. AHMAD ROUF, S.I.P., M.Si. 1 0 0 0 0 0 0 0 0 0 0 0 1
9. MUHAMAD RIDWAN 3 0 0 0 1 0 0 0 0 0 0 0 4
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 29 0 1 0 0 0 0 0 0 0 0 0 30
A.1 6. Partai Buruh 10 0 0 0 0 0 0 2 1 2 0 1 16

A.2 1. Komarudin 11 0 0 0 0 0 0 0 1 0 0 1 13
2. Krisdianto, S.H. 2 1 0 1 0 0 0 0 0 0 0 0 4
3. Mira Sari La Puppung, S.E. 2 0 0 0 0 0 0 0 0 0 0 0 2
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 1 0 1
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 1 1 0 0 1 0 0 0 0 0 0 1 4
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 3 0 0 0 0 0 0 0 0 0 0 0 3
9. Rinda Ayu Pratiwi, S.Sos. 1 0 0 0 0 0 0 0 0 0 0 0 1
10. SAHRUL BAHRI 1 0 0 0 0 0 0 0 0 0 0 0 1
11. Eva Pusvita Sari, S.Kom. 1 0 0 0 1 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 2
3. NASRUDDIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. NAFIZA 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
8. ABDURROKHIM, S.Pt. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 7. Partai Gelombang Rakyat Indonesia 9 1 0 1 2 1 1 3 4 3 3 4 32
A.2 1. WIWID PURWAWAN 2 0 0 1 0 0 0 0 0 0 0 0 3
2. Hj. LULU MASLUCHAH, Lc. 1 0 0 0 0 2 0 0 0 0 1 0 4
3. NASRUDDIN 0 0 0 0 0 2 0 0 0 0 0 0 2
4. NAFIZA 1 0 0 0 1 1 0 0 0 0 0 0 3
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0
6. ANDON TEGAR PRIBADI 0 0 0 0 0 0 0 0 0 0 0 0 0
7. RIZKY RADIANTO FAJRI 0 0 0 0 0 0 0 0 0 0 1 0 1
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ISLAM RAHIMI HUSAIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 1
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 54 2 2 4 3 2 3 2 4 2 1 2 81

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 27 0 0 0 3 1 1 0 1 0 2 1 36
2. DEDI AROZA, S.Ag., M.Si. 8 0 1 1 0 1 0 0 1 0 1 0 13
3. Dra. IIN SUPRIHATIN 3 0 0 0 0 0 0 0 0 0 2 0 5
4. MOCHAMAD ICHSAN M., S.T. 9 0 0 0 0 0 1 0 0 0 0 0 10
5. NUR LAELA TUROHMAH, S.E. 2 0 0 0 0 0 0 0 0 0 1 1 4
6. SOPIAN APIP, S.E. 1 0 0 0 0 0 0 0 0 0 0 0 1
7. ZULFIKAR MAHBUB ROBBANI 7 0 0 1 1 0 0 1 0 0 0 1 11
8. ABDURROKHIM, S.Pt. 1 0 1 0 0 0 0 0 0 1 1 0 4
9. DEWI RACHMAWATI, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0
10. MURDOKO, S.H. 0 0 0 0 0 5 0 0 0 0 0 0 5
11. RETNO UMMY ASTHASARI, S.T.P. 4 0 0 1 0 0 0 0 0 0 0 0 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. ELIA 0 0 0 1 0 0 0 2 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
3. ARIEF BUDIMAN 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 2
4. HERVINA LESTARI 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 2
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 9. Partai Kebangkitan Nusantara 5 0 0 0 5 0 0 0 0 0 0 0 10
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0
3. JAN ADOLF HUKUBUN 0 0 0 0 0 0 0 0 0 0 0 0 0
4. FRANSISKA DWI KESDIATIK 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 1 0 0 0 0 0 0 1
A.1 10. Partai Hati Nurani Rakyat 5 1 0 0 0 3 3 0 0 0 1 0 13

A.2 1. ELIA 3 0 0 0 0 0 0 0 0 0 0 1 4
1 0 0 0 0 0 1 0 0 0 0 0 2
3. ARIEF BUDIMAN 2 0 0 0 0 1 0 0 0 0 0 0 3
4. HERVINA LESTARI 2 0 0 0 0 0 0 0 0 0 0 0 2
5. ANDREAS KURNIAWAN E 1 0 0 0 0 0 0 0 0 0 0 0 1
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 1 0 1
7. YASMIN INAYAH NATA BUWANA 1 0 0 0 1 0 0 0 0 0 0 0 2
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0 0 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 2 0 0 0 0 0 0 0 1 0 0 0 0 3

A.2 1. H. SUPONO 2 0 0 1 1 0 3 2 4 1 0 2 0 2 2 20
3. SARASWATI 3 1 0 1 1 2 2 0 2 3 1 2 1 0 2 21
6. ASTRI SARTIKA 1 1 1 1 0 0 0 1 0 0 1 1 1 1 0 9
9. MERRY APRIYANTI 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 4
10. IIM SOLIHATI 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 3
11. ANI NURMAYANTI 1 0 1 1 0 0 0 0 1 0 0 0 1 1 0 6
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 11. Partai Garda Republik Indonesia 8 0 0 0 0 0 0 1 1 0 1 1 12
A.2 1. A. KHALIK 3 0 0 0 0 0 0 0 0 0 0 1 4
2. YULIANTI BILAKONGA 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 12. Partai Amanat Nasional 90 4 4 2 3 1 1 12 17 5 16 7 162

A.2 1. H. SUPONO 20 2 2 1 3 3 1 4 6 2 1 9 54
2. H. PERMADI DALUNG, S.E., M.M. 203 8 5 4 7 2 4 0 6 9 25 5 278
3. SARASWATI 21 1 2 3 1 1 1 0 0 0 2 0 32
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 16 1 0 1 0 0 1 0 0 0 2 0 21
5. CEPI AL HAKIM, S.T.P., M.Si. 7 0 0 1 0 0 0 0 0 1 0 0 9
6. ASTRI SARTIKA 9 0 1 0 0 0 1 0 1 0 0 0 12
7. REGIVAL PUTRA ADRIAN 1 0 0 0 0 0 0 0 0 0 1 0 2
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 3 0 0 0 0 0 0 0 0 0 0 1 4
9. MERRY APRIYANTI 4 0 0 0 0 0 0 0 0 0 0 0 4
10. IIM SOLIHATI 3 0 0 0 0 0 0 0 0 0 0 0 3
11. ANI NURMAYANTI 6 1 0 0 0 0 0 0 0 0 0 0 7
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1

4. SAIFUL 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
7. REDIKA SEGARA, S.E. 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 13. Partai Bulan Bintang 4 0 0 1 1 0 1 2 3 1 1 1 15
A.2 1. SOLAHUDDIN, S.H., M.H. 2 4 1 0 3 0 2 0 2 2 0 1 17
2. AGUS SUKARNA WIJAYA 2 0 1 1 0 2 0 0 0 0 0 0 6
3. FITRIASARI 1 0 1 0 0 0 0 1 0 0 0 0 3
4. DJUMHAWAN R PERMANA 1 0 0 0 0 0 0 0 0 0 1 0 2
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0 0 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 1 0 0 0 0 0 0 0 0 0 0 0 1
7. WAWANG HUSNAWATI 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Sanusi Permana 1 0 0 0 0 0 0 0 0 0 0 0 1
9. Mochammad Muzaqi 0 0 0 0 0 0 0 0 0 0 0 0 0
10. MOCHAMAD MORO ASIH 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 14. Partai Demokrat 25 0 2 1 0 1 1 0 0 0 2 4 36

A.2 1. DEDE CANDRA SASMITA, S.Ag. 9 0 0 0 0 2 2 0 0 0 2 1 16
2. MANATAP P SIMANJUNTAK 4 1 1 0 0 1 0 0 0 0 0 0 7
3. ANDRIYANTI WIJAYA 2 0 0 0 0 0 0 0 0 0 2 0 4
4. SAIFUL 1 0 0 0 0 0 0 0 0 1 0 1 3
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 1 0 0 0 0 0 0 0 0 0 0 0 1
6. ARNY NURANI SANGAJI 0 0 0 0 0 0 0 0 0 0 0 0 0
7. REDIKA SEGARA, S.E. 1 0 0 0 0 0 1 0 0 0 0 0 2
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0
9. HARKES WOROWATI W. A. 0 0 0 0 0 0 0 0 0 0 0 0 0
10. NAUFAL ANDHIKA IRAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ENDAH HENDRAWASIH 2 0 0 0 0 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
8. DESI FITRI DIANA 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
A.1 16. PARTAI PERINDO 4 2 0 0 1 2 2 1 1 2 2 4 2 2 1 26

A.2 1. RESITA KANIYA 0 0 5 3 3 3 8 4 6 4 6 3 4 11 4 64
2. AGUS WINARNO 1 0 0 0 1 0 1 0 1 1 0 1 2 0 2 10
7. YURIZAL, S.E., M.M. 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 3
9. ELLY MARYANTI 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 15. Partai Solidaritas Indonesia 19 2 2 2 1 0 0 0 2 1 0 0 29
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 7 1 0 0 0 1 3 0 0 0 0 0 12
2. FEBRY CITRA, S.T., M.A.B. 35 1 4 1 1 1 2 0 0 0 0 0 45
3. SIANA RIA, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 1
4. MUHAMMAD ADE ALIYUDIN, S.H. 20 0 2 4 0 0 0 1 0 0 0 0 27
5. JASIMAN SITORUS, S.Kom., M.M. 1 0 0 1 0 0 0 0 0 0 0 0 2
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 1 0 0 0 0 0 1 0 0 0 0 0 2
8. DESI FITRI DIANA 1 0 0 0 0 0 0 0 0 0 0 0 1
A.1 16. PARTAI PERINDO 26 0 0 0 1 0 1 0 0 0 0 1 29

A.2 1. RESITA KANIYA 64 10 0 2 2 0 0 0 0 0 0 0 78
2. AGUS WINARNO 10 0 0 0 0 0 0 0 0 0 0 0 10
3. Drs. SUMARWAN SASTRA 1 0 0 0 0 0 0 0 0 0 0 0 1
4. NENDEN BANURIAH, S.Pd. 0 0 0 0 0 0 0 0 0 0 0 0 0
5. AMARENS MANUHUTU 0 0 0 0 0 0 0 0 0 0 0 0 0
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 0 0 0 0 0 1 0 0 0 0 0 0 1
7. YURIZAL, S.E., M.M. 3 0 0 0 0 0 0 0 0 0 0 0 3
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 1 0 0 0 0 0 0 0 0 0 0 0 1
9. ELLY MARYANTI 1 0 0 0 0 0 0 0 0 0 0 0 1
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 0 0 1 0 1 0 0 1 1 0 0 2 0 0 4 10
3. DWI ARYANTI, S.E. 7 0 2 0 2 2 0 6 2 0 2 1 2 2 2 30
4. IRFAN DARAJAT 0 0 0 0 1 0 0 1 1 1 3 0 1 1 0 9
5. FERRY PERDIAN 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 4
9. GUNAWAN 1 0 0 0 0 0 0 1 1 0 0 0 0 1 0 4
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RIKE ISKANDAR 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 2
A.1 24. Partai Ummat 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 2

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A.1 17. Partai Persatuan Pembangunan 66 7 5 7 6 3 9 0 0 4 0 3 110
A.2 1. H. MUHAMAD ROMLI, A.Md. 50 5 2 4 11 0 3 0 0 0 0 0 75
2. JUHANTA, S.T. 10 1 0 0 1 0 1 0 0 0 0 0 13
3. DWI ARYANTI, S.E. 30 2 1 5 1 2 1 0 1 0 1 2 46
4. IRFAN DARAJAT 9 0 0 0 1 1 1 2 0 0 1 3 18
5. FERRY PERDIAN 4 0 0 0 0 0 0 0 0 0 0 0 4
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 3 0 0 1 0 0 0 0 0 0 0 0 4
7. YENTI NASHI HATUL UMMAH 4 0 1 0 0 0 1 0 0 0 0 0 6
8. ABDUL ROHIM, S.Si., Apt. 5 1 0 0 0 1 0 0 0 1 0 0 8
9. GUNAWAN 4 1 0 0 0 0 0 0 1 0 0 0 6
10. RIA ANWAR 0 1 0 0 0 0 1 0 0 0 0 0 2
11. RIKE ISKANDAR 2 0 0 0 0 0 0 0 0 0 0 0 2
A.1 24. Partai Ummat 2 0 0 0 1 0 0 1 0 0 0 0 4

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 1 0 0 0 0 0 0 0 0 0 1 0 2
2. SELLY AFRIDA OLTAR, S.I.P. 0 0 0 0 0 2 0 0 0 0 0 0 2
3. H. SUMIRAT SAPTA HADI, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 1
4. Drs. H. ASRI AL JUFRI, M.Si. 0 0 0 0 0 0 0 0 0 0 0 0 0
5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Drs. MOCH ZAENAL AL AQILI 0 0 0 0 0 0 0 0 0 0 0 0 0
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0
9. JAKA JATI NUR ALAM 1 0 0 0 0 0 0 1 0 0 0 0 2
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.620 155 115 152 183 121 159 154 183 151 163 119 4.275
B. JUMLAH SUARA TIDAK SAH 479 26 23 41 20 46 51 36 32 35 12 38 839
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.099 181 138 193 203 167 210 190 215 186 175 157 5.114

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: ARGAPURA
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 140 119 123 146 143 138 152 143 105 106 115 164 121 141 150 2.006
JML 260 236 246 296 284 261 295 278 212 208 223 298 224 286 291 3.898
LK 107 85 94 114 95 99 129 118 86 87 95 124 93 109 113 1.548
JML 202 175 196 247 205 203 253 237 181 177 192 234 171 228 223 3.124
LK 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2 4
JML 0 3 0 0 0 0 4 3 0 0 1 8 0 3 2 24
LK 2 2 0 1 1 0 0 2 1 5 0 2 0 0 6 22
JML 3 3 1 3 6 0 0 7 2 8 1 2 0 0 14 50
LK 109 89 94 115 96 99 129 120 87 92 95 126 93 109 121 1.574
JML 205 181 197 250 211 203 257 247 183 185 194 244 171 231 239 3.198
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 57 60 54 51 89 64 44 36 35 28 34 60 58 61 58 789
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 1 0 0 2 0 0 0 0 0 0 0 0 0 0 0 3
JML 3 0 0 4 0 0 0 0 0 0 0 0 0 0 0 7
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
A DATA PEMILIH
LK 2.006 159 103 142 115 127 156 162 143 148 158 165 173 147 156 162 4.222
JML 3.898 292 198 286 210 229 298 294 299 295 300 300 295 296 296 298 8.084
LK 1.548 116 75 118 86 112 114 124 98 101 121 117 98 107 103 123 3.161
JML 3.124 220 155 239 169 210 230 238 219 224 245 225 202 227 223 240 6.390
LK 4 1 2 0 0 0 0 0 0 1 0 0 0 0 0 0 8
PR 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20
(DPTb)
JML 24 1 2 0 0 0 0 0 0 1 0 0 0 0 0 0 28
LK 22 1 6 2 2 0 0 1 0 0 5 0 1 0 1 3 44
PR 28 2 2 3 1 0 0 2 0 0 7 0 3 4 0 1 53
(DPK)
JML 50 3 8 5 3 0 0 3 0 0 12 0 4 4 1 4 97
LK 1.574 118 83 120 88 112 114 125 98 102 126 117 99 107 104 126 3.213
JML 3.198 224 165 244 172 210 230 241 219 225 257 225 206 231 224 244 6.515
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
4 789 74 37 50 43 24 74 59 86 75 49 81 95 71 78 60 1.745
suara cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
LK 3 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 5
PR 4 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 7
pilih
JML 7 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 12
LAMPIRAN MODEL
Halaman 1 Lembar 3

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 031 JUMLAH AKHIR
1 2 3 4 5 6
A DATA PEMILIH
LK 4.222 146 4.368
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 3.862 150 4.012
JML 8.084 296 8.380
LK 3.161 102 3.263
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 3.229 128 3.357
JML 6.390 230 6.620
LK 8 0 8
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 20 0 20
JML 28 0 28
LK 44 4 48
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 53 3 56
JML 97 7 104
LK 3.213 106 3.319
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 3.302 131 3.433
JML 6.515 237 6.752
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 031 JUMLAH AKHIR
1 2 3 4 5
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 8.261 302 8.563
2 Jumlah surat suara yang digunakan 6.515 237 6.752
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 1 1 2
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 1.745 64 1.809
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 031 JUMLAH AKHIR
1 2 3 4 5 6
LK 5 0 5
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 7 0 7
JML 12 0 12
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 1 1 0 0 0 0 0 0 1 0 0 1 0 4


3. UDI SUHANDORO 0 0 2 2 0 4 0 1 0 1 3 0 0 1 1 15
6. NIAR YUNIAR 1 0 0 0 1 0 1 0 0 0 0 1 1 0 1 6
8. SUTIYA ANJANI 1 0 1 1 1 1 0 0 0 0 0 0 0 2 0 7
10. YANTI TARYATI 0 0 1 0 0 0 1 0 0 0 1 0 0 0 0 3
11. CAHYO FITRIADI 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
8. AGUS MULYADI, S.Pd. 4 0 2 0 0 0 0 1 1 0 0 0 0 0 0 1 9
B 213 23 12 23 14 23 25 19 15 14 23 16 21 11 15 25 492
A.2)


3. UDI SUHANDORO 15 1 1 1 0 2 3 1 1 0 1 0 0 1 3 0 30
6. NIAR YUNIAR 6 1 0 2 3 1 0 0 0 0 2 2 0 0 0 0 17
8. SUTIYA ANJANI 7 0 0 0 0 0 2 0 0 1 0 0 0 0 0 0 10
10. YANTI TARYATI 3 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 4
11. CAHYO FITRIADI 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 3
B 463 27 30 28 10 30 37 36 13 21 30 19 39 31 28 37 879
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 031 JUMLAH AKHIR
1 2 3 4 5
A.1 1. Partai Kebangkitan Bangsa 242 24 266
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 131 5 136
2. DINDIN ABDULLAH GHOZALI 35 0 35
3. H. AMIR AMIRULOH, S.H. 37 1 38
4. NAFIZUL ALHAFIZRANA 9 0 9
5. BAGUS DJATI KUSUMA 5 0 5
6. SHOLEHATUN NASIHA, S.Kom. 7 0 7
7. Ir. AAN SURYA PRIYANA 16 0 16
8. AGUS MULYADI, S.Pd. 9 0 9
9. ROSALINDA RAMDHANIAH, S.Ag. 1 0 1
10. TEGUH YULIANTO, S.T. 0 0 0
11. RISMA PUJI RIANTI 0 0 0
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 492 30 522
A.1 2. Partai Gerakan Indonesia Raya 404 26 430

A.2 1. H. RICKY KURNIAWAN, Lc. 182 5 187
2. Ir. PRASETYAWATI, M.M. 154 4 158

3. UDI SUHANDORO 30 0 30
4. H. CECEP GOGOM, S.Ag., M.Pd. 44 3 47
5. YORDA IMAM SUTOMO, S.H. 15 0 15
6. NIAR YUNIAR 17 1 18
7. Dr. AGUS SUHENDI, M.Pd. 15 2 17
8. SUTIYA ANJANI 10 0 10
9. TOTING SUPRIATNA 1 0 1
10. YANTI TARYATI 4 0 4
11. CAHYO FITRIADI 3 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 1 1 2 0 0 0 0 1 1 1 0 0 1 0 0 8
6. H. AGUS RIADI 1 0 0 3 0 0 2 0 0 0 0 0 0 0 0 6
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1

2. H. KUSNADI, S.I.P. 2 2 3 2 1 2 10 5 2 7 4 5 1 4 5 55
6. LINDA OCTAVIA 0 0 2 0 0 0 0 0 1 1 0 1 0 1 1 7
7. H. HELMI BUSTOMI 1 1 0 0 1 0 1 2 0 0 0 0 0 0 1 7
10. FAJAR SETIAWAN 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
4. Hj. DIAN ROSITA 8 0 0 2 0 0 1 0 0 0 0 0 1 2 1 1 16
6. H. AGUS RIADI 6 1 0 0 1 0 0 0 0 0 0 1 1 0 1 0 11
11. ALUN HIMAWAN 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
B 217 6 3 9 11 4 7 20 3 4 10 6 28 19 28 12 387
A.2)

2. H. KUSNADI, S.I.P. 55 6 3 4 2 0 4 4 1 2 7 3 4 4 4 1 104
6. LINDA OCTAVIA 7 0 1 1 1 0 2 0 0 0 0 0 0 1 0 0 13
7. H. HELMI BUSTOMI 7 0 0 0 1 1 1 0 0 0 1 0 0 0 0 1 12
10. FAJAR SETIAWAN 3 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 5
B 684 72 53 49 36 28 52 49 107 109 94 100 36 44 31 31 1.575
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 3. Partai Demokrasi Indonesia Perjuangan 128 12 140
A.2 1. Hj. ASYANTI ROZANA, S.E. 52 1 53
2. DONI MARADONA HUTABARAT, S.H. 134 4 138
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 22 1 23
4. Hj. DIAN ROSITA 16 2 18
5. THARIQ HALILINTAR 16 0 16
6. H. AGUS RIADI 11 1 12
7. IRAWATY OCTORA, S.E., M.Si. 2 0 2
8. MANGONTANG SIMANJUNTAK 1 0 1
9. BAMBANG SUMANTRI, S.Sos. 2 0 2
10. EUGINIA NATANIA PUTRI 2 0 2
11. ALUN HIMAWAN 1 0 1
A.1 4. Partai Golongan Karya 528 17 545

A.2 1. SAMSUL HIDAYAT, S.H. 788 17 805
2. H. KUSNADI, S.I.P. 104 5 109
3. KURNIAWATYNINGSIH, S.E. 42 0 42
4. ADI RESTU PERMADI 54 1 55
5. KHAERUL ANAM, S.Pi., M.Si. 12 0 12
6. LINDA OCTAVIA 13 0 13
7. H. HELMI BUSTOMI 12 1 13
8. MUNAWARAH SUNUSI, S.E., M.Si. 5 0 5
9. RENO ANGGARA MUKTI, S.ST.Par. 11 1 12
10. FAJAR SETIAWAN 5 0 5
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 1 0 1
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 1.575 42 1.617
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 2 1 1 1 1 0 0 2 0 0 4 2 3 4 0 21
A.2 1. M. RIZKY 2 1 1 4 1 0 1 0 1 2 1 0 0 3 3 20
2. DONDY DWIGUNTIA 9 8 4 7 2 1 1 5 2 0 0 1 0 0 0 40
5. DELLA PUSPITA 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 3
6. AJID, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 0 0 0 0 0 0 0 3 0 0 2 0 9 0 2 16
A.1 6. Partai Buruh 1 3 0 1 0 0 0 1 0 0 0 1 0 0 0 7

A.2 1. Komarudin 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 2
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
8. Ade Yuswandi 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 5. Partai NasDem 21 0 1 2 0 3 1 1 0 0 1 0 1 2 2 1 36
A.2 1. M. RIZKY 20 0 1 0 1 0 2 1 0 0 1 1 0 0 0 0 27
2. DONDY DWIGUNTIA 40 1 0 1 0 2 0 0 2 0 0 0 1 0 0 0 47
5. DELLA PUSPITA 3 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 5
6. AJID, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
7. UMMI NURAENI, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
9. MUHAMAD RIDWAN 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
10. AWALUDDIN, S.T. 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
11. ARIFIN, S.Hut. 16 4 3 5 6 8 0 0 0 0 0 0 0 0 0 0 42
B 105 6 5 8 8 13 4 2 3 0 2 1 2 2 4 1 166
A.2)
A.1 6. Partai Buruh 7 0 0 1 0 1 0 0 1 2 0 0 1 0 0 0 13

A.2 1. Komarudin 2 0 0 0 0 1 0 0 2 0 0 0 0 0 0 2 7
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. Ade Yuswandi 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 11 0 0 1 0 2 0 0 3 2 0 0 1 0 0 2 22
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 5. Partai NasDem 36 4 40
A.2 1. M. RIZKY 27 3 30
2. DONDY DWIGUNTIA 47 0 47
3. VICA FITHRI NOER AZIZAH 1 0 1
4. MELIHASRAT JAYA ZAI, S.E. 2 0 2
5. DELLA PUSPITA 5 0 5
6. AJID, S.Ag. 1 0 1
7. UMMI NURAENI, S.H. 1 0 1
8. AHMAD ROUF, S.I.P., M.Si. 2 0 2
9. MUHAMAD RIDWAN 1 1 2
10. AWALUDDIN, S.T. 1 0 1
11. ARIFIN, S.Hut. 42 0 42
A.1 6. Partai Buruh 13 2 15

A.2 1. Komarudin 7 1 8
2. Krisdianto, S.H. 0 0 0
3. Mira Sari La Puppung, S.E. 0 0 0
4. Agus Sarjanto, S.H. 0 1 1
5. Sugiarta 0 0 0
6. Lilis Minarni 0 0 0
7. Abdul Oir, S.H. 1 0 1
8. Ade Yuswandi 1 0 1
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0
10. SAHRUL BAHRI 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 1 0 0 0 1 0 0 0 0 0 1 0 0 0 3
3. NASRUDDIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
8. LINA KADARMINI 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 1 0 0 0 2 1 0 0 0 4
8. ABDURROKHIM, S.Pt. 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2
10. MURDOKO, S.H. 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. WIWID PURWAWAN 3 0 0 3 0 1 1 0 0 0 0 0 0 0 0 0 8
3. NASRUDDIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. LINA KADARMINI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 11 1 0 5 0 2 3 2 2 0 0 1 0 0 0 0 27
A.2)

6. SOPIAN APIP, S.E. 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
8. ABDURROKHIM, S.Pt. 2 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 5
10. MURDOKO, S.H. 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
B 187 5 10 6 1 3 8 8 9 17 12 11 2 6 1 6 292
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 7. Partai Gelombang Rakyat Indonesia 10 0 10
A.2 1. WIWID PURWAWAN 8 0 8
2. Hj. LULU MASLUCHAH, Lc. 5 1 6
3. NASRUDDIN 0 0 0
4. NAFIZA 0 0 0
5. FERRY ARDIAN AR. 1 0 1
6. ANDON TEGAR PRIBADI 1 0 1
7. RIZKY RADIANTO FAJRI 0 0 0
8. LINA KADARMINI 1 0 1
9. ISLAM RAHIMI HUSAIN, S.T. 0 0 0
10. ADE SAEPUL, S.Ag. 1 0 1
11. MUHTADIN 0 0 0
A.1 8. Partai Keadilan Sejahtera 98 2 100

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 84 0 84
2. DEDI AROZA, S.Ag., M.Si. 24 1 25
3. Dra. IIN SUPRIHATIN 10 1 11
4. MOCHAMAD ICHSAN M., S.T. 14 0 14
5. NUR LAELA TUROHMAH, S.E. 5 0 5
6. SOPIAN APIP, S.E. 4 0 4
7. ZULFIKAR MAHBUB ROBBANI 19 0 19
8. ABDURROKHIM, S.Pt. 5 0 5
9. DEWI RACHMAWATI, S.E. 7 0 7
10. MURDOKO, S.H. 2 0 2
11. RETNO UMMY ASTHASARI, S.T.P. 20 0 20
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. ELIA 0 1 0 0 0 0 0 1 0 2 0 0 0 0 0 4
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
3. ARIEF BUDIMAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2
A.2)

A.2 1. ELIA 4 0 0 0 0 0 2 1 0 0 0 0 0 1 0 0 8
1 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 4
3. ARIEF BUDIMAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 10 0 0 1 0 1 5 9 0 0 0 0 1 3 1 0 31
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 9. Partai Kebangkitan Nusantara 1 1 2
A.2 1. Neneng Rohimah 1 0 1
2. Irwan Yani 0 0 0
3. JAN ADOLF HUKUBUN 0 0 0
4. FRANSISKA DWI KESDIATIK 0 0 0
5. Imam Fauzi 0 0 0
6. Sri Rosmaryati 0 0 0
7. ALI MUNAJIB 0 0 0
8. Aprizal Hamid 0 0 0
9. Nadya Oktafiani 0 0 0
A.1 10. Partai Hati Nurani Rakyat 15 0 15

A.2 1. ELIA 8 0 8
4 0 4
3. ARIEF BUDIMAN 0 0 0
4. HERVINA LESTARI 1 0 1
5. ANDREAS KURNIAWAN E 2 0 2
6. DHEMAS PRADITYA 0 0 0
7. YASMIN INAYAH NATA BUWANA 1 0 1
8. NIRWAN PRATAMA PUTRA 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1

A.2 1. H. SUPONO 0 0 6 1 0 2 3 2 3 3 0 4 1 4 5 34
3. SARASWATI 2 0 1 0 0 1 0 2 1 0 0 1 1 3 0 12
6. ASTRI SARTIKA 1 0 1 1 1 0 1 0 0 0 0 1 0 0 0 6
9. MERRY APRIYANTI 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 2
10. IIM SOLIHATI 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. A. KHALIK 1 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 6
B 3 0 0 8 1 2 0 0 0 0 0 0 0 0 0 0 14
A.2)

A.2 1. H. SUPONO 34 1 3 1 2 1 4 3 2 0 1 5 0 2 5 4 68
3. SARASWATI 12 1 1 1 0 1 4 2 1 0 1 0 1 1 0 2 28
6. ASTRI SARTIKA 6 1 0 2 1 0 0 2 0 1 1 0 0 0 0 0 14
9. MERRY APRIYANTI 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
10. IIM SOLIHATI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 3 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
B 396 32 15 57 42 56 39 27 19 14 11 20 33 50 64 83 958
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 11. Partai Garda Republik Indonesia 7 0 7
A.2 1. A. KHALIK 6 0 6
2. YULIANTI BILAKONGA 1 0 1
A.1 12. Partai Amanat Nasional 160 10 170

A.2 1. H. SUPONO 68 0 68
2. H. PERMADI DALUNG, S.E., M.M. 514 14 528
3. SARASWATI 28 1 29
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 149 2 151
5. CEPI AL HAKIM, S.T.P., M.Si. 11 0 11
6. ASTRI SARTIKA 14 0 14
7. REGIVAL PUTRA ADRIAN 1 0 1
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 6 0 6
9. MERRY APRIYANTI 2 0 2
10. IIM SOLIHATI 1 0 1
11. ANI NURMAYANTI 4 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. KARDAN 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
3. FITRIASARI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 10 0 0 1 1 0 0 1 1 0 0 0 3 1 0 0 18
A.2)

4. SAIFUL 2 0 0 1 0 2 0 1 0 0 0 0 0 0 0 0 6
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. KARDAN 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
B 81 2 2 5 2 8 6 5 3 5 4 2 1 7 2 2 137
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 13. Partai Bulan Bintang 7 2 9
A.2 1. SOLAHUDDIN, S.H., M.H. 6 0 6
2. AGUS SUKARNA WIJAYA 0 0 0
3. FITRIASARI 1 0 1
4. DJUMHAWAN R PERMANA 1 0 1
5. Deni Rusydiana, S.H.I. 2 0 2
6. YANI SURYANI FIKRIAH 1 0 1
7. WAWANG HUSNAWATI 0 0 0
8. Sanusi Permana 0 0 0
9. Mochammad Muzaqi 0 0 0
10. MOCHAMAD MORO ASIH 0 0 0
A.1 14. Partai Demokrat 47 0 47

A.2 1. DEDE CANDRA SASMITA, S.Ag. 56 1 57
2. MANATAP P SIMANJUNTAK 9 1 10
3. ANDRIYANTI WIJAYA 10 0 10
4. SAIFUL 6 0 6
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 2 0 2
6. ARNY NURANI SANGAJI 4 0 4
7. REDIKA SEGARA, S.E. 0 0 0
8. KARDAN 2 0 2
9. HARKES WOROWATI W. A. 0 0 0
10. NAUFAL ANDHIKA IRAWAN 0 0 0
11. ENDAH HENDRAWASIH 1 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 2
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 2 0 1 2 1 1 0 0 0 0 0 0 1 1 0 9

A.2 1. RESITA KANIYA 1 0 1 0 3 0 0 0 0 0 0 0 0 2 0 7
2. AGUS WINARNO 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 2
7. YURIZAL, S.E., M.M. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
3. SIANA RIA, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
8. DESI FITRI DIANA 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
B 30 1 0 1 0 4 3 2 1 0 3 1 1 1 2 5 55
A.2)
A.1 16. PARTAI PERINDO 9 1 0 0 4 1 0 2 0 0 0 2 1 0 0 6 26

A.2 1. RESITA KANIYA 7 1 1 0 0 0 0 1 1 0 0 15 0 0 0 0 26
2. AGUS WINARNO 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
7. YURIZAL, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 3
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 27 2 1 1 4 1 0 8 1 0 3 18 1 0 0 6 73
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 15. Partai Solidaritas Indonesia 21 1 22
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 9 1 10
2. FEBRY CITRA, S.T., M.A.B. 12 0 12
3. SIANA RIA, S.E., M.M. 2 0 2
4. MUHAMMAD ADE ALIYUDIN, S.H. 7 0 7
5. JASIMAN SITORUS, S.Kom., M.M. 1 0 1
6. DIAH WINARSIH 0 0 0
7. GUNADI, M.Ag. 2 0 2
8. DESI FITRI DIANA 1 0 1
A.1 16. PARTAI PERINDO 26 0 26

A.2 1. RESITA KANIYA 26 0 26
2. AGUS WINARNO 2 0 2
3. Drs. SUMARWAN SASTRA 4 0 4
4. NENDEN BANURIAH, S.Pd. 5 1 6
5. AMARENS MANUHUTU 2 0 2
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 1 0 1
7. YURIZAL, S.E., M.M. 1 0 1
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 3 0 3
9. ELLY MARYANTI 0 0 0
10. RAHMAT HIDAYAT 3 0 3
11. MOHAMAD SATIBI 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 0 0 0 3 1 0 0 0 0 0 1 1 0 0 1 7
3. DWI ARYANTI, S.E. 0 0 3 0 2 1 0 1 1 1 3 0 0 2 1 15
4. IRFAN DARAJAT 1 0 0 0 0 1 3 2 0 0 0 0 1 0 0 8
5. FERRY PERDIAN 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 3
9. GUNAWAN 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 2
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
11. RIKE ISKANDAR 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 2
A.1 24. Partai Ummat 0 0 0 0 0 0 1 1 0 0 0 2 0 1 0 5

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
2. JUHANTA, S.T. 7 0 0 0 0 1 2 0 1 0 0 0 0 0 0 0 11
3. DWI ARYANTI, S.E. 15 2 1 1 0 0 2 3 3 6 5 1 0 0 0 0 39
4. IRFAN DARAJAT 8 1 0 1 0 0 0 0 0 1 0 0 0 0 1 1 13
5. FERRY PERDIAN 3 2 0 0 0 0 1 0 0 0 0 1 1 0 0 0 8
9. GUNAWAN 2 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 3
10. RIA ANWAR 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. RIKE ISKANDAR 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
B 143 10 8 7 7 3 12 15 17 13 25 9 5 4 1 4 283
A.2)
A.1 24. Partai Ummat 5 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 8

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 7 2 0 2 1 0 0 0 0 1 1 0 0 0 0 0 14
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 17. Partai Persatuan Pembangunan 98 3 101
A.2 1. H. MUHAMAD ROMLI, A.Md. 98 0 98
2. JUHANTA, S.T. 11 0 11
3. DWI ARYANTI, S.E. 39 0 39
4. IRFAN DARAJAT 13 0 13
5. FERRY PERDIAN 8 0 8
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 5 0 5
7. YENTI NASHI HATUL UMMAH 4 0 4
8. ABDUL ROHIM, S.Si., Apt. 1 0 1
9. GUNAWAN 3 0 3
10. RIA ANWAR 1 0 1
11. RIKE ISKANDAR 2 0 2
A.1 24. Partai Ummat 8 0 8

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 2 0 2
2. SELLY AFRIDA OLTAR, S.I.P. 2 0 2
3. H. SUMIRAT SAPTA HADI, S.Ag. 1 0 1
4. Drs. H. ASRI AL JUFRI, M.Si. 0 0 0
5. RITA HERLINA, S.E. 0 0 0
6. Drs. MOCH ZAENAL AL AQILI 0 0 0
7. FAUZIAH TABRIYANI 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0
9. JAKA JATI NUR ALAM 1 0 1
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

B. JUMLAH SUARA TIDAK SAH 600 35 26 32 34 30 29 38 22 25 39 20 32 52 47 29 1.090
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 031 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 5.425 189 5.614
B. JUMLAH SUARA TIDAK SAH 1.090 48 1.138
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 6.515 237 6.752

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: BANGUNJAYA
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 152 135 101 152 135 131 129 109 125 102 105 151 94 137 132 1.890
JML 295 274 216 278 267 261 247 214 226 212 202 283 189 280 261 3.705
LK 117 92 78 108 114 108 109 89 91 86 76 124 85 111 88 1.476
JML 239 202 167 218 232 219 212 180 180 175 164 243 180 242 196 3.049
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LK 0 0 0 1 1 2 1 0 1 0 0 0 0 0 0 6
JML 0 0 0 2 1 2 4 0 1 1 0 0 0 0 0 11
LK 117 92 78 109 115 110 110 89 92 86 76 124 85 111 88 1.482
JML 239 202 167 220 233 221 216 180 181 176 164 243 180 242 196 3.060
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 62 78 54 64 40 46 36 36 49 41 43 46 13 44 71 723
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

JUMLAH TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS JUMLAH
PINDAHAN 016 017 018 019 020 021 022 023 024 025 026 027 028 029 AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 1.890 111 151 141 151 151 76 87 152 124 116 141 123 165 153 3.732
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 1.815 103 145 129 137 131 64 69 129 101 99 140 115 122 139 3.438
JML 3.705 214 296 270 288 282 140 156 281 225 215 281 238 287 292 7.170
LK 1.476 87 120 114 120 124 66 69 103 94 86 108 84 108 89 2.848
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.573 97 125 117 121 121 62 62 114 88 80 119 85 93 94 2.951
JML 3.049 184 245 231 241 245 128 131 217 182 166 227 169 201 183 5.799
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(DPTb)
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LK 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
JML 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11
LK 1.482 87 120 114 120 124 66 69 103 94 86 108 84 108 89 2.854
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.578 97 125 117 121 121 62 62 114 88 80 119 85 93 94 2.956
JML 3.060 184 245 231 241 245 128 131 217 182 166 227 169 201 183 5.810
NO. URAIAN RINCIAN

JUMLAH TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS TPS JUMLAH
PINDAHAN 016 017 018 019 020 021 022 023 024 025 026 027 028 029 AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 3.785 219 298 276 292 288 143 160 287 230 220 287 243 293 298 7.319
2 Jumlah surat suara yang digunakan 3.060 184 245 231 241 245 128 131 217 182 166 227 169 201 183 5.810
4 723 35 53 45 51 43 15 29 70 48 54 60 74 92 115 1.507
cadangan
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 TPS 027 TPS 028 TPS 029 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
PR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
pilih
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 2


3. UDI SUHANDORO 2 1 0 1 0 0 2 0 0 1 0 2 3 0 0 12
6. NIAR YUNIAR 0 0 1 0 0 1 0 0 0 0 0 2 3 1 1 9
8. SUTIYA ANJANI 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
10. YANTI TARYATI 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
11. CAHYO FITRIADI 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 TPS 027 TPS 028 TPS 029 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2


3. UDI SUHANDORO 12 2 1 0 1 0 1 1 0 1 2 0 3 0 3 27
6. NIAR YUNIAR 9 0 0 0 1 2 0 0 1 0 1 0 2 2 1 19
8. SUTIYA ANJANI 1 1 0 0 1 1 0 0 0 0 0 0 1 1 0 6
10. YANTI TARYATI 1 0 0 2 1 1 0 0 0 0 0 0 0 1 0 6
11. CAHYO FITRIADI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 0 0 1 0 2 1 1 3 0 1 0 1 1 1 12
6. H. AGUS RIADI 1 0 2 0 1 1 1 0 1 0 0 0 0 1 0 8
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1

2. H. KUSNADI, S.I.P. 3 2 0 4 1 1 1 0 0 2 1 3 0 2 0 20
6. LINDA OCTAVIA 0 0 1 0 3 1 1 1 0 0 0 0 1 0 0 8
7. H. HELMI BUSTOMI 2 0 3 0 0 0 0 0 0 0 1 1 0 2 0 9
10. FAJAR SETIAWAN 1 0 0 0 1 0 0 1 0 0 0 2 1 1 0 7
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 12 1 0 0 0 0 0 0 2 0 0 0 0 0 0 15
6. H. AGUS RIADI 8 1 0 0 1 0 0 0 0 0 0 0 0 0 0 10
11. ALUN HIMAWAN 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2

2. H. KUSNADI, S.I.P. 20 1 0 1 1 0 0 0 2 2 3 1 0 0 1 32
6. LINDA OCTAVIA 8 0 0 0 0 1 1 0 0 0 0 0 0 0 0 10
7. H. HELMI BUSTOMI 9 0 0 0 1 1 0 0 0 1 0 1 0 0 0 13
10. FAJAR SETIAWAN 7 0 2 2 0 0 0 0 0 1 3 0 0 1 0 16
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 3 0 1 1 4 3 1 0 1 1 0 1 2 0 1 19
A.2 1. M. RIZKY 1 1 1 0 0 1 0 1 0 1 1 0 0 1 2 10
2. DONDY DWIGUNTIA 1 1 0 0 1 0 0 0 0 1 0 0 2 1 0 7
5. DELLA PUSPITA 3 1 0 0 1 0 1 0 0 2 0 2 0 0 0 10
6. AJID, S.Ag. 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2
7. UMMI NURAENI, S.H. 0 0 0 0 0 1 0 0 0 0 1 2 0 0 0 4
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2
10. AWALUDDIN, S.T. 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
11. ARIFIN, S.Hut. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 6. Partai Buruh 0 1 0 1 1 0 0 0 0 0 0 1 1 1 0 6

A.2 1. Komarudin 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
2. Krisdianto, S.H. 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 19 1 3 3 1 3 0 0 2 3 1 8 4 5 6 59
A.2 1. M. RIZKY 10 1 0 1 0 2 0 0 1 0 0 5 1 1 1 23
2. DONDY DWIGUNTIA 7 0 1 3 1 0 0 0 1 1 0 50 23 8 4 99
5. DELLA PUSPITA 10 0 3 2 0 0 0 0 1 0 0 0 0 0 0 16
6. AJID, S.Ag. 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 3
7. UMMI NURAENI, S.H. 4 0 0 0 0 0 1 0 0 0 0 0 0 0 0 5
9. MUHAMAD RIDWAN 2 0 1 0 0 1 0 0 0 1 0 1 0 0 0 6
10. AWALUDDIN, S.T. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. ARIFIN, S.Hut. 0 0 0 0 0 0 0 0 0 0 0 1 1 15 50 67
A.1 6. Partai Buruh 6 0 1 1 1 0 0 1 0 0 0 1 0 0 0 11

A.2 1. Komarudin 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 3
2. Krisdianto, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2
4. Agus Sarjanto, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 3
7. Abdul Oir, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. Ade Yuswandi 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 1 0 2 2 0 0 0 0 0 0 0 0 0 5
3. NASRUDDIN 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. ABDURROKHIM, S.Pt. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 5 1 0 0 0 0 0 0 0 0 0 0 0 1 0 7
3. NASRUDDIN 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
8. ABDURROKHIM, S.Pt. 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 3
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 1 0 0 0 0 0 0 0 0 0 0 2 0 0 3

A.2 1. ELIA 0 0 0 0 2 1 0 0 0 0 0 1 0 0 0 4
0 0 0 1 1 0 0 0 0 0 0 1 1 0 0 4
3. ARIEF BUDIMAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 1 0 0 1 0 0 0 0 0 1 0 0 0 0 3
2. Irwan Yani 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2
5. Imam Fauzi 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3

A.2 1. ELIA 4 0 0 0 0 0 1 0 0 0 0 0 0 0 0 5
4 0 1 0 0 0 0 0 0 0 1 1 0 0 0 7
3. ARIEF BUDIMAN 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 2
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. H. SUPONO 2 5 1 1 2 0 0 1 0 3 2 0 0 0 3 20
3. SARASWATI 0 2 1 4 2 1 1 0 0 0 2 2 0 3 1 19
6. ASTRI SARTIKA 1 0 2 0 1 1 0 1 1 1 0 0 0 1 0 9
9. MERRY APRIYANTI 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 3
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ANI NURMAYANTI 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1

A.2 1. H. SUPONO 20 0 3 1 3 2 1 0 1 2 0 2 1 1 3 40
3. SARASWATI 19 1 0 1 4 1 1 2 1 1 2 3 1 1 0 38
6. ASTRI SARTIKA 9 1 0 0 0 0 0 0 0 0 2 0 0 0 0 12
9. MERRY APRIYANTI 3 0 0 0 0 0 0 0 0 0 0 0 1 0 1 5
10. IIM SOLIHATI 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 693 48 62 51 30 30 14 38 40 29 25 36 12 8 34 1.150
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 0 0 0 0 0 0 0 0 2 2 0 1 0 0 0 5
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 1 0 0 0 0 0 0 0 0 0 1 2 0 0 1 5
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 5 0 0 0 0 0 0 0 1 0 0 1 1 0 1 9
7. REDIKA SEGARA, S.E. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
6. DIAH WINARSIH 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 2
7. GUNADI, M.Ag. 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 2
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
A.1 16. PARTAI PERINDO 0 0 0 0 1 1 1 0 0 0 0 0 1 1 0 5

A.2 1. RESITA KANIYA 0 0 0 1 0 0 0 0 0 1 2 3 14 1 0 22
2. AGUS WINARNO 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 3
7. YURIZAL, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2
6. DIAH WINARSIH 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
7. GUNADI, M.Ag. 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
8. DESI FITRI DIANA 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2
A.1 16. PARTAI PERINDO 5 0 0 0 0 1 1 1 0 0 0 0 0 1 0 9

A.2 1. RESITA KANIYA 22 0 0 1 0 0 5 1 0 0 1 0 0 0 0 30
2. AGUS WINARNO 3 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4
7. YURIZAL, S.E., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 2 1 0 0 1 1 0 1 0 0 0 2 1 0 0 9
3. DWI ARYANTI, S.E. 4 3 3 4 2 3 1 2 1 0 3 5 1 4 1 37
4. IRFAN DARAJAT 2 0 0 0 0 0 0 0 0 0 0 1 1 1 2 7
5. FERRY PERDIAN 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
9. GUNAWAN 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2
10. RIA ANWAR 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 2
A.1 24. Partai Ummat 0 4 0 1 0 0 0 0 0 1 0 0 0 0 0 6

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 9 1 0 1 0 0 2 3 0 0 1 1 5 7 2 32
3. DWI ARYANTI, S.E. 37 2 1 2 5 1 1 0 1 2 1 3 0 1 0 57
4. IRFAN DARAJAT 7 2 0 1 0 0 0 1 0 0 2 1 0 1 0 15
5. FERRY PERDIAN 1 0 1 0 0 1 0 0 0 0 1 5 0 1 1 11
9. GUNAWAN 2 0 0 1 0 0 1 0 0 0 0 0 0 0 0 4
10. RIA ANWAR 1 0 0 1 1 0 0 0 0 0 1 0 1 0 0 5
11. RIKE ISKANDAR 2 0 0 0 0 1 0 0 0 0 0 0 0 1 0 4
A.1 24. Partai Ummat 6 0 0 0 0 0 0 1 0 1 0 0 0 0 1 9

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 TPS 023 TPS 024 TPS 025 TPS 026 TPS 027 TPS 028 TPS 029 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.397 155 193 181 161 181 71 97 162 130 131 193 157 172 170 4.551
B. JUMLAH SUARA TIDAK SAH 663 29 52 50 80 64 57 34 55 52 35 34 12 29 13 1.259
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.060 184 245 231 241 245 128 131 217 182 166 227 169 201 183 5.810

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: RENGASJAJAR
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 113 120 115 119 125 117 107 136 103 121 131 133 112 107 117 1.776
JML 222 224 220 233 245 252 222 268 213 236 245 250 237 226 230 3.523
LK 89 102 91 97 111 92 91 104 83 103 111 104 86 97 82 1.443
JML 184 200 187 199 223 213 192 222 177 208 219 206 197 207 184 3.018
LK 0 2 0 0 0 1 0 0 0 1 1 0 0 0 0 5
JML 0 2 0 0 0 2 0 0 0 1 1 1 0 0 0 7
LK 1 0 0 0 3 1 0 0 0 0 1 0 1 3 0 10
JML 2 0 3 0 5 1 0 0 0 0 1 0 3 3 0 18
LK 90 104 91 97 114 94 91 104 83 104 113 104 87 100 82 1.458
JML 186 202 190 199 228 216 192 222 177 209 221 207 200 210 184 3.043
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 41 27 35 39 22 42 35 42 41 32 29 48 43 21 51 548
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 3
JML 2 0 4 0 0 0 0 0 0 0 0 0 0 0 0 6
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
A DATA PEMILIH
LK 1.776 109 138 139 146 133 115 129 84 125 146 135 137 99 97 105 3.613
JML 3.523 203 265 269 287 247 223 235 157 238 261 254 260 204 182 203 7.011
LK 1.443 92 115 117 116 109 95 95 67 96 113 100 113 74 83 79 2.907
JML 3.018 179 230 230 229 208 190 186 131 202 214 206 233 164 161 161 5.942
LK 5 0 3 0 0 0 0 2 0 0 0 0 0 0 1 0 11
PR 2 0 3 0 1 0 0 1 0 0 0 0 0 0 0 0 7
(DPTb)
JML 7 0 6 0 1 0 0 3 0 0 0 0 0 0 1 0 18
LK 10 2 4 4 0 0 0 0 0 0 0 0 0 0 0 0 20
PR 8 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 14
(DPK)
JML 18 5 7 4 0 0 0 0 0 0 0 0 0 0 0 0 34
LK 1.458 94 122 121 116 109 95 97 67 96 113 100 113 74 84 79 2.938
JML 3.043 184 243 234 230 208 190 189 131 202 214 206 233 164 162 161 5.994
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
4 548 23 28 41 63 34 38 48 130 41 53 54 33 45 24 47 1.250
suara cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
LK 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
PR 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4
pilih
JML 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7
LAMPIRAN MODEL
Halaman 1 Lembar 3

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 031 TPS 032 JUMLAH AKHIR
1 2 3 4 5 6 7
A DATA PEMILIH
LK 3.613 95 129 3.837
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 3.398 87 127 3.612
JML 7.011 182 256 7.449
LK 2.907 70 107 3.084
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 3.035 63 116 3.214
JML 5.942 133 223 6.298
LK 11 1 0 12
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 7 0 0 7
JML 18 1 0 19
LK 20 0 5 25
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 14 1 2 17
JML 34 1 7 42
LK 2.938 71 112 3.121
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 3.056 64 118 3.238
JML 5.994 135 230 6.359
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 031 TPS 032 JUMLAH AKHIR
1 2 3 4 5 6
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 7.245 186 262 7.693
2 Jumlah surat suara yang digunakan 5.994 135 230 6.359
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 1 0 0 1
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 1.250 51 32 1.333
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 031 TPS 032 JUMLAH AKHIR
1 2 3 4 5 6 7
LK 3 0 1 4
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 4 0 2 6
JML 7 0 3 10
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0


3. UDI SUHANDORO 2 1 1 0 0 0 0 0 0 4 2 0 1 0 0 11
6. NIAR YUNIAR 1 1 1 1 0 0 0 1 0 0 2 1 0 1 0 9
8. SUTIYA ANJANI 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 4
10. YANTI TARYATI 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 2
11. CAHYO FITRIADI 1 0 1 0 0 0 0 0 0 2 0 0 0 0 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
8. AGUS MULYADI, S.Pd. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 124 9 14 7 5 7 5 6 0 2 9 9 11 6 7 4 225
A.2)


3. UDI SUHANDORO 11 0 0 3 0 0 0 1 0 0 0 0 0 1 1 1 18
6. NIAR YUNIAR 9 0 0 1 1 0 1 1 0 0 0 0 1 1 0 0 15
8. SUTIYA ANJANI 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
10. YANTI TARYATI 2 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 4
11. CAHYO FITRIADI 4 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 5
B 240 10 17 32 35 25 12 33 12 2 18 12 9 17 13 15 502
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 031 TPS 032 JUMLAH AKHIR
1 2 3 4 5 6
A.1 1. Partai Kebangkitan Bangsa 104 4 5 113
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 64 1 1 66
2. DINDIN ABDULLAH GHOZALI 26 0 0 26
3. H. AMIR AMIRULOH, S.H. 12 0 1 13
4. NAFIZUL ALHAFIZRANA 3 0 0 3
5. BAGUS DJATI KUSUMA 5 0 0 5
6. SHOLEHATUN NASIHA, S.Kom. 4 0 1 5
7. Ir. AAN SURYA PRIYANA 3 0 0 3
8. AGUS MULYADI, S.Pd. 0 0 0 0
9. ROSALINDA RAMDHANIAH, S.Ag. 0 0 0 0
10. TEGUH YULIANTO, S.T. 1 0 0 1
11. RISMA PUJI RIANTI 3 0 0 3
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 225 5 8 238
A.1 2. Partai Gerakan Indonesia Raya 240 7 7 254

A.2 1. H. RICKY KURNIAWAN, Lc. 107 2 3 112
2. Ir. PRASETYAWATI, M.M. 64 0 2 66

3. UDI SUHANDORO 18 0 1 19
4. H. CECEP GOGOM, S.Ag., M.Pd. 28 0 0 28
5. YORDA IMAM SUTOMO, S.H. 3 1 0 4
6. NIAR YUNIAR 15 0 2 17
7. Dr. AGUS SUHENDI, M.Pd. 11 0 0 11
8. SUTIYA ANJANI 4 0 1 5
9. TOTING SUPRIATNA 3 0 0 3
10. YANTI TARYATI 4 0 0 4
11. CAHYO FITRIADI 5 0 0 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 0 0 0 1 0 0 0 3 0 0 1 1 0 0 6
6. H. AGUS RIADI 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 3
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2. H. KUSNADI, S.I.P. 1 3 0 1 0 0 0 1 0 2 0 2 1 0 1 12
6. LINDA OCTAVIA 0 1 0 1 0 0 0 0 0 1 1 0 0 0 0 4
7. H. HELMI BUSTOMI 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 4
10. FAJAR SETIAWAN 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
4. Hj. DIAN ROSITA 6 0 0 0 0 0 0 0 0 0 0 1 2 0 0 1 10
6. H. AGUS RIADI 3 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 5
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 95 6 8 3 17 17 14 8 6 2 8 15 8 3 6 4 220
A.2)

2. H. KUSNADI, S.I.P. 12 4 0 1 1 1 0 0 1 0 1 0 0 0 2 2 25
6. LINDA OCTAVIA 4 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 6
7. H. HELMI BUSTOMI 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
10. FAJAR SETIAWAN 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 4
B 112 10 3 14 9 14 6 2 3 5 8 4 4 5 4 4 207
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6
A.1 3. Partai Demokrasi Indonesia Perjuangan 119 5 2 126
A.2 1. Hj. ASYANTI ROZANA, S.E. 33 0 1 34
2. DONI MARADONA HUTABARAT, S.H. 24 1 1 26
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 10 0 1 11
4. Hj. DIAN ROSITA 10 1 0 11
5. THARIQ HALILINTAR 12 0 1 13
6. H. AGUS RIADI 5 1 0 6
7. IRAWATY OCTORA, S.E., M.Si. 0 0 0 0
8. MANGONTANG SIMANJUNTAK 0 0 0 0
9. BAMBANG SUMANTRI, S.Sos. 4 0 0 4
10. EUGINIA NATANIA PUTRI 3 0 0 3
11. ALUN HIMAWAN 0 0 0 0
A.1 4. Partai Golongan Karya 75 3 1 79

A.2 1. SAMSUL HIDAYAT, S.H. 40 0 0 40
2. H. KUSNADI, S.I.P. 25 1 2 28
3. KURNIAWATYNINGSIH, S.E. 10 0 0 10
4. ADI RESTU PERMADI 14 1 0 15
5. KHAERUL ANAM, S.Pi., M.Si. 9 0 0 9
6. LINDA OCTAVIA 6 0 1 7
7. H. HELMI BUSTOMI 4 0 1 5
8. MUNAWARAH SUNUSI, S.E., M.Si. 1 0 0 1
9. RENO ANGGARA MUKTI, S.ST.Par. 18 0 0 18
10. FAJAR SETIAWAN 4 0 0 4
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 1 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 3 3 3 0 3 0 0 1 0 0 0 0 2 1 5 21
A.2 1. M. RIZKY 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 3
2. DONDY DWIGUNTIA 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2
5. DELLA PUSPITA 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 2
6. AJID, S.Ag. 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 2
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. MUHAMAD RIDWAN 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
11. ARIFIN, S.Hut. 9 12 17 21 0 0 0 0 0 0 0 0 0 0 0 59
A.1 6. Partai Buruh 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1

A.2 1. Komarudin 0 0 1 0 0 0 0 0 0 0 0 1 0 2 0 4
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.1 5. Partai NasDem 21 0 2 1 0 1 0 0 0 1 4 0 5 0 2 1 38
A.2 1. M. RIZKY 3 0 0 0 1 2 1 0 0 0 1 1 1 0 2 0 12
2. DONDY DWIGUNTIA 2 0 0 0 0 2 0 0 3 0 1 3 4 3 2 3 23
5. DELLA PUSPITA 2 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 4
6. AJID, S.Ag. 2 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 5
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. MUHAMAD RIDWAN 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3
10. AWALUDDIN, S.T. 1 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 4
11. ARIFIN, S.Hut. 59 0 0 0 0 0 0 16 0 0 0 0 0 1 0 0 76
B 94 0 3 1 1 5 2 17 4 2 8 6 12 4 6 5 170
A.2)
A.1 6. Partai Buruh 1 0 0 2 0 0 0 0 0 0 1 0 0 0 0 1 5

A.2 1. Komarudin 4 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 5
2. Krisdianto, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 2
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 7 0 0 4 1 1 0 0 0 0 1 0 1 0 0 1 16
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6
A.1 5. Partai NasDem 38 2 2 42
A.2 1. M. RIZKY 12 0 0 12
2. DONDY DWIGUNTIA 23 0 2 25
3. VICA FITHRI NOER AZIZAH 1 0 0 1
4. MELIHASRAT JAYA ZAI, S.E. 3 0 0 3
5. DELLA PUSPITA 4 0 0 4
6. AJID, S.Ag. 5 0 0 5
7. UMMI NURAENI, S.H. 0 0 0 0
8. AHMAD ROUF, S.I.P., M.Si. 1 0 0 1
9. MUHAMAD RIDWAN 3 1 0 4
10. AWALUDDIN, S.T. 4 0 0 4
11. ARIFIN, S.Hut. 76 0 0 76
A.1 6. Partai Buruh 5 0 0 5

A.2 1. Komarudin 5 1 0 6
2. Krisdianto, S.H. 2 0 0 2
3. Mira Sari La Puppung, S.E. 1 0 0 1
4. Agus Sarjanto, S.H. 0 0 0 0
5. Sugiarta 0 0 0 0
6. Lilis Minarni 2 0 0 2
7. Abdul Oir, S.H. 0 0 0 0
8. Ade Yuswandi 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 1 0 0 1
10. SAHRUL BAHRI 0 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 3
3. NASRUDDIN 0 0 0 0 0 1 0 1 0 0 0 0 1 0 1 4
4. NAFIZA 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 2
10. ADE SAEPUL, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2
8. ABDURROKHIM, S.Pt. 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 3
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. WIWID PURWAWAN 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
3. NASRUDDIN 4 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 6
4. NAFIZA 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 3
5. FERRY ARDIAN AR. 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
8. LINA KADARMINI 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3
10. ADE SAEPUL, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 22 2 0 1 0 2 1 1 0 2 1 1 2 1 0 1 37
A.2)

6. SOPIAN APIP, S.E. 2 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 5
8. ABDURROKHIM, S.Pt. 3 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 101 0 14 2 3 5 15 1 4 23 13 5 10 4 7 7 214
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6
A.1 7. Partai Gelombang Rakyat Indonesia 12 2 1 15
A.2 1. WIWID PURWAWAN 3 0 0 3
2. Hj. LULU MASLUCHAH, Lc. 3 0 0 3
3. NASRUDDIN 6 0 0 6
4. NAFIZA 3 1 0 4
5. FERRY ARDIAN AR. 2 0 0 2
6. ANDON TEGAR PRIBADI 0 0 0 0
7. RIZKY RADIANTO FAJRI 3 0 0 3
8. LINA KADARMINI 3 0 0 3
9. ISLAM RAHIMI HUSAIN, S.T. 1 0 0 1
10. ADE SAEPUL, S.Ag. 1 0 0 1
11. MUHTADIN 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 71 2 0 73

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 33 0 0 33
2. DEDI AROZA, S.Ag., M.Si. 35 0 0 35
3. Dra. IIN SUPRIHATIN 23 0 0 23
4. MOCHAMAD ICHSAN M., S.T. 23 1 1 25
5. NUR LAELA TUROHMAH, S.E. 6 0 0 6
6. SOPIAN APIP, S.E. 5 0 0 5
7. ZULFIKAR MAHBUB ROBBANI 8 0 0 8
8. ABDURROKHIM, S.Pt. 5 0 0 5
9. DEWI RACHMAWATI, S.E. 0 0 0 0
10. MURDOKO, S.H. 0 0 0 0
11. RETNO UMMY ASTHASARI, S.T.P. 5 0 0 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. ELIA 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 2
1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 3
3. ARIEF BUDIMAN 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 3
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. Neneng Rohimah 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
2. Irwan Yani 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
B 6 0 0 0 0 0 0 2 0 0 3 0 0 0 0 0 11
A.2)

A.2 1. ELIA 2 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 4
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
3. ARIEF BUDIMAN 3 0 0 0 0 0 3 0 0 0 0 0 3 2 0 0 11
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 13 0 0 0 0 3 3 0 0 1 0 1 4 2 0 0 27
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6
A.1 9. Partai Kebangkitan Nusantara 7 0 0 7
A.2 1. Neneng Rohimah 1 0 0 1
2. Irwan Yani 1 0 0 1
3. JAN ADOLF HUKUBUN 1 0 0 1
4. FRANSISKA DWI KESDIATIK 0 0 0 0
5. Imam Fauzi 0 0 0 0
6. Sri Rosmaryati 0 0 0 0
7. ALI MUNAJIB 0 0 0 0
8. Aprizal Hamid 0 0 0 0
9. Nadya Oktafiani 1 0 0 1
A.1 10. Partai Hati Nurani Rakyat 5 0 0 5

A.2 1. ELIA 4 1 0 5
3 0 0 3
3. ARIEF BUDIMAN 11 0 0 11
4. HERVINA LESTARI 1 0 0 1
5. ANDREAS KURNIAWAN E 2 0 0 2
6. DHEMAS PRADITYA 0 0 0 0
7. YASMIN INAYAH NATA BUWANA 1 0 0 1
8. NIRWAN PRATAMA PUTRA 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. H. SUPONO 1 2 2 0 3 1 2 2 3 0 0 4 0 1 5 26
3. SARASWATI 2 2 0 3 3 1 0 1 3 2 0 0 3 2 0 22
6. ASTRI SARTIKA 1 1 0 1 0 2 2 1 1 1 1 0 0 1 0 12
9. MERRY APRIYANTI 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 2
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ANI NURMAYANTI 3 1 0 0 0 0 0 0 1 0 2 0 0 0 0 7
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A.2 1. A. KHALIK 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
B 6 0 0 0 2 2 1 6 0 0 1 0 0 0 0 0 18
A.2)

A.2 1. H. SUPONO 26 2 1 4 5 2 0 1 1 0 0 4 3 1 3 1 54
2. H. PERMADI DALUNG, S.E., M.M. 640 58 66 70 54 40 27 25 55 77 35 53 49 32 51 16 1.348
3. SARASWATI 22 4 2 2 3 1 4 1 1 1 2 4 3 1 1 1 53
6. ASTRI SARTIKA 12 1 2 0 0 0 0 0 0 1 1 0 1 1 0 0 19
9. MERRY APRIYANTI 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
10. IIM SOLIHATI 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 2
11. ANI NURMAYANTI 7 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 9
B 1.355 79 105 112 97 64 49 33 65 90 50 78 64 45 64 45 2.395
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6
A.1 11. Partai Garda Republik Indonesia 14 0 0 14
A.2 1. A. KHALIK 1 0 0 1
2. YULIANTI BILAKONGA 3 0 0 3
A.1 12. Partai Amanat Nasional 297 7 6 310

A.2 1. H. SUPONO 54 0 3 57
2. H. PERMADI DALUNG, S.E., M.M. 1.348 14 70 1.432
3. SARASWATI 53 0 1 54
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 591 10 5 606
5. CEPI AL HAKIM, S.T.P., M.Si. 10 0 0 10
6. ASTRI SARTIKA 19 0 0 19
7. REGIVAL PUTRA ADRIAN 3 0 0 3
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 7 0 0 7
9. MERRY APRIYANTI 2 0 2 4
10. IIM SOLIHATI 2 0 0 2
11. ANI NURMAYANTI 9 0 0 9
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 2.395 31 87 2.513
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 3
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
3. FITRIASARI 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 2
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 4 1 2 1 1 0 1 1 0 0 1 0 2 0 0 1 15
A.2)

4. SAIFUL 3 0 0 0 0 1 1 1 0 0 1 1 0 0 0 0 8
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 86 8 10 4 5 6 8 12 1 9 6 4 10 7 6 17 199
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6
A.1 13. Partai Bulan Bintang 5 0 0 5
A.2 1. SOLAHUDDIN, S.H., M.H. 3 0 0 3
2. AGUS SUKARNA WIJAYA 2 0 1 3
3. FITRIASARI 2 0 0 2
4. DJUMHAWAN R PERMANA 0 0 0 0
5. Deni Rusydiana, S.H.I. 0 0 0 0
6. YANI SURYANI FIKRIAH 1 0 0 1
7. WAWANG HUSNAWATI 0 0 0 0
8. Sanusi Permana 0 0 0 0
9. Mochammad Muzaqi 2 0 0 2
10. MOCHAMAD MORO ASIH 0 0 0 0
A.1 14. Partai Demokrat 57 1 2 60

A.2 1. DEDE CANDRA SASMITA, S.Ag. 94 4 6 104
2. MANATAP P SIMANJUNTAK 19 0 0 19
3. ANDRIYANTI WIJAYA 8 0 0 8
4. SAIFUL 8 1 0 9
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 2 0 0 2
6. ARNY NURANI SANGAJI 4 0 0 4
7. REDIKA SEGARA, S.E. 0 0 0 0
8. KARDAN 0 0 0 0
9. HARKES WOROWATI W. A. 2 0 0 2
10. NAUFAL ANDHIKA IRAWAN 2 1 0 3
11. ENDAH HENDRAWASIH 3 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 1 2 0 0 0 0 0 0 0 0 1 0 0 0 0 4
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 2
A.1 16. PARTAI PERINDO 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 3

A.2 1. RESITA KANIYA 1 2 3 0 0 0 1 1 0 0 0 1 0 0 0 9
2. AGUS WINARNO 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 2
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 3
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
11. MOHAMAD SATIBI 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
3. SIANA RIA, S.E., M.M. 4 0 1 1 0 0 1 1 1 0 0 1 0 1 0 0 11
6. DIAH WINARSIH 1 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 4
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
8. DESI FITRI DIANA 2 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 5
B 43 2 3 5 2 5 15 3 2 9 8 8 9 2 2 1 119
A.2)
A.1 16. PARTAI PERINDO 3 0 0 2 0 0 2 0 2 0 0 0 0 0 0 1 10

A.2 1. RESITA KANIYA 9 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 10
2. AGUS WINARNO 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 3 0 2 0 0 0 0 0 0 0 0 0 0 1 0 0 6
10. RAHMAT HIDAYAT 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2
11. MOHAMAD SATIBI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
B 21 0 4 2 0 0 2 2 2 0 0 0 0 1 0 1 35
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6
A.1 15. Partai Solidaritas Indonesia 43 1 2 46
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 20 0 0 20
2. FEBRY CITRA, S.T., M.A.B. 12 0 0 12
3. SIANA RIA, S.E., M.M. 11 1 0 12
4. MUHAMMAD ADE ALIYUDIN, S.H. 20 1 0 21
5. JASIMAN SITORUS, S.Kom., M.M. 3 0 0 3
6. DIAH WINARSIH 4 0 0 4
7. GUNADI, M.Ag. 1 0 0 1
8. DESI FITRI DIANA 5 0 0 5
A.1 16. PARTAI PERINDO 10 3 0 13

A.2 1. RESITA KANIYA 10 0 0 10
2. AGUS WINARNO 2 0 0 2
3. Drs. SUMARWAN SASTRA 1 0 0 1
4. NENDEN BANURIAH, S.Pd. 2 0 0 2
5. AMARENS MANUHUTU 0 0 0 0
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 1 0 0 1
7. YURIZAL, S.E., M.M. 0 0 0 0
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 0 0 0 0
9. ELLY MARYANTI 6 0 0 6
10. RAHMAT HIDAYAT 2 1 0 3
11. MOHAMAD SATIBI 1 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 3 2 1 1 0 0 0 0 1 0 6 2 0 2 3 21
3. DWI ARYANTI, S.E. 2 8 4 0 0 0 1 2 1 0 2 2 3 2 1 28
4. IRFAN DARAJAT 0 2 1 1 0 2 0 0 0 1 2 0 1 2 4 16
5. FERRY PERDIAN 1 0 1 0 0 1 0 1 0 0 0 0 6 4 1 15
9. GUNAWAN 0 0 0 0 0 0 1 0 0 2 1 1 0 0 1 6
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 1 1 1 0 0 2 5
11. RIKE ISKANDAR 0 0 0 2 0 0 0 0 0 1 0 0 0 0 0 3
A.1 24. Partai Ummat 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 3

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
2. JUHANTA, S.T. 21 4 3 1 2 2 1 1 0 2 1 3 1 1 0 1 44
3. DWI ARYANTI, S.E. 28 5 2 2 4 5 4 3 0 4 4 7 4 5 1 2 80
4. IRFAN DARAJAT 16 0 1 0 0 1 0 1 0 0 0 0 1 1 1 1 23
5. FERRY PERDIAN 15 1 1 0 1 1 0 0 0 0 1 1 0 1 1 1 24
9. GUNAWAN 6 1 2 0 0 0 2 0 2 2 2 1 1 1 0 0 20
10. RIA ANWAR 5 0 1 0 0 0 0 0 0 0 0 1 0 2 0 0 9
11. RIKE ISKANDAR 3 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 6
B 250 24 29 12 18 23 26 25 11 22 43 33 46 45 30 24 661
A.2)
A.1 24. Partai Ummat 3 1 0 0 0 0 0 1 0 0 1 0 1 0 0 1 8

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
B 7 1 0 0 0 0 0 1 0 1 1 1 2 1 0 5 20
A.2)
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6
A.1 17. Partai Persatuan Pembangunan 221 7 19 247
A.2 1. H. MUHAMAD ROMLI, A.Md. 187 9 23 219
2. JUHANTA, S.T. 44 1 2 47
3. DWI ARYANTI, S.E. 80 1 3 84
4. IRFAN DARAJAT 23 1 0 24
5. FERRY PERDIAN 24 2 1 27
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 16 0 2 18
7. YENTI NASHI HATUL UMMAH 28 1 1 30
8. ABDUL ROHIM, S.Si., Apt. 3 1 0 4
9. GUNAWAN 20 0 0 20
10. RIA ANWAR 9 0 1 10
11. RIKE ISKANDAR 6 0 0 6
A.1 24. Partai Ummat 8 2 3 13

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 6 1 2 9
2. SELLY AFRIDA OLTAR, S.I.P. 1 0 1 2
3. H. SUMIRAT SAPTA HADI, S.Ag. 1 0 0 1
4. Drs. H. ASRI AL JUFRI, M.Si. 2 0 1 3
5. RITA HERLINA, S.E. 1 0 0 1
6. Drs. MOCH ZAENAL AL AQILI 1 0 0 1
7. FAUZIAH TABRIYANI 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0
9. JAKA JATI NUR ALAM 0 0 0 0
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

B. JUMLAH SUARA TIDAK SAH 457 32 31 34 34 29 30 36 21 32 35 29 39 21 17 26 903
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 031 TPS 032 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 5.091 110 198 5.399
B. JUMLAH SUARA TIDAK SAH 903 25 32 960
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 5.994 135 230 6.359

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: BATUJAJAR
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 129 122 98 66 96 142 126 100 137 150 117 146 152 150 129 1.860
JML 261 246 191 129 195 259 226 188 272 293 201 265 279 271 237 3.513
LK 120 117 80 58 85 123 120 98 107 120 114 140 119 140 128 1.669
JML 241 239 169 116 181 234 214 168 225 231 198 253 234 258 216 3.177
LK 1 0 0 2 0 1 0 0 0 0 0 1 0 0 0 5
JML 2 0 0 3 1 2 0 0 0 0 0 3 0 0 0 11
LK 0 0 0 0 1 0 1 0 0 0 1 2 0 0 0 5
JML 0 0 0 0 2 0 2 0 0 0 4 5 1 4 0 18
LK 121 117 80 60 86 124 121 98 107 120 115 143 119 140 128 1.679
JML 243 239 169 119 184 236 216 168 225 231 202 261 235 262 216 3.206
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 22 12 27 13 15 29 15 24 53 66 5 9 50 15 26 381
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12
A DATA PEMILIH
LK 1.860 102 147 98 109 106 121 69 2.612
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 1.653 86 130 82 104 97 112 54 2.318
JML 3.513 188 277 180 213 203 233 123 4.930
LK 1.669 83 81 80 95 97 105 65 2.275
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.508 72 116 71 95 92 99 52 2.105
JML 3.177 155 197 151 190 189 204 117 4.380
LK 5 0 0 0 0 1 1 0 7
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 6 0 0 0 1 1 0 0 8
JML 11 0 0 0 1 2 1 0 15
LK 5 0 1 2 0 0 0 0 8
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 13 0 2 1 0 0 1 0 17
JML 18 0 3 3 0 0 1 0 25
LK 1.679 83 82 82 95 98 106 65 2.290
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.527 72 118 72 96 93 100 52 2.130
JML 3.206 155 200 154 191 191 206 117 4.420
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 3.587 192 283 186 218 208 237 126 5.037
2 Jumlah surat suara yang digunakan 3.206 155 200 154 191 191 206 117 4.420
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 0 0 0 0 1 0 0 0 1
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 381 37 83 32 26 17 31 9 616
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12
LK 0 0 0 0 0 0 0 0 0
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2


3. UDI SUHANDORO 1 0 0 1 0 1 1 0 1 1 0 0 1 1 1 9
6. NIAR YUNIAR 1 0 0 0 0 0 0 0 0 1 0 1 1 0 2 6
8. SUTIYA ANJANI 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
10. YANTI TARYATI 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. CAHYO FITRIADI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 1. Partai Kebangkitan Bangsa 44 3 1 1 7 4 3 2 65
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 63 1 0 0 1 2 3 1 71
2. DINDIN ABDULLAH GHOZALI 5 0 0 1 0 0 0 1 7
3. H. AMIR AMIRULOH, S.H. 10 0 1 0 1 1 0 0 13
4. NAFIZUL ALHAFIZRANA 3 0 1 0 0 0 0 0 4
5. BAGUS DJATI KUSUMA 4 0 1 0 0 0 0 0 5
6. SHOLEHATUN NASIHA, S.Kom. 2 0 1 0 0 0 0 1 4
7. Ir. AAN SURYA PRIYANA 1 0 0 0 0 0 0 0 1
8. AGUS MULYADI, S.Pd. 2 0 0 0 0 0 0 0 2
9. ROSALINDA RAMDHANIAH, S.Ag. 0 0 0 0 0 0 0 0 0
10. TEGUH YULIANTO, S.T. 0 0 0 0 0 0 0 0 0
11. RISMA PUJI RIANTI 1 0 0 0 0 0 0 0 1
A.1 2. Partai Gerakan Indonesia Raya 101 11 12 7 11 7 14 15 178

A.2 1. H. RICKY KURNIAWAN, Lc. 43 2 4 2 4 1 3 5 64
2. Ir. PRASETYAWATI, M.M. 40 2 2 7 15 1 11 3 81

3. UDI SUHANDORO 9 0 1 0 4 0 1 0 15
4. H. CECEP GOGOM, S.Ag., M.Pd. 9 1 0 1 1 0 0 0 12
5. YORDA IMAM SUTOMO, S.H. 5 0 0 0 0 1 0 0 6
6. NIAR YUNIAR 6 0 0 0 0 0 1 0 7
7. Dr. AGUS SUHENDI, M.Pd. 3 0 0 0 0 0 1 0 4
8. SUTIYA ANJANI 1 0 1 0 0 0 0 1 3
9. TOTING SUPRIATNA 1 0 0 0 0 0 1 0 2
10. YANTI TARYATI 1 0 0 1 0 0 0 0 2
11. CAHYO FITRIADI 0 0 1 0 0 0 1 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 0 0 0 0 1 0 0 1 0 1 0 0 1 0 4
6. H. AGUS RIADI 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 2
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2. H. KUSNADI, S.I.P. 0 2 0 0 1 1 0 2 4 3 0 1 1 0 2 17
6. LINDA OCTAVIA 0 1 0 0 0 0 0 0 1 2 0 0 0 0 0 4
7. H. HELMI BUSTOMI 0 0 0 1 0 0 0 1 0 1 0 0 1 1 0 5
10. FAJAR SETIAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 3. Partai Demokrasi Indonesia Perjuangan 55 12 5 6 4 3 4 5 94
A.2 1. Hj. ASYANTI ROZANA, S.E. 27 1 1 0 2 0 3 1 35
2. DONI MARADONA HUTABARAT, S.H. 14 3 5 0 1 1 0 1 25
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 12 5 2 1 1 0 0 0 21
4. Hj. DIAN ROSITA 4 0 0 0 0 0 0 0 4
5. THARIQ HALILINTAR 4 0 1 0 0 0 1 0 6
6. H. AGUS RIADI 2 0 0 0 1 0 0 0 3
7. IRAWATY OCTORA, S.E., M.Si. 1 0 0 0 0 0 0 0 1
8. MANGONTANG SIMANJUNTAK 1 0 0 0 0 0 0 0 1
9. BAMBANG SUMANTRI, S.Sos. 1 0 0 0 0 0 0 0 1
10. EUGINIA NATANIA PUTRI 0 0 0 0 0 0 0 0 0
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0
A.1 4. Partai Golongan Karya 42 6 11 1 4 2 1 0 67

A.2 1. SAMSUL HIDAYAT, S.H. 26 2 4 0 3 1 0 2 38
2. H. KUSNADI, S.I.P. 17 0 0 2 1 1 0 0 21
3. KURNIAWATYNINGSIH, S.E. 10 1 0 0 0 0 1 1 13
4. ADI RESTU PERMADI 8 1 0 0 0 0 0 0 9
5. KHAERUL ANAM, S.Pi., M.Si. 3 0 0 0 0 0 0 0 3
6. LINDA OCTAVIA 4 0 1 0 0 2 0 1 8
7. H. HELMI BUSTOMI 5 0 0 1 0 0 0 0 6
8. MUNAWARAH SUNUSI, S.E., M.Si. 5 0 1 0 0 0 0 0 6
9. RENO ANGGARA MUKTI, S.ST.Par. 22 0 0 0 0 0 0 0 22
10. FAJAR SETIAWAN 0 0 1 0 0 0 0 1 2
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 3 2 0 1 0 5 1 0 1 1 1 3 0 0 0 18
A.2 1. M. RIZKY 0 1 0 0 1 1 0 0 0 0 2 0 0 0 0 5
2. DONDY DWIGUNTIA 0 0 0 0 1 2 0 1 1 0 25 20 0 0 0 50
5. DELLA PUSPITA 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 4
6. AJID, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 2 0 0 0 3 0 0 0 0 0 0 1 0 0 0 6
A.1 6. Partai Buruh 0 0 1 0 1 0 0 0 0 1 0 0 0 0 0 3

A.2 1. Komarudin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 5. Partai NasDem 18 0 2 0 0 1 0 0 21
A.2 1. M. RIZKY 5 1 1 1 0 0 0 0 8
2. DONDY DWIGUNTIA 50 0 7 0 0 0 0 0 57
3. VICA FITHRI NOER AZIZAH 3 0 0 0 0 0 0 1 4
4. MELIHASRAT JAYA ZAI, S.E. 1 0 0 0 0 0 0 0 1
5. DELLA PUSPITA 4 0 1 0 0 0 0 0 5
6. AJID, S.Ag. 0 0 0 0 0 0 0 0 0
7. UMMI NURAENI, S.H. 0 1 0 0 0 0 0 0 1
8. AHMAD ROUF, S.I.P., M.Si. 0 0 0 0 0 0 0 0 0
9. MUHAMAD RIDWAN 1 0 0 0 0 0 0 0 1
10. AWALUDDIN, S.T. 0 0 0 0 0 0 1 0 1
11. ARIFIN, S.Hut. 6 0 0 0 0 0 16 0 22
A.1 6. Partai Buruh 3 0 1 0 0 0 0 0 4

A.2 1. Komarudin 1 0 1 0 1 0 0 0 3
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0
3. Mira Sari La Puppung, S.E. 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 1 1
11. Eva Pusvita Sari, S.Kom. 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 3
3. NASRUDDIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
4. NAFIZA 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
8. ABDURROKHIM, S.Pt. 0 2 0 0 0 0 1 1 0 0 0 0 0 0 0 4
10. MURDOKO, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 7. Partai Gelombang Rakyat Indonesia 5 0 2 0 0 0 1 0 8
A.2 1. WIWID PURWAWAN 3 1 0 0 0 0 0 0 4
2. Hj. LULU MASLUCHAH, Lc. 1 0 0 0 0 0 0 0 1
3. NASRUDDIN 1 1 0 0 0 0 0 0 2
4. NAFIZA 1 0 0 0 0 0 0 0 1
5. FERRY ARDIAN AR. 1 0 0 0 0 0 0 0 1
6. ANDON TEGAR PRIBADI 0 0 0 0 0 0 0 0 0
7. RIZKY RADIANTO FAJRI 1 0 0 0 0 0 0 0 1
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0
9. ISLAM RAHIMI HUSAIN, S.T. 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 22 0 1 2 0 0 1 0 26

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 22 0 3 0 2 0 0 0 27
2. DEDI AROZA, S.Ag., M.Si. 7 0 1 0 1 1 0 0 10
3. Dra. IIN SUPRIHATIN 5 0 1 0 0 0 0 0 6
4. MOCHAMAD ICHSAN M., S.T. 5 0 0 1 0 1 0 0 7
5. NUR LAELA TUROHMAH, S.E. 4 0 0 0 0 1 0 0 5
6. SOPIAN APIP, S.E. 1 0 1 0 0 0 0 0 2
7. ZULFIKAR MAHBUB ROBBANI 5 0 0 0 0 0 0 0 5
8. ABDURROKHIM, S.Pt. 4 0 0 0 1 0 0 0 5
9. DEWI RACHMAWATI, S.E. 0 0 0 0 0 0 0 0 0
10. MURDOKO, S.H. 1 0 0 0 0 0 0 0 1
11. RETNO UMMY ASTHASARI, S.T.P. 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
6. Sri Rosmaryati 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. ELIA 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
3. ARIEF BUDIMAN 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 9. Partai Kebangkitan Nusantara 1 0 0 1 0 0 2 0 4
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0
3. JAN ADOLF HUKUBUN 0 0 0 0 0 0 0 0 0
4. FRANSISKA DWI KESDIATIK 1 0 0 0 0 0 0 0 1
5. Imam Fauzi 1 0 0 0 0 0 0 0 1
6. Sri Rosmaryati 1 0 0 0 0 0 0 0 1
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0
A.1 10. Partai Hati Nurani Rakyat 2 0 0 0 0 0 0 0 2

A.2 1. ELIA 1 0 0 0 0 0 0 0 1
1 0 1 0 0 0 0 0 2
3. ARIEF BUDIMAN 1 0 0 1 0 0 0 0 2
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0
5. ANDREAS KURNIAWAN E 0 0 0 0 0 1 0 0 1
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0
7. YASMIN INAYAH NATA BUWANA 0 0 0 0 0 0 0 0 0
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. H. SUPONO 4 2 1 1 4 2 2 6 0 3 3 1 3 3 1 36
3. SARASWATI 2 2 1 1 1 1 3 0 0 0 0 1 2 1 0 15
6. ASTRI SARTIKA 0 0 1 1 0 0 0 2 0 1 0 1 0 1 0 7
9. MERRY APRIYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. IIM SOLIHATI 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 11. Partai Garda Republik Indonesia 3 0 0 0 0 2 5 0 10
A.2 1. A. KHALIK 0 0 0 0 0 1 0 0 1
2. YULIANTI BILAKONGA 0 0 0 0 0 0 1 0 1
A.1 12. Partai Amanat Nasional 136 4 6 5 5 3 5 0 164

A.2 1. H. SUPONO 36 0 2 0 2 1 1 1 43
2. H. PERMADI DALUNG, S.E., M.M. 495 16 26 26 2 29 25 0 619
3. SARASWATI 15 0 0 0 1 1 1 0 18
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 315 6 1 3 6 7 0 0 338
5. CEPI AL HAKIM, S.T.P., M.Si. 8 0 0 0 0 0 0 0 8
6. ASTRI SARTIKA 7 0 1 0 0 1 0 0 9
7. REGIVAL PUTRA ADRIAN 3 0 0 1 0 1 0 0 5
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 0 0 0 4 1 0 1 1 7
9. MERRY APRIYANTI 0 0 0 2 0 0 0 0 2
10. IIM SOLIHATI 1 0 0 0 0 0 0 0 1
11. ANI NURMAYANTI 2 0 0 0 0 0 0 0 2
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 1.018 26 36 41 17 43 33 2 1.216
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 3
8. Sanusi Permana 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1

4. SAIFUL 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. KARDAN 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 13. Partai Bulan Bintang 3 0 0 0 0 1 0 0 4
A.2 1. SOLAHUDDIN, S.H., M.H. 0 0 0 0 0 0 0 0 0
2. AGUS SUKARNA WIJAYA 2 0 0 0 0 0 1 0 3
3. FITRIASARI 3 0 0 0 0 0 0 0 3
4. DJUMHAWAN R PERMANA 0 0 0 0 0 0 0 0 0
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 0 0 0 0 0 0 0 0 0
7. WAWANG HUSNAWATI 0 0 0 0 0 0 0 0 0
8. Sanusi Permana 1 0 0 0 0 0 0 0 1
9. Mochammad Muzaqi 0 0 0 0 0 0 0 0 0
10. MOCHAMAD MORO ASIH 0 0 0 0 0 0 0 0 0
A.1 14. Partai Demokrat 37 3 4 1 2 1 6 1 55

A.2 1. DEDE CANDRA SASMITA, S.Ag. 82 4 4 4 6 3 0 5 108
2. MANATAP P SIMANJUNTAK 15 1 1 3 1 3 1 0 25
3. ANDRIYANTI WIJAYA 3 0 0 0 0 1 0 1 5
4. SAIFUL 1 0 0 1 0 1 1 0 4
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 3 0 0 0 0 0 0 0 3
6. ARNY NURANI SANGAJI 0 0 0 1 1 0 1 0 3
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0
8. KARDAN 1 0 0 0 0 0 0 0 1
9. HARKES WOROWATI W. A. 0 0 0 5 0 1 1 0 7
10. NAUFAL ANDHIKA IRAWAN 0 0 0 0 0 0 1 0 1
11. ENDAH HENDRAWASIH 0 0 0 0 0 0 1 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 2 0 0 0 0 0 1 0 0 0 0 0 0 0 0 3
6. DIAH WINARSIH 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 3

A.2 1. RESITA KANIYA 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 2
2. AGUS WINARNO 4 0 0 0 0 1 0 0 0 0 0 1 0 1 1 8
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 15. Partai Solidaritas Indonesia 18 0 1 0 1 0 1 1 22
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 7 0 1 0 0 1 0 0 9
2. FEBRY CITRA, S.T., M.A.B. 13 0 0 0 0 1 0 0 14
3. SIANA RIA, S.E., M.M. 3 0 1 0 0 0 1 0 5
4. MUHAMMAD ADE ALIYUDIN, S.H. 8 0 0 1 0 0 0 0 9
5. JASIMAN SITORUS, S.Kom., M.M. 3 0 0 0 0 0 0 0 3
6. DIAH WINARSIH 2 0 0 0 0 0 0 0 2
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 0 0 0 0 0 0 1 1 2
A.1 16. PARTAI PERINDO 3 0 0 0 0 0 0 0 3

A.2 1. RESITA KANIYA 2 0 0 0 0 1 1 1 5
2. AGUS WINARNO 8 0 1 0 0 0 0 0 9
3. Drs. SUMARWAN SASTRA 2 0 0 0 0 0 0 0 2
4. NENDEN BANURIAH, S.Pd. 0 0 0 0 0 0 0 0 0
5. AMARENS MANUHUTU 0 0 0 0 0 0 0 0 0
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 0 0 0 0 0 0 0 0 0
7. YURIZAL, S.E., M.M. 0 0 0 7 0 1 0 0 8
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 0 0 1 0 1 0 0 0 2
10. RAHMAT HIDAYAT 0 0 0 0 0 0 1 0 1
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 1 0 3 0 2 1 1 0 1 2 0 3 0 1 0 15
3. DWI ARYANTI, S.E. 2 3 2 1 4 7 0 7 13 7 3 1 2 5 1 58
4. IRFAN DARAJAT 0 0 0 0 2 0 0 0 1 0 0 0 0 1 0 4
5. FERRY PERDIAN 0 0 0 0 1 2 0 0 0 0 1 2 1 0 2 9
9. GUNAWAN 0 0 0 0 1 2 0 0 0 0 0 0 1 0 0 4
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 0 0 0 0 1 6 2 1 1 0 0 0 0 0 0 11

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11
A.1 17. Partai Persatuan Pembangunan 129 12 5 1 11 15 20 6 199
A.2 1. H. MUHAMAD ROMLI, A.Md. 71 3 5 0 13 5 0 3 100
2. JUHANTA, S.T. 15 2 3 0 1 3 1 1 26
3. DWI ARYANTI, S.E. 58 5 6 2 2 11 3 2 89
4. IRFAN DARAJAT 4 0 1 0 1 0 1 0 7
5. FERRY PERDIAN 9 0 1 0 0 0 0 0 10
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 7 0 0 0 0 2 0 0 9
7. YENTI NASHI HATUL UMMAH 4 0 0 0 0 0 0 0 4
8. ABDUL ROHIM, S.Si., Apt. 1 0 0 0 0 0 0 0 1
9. GUNAWAN 4 0 0 0 0 1 0 1 6
10. RIA ANWAR 1 0 0 0 0 0 0 0 1
11. RIKE ISKANDAR 0 1 0 0 0 0 0 0 1
A.1 24. Partai Ummat 11 0 0 0 1 0 1 0 13

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 52 0 0 0 0 0 0 0 52
2. SELLY AFRIDA OLTAR, S.I.P. 6 0 0 0 0 1 0 0 7
3. H. SUMIRAT SAPTA HADI, S.Ag. 0 0 0 0 0 0 0 0 0
4. Drs. H. ASRI AL JUFRI, M.Si. 0 0 0 0 0 0 0 0 0
5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0
6. Drs. MOCH ZAENAL AL AQILI 1 0 0 0 0 0 0 0 1
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 1 0 0 0 0 0 0 0 1
9. JAKA JATI NUR ALAM 1 0 0 0 0 0 0 0 1
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 TPS 021 TPS 022 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.423 112 152 104 124 131 153 68 3.267
B. JUMLAH SUARA TIDAK SAH 783 43 48 50 67 60 53 49 1.153
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.206 155 200 154 191 191 206 117 4.420

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: WARGAJAYA
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 148 151 157 154 160 145 153 126 116 145 154 159 153 149 155 2.225
JML 298 293 293 299 297 291 300 232 234 275 282 300 278 270 297 4.239
LK 104 122 126 119 112 105 121 91 97 120 124 110 106 116 121 1.694
JML 230 247 247 249 227 218 239 186 194 235 241 225 214 229 244 3.425
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LK 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 3
JML 0 0 0 1 0 2 0 0 0 0 1 0 0 1 0 5
LK 104 122 126 120 112 106 121 91 97 120 124 110 106 117 121 1.697
JML 230 247 247 250 227 220 239 186 194 235 242 225 214 230 244 3.430
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 74 51 53 55 75 76 67 51 45 46 46 81 70 46 60 896
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9
A DATA PEMILIH
LK 2.225 151 120 147 109 2.752
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 2.014 128 116 116 107 2.481
JML 4.239 279 236 263 216 5.233
LK 1.694 120 99 124 71 2.108
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.731 104 99 102 91 2.127
JML 3.425 224 198 226 162 4.235
LK 0 0 0 0 0 0
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 0 0 0 0 0 0
JML 0 0 0 0 0 0
LK 3 0 0 1 0 4
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 2 0 1 0 0 3
JML 5 0 1 1 0 7
LK 1.697 120 99 125 71 2.112
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.733 104 100 102 91 2.130
JML 3.430 224 199 227 162 4.242
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 JUMLAH AKHIR
1 2 3 4 5 6 7 8
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 4.327 286 241 270 221 5.345
2 Jumlah surat suara yang digunakan 3.430 224 199 227 162 4.242
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 1 0 0 1 0 2
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 896 62 42 42 59 1.101
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9
LK 0 0 0 0 1 1
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 0 1 0 0 0 1
JML 0 1 0 0 1 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1


3. UDI SUHANDORO 2 0 0 1 2 0 0 0 0 0 0 1 2 1 2 11
6. NIAR YUNIAR 4 2 1 1 1 2 0 0 1 4 1 1 0 2 1 21
8. SUTIYA ANJANI 0 0 0 0 0 1 0 2 0 2 0 0 0 0 0 5
10. YANTI TARYATI 0 0 0 0 2 0 0 1 0 1 0 0 1 0 0 5
11. CAHYO FITRIADI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 JUMLAH AKHIR
1 2 3 4 5 6 7 8
A.1 1. Partai Kebangkitan Bangsa 128 3 3 4 2 140
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 60 3 2 4 1 70
2. DINDIN ABDULLAH GHOZALI 4 0 1 0 0 5
3. H. AMIR AMIRULOH, S.H. 13 1 0 0 0 14
4. NAFIZUL ALHAFIZRANA 5 0 0 0 1 6
5. BAGUS DJATI KUSUMA 6 0 1 0 0 7
6. SHOLEHATUN NASIHA, S.Kom. 1 1 0 0 0 2
7. Ir. AAN SURYA PRIYANA 5 2 1 0 2 10
8. AGUS MULYADI, S.Pd. 1 1 0 0 1 3
9. ROSALINDA RAMDHANIAH, S.Ag. 2 0 0 0 0 2
10. TEGUH YULIANTO, S.T. 1 0 0 0 0 1
11. RISMA PUJI RIANTI 1 0 0 0 0 1
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 227 11 8 8 7 261
A.1 2. Partai Gerakan Indonesia Raya 144 18 17 12 9 200

A.2 1. H. RICKY KURNIAWAN, Lc. 74 4 5 5 4 92
2. Ir. PRASETYAWATI, M.M. 46 7 12 7 16 88

3. UDI SUHANDORO 11 4 2 0 1 18
4. H. CECEP GOGOM, S.Ag., M.Pd. 72 10 2 0 8 92
5. YORDA IMAM SUTOMO, S.H. 13 0 1 0 1 15
6. NIAR YUNIAR 21 0 0 0 2 23
7. Dr. AGUS SUHENDI, M.Pd. 8 2 0 0 0 10
8. SUTIYA ANJANI 5 1 1 0 1 8
9. TOTING SUPRIATNA 0 1 0 1 1 3
10. YANTI TARYATI 5 0 0 1 2 8
11. CAHYO FITRIADI 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 1 1 0 0 1 1 0 1 0 1 0 1 0 0 13 20
6. H. AGUS RIADI 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
11. ALUN HIMAWAN 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1

2. H. KUSNADI, S.I.P. 4 2 2 5 4 2 1 3 2 1 2 5 4 3 4 44
6. LINDA OCTAVIA 3 2 2 1 0 2 0 1 0 3 0 0 1 1 0 16
7. H. HELMI BUSTOMI 0 3 1 2 2 1 0 1 0 1 1 0 1 0 0 13
10. FAJAR SETIAWAN 0 2 0 0 0 2 0 0 0 0 0 0 1 0 1 6
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8
A.1 3. Partai Demokrasi Indonesia Perjuangan 85 0 0 9 7 101
A.2 1. Hj. ASYANTI ROZANA, S.E. 30 1 1 2 1 35
2. DONI MARADONA HUTABARAT, S.H. 62 0 0 5 3 70
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 13 0 0 1 0 14
4. Hj. DIAN ROSITA 20 0 1 18 0 39
5. THARIQ HALILINTAR 7 0 0 0 0 7
6. H. AGUS RIADI 1 0 1 0 0 2
7. IRAWATY OCTORA, S.E., M.Si. 3 0 0 1 0 4
8. MANGONTANG SIMANJUNTAK 0 0 0 0 0 0
9. BAMBANG SUMANTRI, S.Sos. 1 0 0 0 0 1
10. EUGINIA NATANIA PUTRI 2 0 0 0 0 2
11. ALUN HIMAWAN 1 0 0 0 0 1
A.1 4. Partai Golongan Karya 169 7 7 12 10 205

A.2 1. SAMSUL HIDAYAT, S.H. 197 15 4 5 4 225
2. H. KUSNADI, S.I.P. 44 6 7 9 2 68
3. KURNIAWATYNINGSIH, S.E. 17 2 3 1 0 23
4. ADI RESTU PERMADI 16 1 3 2 3 25
5. KHAERUL ANAM, S.Pi., M.Si. 3 0 1 1 0 5
6. LINDA OCTAVIA 16 0 0 1 0 17
7. H. HELMI BUSTOMI 13 0 1 2 0 16
8. MUNAWARAH SUNUSI, S.E., M.Si. 1 0 0 1 2 4
9. RENO ANGGARA MUKTI, S.ST.Par. 33 8 9 8 8 66
10. FAJAR SETIAWAN 6 3 0 0 1 10
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 3 0 0 0 2 5
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 2 2 3 4 0 8 6 1 2 6 3 4 6 1 2 50
A.2 1. M. RIZKY 4 2 5 3 0 7 2 0 1 5 1 4 4 1 0 39
2. DONDY DWIGUNTIA 20 21 12 5 3 2 7 4 2 21 18 18 21 1 3 158
5. DELLA PUSPITA 0 0 0 2 0 1 0 0 0 0 0 0 0 1 0 4
6. AJID, S.Ag. 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 3
7. UMMI NURAENI, S.H. 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 2
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 1 0 1 2 0 0 4
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 0 0 8 0 13 7 23 1 15 22 25 9 9 12 4 148
A.1 6. Partai Buruh 1 1 0 2 0 0 1 0 0 0 1 0 0 0 0 6

A.2 1. Komarudin 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
2. Krisdianto, S.H. 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 2
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8
A.1 5. Partai NasDem 50 2 0 4 3 59
A.2 1. M. RIZKY 39 1 0 3 0 43
2. DONDY DWIGUNTIA 158 16 6 22 4 206
3. VICA FITHRI NOER AZIZAH 3 0 0 0 0 3
4. MELIHASRAT JAYA ZAI, S.E. 1 0 0 0 0 1
5. DELLA PUSPITA 4 1 0 0 1 6
6. AJID, S.Ag. 3 0 0 0 0 3
7. UMMI NURAENI, S.H. 2 0 0 0 0 2
8. AHMAD ROUF, S.I.P., M.Si. 2 0 0 0 0 2
9. MUHAMAD RIDWAN 4 0 0 0 0 4
10. AWALUDDIN, S.T. 0 0 0 0 0 0
11. ARIFIN, S.Hut. 148 14 6 24 3 195
A.1 6. Partai Buruh 6 4 4 0 0 14

A.2 1. Komarudin 1 0 1 0 0 2
2. Krisdianto, S.H. 2 0 0 0 0 2
3. Mira Sari La Puppung, S.E. 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 1 1
5. Sugiarta 0 0 0 0 0 0
6. Lilis Minarni 2 0 1 1 1 5
7. Abdul Oir, S.H. 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 0 1 0 1 0 2 1 0 0 0 4 0 1 10
3. NASRUDDIN 0 1 0 0 1 0 0 0 1 0 0 0 1 0 0 4
4. NAFIZA 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 2
5. FERRY ARDIAN AR. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
11. MUHTADIN 0 0 0 0 0 2 0 0 0 0 0 0 0 2 0 4

6. SOPIAN APIP, S.E. 0 0 0 0 2 0 0 1 3 0 1 0 0 0 0 7
8. ABDURROKHIM, S.Pt. 0 1 0 0 0 0 1 1 2 2 0 0 1 0 1 9
10. MURDOKO, S.H. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8
A.1 7. Partai Gelombang Rakyat Indonesia 31 1 4 4 0 40
A.2 1. WIWID PURWAWAN 10 0 1 0 1 12
2. Hj. LULU MASLUCHAH, Lc. 6 1 0 0 0 7
3. NASRUDDIN 4 1 0 0 0 5
4. NAFIZA 2 1 0 0 1 4
5. FERRY ARDIAN AR. 1 0 0 0 0 1
6. ANDON TEGAR PRIBADI 1 0 0 1 0 2
7. RIZKY RADIANTO FAJRI 2 0 0 0 0 2
8. LINA KADARMINI 0 1 0 0 1 2
9. ISLAM RAHIMI HUSAIN, S.T. 1 0 0 0 0 1
10. ADE SAEPUL, S.Ag. 1 0 1 0 0 2
11. MUHTADIN 4 0 0 1 0 5
A.1 8. Partai Keadilan Sejahtera 35 3 6 3 2 49

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 33 2 1 0 2 38
2. DEDI AROZA, S.Ag., M.Si. 7 0 3 0 0 10
3. Dra. IIN SUPRIHATIN 0 0 0 0 0 0
4. MOCHAMAD ICHSAN M., S.T. 7 0 0 0 0 7
5. NUR LAELA TUROHMAH, S.E. 4 0 0 0 0 4
6. SOPIAN APIP, S.E. 7 0 0 0 0 7
7. ZULFIKAR MAHBUB ROBBANI 12 0 3 1 1 17
8. ABDURROKHIM, S.Pt. 9 0 0 1 0 10
9. DEWI RACHMAWATI, S.E. 1 0 0 0 0 1
10. MURDOKO, S.H. 1 0 0 0 1 2
11. RETNO UMMY ASTHASARI, S.T.P. 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
2. Irwan Yani 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

A.2 1. ELIA 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 2
3. ARIEF BUDIMAN 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 2
4. HERVINA LESTARI 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 2
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8
A.1 9. Partai Kebangkitan Nusantara 10 0 1 4 2 17
A.2 1. Neneng Rohimah 1 0 0 0 0 1
2. Irwan Yani 1 0 0 0 0 1
3. JAN ADOLF HUKUBUN 1 0 0 0 0 1
4. FRANSISKA DWI KESDIATIK 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0
6. Sri Rosmaryati 1 0 0 0 0 1
7. ALI MUNAJIB 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0
A.1 10. Partai Hati Nurani Rakyat 0 2 0 0 0 2

A.2 1. ELIA 2 0 0 0 0 2
2 0 1 0 0 3
3. ARIEF BUDIMAN 2 0 0 0 0 2
4. HERVINA LESTARI 2 0 0 0 0 2
5. ANDREAS KURNIAWAN E 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0
7. YASMIN INAYAH NATA BUWANA 1 0 0 0 0 1
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1

A.2 1. H. SUPONO 1 0 1 1 2 1 3 0 3 0 0 0 2 3 0 17
3. SARASWATI 0 0 1 1 2 2 0 0 3 0 1 1 0 0 0 11
6. ASTRI SARTIKA 0 0 0 0 0 0 2 1 1 0 0 0 1 0 0 5
9. MERRY APRIYANTI 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 2
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
11. ANI NURMAYANTI 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8
A.1 11. Partai Garda Republik Indonesia 11 0 0 0 1 12
A.2 1. A. KHALIK 1 0 0 0 0 1
2. YULIANTI BILAKONGA 1 0 0 0 0 1
A.1 12. Partai Amanat Nasional 43 3 2 0 2 50

A.2 1. H. SUPONO 17 1 2 0 2 22
2. H. PERMADI DALUNG, S.E., M.M. 66 6 19 0 0 91
3. SARASWATI 11 0 0 1 0 12
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 13 6 4 1 1 25
5. CEPI AL HAKIM, S.T.P., M.Si. 2 0 0 0 0 2
6. ASTRI SARTIKA 5 1 0 0 0 6
7. REGIVAL PUTRA ADRIAN 1 1 0 0 0 2
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 6 1 0 0 0 7
9. MERRY APRIYANTI 2 1 0 0 0 3
10. IIM SOLIHATI 1 0 0 0 0 1
11. ANI NURMAYANTI 1 0 1 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 4
7. REDIKA SEGARA, S.E. 0 0 1 0 0 0 1 0 0 0 0 1 1 1 0 5
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8
A.1 13. Partai Bulan Bintang 9 0 1 0 0 10
A.2 1. SOLAHUDDIN, S.H., M.H. 4 0 0 1 0 5
2. AGUS SUKARNA WIJAYA 2 0 0 0 0 2
3. FITRIASARI 1 0 0 0 1 2
4. DJUMHAWAN R PERMANA 0 0 1 0 0 1
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 0 0 0 0 0 0
7. WAWANG HUSNAWATI 0 0 0 0 0 0
8. Sanusi Permana 0 0 0 0 0 0
9. Mochammad Muzaqi 0 0 0 0 0 0
10. MOCHAMAD MORO ASIH 0 0 0 0 0 0
A.1 14. Partai Demokrat 37 0 1 3 1 42

A.2 1. DEDE CANDRA SASMITA, S.Ag. 246 7 12 4 0 269
2. MANATAP P SIMANJUNTAK 1 0 0 0 0 1
3. ANDRIYANTI WIJAYA 4 0 0 0 1 5
4. SAIFUL 4 0 0 1 0 5
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 3 0 0 0 1 4
6. ARNY NURANI SANGAJI 0 0 0 0 0 0
7. REDIKA SEGARA, S.E. 5 0 0 0 0 5
8. KARDAN 0 0 0 0 0 0
9. HARKES WOROWATI W. A. 2 0 0 0 0 2
10. NAUFAL ANDHIKA IRAWAN 1 1 0 0 0 2
11. ENDAH HENDRAWASIH 2 1 0 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
6. DIAH WINARSIH 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
7. GUNADI, M.Ag. 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 3
8. DESI FITRI DIANA 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
A.1 16. PARTAI PERINDO 0 0 1 0 0 1 1 1 0 0 0 0 0 1 0 5

A.2 1. RESITA KANIYA 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
2. AGUS WINARNO 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 2
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8
A.1 15. Partai Solidaritas Indonesia 11 0 1 0 1 13
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 9 3 0 0 0 12
2. FEBRY CITRA, S.T., M.A.B. 2 0 0 0 1 3
3. SIANA RIA, S.E., M.M. 1 0 0 0 0 1
4. MUHAMMAD ADE ALIYUDIN, S.H. 4 0 0 0 1 5
5. JASIMAN SITORUS, S.Kom., M.M. 0 0 0 1 0 1
6. DIAH WINARSIH 1 0 0 0 0 1
7. GUNADI, M.Ag. 3 0 0 0 0 3
8. DESI FITRI DIANA 1 0 0 1 0 2
A.1 16. PARTAI PERINDO 5 0 1 0 0 6

A.2 1. RESITA KANIYA 1 0 0 1 0 2
2. AGUS WINARNO 2 0 0 0 0 2
3. Drs. SUMARWAN SASTRA 1 0 0 1 0 2
4. NENDEN BANURIAH, S.Pd. 0 0 0 0 0 0
5. AMARENS MANUHUTU 1 0 0 0 0 1
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 0 0 0 0 0 0
7. YURIZAL, S.E., M.M. 1 0 0 0 0 1
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 0 0 0 0 0 0
9. ELLY MARYANTI 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 0 0 0 0 2 0 2 1 2 0 1 0 2 1 0 11
3. DWI ARYANTI, S.E. 1 1 1 5 3 1 5 5 2 3 1 2 1 5 3 39
4. IRFAN DARAJAT 0 1 2 0 0 3 0 0 0 0 1 0 0 2 0 9
5. FERRY PERDIAN 0 1 1 17 0 1 0 0 0 0 1 0 0 0 0 21
9. GUNAWAN 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
10. RIA ANWAR 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 3
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
A.1 24. Partai Ummat 1 0 0 2 0 1 0 0 1 0 0 0 0 0 0 5

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8
A.1 17. Partai Persatuan Pembangunan 120 1 1 6 2 130
A.2 1. H. MUHAMAD ROMLI, A.Md. 101 3 2 2 2 110
2. JUHANTA, S.T. 11 1 0 0 1 13
3. DWI ARYANTI, S.E. 39 1 0 0 1 41
4. IRFAN DARAJAT 9 0 1 1 0 11
5. FERRY PERDIAN 21 0 0 0 0 21
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 4 0 0 0 0 4
7. YENTI NASHI HATUL UMMAH 3 0 0 0 0 3
8. ABDUL ROHIM, S.Si., Apt. 13 1 0 1 0 15
9. GUNAWAN 1 0 0 0 1 2
10. RIA ANWAR 3 0 0 0 0 3
11. RIKE ISKANDAR 1 0 0 0 0 1
A.1 24. Partai Ummat 5 0 0 0 0 5

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 2 0 0 1 0 3
2. SELLY AFRIDA OLTAR, S.I.P. 1 0 0 0 0 1
3. H. SUMIRAT SAPTA HADI, S.Ag. 1 0 0 0 0 1
4. Drs. H. ASRI AL JUFRI, M.Si. 0 0 0 0 0 0
5. RITA HERLINA, S.E. 0 0 0 0 0 0
6. Drs. MOCH ZAENAL AL AQILI 0 0 0 0 0 0
7. FAUZIAH TABRIYANI 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0
9. JAKA JATI NUR ALAM 0 0 0 0 0 0
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.876 190 174 207 139 3.586
B. JUMLAH SUARA TIDAK SAH 554 34 25 20 23 656
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.430 224 199 227 162 4.242

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: SUKARAKSA
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 160 158 159 149 167 157 152 160 151 153 161 160 153 170 158 2.368
JML 299 295 298 291 300 291 283 300 286 279 300 298 299 300 294 4.413
LK 132 126 133 114 131 113 95 116 130 121 148 110 113 119 121 1.822
JML 258 249 255 237 243 219 212 234 252 235 271 224 231 221 233 3.574
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LK 0 0 3 0 0 0 0 2 0 0 0 0 0 0 0 5
JML 0 0 3 0 0 0 0 4 0 0 0 0 0 0 0 7
LK 132 126 136 114 131 113 95 118 130 121 148 110 113 119 121 1.827
JML 258 249 258 237 243 219 212 238 252 235 271 224 231 221 233 3.581
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 47 52 46 60 61 78 77 68 40 50 35 80 74 85 67 920
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14
A DATA PEMILIH
LK 2.368 169 143 156 132 123 125 139 89 146 3.590
JML 4.413 291 281 295 232 228 251 273 175 273 6.712
LK 1.822 128 122 125 101 100 107 102 82 121 2.810
JML 3.574 234 247 249 185 202 217 219 165 224 5.516
LK 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0
LK 5 0 1 0 0 0 0 1 0 0 7
JML 7 0 2 0 0 0 0 2 0 0 11
LK 1.827 128 123 125 101 100 107 103 82 121 2.817
JML 3.581 234 249 249 185 202 217 221 165 224 5.527
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 920 63 38 52 52 30 40 58 14 55 1.322
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14
LK 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 1 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 3


3. UDI SUHANDORO 1 1 1 6 2 0 0 0 0 2 1 1 3 1 1 20
6. NIAR YUNIAR 0 0 1 0 1 1 1 2 0 0 0 1 2 1 0 10
8. SUTIYA ANJANI 0 0 0 0 0 1 1 1 0 1 1 0 1 0 0 6
10. YANTI TARYATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. CAHYO FITRIADI 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
8. AGUS MULYADI, S.Pd. 3 0 1 0 1 1 0 1 0 0 7


3. UDI SUHANDORO 20 1 1 0 1 1 2 0 0 1 27
6. NIAR YUNIAR 10 0 1 1 0 2 0 1 0 3 18
8. SUTIYA ANJANI 6 1 0 0 0 0 0 3 0 1 11
10. YANTI TARYATI 0 0 0 0 0 1 0 0 0 1 2
11. CAHYO FITRIADI 1 0 0 0 0 0 0 0 1 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 0 0 0 0 1 0 1 0 0 1 0 0 0 0 3
6. H. AGUS RIADI 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 2
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1

2. H. KUSNADI, S.I.P. 3 4 2 2 4 1 1 4 2 0 0 0 0 1 1 25
6. LINDA OCTAVIA 0 0 0 2 1 1 0 2 0 0 0 0 0 0 0 6
7. H. HELMI BUSTOMI 1 2 0 3 1 0 1 1 0 0 0 0 0 0 0 9
10. FAJAR SETIAWAN 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
4. Hj. DIAN ROSITA 3 0 0 0 0 0 1 0 1 2 7
6. H. AGUS RIADI 2 0 0 0 0 0 0 0 0 0 2
11. ALUN HIMAWAN 1 0 0 0 0 0 0 0 0 0 1

2. H. KUSNADI, S.I.P. 25 2 1 1 2 1 1 1 1 3 38
6. LINDA OCTAVIA 6 0 0 0 1 0 1 1 0 0 9
7. H. HELMI BUSTOMI 9 2 0 2 1 0 0 0 1 2 17
10. FAJAR SETIAWAN 3 3 1 1 0 0 0 0 0 1 9
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 574 52 161 168 15 29 74 43 83 43 1.242
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 1 1 0 0 1 2 0 3 1 1 1 3 0 3 1 18
A.2 1. M. RIZKY 1 1 1 1 1 0 0 2 2 1 6 4 3 3 2 28
2. DONDY DWIGUNTIA 0 0 0 0 1 0 0 1 0 2 65 7 1 1 1 79
5. DELLA PUSPITA 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 4
6. AJID, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 1 0 0 0 1 0 3 1 0 6
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
A.1 6. Partai Buruh 0 0 0 1 1 0 1 0 0 0 1 3 0 0 1 8

A.2 1. Komarudin 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 5. Partai NasDem 18 0 1 1 4 4 1 1 1 1 32
A.2 1. M. RIZKY 28 6 1 1 2 4 1 2 0 1 46
2. DONDY DWIGUNTIA 79 2 1 0 0 18 0 10 0 0 110
5. DELLA PUSPITA 4 0 0 1 0 1 0 0 0 0 6
6. AJID, S.Ag. 0 0 0 0 0 0 0 0 0 0 0
7. UMMI NURAENI, S.H. 6 0 0 0 0 0 0 0 0 0 6
9. MUHAMAD RIDWAN 1 0 0 1 0 0 0 1 0 0 3
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 1 0 0 0 0 0 0 0 0 1 2
A.1 6. Partai Buruh 8 1 0 1 2 0 0 0 0 1 13

A.2 1. Komarudin 1 0 0 0 0 2 2 0 0 3 8
2. Krisdianto, S.H. 0 0 0 0 0 1 0 0 0 0 1
4. Agus Sarjanto, S.H. 1 0 0 0 0 1 0 0 2 0 4
5. Sugiarta 0 0 0 0 0 0 1 0 0 0 1
6. Lilis Minarni 1 0 0 0 0 0 0 0 0 0 1
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 1 0 0 0 0 1
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 1 1 1 2 2 0 0 2 1 0 1 1 0 0 0 12
3. NASRUDDIN 0 1 1 0 0 0 0 1 0 0 0 1 0 0 0 4
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 2
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
8. ABDURROKHIM, S.Pt. 0 0 1 0 2 0 0 0 1 0 0 1 2 0 0 7
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.2 1. WIWID PURWAWAN 12 5 0 0 0 0 0 0 0 1 18
3. NASRUDDIN 4 0 0 0 0 0 0 0 0 0 4
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 2 0 0 0 0 0 0 0 0 0 2
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 1 1
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 1 0 0 0 0 0 0 0 0 1 2

6. SOPIAN APIP, S.E. 1 0 0 0 0 0 0 3 0 0 4
8. ABDURROKHIM, S.Pt. 7 0 0 0 0 2 7 0 0 0 16
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 3

A.2 1. ELIA 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
3. ARIEF BUDIMAN 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 2
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 1 0 1
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 1 0 0 0 0 0 0 0 0 0 1
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 3 0 0 1 0 0 0 0 0 0 4

A.2 1. ELIA 2 0 0 0 0 0 0 0 0 4 6
1 0 0 0 0 0 0 1 0 1 3
3. ARIEF BUDIMAN 2 0 0 0 0 0 0 0 0 1 3
4. HERVINA LESTARI 0 0 0 0 1 0 0 0 0 0 1
6. DHEMAS PRADITYA 2 0 0 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1

A.2 1. H. SUPONO 3 1 0 0 1 0 0 2 0 0 1 0 0 0 4 12
3. SARASWATI 0 1 0 0 0 3 1 3 0 1 0 0 0 0 0 9
6. ASTRI SARTIKA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. MERRY APRIYANTI 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 2
10. IIM SOLIHATI 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 3
11. ANI NURMAYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.2 1. A. KHALIK 1 0 0 0 0 0 0 0 0 1 2

A.2 1. H. SUPONO 12 1 2 0 3 1 2 2 1 5 29
3. SARASWATI 9 0 0 0 0 0 1 3 0 3 16
6. ASTRI SARTIKA 0 0 0 0 0 0 0 2 0 0 2
9. MERRY APRIYANTI 2 0 0 0 0 0 0 0 0 0 2
10. IIM SOLIHATI 3 0 0 0 0 0 0 0 0 0 3
11. ANI NURMAYANTI 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 3
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. KARDAN 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
3. FITRIASARI 1 0 0 0 1 0 0 0 0 0 2
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 3 0 0 0 0 2 0 0 0 0 5
7. REDIKA SEGARA, S.E. 0 0 1 0 0 0 0 0 0 0 1
8. KARDAN 1 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 2
6. DIAH WINARSIH 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 1 4 2 0 1 0 1 0 1 0 1 0 0 2 0 13

A.2 1. RESITA KANIYA 5 0 1 0 0 0 0 0 1 0 0 0 0 0 1 8
2. AGUS WINARNO 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 3
7. YURIZAL, S.E., M.M. 0 0 8 8 5 0 12 0 0 0 0 0 0 0 0 33
9. ELLY MARYANTI 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 4
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
3. SIANA RIA, S.E., M.M. 2 0 0 0 0 0 0 1 0 0 3
6. DIAH WINARSIH 1 0 0 0 0 0 0 0 0 0 1
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 0 0 0 0 0 0 1 0 0 0 1
A.1 16. PARTAI PERINDO 13 0 0 0 1 0 0 0 0 0 14

A.2 1. RESITA KANIYA 8 0 1 0 0 0 0 0 1 1 11
2. AGUS WINARNO 3 0 0 0 0 0 0 0 0 0 3
7. YURIZAL, S.E., M.M. 33 0 0 0 0 0 1 0 0 0 34
9. ELLY MARYANTI 4 0 1 0 0 0 0 0 0 0 5
10. RAHMAT HIDAYAT 1 0 0 0 0 0 0 0 0 0 1
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 0 0 0 0 0 1 1 1 0 0 0 1 0 2 0 6
3. DWI ARYANTI, S.E. 0 7 2 1 0 5 4 1 0 1 1 1 0 1 1 25
4. IRFAN DARAJAT 24 15 18 2 0 16 6 4 66 99 34 10 20 26 33 373
5. FERRY PERDIAN 0 2 1 1 0 0 1 2 0 0 1 0 1 1 1 11
9. GUNAWAN 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 2
10. RIA ANWAR 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 2
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 1 0 0 0 0 0 0 0 0 0 0 3 0 0 0 4

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
2. JUHANTA, S.T. 6 0 0 1 2 2 1 1 1 1 15
3. DWI ARYANTI, S.E. 25 4 3 3 7 4 5 3 0 2 56
4. IRFAN DARAJAT 373 13 1 2 10 23 4 21 2 10 459
5. FERRY PERDIAN 11 0 0 0 0 0 0 1 0 1 13
9. GUNAWAN 2 0 0 0 1 0 0 0 2 0 5
10. RIA ANWAR 2 0 1 0 0 0 0 0 0 0 3
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 4 0 0 0 1 0 1 0 0 0 6

5. RITA HERLINA, S.E. 0 1 0 0 0 0 0 0 0 0 1
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

B. JUMLAH SUARA TIDAK SAH 559 40 22 9 41 21 14 32 18 31 787

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: BANYUWANGI
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 152 140 149 146 145 129 156 152 150 133 110 126 130 138 110 2.066
JML 282 274 292 286 279 238 292 277 271 243 208 228 250 253 210 3.883
LK 123 105 128 116 119 100 107 132 112 105 91 104 92 111 83 1.628
JML 242 225 259 235 245 196 223 244 225 203 182 196 191 213 167 3.246
LK 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 3
JML 0 0 1 1 0 0 0 1 1 1 0 0 1 0 0 6
LK 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 2
JML 0 0 2 0 0 2 0 0 0 0 0 0 0 0 0 4
LK 123 105 130 116 119 101 107 132 113 106 91 104 92 111 83 1.633
JML 242 225 262 236 245 198 223 245 226 204 182 196 192 213 167 3.256
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 46 55 37 56 40 45 76 38 52 44 31 37 63 46 48 714
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 2
JML 0 0 0 2 1 0 0 1 0 0 3 0 0 0 0 7
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 016 JUMLAH AKHIR
1 2 3 4 5 6
A DATA PEMILIH
LK 2.066 116 2.182
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 1.817 102 1.919
JML 3.883 218 4.101
LK 1.628 91 1.719
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.618 89 1.707
JML 3.246 180 3.426
LK 3 0 3
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 3 0 3
JML 6 0 6
LK 2 0 2
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 2 0 2
JML 4 0 4
LK 1.633 91 1.724
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.623 89 1.712
JML 3.256 180 3.436
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 016 JUMLAH AKHIR
1 2 3 4 5
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 3.970 223 4.193
2 Jumlah surat suara yang digunakan 3.256 180 3.436
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 0 0 0
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 714 43 757
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 JUMLAH AKHIR
1 2 3 4 5 6
LK 2 0 2
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 5 0 5
JML 7 0 7
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 2


3. UDI SUHANDORO 1 1 1 2 0 0 0 3 3 0 0 1 0 1 2 15
6. NIAR YUNIAR 2 0 0 0 0 0 0 0 1 1 0 2 0 0 0 6
8. SUTIYA ANJANI 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 2
10. YANTI TARYATI 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 3
11. CAHYO FITRIADI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 1. Partai Kebangkitan Bangsa 128 5 133
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 59 3 62
2. DINDIN ABDULLAH GHOZALI 11 0 11
3. H. AMIR AMIRULOH, S.H. 12 1 13
4. NAFIZUL ALHAFIZRANA 2 0 2
5. BAGUS DJATI KUSUMA 20 0 20
6. SHOLEHATUN NASIHA, S.Kom. 2 0 2
7. Ir. AAN SURYA PRIYANA 3 0 3
8. AGUS MULYADI, S.Pd. 2 0 2
9. ROSALINDA RAMDHANIAH, S.Ag. 1 0 1
10. TEGUH YULIANTO, S.T. 2 0 2
11. RISMA PUJI RIANTI 11 0 11
A.1 2. Partai Gerakan Indonesia Raya 191 9 200

A.2 1. H. RICKY KURNIAWAN, Lc. 84 4 88
2. Ir. PRASETYAWATI, M.M. 35 0 35

3. UDI SUHANDORO 15 1 16
4. H. CECEP GOGOM, S.Ag., M.Pd. 17 1 18
5. YORDA IMAM SUTOMO, S.H. 12 0 12
6. NIAR YUNIAR 6 1 7
7. Dr. AGUS SUHENDI, M.Pd. 13 0 13
8. SUTIYA ANJANI 2 0 2
9. TOTING SUPRIATNA 5 1 6
10. YANTI TARYATI 3 0 3
11. CAHYO FITRIADI 0 1 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 4
6. H. AGUS RIADI 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 2
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2. H. KUSNADI, S.I.P. 1 0 3 3 0 1 5 4 3 0 1 2 0 5 3 31
6. LINDA OCTAVIA 0 1 0 1 0 1 0 1 1 0 1 1 0 1 0 8
7. H. HELMI BUSTOMI 0 0 1 0 0 1 1 1 1 2 0 0 1 0 1 9
10. FAJAR SETIAWAN 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 3. Partai Demokrasi Indonesia Perjuangan 70 3 73
A.2 1. Hj. ASYANTI ROZANA, S.E. 26 1 27
2. DONI MARADONA HUTABARAT, S.H. 19 0 19
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 5 0 5
4. Hj. DIAN ROSITA 4 0 4
5. THARIQ HALILINTAR 8 0 8
6. H. AGUS RIADI 2 0 2
7. IRAWATY OCTORA, S.E., M.Si. 4 0 4
8. MANGONTANG SIMANJUNTAK 0 0 0
9. BAMBANG SUMANTRI, S.Sos. 2 0 2
10. EUGINIA NATANIA PUTRI 0 0 0
11. ALUN HIMAWAN 0 0 0
A.1 4. Partai Golongan Karya 152 9 161

A.2 1. SAMSUL HIDAYAT, S.H. 98 3 101
2. H. KUSNADI, S.I.P. 31 0 31
3. KURNIAWATYNINGSIH, S.E. 17 0 17
4. ADI RESTU PERMADI 19 0 19
5. KHAERUL ANAM, S.Pi., M.Si. 11 0 11
6. LINDA OCTAVIA 8 0 8
7. H. HELMI BUSTOMI 9 0 9
8. MUNAWARAH SUNUSI, S.E., M.Si. 5 0 5
9. RENO ANGGARA MUKTI, S.ST.Par. 170 6 176
10. FAJAR SETIAWAN 3 0 3
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 2 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 4 2 10 2 11 5 1 4 7 2 4 1 1 1 3 58
A.2 1. M. RIZKY 2 0 48 4 19 14 2 3 1 3 9 3 1 1 2 112
2. DONDY DWIGUNTIA 7 0 3 0 1 0 0 3 6 4 0 7 27 12 8 78
5. DELLA PUSPITA 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
6. AJID, S.Ag. 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
7. UMMI NURAENI, S.H. 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 2 0 1 0 0 0 1 0 4
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
A.1 6. Partai Buruh 1 1 0 0 1 0 4 2 0 1 2 6 1 1 0 20

A.2 1. Komarudin 0 0 0 2 0 0 0 0 0 0 0 1 0 0 0 3
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5. Sugiarta 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 2
6. Lilis Minarni 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 5. Partai NasDem 58 2 60
A.2 1. M. RIZKY 112 3 115
2. DONDY DWIGUNTIA 78 7 85
3. VICA FITHRI NOER AZIZAH 2 1 3
4. MELIHASRAT JAYA ZAI, S.E. 1 0 1
5. DELLA PUSPITA 1 0 1
6. AJID, S.Ag. 1 0 1
7. UMMI NURAENI, S.H. 1 0 1
8. AHMAD ROUF, S.I.P., M.Si. 1 0 1
9. MUHAMAD RIDWAN 4 0 4
10. AWALUDDIN, S.T. 0 0 0
11. ARIFIN, S.Hut. 1 0 1
A.1 6. Partai Buruh 20 1 21

A.2 1. Komarudin 3 0 3
2. Krisdianto, S.H. 0 0 0
3. Mira Sari La Puppung, S.E. 1 0 1
4. Agus Sarjanto, S.H. 1 0 1
5. Sugiarta 2 0 2
6. Lilis Minarni 1 0 1
7. Abdul Oir, S.H. 0 1 1
8. Ade Yuswandi 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0
10. SAHRUL BAHRI 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 1 0 0 2 0 2 1 0 0 1 1 0 0 8
3. NASRUDDIN 1 0 2 0 0 0 0 0 1 1 1 0 0 1 0 7
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1

6. SOPIAN APIP, S.E. 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 3
8. ABDURROKHIM, S.Pt. 1 0 0 0 0 1 0 1 1 0 1 0 0 0 0 5
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 7. Partai Gelombang Rakyat Indonesia 40 7 47
A.2 1. WIWID PURWAWAN 8 0 8
2. Hj. LULU MASLUCHAH, Lc. 3 0 3
3. NASRUDDIN 7 0 7
4. NAFIZA 0 0 0
5. FERRY ARDIAN AR. 0 0 0
6. ANDON TEGAR PRIBADI 1 0 1
7. RIZKY RADIANTO FAJRI 2 0 2
8. LINA KADARMINI 0 0 0
9. ISLAM RAHIMI HUSAIN, S.T. 1 0 1
10. ADE SAEPUL, S.Ag. 0 0 0
11. MUHTADIN 1 0 1
A.1 8. Partai Keadilan Sejahtera 60 6 66

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 51 5 56
2. DEDI AROZA, S.Ag., M.Si. 12 2 14
3. Dra. IIN SUPRIHATIN 5 1 6
4. MOCHAMAD ICHSAN M., S.T. 7 0 7
5. NUR LAELA TUROHMAH, S.E. 4 0 4
6. SOPIAN APIP, S.E. 3 0 3
7. ZULFIKAR MAHBUB ROBBANI 29 4 33
8. ABDURROKHIM, S.Pt. 5 2 7
9. DEWI RACHMAWATI, S.E. 0 0 0
10. MURDOKO, S.H. 0 0 0
11. RETNO UMMY ASTHASARI, S.T.P. 3 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 1 0 0 0 2 0 0 0 0 0 0 1 4
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1

A.2 1. ELIA 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
3. ARIEF BUDIMAN 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
4. HERVINA LESTARI 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 9. Partai Kebangkitan Nusantara 12 0 12
A.2 1. Neneng Rohimah 4 0 4
2. Irwan Yani 0 0 0
3. JAN ADOLF HUKUBUN 0 0 0
4. FRANSISKA DWI KESDIATIK 0 0 0
5. Imam Fauzi 1 0 1
6. Sri Rosmaryati 0 0 0
7. ALI MUNAJIB 0 0 0
8. Aprizal Hamid 0 0 0
9. Nadya Oktafiani 1 0 1
A.1 10. Partai Hati Nurani Rakyat 4 0 4

A.2 1. ELIA 1 0 1
1 0 1
3. ARIEF BUDIMAN 1 0 1
4. HERVINA LESTARI 1 0 1
5. ANDREAS KURNIAWAN E 0 0 0
6. DHEMAS PRADITYA 0 0 0
7. YASMIN INAYAH NATA BUWANA 1 0 1
8. NIRWAN PRATAMA PUTRA 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 1 0 0 1 0 0 1 0 0 3

A.2 1. H. SUPONO 5 1 4 1 0 0 1 2 2 3 2 0 1 5 3 30
3. SARASWATI 0 0 1 0 0 1 0 2 0 0 1 1 0 1 3 10
6. ASTRI SARTIKA 0 0 0 0 0 0 2 0 0 0 0 1 1 0 0 4
9. MERRY APRIYANTI 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ANI NURMAYANTI 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 11. Partai Garda Republik Indonesia 4 1 5
A.2 1. A. KHALIK 3 0 3
2. YULIANTI BILAKONGA 1 0 1
A.1 12. Partai Amanat Nasional 69 8 77

A.2 1. H. SUPONO 30 0 30
2. H. PERMADI DALUNG, S.E., M.M. 126 1 127
3. SARASWATI 10 0 10
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 26 0 26
5. CEPI AL HAKIM, S.T.P., M.Si. 4 0 4
6. ASTRI SARTIKA 4 0 4
7. REGIVAL PUTRA ADRIAN 4 0 4
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 11 0 11
9. MERRY APRIYANTI 1 0 1
10. IIM SOLIHATI 0 0 0
11. ANI NURMAYANTI 1 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 2
8. Sanusi Permana 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 2

4. SAIFUL 0 0 0 0 0 3 0 0 0 0 1 0 0 0 0 4
7. REDIKA SEGARA, S.E. 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
8. KARDAN 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 13. Partai Bulan Bintang 70 3 73
A.2 1. SOLAHUDDIN, S.H., M.H. 63 4 67
2. AGUS SUKARNA WIJAYA 5 1 6
3. FITRIASARI 2 0 2
4. DJUMHAWAN R PERMANA 1 1 2
5. Deni Rusydiana, S.H.I. 1 0 1
6. YANI SURYANI FIKRIAH 0 0 0
7. WAWANG HUSNAWATI 0 0 0
8. Sanusi Permana 2 0 2
9. Mochammad Muzaqi 0 0 0
10. MOCHAMAD MORO ASIH 0 0 0
A.1 14. Partai Demokrat 59 1 60

A.2 1. DEDE CANDRA SASMITA, S.Ag. 151 15 166
2. MANATAP P SIMANJUNTAK 3 0 3
3. ANDRIYANTI WIJAYA 7 0 7
4. SAIFUL 4 2 6
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 9 1 10
6. ARNY NURANI SANGAJI 2 0 2
7. REDIKA SEGARA, S.E. 1 0 1
8. KARDAN 2 0 2
9. HARKES WOROWATI W. A. 0 0 0
10. NAUFAL ANDHIKA IRAWAN 0 1 1
11. ENDAH HENDRAWASIH 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 2
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
8. DESI FITRI DIANA 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 2
A.1 16. PARTAI PERINDO 2 2 1 3 5 1 0 1 1 0 0 0 2 0 1 19

A.2 1. RESITA KANIYA 0 0 0 1 2 2 0 0 1 0 1 0 0 0 0 7
2. AGUS WINARNO 0 0 1 0 2 0 0 0 0 0 0 0 0 0 1 4
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 15. Partai Solidaritas Indonesia 14 0 14
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 9 0 9
2. FEBRY CITRA, S.T., M.A.B. 5 0 5
3. SIANA RIA, S.E., M.M. 2 0 2
4. MUHAMMAD ADE ALIYUDIN, S.H. 7 0 7
5. JASIMAN SITORUS, S.Kom., M.M. 1 0 1
6. DIAH WINARSIH 0 0 0
7. GUNADI, M.Ag. 1 0 1
8. DESI FITRI DIANA 2 0 2
A.1 16. PARTAI PERINDO 19 0 19

A.2 1. RESITA KANIYA 7 1 8
2. AGUS WINARNO 4 0 4
3. Drs. SUMARWAN SASTRA 3 0 3
4. NENDEN BANURIAH, S.Pd. 3 0 3
5. AMARENS MANUHUTU 1 0 1
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 0 0 0
7. YURIZAL, S.E., M.M. 1 0 1
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 0 0 0
9. ELLY MARYANTI 0 0 0
10. RAHMAT HIDAYAT 1 0 1
11. MOHAMAD SATIBI 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 1 0 0 0 0 0 0 0 0 2 0 1 1 0 0 5
3. DWI ARYANTI, S.E. 0 1 0 0 1 0 0 0 0 0 0 1 1 1 2 7
4. IRFAN DARAJAT 1 0 1 0 2 1 2 0 0 1 0 0 0 0 0 8
5. FERRY PERDIAN 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 3
9. GUNAWAN 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 3
10. RIA ANWAR 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 3
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 0 0 1 2 1 1 0 0 0 0 0 0 1 0 0 6

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5
A.1 17. Partai Persatuan Pembangunan 54 6 60
A.2 1. H. MUHAMAD ROMLI, A.Md. 71 2 73
2. JUHANTA, S.T. 5 2 7
3. DWI ARYANTI, S.E. 7 3 10
4. IRFAN DARAJAT 8 0 8
5. FERRY PERDIAN 3 0 3
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 4 0 4
7. YENTI NASHI HATUL UMMAH 4 0 4
8. ABDUL ROHIM, S.Si., Apt. 1 0 1
9. GUNAWAN 3 1 4
10. RIA ANWAR 3 0 3
11. RIKE ISKANDAR 0 0 0
A.1 24. Partai Ummat 6 0 6

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 4 0 4
2. SELLY AFRIDA OLTAR, S.I.P. 0 0 0
3. H. SUMIRAT SAPTA HADI, S.Ag. 2 0 2
4. Drs. H. ASRI AL JUFRI, M.Si. 1 0 1
5. RITA HERLINA, S.E. 0 0 0
6. Drs. MOCH ZAENAL AL AQILI 1 0 1
7. FAUZIAH TABRIYANI 0 1 1
8. HERRY SUKARTA, S.E. 1 0 1
9. JAKA JATI NUR ALAM 2 0 2
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.794 146 2.940
B. JUMLAH SUARA TIDAK SAH 462 34 496
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.256 180 3.436

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: BANYUASIH
NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
A DATA PEMILIH
LK 150 159 165 127 139 97 119 170 146 150 155 164 159 1.900
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 146 139 133 120 125 88 86 128 124 147 144 136 141 1.657
JML 296 298 298 247 264 185 205 298 270 297 299 300 300 3.557
LK 118 118 139 103 107 79 89 136 112 122 112 145 112 1.492
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 119 106 111 98 107 71 73 109 95 112 107 114 100 1.322
JML 237 224 250 201 214 150 162 245 207 234 219 259 212 2.814
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LK 0 0 0 0 2 3 0 0 1 1 0 0 0 7
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 0 0 0 0 4 3 0 0 0 3 1 0 0 11
JML 0 0 0 0 6 6 0 0 1 4 1 0 0 18
LK 118 118 139 103 109 82 89 136 113 123 112 145 112 1.499
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 119 106 111 98 111 74 73 109 95 115 108 114 100 1.333
JML 237 224 250 201 220 156 162 245 208 238 220 259 212 2.832
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 302 304 304 252 270 189 210 304 306 303 305 306 306 3.661
2 Jumlah surat suara yang digunakan 237 224 250 201 220 156 162 245 208 238 220 259 212 2.832
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 0 0 0 0 0 0 3 0 0 0 0 0 0 3
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 65 80 54 51 50 33 45 59 98 65 85 47 94 826
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 1. Partai Kebangkitan Bangsa 6 13 3 5 10 12 11 12 14 20 10 29 18 163
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 4 7 0 0 2 0 2 2 6 5 2 8 6 44
2. DINDIN ABDULLAH GHOZALI 1 2 0 0 2 0 0 0 4 1 0 0 0 10
3. H. AMIR AMIRULOH, S.H. 0 0 0 0 0 0 0 0 4 0 0 0 1 5
4. NAFIZUL ALHAFIZRANA 0 0 0 1 0 0 0 0 2 0 0 0 0 3
5. BAGUS DJATI KUSUMA 1 1 0 0 0 0 1 0 0 0 0 0 0 3
6. SHOLEHATUN NASIHA, S.Kom. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Ir. AAN SURYA PRIYANA 0 1 0 0 0 1 0 0 1 0 0 0 0 3
8. AGUS MULYADI, S.Pd. 0 0 1 0 0 0 0 0 0 0 0 0 0 1
9. ROSALINDA RAMDHANIAH, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. TEGUH YULIANTO, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RISMA PUJI RIANTI 0 1 0 1 0 0 0 0 0 0 0 0 0 2
A.1 2. Partai Gerakan Indonesia Raya 22 3 12 10 7 9 10 16 3 15 5 10 11 133

A.2 1. H. RICKY KURNIAWAN, Lc. 4 8 7 3 4 3 2 2 1 4 2 3 4 47
2. Ir. PRASETYAWATI, M.M. 6 2 4 4 1 4 4 3 2 1 0 1 1 33

3. UDI SUHANDORO 2 2 0 2 0 0 0 0 0 1 0 0 0 7
4. H. CECEP GOGOM, S.Ag., M.Pd. 0 1 0 0 2 0 0 0 0 0 0 0 0 3
5. YORDA IMAM SUTOMO, S.H. 1 0 0 1 0 0 0 0 0 0 0 0 0 2
6. NIAR YUNIAR 0 0 0 0 0 1 0 0 0 0 0 0 0 1
7. Dr. AGUS SUHENDI, M.Pd. 1 0 0 0 0 0 0 0 0 0 0 1 1 3
8. SUTIYA ANJANI 0 0 0 0 1 0 0 0 0 0 0 0 0 1
9. TOTING SUPRIATNA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. YANTI TARYATI 1 1 0 1 0 0 0 0 0 0 0 1 0 4
11. CAHYO FITRIADI 0 1 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 3. Partai Demokrasi Indonesia Perjuangan 5 5 3 5 3 4 2 6 9 5 1 0 4 52
A.2 1. Hj. ASYANTI ROZANA, S.E. 2 0 4 6 1 1 1 0 5 1 0 0 0 21
2. DONI MARADONA HUTABARAT, S.H. 2 3 4 2 0 1 0 0 4 0 0 0 0 16
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 1 1 0 2 0 0 0 0 4 0 0 0 0 8
4. Hj. DIAN ROSITA 1 0 0 0 1 0 0 0 0 0 0 0 0 2
5. THARIQ HALILINTAR 0 0 0 1 0 0 0 0 0 0 0 0 0 1
6. H. AGUS RIADI 0 1 0 0 0 0 0 0 0 0 0 0 0 1
7. IRAWATY OCTORA, S.E., M.Si. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
8. MANGONTANG SIMANJUNTAK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. BAMBANG SUMANTRI, S.Sos. 0 0 0 0 1 0 0 0 0 0 0 0 0 1
10. EUGINIA NATANIA PUTRI 0 0 0 0 0 0 0 0 1 0 0 0 0 1
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 4. Partai Golongan Karya 11 7 4 13 9 6 17 23 9 6 3 13 14 135

A.2 1. SAMSUL HIDAYAT, S.H. 5 2 11 0 7 2 4 10 2 4 1 4 2 54
2. H. KUSNADI, S.I.P. 19 18 15 22 23 8 10 8 0 4 0 1 4 132
3. KURNIAWATYNINGSIH, S.E. 0 1 1 1 4 0 2 1 0 1 0 0 1 12
4. ADI RESTU PERMADI 1 2 2 1 2 0 1 1 0 0 0 0 0 10
5. KHAERUL ANAM, S.Pi., M.Si. 1 0 1 0 0 0 0 2 0 2 0 1 2 9
6. LINDA OCTAVIA 0 0 0 0 0 0 2 1 0 0 0 0 1 4
7. H. HELMI BUSTOMI 0 0 0 0 1 0 0 0 0 0 0 0 0 1
8. MUNAWARAH SUNUSI, S.E., M.Si. 0 0 0 0 0 0 0 0 1 0 0 0 0 1
9. RENO ANGGARA MUKTI, S.ST.Par. 0 0 0 0 2 0 1 7 3 9 0 0 1 23
10. FAJAR SETIAWAN 0 0 0 0 0 0 0 1 0 0 0 0 0 1
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 5. Partai NasDem 8 4 0 4 6 6 8 4 16 21 10 15 8 110
A.2 1. M. RIZKY 28 35 53 23 33 46 37 18 42 61 97 113 51 637
2. DONDY DWIGUNTIA 2 2 1 1 2 0 0 2 1 2 2 1 0 16
3. VICA FITHRI NOER AZIZAH 0 0 0 0 1 0 0 0 0 0 0 0 0 1
4. MELIHASRAT JAYA ZAI, S.E. 0 0 0 0 0 0 0 0 0 0 1 0 0 1
5. DELLA PUSPITA 0 1 0 0 0 0 0 0 0 0 0 0 0 1
6. AJID, S.Ag. 0 1 0 0 0 0 0 0 0 0 0 0 0 1
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. AHMAD ROUF, S.I.P., M.Si. 0 2 0 1 0 0 0 0 0 0 0 0 0 3
9. MUHAMAD RIDWAN 0 1 0 2 0 0 0 0 0 0 0 0 0 3
10. AWALUDDIN, S.T. 0 1 0 0 0 0 0 0 0 0 0 0 0 1
11. ARIFIN, S.Hut. 0 16 16 18 4 3 2 3 1 3 0 0 0 66
A.1 6. Partai Buruh 0 0 1 0 0 0 1 0 0 0 0 0 0 2

A.2 1. Komarudin 1 0 0 0 1 0 0 0 0 0 0 0 0 2
2. Krisdianto, S.H. 0 0 0 1 0 0 0 0 0 0 0 0 1 2
3. Mira Sari La Puppung, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 7. Partai Gelombang Rakyat Indonesia 5 2 3 0 1 0 1 2 0 0 2 0 2 18
A.2 1. WIWID PURWAWAN 1 1 6 0 0 0 0 2 0 0 0 0 0 10
2. Hj. LULU MASLUCHAH, Lc. 3 2 0 5 0 0 0 1 2 0 0 0 0 13
3. NASRUDDIN 0 0 1 0 0 0 0 0 0 0 0 0 0 1
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. ANDON TEGAR PRIBADI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. RIZKY RADIANTO FAJRI 0 0 1 0 0 0 0 0 0 0 0 0 0 1
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ISLAM RAHIMI HUSAIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 0 1 0 0 0 0 0 2 1 1 0 0 1 6

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 0 2 1 2 0 0 0 0 0 0 0 0 0 5
2. DEDI AROZA, S.Ag., M.Si. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. Dra. IIN SUPRIHATIN 1 0 0 0 0 0 0 0 0 0 0 0 0 1
4. MOCHAMAD ICHSAN M., S.T. 0 1 0 0 0 0 0 0 1 0 0 0 0 2
5. NUR LAELA TUROHMAH, S.E. 0 0 0 0 0 1 0 0 0 0 0 0 0 1
6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ZULFIKAR MAHBUB ROBBANI 1 0 0 0 0 0 0 0 0 0 0 0 0 1
8. ABDURROKHIM, S.Pt. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. DEWI RACHMAWATI, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 1 1
11. RETNO UMMY ASTHASARI, S.T.P. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 9. Partai Kebangkitan Nusantara 0 1 0 0 0 0 0 1 1 1 0 1 0 5
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. JAN ADOLF HUKUBUN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. FRANSISKA DWI KESDIATIK 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 10. Partai Hati Nurani Rakyat 3 0 2 0 0 0 0 0 0 1 0 0 1 7

A.2 1. ELIA 2 0 2 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. ARIEF BUDIMAN 0 1 0 0 0 0 0 0 0 0 0 1 0 2
4. HERVINA LESTARI 1 0 1 0 0 0 0 0 0 0 0 0 0 2
5. ANDREAS KURNIAWAN E 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 1 0 0 0 0 0 0 0 0 0 0 0 0 1
7. YASMIN INAYAH NATA BUWANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 11. Partai Garda Republik Indonesia 1 0 1 0 0 1 1 0 0 1 0 0 1 6
A.2 1. A. KHALIK 0 0 0 0 0 0 0 1 0 0 0 0 0 1
2. YULIANTI BILAKONGA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 12. Partai Amanat Nasional 5 11 8 7 5 7 7 6 9 8 5 6 0 84

A.2 1. H. SUPONO 4 5 6 1 3 0 2 6 4 1 5 7 1 45
2. H. PERMADI DALUNG, S.E., M.M. 2 2 0 2 8 3 9 4 10 11 0 0 0 51
3. SARASWATI 0 0 0 0 0 0 0 0 1 0 0 0 0 1
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 2 8 23 7 3 1 0 1 0 0 1 1 2 49
5. CEPI AL HAKIM, S.T.P., M.Si. 0 0 2 0 1 0 0 1 0 0 0 0 0 4
6. ASTRI SARTIKA 0 1 1 0 0 0 0 0 2 0 0 0 0 4
7. REGIVAL PUTRA ADRIAN 0 0 0 1 0 0 0 1 0 0 0 0 0 2
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 0 0 1 0 0 0 0 0 0 1 1 0 0 3
9. MERRY APRIYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ANI NURMAYANTI 0 0 0 0 1 0 0 1 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 13. Partai Bulan Bintang 0 0 0 0 2 0 3 3 2 5 0 1 1 17
A.2 1. SOLAHUDDIN, S.H., M.H. 0 1 0 0 3 1 1 6 1 1 1 0 5 20
2. AGUS SUKARNA WIJAYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. FITRIASARI 0 0 0 0 0 0 0 0 1 1 0 0 0 2
4. DJUMHAWAN R PERMANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. WAWANG HUSNAWATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Mochammad Muzaqi 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. MOCHAMAD MORO ASIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 14. Partai Demokrat 2 3 0 2 3 1 1 0 3 0 1 1 1 18

A.2 1. DEDE CANDRA SASMITA, S.Ag. 2 1 0 0 3 2 0 0 1 0 1 0 1 11
2. MANATAP P SIMANJUNTAK 1 0 0 0 1 0 0 0 0 1 0 0 0 3
3. ANDRIYANTI WIJAYA 0 0 0 0 1 0 0 0 0 0 0 0 0 1
4. SAIFUL 0 0 1 0 1 0 0 0 0 0 0 0 0 2
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 0 0 0 1 0 0 0 0 0 0 0 0 0 1
6. ARNY NURANI SANGAJI 1 2 0 0 0 0 0 0 0 0 0 0 0 3
7. REDIKA SEGARA, S.E. 0 0 0 0 1 0 0 0 0 0 0 0 0 1
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. HARKES WOROWATI W. A. 0 0 0 0 2 2 0 0 0 0 0 0 0 4
10. NAUFAL ANDHIKA IRAWAN 0 0 0 1 0 0 0 0 1 0 0 0 0 2
11. ENDAH HENDRAWASIH 0 0 0 1 0 1 0 0 0 0 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 15. Partai Solidaritas Indonesia 1 0 1 0 0 0 0 2 0 0 0 0 0 4
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 1 0 1 0 0 0 0 0 1 0 0 0 0 3
2. FEBRY CITRA, S.T., M.A.B. 1 0 0 0 0 0 0 0 0 0 0 0 1 2
3. SIANA RIA, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. MUHAMMAD ADE ALIYUDIN, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. JASIMAN SITORUS, S.Kom., M.M. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 0 1 0 0 0 0 0 1 1 0 0 0 0 3

A.2 1. RESITA KANIYA 0 0 0 0 0 0 0 4 0 0 0 0 1 5
2. AGUS WINARNO 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. Drs. SUMARWAN SASTRA 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. NENDEN BANURIAH, S.Pd. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. AMARENS MANUHUTU 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 0 0 0 0 0 0 0 1 0 0 0 0 0 1
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
A.1 17. Partai Persatuan Pembangunan 1 1 2 1 0 0 0 1 0 0 1 0 0 7
A.2 1. H. MUHAMAD ROMLI, A.Md. 0 1 4 0 2 0 0 1 0 1 0 0 1 10
2. JUHANTA, S.T. 0 0 0 0 0 1 0 0 0 0 0 0 0 1
3. DWI ARYANTI, S.E. 0 0 0 0 1 0 0 0 0 0 0 0 1 2
4. IRFAN DARAJAT 0 5 2 2 0 0 0 0 0 0 0 0 0 9
5. FERRY PERDIAN 0 1 0 0 0 0 0 0 0 0 0 0 0 1
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. YENTI NASHI HATUL UMMAH 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. ABDUL ROHIM, S.Si., Apt. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. GUNAWAN 0 0 0 0 1 0 0 0 0 0 0 0 0 1
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RIKE ISKANDAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 24. Partai Ummat 0 0 0 0 0 0 0 1 0 0 1 0 0 2

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 0 0 0 1 0 0 0 0 0 0 0 0 0 1
2. SELLY AFRIDA OLTAR, S.I.P. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. H. SUMIRAT SAPTA HADI, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Drs. H. ASRI AL JUFRI, M.Si. 1 0 0 0 0 0 0 0 0 0 0 0 0 1
5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Drs. MOCH ZAENAL AL AQILI 0 0 0 0 0 0 0 0 0 1 0 0 0 1
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 1 0 0 1
9. JAKA JATI NUR ALAM 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
NO. URAIAN RINCIAN
V DATA SUARA SAH DAN TIDAK SAH TPS 001 TPS 002 TPS 003 TPS 004 TPS 005 TPS 006 TPS 007 TPS 008 TPS 009 TPS 010 TPS 011 TPS 012 TPS 013 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 181 200 213 165 173 128 143 171 177 201 154 219 152 2.277
B. JUMLAH SUARA TIDAK SAH 56 24 37 36 47 28 19 74 31 37 66 40 60 555
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 237 224 250 201 220 156 162 245 208 238 220 259 212 2.832

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: MEKARJAYA
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 155 164 142 142 155 145 140 139 140 145 161 161 155 113 132 2.189
JML 282 294 282 268 283 273 270 280 268 298 296 297 294 221 238 4.144
LK 103 122 110 110 121 103 102 115 117 115 119 126 110 86 89 1.648
JML 214 237 223 219 224 208 222 239 226 241 223 242 230 170 184 3.302
LK 0 1 1 2 0 1 0 9 0 0 1 0 1 1 1 18
JML 0 2 3 2 0 2 0 14 0 1 1 0 1 1 1 28
LK 0 1 0 1 0 0 0 2 1 0 0 0 0 3 0 8
JML 0 2 0 1 0 0 0 3 2 0 1 0 0 6 0 15
LK 103 124 111 113 121 104 102 126 118 115 120 126 111 90 90 1.674
JML 214 241 226 222 224 210 222 256 228 242 225 242 231 177 185 3.345
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 74 61 62 52 65 69 54 29 44 60 77 60 70 49 57 883
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

I DATA PEMILIH DAN PENGGUNAAN HAK PILIH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10
A DATA PEMILIH
LK 2.189 129 159 132 150 120 2.879
Jumlah Pemilih dalam Daftar Pemilih Tetap (DPT) PR 1.955 91 130 103 126 109 2.514
JML 4.144 220 289 235 276 229 5.393
LK 1.648 94 123 106 123 85 2.179
1. Jumlah pengguna hak pilih dalam Daftar Pemilih Tetap (DPT) PR 1.654 79 107 84 112 95 2.131
JML 3.302 173 230 190 235 180 4.310
LK 18 0 0 0 0 1 19
2. Jumlah pengguna hak pilih dalam Daftar Pemilih Tambahan (DPTb) PR 10 0 0 0 0 0 10
JML 28 0 0 0 0 1 29
LK 8 0 0 0 0 0 8
3. Jumlah pengguna hak pilih dalam Daftar Pemilih Khusus (DPK) PR 7 0 0 0 0 0 7
JML 15 0 0 0 0 0 15
LK 1.674 94 123 106 123 86 2.206
4. Jumlah Pengguna Hak Pilih (B.1+B.2+B.3) PR 1.671 79 107 84 112 95 2.148
JML 3.345 173 230 190 235 181 4.354
NO. URAIAN RINCIAN

II DATA PENGGUNAAN SURAT SUARA JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9
1 Jumlah surat suara yang diterima, termasuk surat suara cadangan 2% dari DPT 4.230 225 300 240 282 234 5.511
2 Jumlah surat suara yang digunakan 3.345 173 230 190 235 181 4.354
3 Jumlah surat suara dikembalikan oleh pemilih (karena rusak atau keliru coblos) 2 0 0 0 0 0 2
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 883 52 70 50 47 53 1.155
NO. URAIAN RINCIAN

III DATA PEMILIH DISABILITAS JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9 10
LK 0 0 0 0 0 0 0
Jumlah seluruh Pemilih disabilitas yang menggunakan hak pilih PR 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 0 0 1 0 0 1 0 0 2 0 0 4


3. UDI SUHANDORO 2 0 0 3 1 1 2 1 0 3 2 0 4 0 1 20
6. NIAR YUNIAR 1 1 0 1 0 0 0 1 2 2 0 1 1 0 0 10
8. SUTIYA ANJANI 0 1 0 0 0 2 0 0 0 1 1 1 0 1 0 7
10. YANTI TARYATI 0 0 0 0 0 2 0 0 1 0 0 0 0 0 0 3
11. CAHYO FITRIADI 0 0 1 0 0 1 0 1 0 0 0 0 2 2 0 7
LAMPIRAN MODEL

NO. URAIAN RINCIAN

IV DATA PEROLEHAN SUARA PARTAI POLITIK DAN SUARA CALON JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 JUMLAH AKHIR
1 2 3 4 5 6 7 8 9
A.1 1. Partai Kebangkitan Bangsa 98 4 11 4 5 4 126
A.2 1. ERNI SUGIYANTI, S.Ag., M.M. 327 5 7 8 17 2 366
2. DINDIN ABDULLAH GHOZALI 48 1 4 0 1 1 55
3. H. AMIR AMIRULOH, S.H. 19 2 3 3 0 0 27
4. NAFIZUL ALHAFIZRANA 11 0 6 8 0 0 25
5. BAGUS DJATI KUSUMA 18 0 1 1 1 0 21
6. SHOLEHATUN NASIHA, S.Kom. 5 0 0 1 0 1 7
7. Ir. AAN SURYA PRIYANA 5 0 1 0 0 0 6
8. AGUS MULYADI, S.Pd. 4 1 0 0 0 0 5
9. ROSALINDA RAMDHANIAH, S.Ag. 3 0 0 0 0 0 3
10. TEGUH YULIANTO, S.T. 2 0 0 0 0 0 2
11. RISMA PUJI RIANTI 1 0 0 0 0 0 1
B JUMLAH SUARA SAH PARTAI POLITIK DAN CALON (A.1 + A.2) 541 13 33 25 24 8 644
A.1 2. Partai Gerakan Indonesia Raya 158 5 17 12 22 15 229

A.2 1. H. RICKY KURNIAWAN, Lc. 80 2 15 7 8 5 117
2. Ir. PRASETYAWATI, M.M. 73 4 16 30 3 11 137

3. UDI SUHANDORO 20 3 1 3 2 2 31
4. H. CECEP GOGOM, S.Ag., M.Pd. 27 0 5 2 1 6 41
5. YORDA IMAM SUTOMO, S.H. 10 1 0 0 0 0 11
6. NIAR YUNIAR 10 0 4 2 1 1 18
7. Dr. AGUS SUHENDI, M.Pd. 14 0 1 1 1 0 17
8. SUTIYA ANJANI 7 0 1 1 0 0 9
9. TOTING SUPRIATNA 0 0 1 0 1 0 2
10. YANTI TARYATI 3 0 2 0 0 1 6
11. CAHYO FITRIADI 7 0 0 0 0 0 7
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 0 0 1 0 1 0 0 2 0 1 1 0 0 1 7
6. H. AGUS RIADI 0 1 0 1 0 1 0 0 0 0 0 0 0 1 0 4
11. ALUN HIMAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2. H. KUSNADI, S.I.P. 0 1 1 3 0 0 0 1 2 1 1 0 0 0 0 10
6. LINDA OCTAVIA 0 1 0 0 0 1 4 0 3 0 0 2 1 0 0 12
7. H. HELMI BUSTOMI 7 1 0 0 2 0 3 0 2 0 1 0 1 0 0 17
10. FAJAR SETIAWAN 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9
A.1 3. Partai Demokrasi Indonesia Perjuangan 102 3 5 0 7 5 122
A.2 1. Hj. ASYANTI ROZANA, S.E. 41 0 3 3 0 3 50
2. DONI MARADONA HUTABARAT, S.H. 187 0 6 1 1 5 200
3. H. KARYAWAN FATHURACHMAN, S.H., M.H. 22 0 2 1 0 0 25
4. Hj. DIAN ROSITA 7 1 4 0 0 0 12
5. THARIQ HALILINTAR 23 0 0 1 1 0 25
6. H. AGUS RIADI 4 0 0 0 0 0 4
7. IRAWATY OCTORA, S.E., M.Si. 2 0 0 2 0 0 4
8. MANGONTANG SIMANJUNTAK 2 0 0 0 0 0 2
9. BAMBANG SUMANTRI, S.Sos. 5 0 0 0 0 0 5
10. EUGINIA NATANIA PUTRI 4 0 0 0 0 0 4
11. ALUN HIMAWAN 0 0 0 0 0 0 0
A.1 4. Partai Golongan Karya 46 2 3 5 1 2 59

A.2 1. SAMSUL HIDAYAT, S.H. 41 0 2 2 1 4 50
2. H. KUSNADI, S.I.P. 10 1 3 0 2 2 18
3. KURNIAWATYNINGSIH, S.E. 9 1 0 1 0 0 11
4. ADI RESTU PERMADI 12 0 2 1 0 0 15
5. KHAERUL ANAM, S.Pi., M.Si. 5 0 0 2 0 0 7
6. LINDA OCTAVIA 12 0 0 1 0 0 13
7. H. HELMI BUSTOMI 17 0 1 0 0 1 19
8. MUNAWARAH SUNUSI, S.E., M.Si. 1 0 0 1 0 0 2
9. RENO ANGGARA MUKTI, S.ST.Par. 25 0 2 5 0 1 33
10. FAJAR SETIAWAN 2 0 0 0 0 0 2
11. JULIO JEKONIA RESOWIJOYO, B.A., M.B.A. 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 0 0 2 4 1 2 1 1 1 1 2 1 0 3 4 23
A.2 1. M. RIZKY 0 2 0 1 2 2 3 0 1 2 0 0 4 1 5 23
2. DONDY DWIGUNTIA 1 2 2 1 0 2 0 0 1 1 1 3 4 13 9 40
5. DELLA PUSPITA 2 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3
6. AJID, S.Ag. 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
7. UMMI NURAENI, S.H. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
9. MUHAMAD RIDWAN 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 3
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ARIFIN, S.Hut. 0 0 0 6 0 1 0 17 8 0 0 1 10 13 0 56
A.1 6. Partai Buruh 0 0 0 0 0 0 1 0 2 2 0 1 0 1 0 7

A.2 1. Komarudin 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 3
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 2
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9
A.1 5. Partai NasDem 23 7 1 1 4 1 37
A.2 1. M. RIZKY 23 0 0 0 4 0 27
2. DONDY DWIGUNTIA 40 17 0 2 7 6 72
3. VICA FITHRI NOER AZIZAH 2 0 0 0 1 0 3
4. MELIHASRAT JAYA ZAI, S.E. 1 0 0 0 0 0 1
5. DELLA PUSPITA 3 1 1 0 1 0 6
6. AJID, S.Ag. 2 0 0 0 0 0 2
7. UMMI NURAENI, S.H. 1 0 0 0 0 0 1
8. AHMAD ROUF, S.I.P., M.Si. 2 0 0 0 0 0 2
9. MUHAMAD RIDWAN 3 0 0 0 1 0 4
10. AWALUDDIN, S.T. 0 0 0 0 1 0 1
11. ARIFIN, S.Hut. 56 0 0 0 0 0 56
A.1 6. Partai Buruh 7 0 1 0 0 0 8

A.2 1. Komarudin 3 0 0 1 0 0 4
2. Krisdianto, S.H. 0 0 1 1 0 0 2
3. Mira Sari La Puppung, S.E. 1 0 0 1 0 0 2
4. Agus Sarjanto, S.H. 0 0 1 1 1 0 3
5. Sugiarta 2 0 0 0 0 0 2
6. Lilis Minarni 2 0 0 0 0 0 2
7. Abdul Oir, S.H. 0 0 0 0 0 1 1
8. Ade Yuswandi 0 0 0 0 0 0 0
9. Rinda Ayu Pratiwi, S.Sos. 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0
11. Eva Pusvita Sari, S.Kom. 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 3
3. NASRUDDIN 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 2
4. NAFIZA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 0 0 0 0 0 1 0 0 0 0 0 1 2 0 0 4
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 2
8. ABDURROKHIM, S.Pt. 0 0 2 0 0 1 0 0 0 1 1 4 2 3 0 14
10. MURDOKO, S.H. 9 8 1 0 0 0 0 0 0 0 0 1 0 0 0 19
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9
A.1 7. Partai Gelombang Rakyat Indonesia 10 2 1 0 3 0 16
A.2 1. WIWID PURWAWAN 3 0 1 0 0 1 5
2. Hj. LULU MASLUCHAH, Lc. 2 0 0 0 0 0 2
3. NASRUDDIN 2 1 0 0 0 0 3
4. NAFIZA 0 0 0 0 0 0 0
5. FERRY ARDIAN AR. 4 0 0 0 0 0 4
6. ANDON TEGAR PRIBADI 0 0 0 0 0 0 0
7. RIZKY RADIANTO FAJRI 2 1 1 0 0 0 4
8. LINA KADARMINI 0 0 0 0 0 0 0
9. ISLAM RAHIMI HUSAIN, S.T. 1 0 0 0 0 0 1
10. ADE SAEPUL, S.Ag. 1 0 0 0 0 0 1
11. MUHTADIN 0 0 0 0 0 0 0
A.1 8. Partai Keadilan Sejahtera 41 2 1 0 3 1 48

A.2 1. H. FIKRI HUDI OKTIARWAN, S.Sos. 35 9 1 1 0 5 51
2. DEDI AROZA, S.Ag., M.Si. 8 0 1 2 0 3 14
3. Dra. IIN SUPRIHATIN 6 0 1 0 0 0 7
4. MOCHAMAD ICHSAN M., S.T. 11 1 0 0 0 0 12
5. NUR LAELA TUROHMAH, S.E. 4 0 0 0 0 0 4
6. SOPIAN APIP, S.E. 2 0 0 0 0 0 2
7. ZULFIKAR MAHBUB ROBBANI 9 0 0 1 2 2 14
8. ABDURROKHIM, S.Pt. 14 1 2 1 0 0 18
9. DEWI RACHMAWATI, S.E. 1 1 0 0 0 0 2
10. MURDOKO, S.H. 19 0 0 0 0 0 19
11. RETNO UMMY ASTHASARI, S.T.P. 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 2

A.2 1. ELIA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
3. ARIEF BUDIMAN 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 2
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
6. DHEMAS PRADITYA 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9
A.1 9. Partai Kebangkitan Nusantara 1 0 0 0 1 0 2
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0
2. Irwan Yani 0 0 1 0 0 0 1
3. JAN ADOLF HUKUBUN 1 1 0 0 0 0 2
4. FRANSISKA DWI KESDIATIK 1 0 0 0 0 0 1
5. Imam Fauzi 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0
7. ALI MUNAJIB 1 0 0 0 0 0 1
8. Aprizal Hamid 0 0 0 0 0 0 0
9. Nadya Oktafiani 2 0 0 0 0 0 2
A.1 10. Partai Hati Nurani Rakyat 4 0 0 0 0 1 5

A.2 1. ELIA 0 0 0 0 0 0 0
1 0 1 0 0 0 2
3. ARIEF BUDIMAN 2 0 0 0 0 0 2
4. HERVINA LESTARI 1 0 0 0 0 0 1
5. ANDREAS KURNIAWAN E 1 0 0 0 0 0 1
6. DHEMAS PRADITYA 1 0 0 0 0 0 1
7. YASMIN INAYAH NATA BUWANA 0 0 0 0 0 0 0
8. NIRWAN PRATAMA PUTRA 0 0 0 0 0 0 0
9. RD. MOCH. FARIEDHAN 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1

A.2 1. H. SUPONO 1 1 1 1 1 4 6 2 4 0 3 1 2 1 0 28
3. SARASWATI 1 1 1 1 0 3 4 6 8 0 1 1 1 1 0 29
6. ASTRI SARTIKA 0 0 0 0 0 1 1 2 1 0 0 0 0 0 0 5
9. MERRY APRIYANTI 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 2
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. ANI NURMAYANTI 0 0 0 1 0 0 0 1 0 0 0 1 0 0 0 3
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9
A.1 11. Partai Garda Republik Indonesia 1 3 0 0 0 0 4
A.2 1. A. KHALIK 1 0 0 0 0 0 1
2. YULIANTI BILAKONGA 0 0 0 1 0 0 1
A.1 12. Partai Amanat Nasional 58 3 3 5 3 0 72

A.2 1. H. SUPONO 28 1 0 1 20 0 50
2. H. PERMADI DALUNG, S.E., M.M. 42 1 1 7 1 0 52
3. SARASWATI 29 1 0 1 0 0 31
4. AYI SAHRUL HAMZAH, S.Sn., M.A.P. 28 1 1 0 0 0 30
5. CEPI AL HAKIM, S.T.P., M.Si. 6 1 0 0 1 0 8
6. ASTRI SARTIKA 5 1 0 0 0 1 7
7. REGIVAL PUTRA ADRIAN 2 0 1 0 0 0 3
8. MUHAMMAD ANWAR FAUZI, S.I.Kom. 10 0 1 0 1 0 12
9. MERRY APRIYANTI 2 0 0 1 0 0 3
10. IIM SOLIHATI 0 0 0 0 0 0 0
11. ANI NURMAYANTI 3 0 0 0 1 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 1 0 0 0 1 0 0 0 0 1 1 0 0 0 0 4
7. REDIKA SEGARA, S.E. 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 3
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9
A.1 13. Partai Bulan Bintang 3 0 0 0 1 0 4
A.2 1. SOLAHUDDIN, S.H., M.H. 5 1 0 0 0 0 6
2. AGUS SUKARNA WIJAYA 1 0 0 0 0 0 1
3. FITRIASARI 1 0 0 1 0 0 2
4. DJUMHAWAN R PERMANA 0 0 0 0 0 0 0
5. Deni Rusydiana, S.H.I. 0 0 0 0 0 0 0
6. YANI SURYANI FIKRIAH 0 0 0 0 0 0 0
7. WAWANG HUSNAWATI 0 0 0 0 0 0 0
8. Sanusi Permana 0 0 0 0 0 0 0
9. Mochammad Muzaqi 1 0 0 0 0 0 1
10. MOCHAMAD MORO ASIH 1 0 0 0 0 0 1
A.1 14. Partai Demokrat 25 1 1 1 0 0 28

A.2 1. DEDE CANDRA SASMITA, S.Ag. 93 1 2 0 0 0 96
2. MANATAP P SIMANJUNTAK 1 0 0 0 0 0 1
3. ANDRIYANTI WIJAYA 7 0 0 0 0 0 7
4. SAIFUL 4 1 0 0 0 0 5
5. Letkol (Purn.) USMAN SINAMBELA, S.E. 10 0 0 0 0 0 10
6. ARNY NURANI SANGAJI 3 0 0 0 1 0 4
7. REDIKA SEGARA, S.E. 3 0 0 0 0 0 3
8. KARDAN 0 0 0 0 0 0 0
9. HARKES WOROWATI W. A. 5 0 0 0 0 0 5
10. NAUFAL ANDHIKA IRAWAN 2 0 1 0 0 0 3
11. ENDAH HENDRAWASIH 1 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 1 0 0 0 0 1 0 0 0 0 1 0 2 0 0 5
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
7. GUNADI, M.Ag. 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 2
8. DESI FITRI DIANA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 3

A.2 1. RESITA KANIYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. AGUS WINARNO 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2
7. YURIZAL, S.E., M.M. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9
A.1 15. Partai Solidaritas Indonesia 13 0 1 0 2 0 16
A.2 1. I GEDE NGURAH EKA DHARMAYUDHA, S.H. 9 0 0 0 0 0 9
2. FEBRY CITRA, S.T., M.A.B. 7 1 1 0 2 0 11
3. SIANA RIA, S.E., M.M. 5 0 1 0 0 0 6
4. MUHAMMAD ADE ALIYUDIN, S.H. 9 0 1 0 0 0 10
5. JASIMAN SITORUS, S.Kom., M.M. 1 0 0 0 0 0 1
6. DIAH WINARSIH 1 0 0 0 0 0 1
7. GUNADI, M.Ag. 2 0 0 0 0 0 2
8. DESI FITRI DIANA 0 0 0 0 0 0 0
A.1 16. PARTAI PERINDO 3 1 1 0 1 0 6

A.2 1. RESITA KANIYA 0 0 0 0 0 0 0
2. AGUS WINARNO 2 0 0 0 0 0 2
3. Drs. SUMARWAN SASTRA 1 0 0 0 0 0 1
4. NENDEN BANURIAH, S.Pd. 2 0 0 0 0 0 2
5. AMARENS MANUHUTU 1 0 0 0 0 0 1
6. R. PEPEN RUSTAM EFFENDI, S.H., M.H. 2 0 0 0 0 0 2
7. YURIZAL, S.E., M.M. 0 0 3 1 0 0 4
8. AGUS WIJAYA, S.H., M.H., M.Si., CRA. 1 0 0 0 0 0 1
9. ELLY MARYANTI 0 0 0 0 1 0 1
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 1 1 1 1 0 0 1 0 0 1 1 0 0 1 1 9
3. DWI ARYANTI, S.E. 2 0 1 0 4 1 0 1 0 4 0 5 0 10 1 29
4. IRFAN DARAJAT 0 1 0 1 0 0 1 0 0 1 0 2 1 1 1 9
5. FERRY PERDIAN 0 0 1 7 0 0 0 0 1 51 23 18 19 1 1 122
9. GUNAWAN 1 0 0 0 1 0 0 0 0 0 0 2 0 0 0 4
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. RIKE ISKANDAR 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 2
A.1 24. Partai Ummat 0 0 0 1 0 1 0 0 0 1 0 1 0 1 0 5

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9
A.1 17. Partai Persatuan Pembangunan 63 16 0 0 3 13 95
A.2 1. H. MUHAMAD ROMLI, A.Md. 107 29 5 0 1 32 174
2. JUHANTA, S.T. 9 0 0 0 0 0 9
3. DWI ARYANTI, S.E. 29 3 3 1 2 0 38
4. IRFAN DARAJAT 9 0 1 0 0 0 10
5. FERRY PERDIAN 122 0 1 0 0 0 123
6. MAYA UMMI AZIZATUS SA'ADAH, S.Pd., M.M. 7 0 0 0 0 0 7
7. YENTI NASHI HATUL UMMAH 3 0 0 0 0 0 3
8. ABDUL ROHIM, S.Si., Apt. 2 0 0 0 0 0 2
9. GUNAWAN 4 0 0 0 0 1 5
10. RIA ANWAR 0 0 1 0 0 0 1
11. RIKE ISKANDAR 2 0 0 0 0 0 2
A.1 24. Partai Ummat 5 0 0 0 0 0 5

A.2 1. H. BUYUNG SAKTI HAMEL, S.K.M., M.K.M. 1 0 0 0 0 0 1
2. SELLY AFRIDA OLTAR, S.I.P. 2 0 0 0 0 0 2
3. H. SUMIRAT SAPTA HADI, S.Ag. 1 0 0 0 0 0 1
4. Drs. H. ASRI AL JUFRI, M.Si. 0 0 0 0 0 0 0
5. RITA HERLINA, S.E. 0 0 0 0 0 0 0
6. Drs. MOCH ZAENAL AL AQILI 1 0 0 0 0 0 1
7. FAUZIAH TABRIYANI 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0
9. JAKA JATI NUR ALAM 1 0 0 0 0 0 1
LAMPIRAN MODEL
NO. URAIAN RINCIAN
NO. URAIAN RINCIAN

V DATA SUARA SAH DAN TIDAK SAH JUMLAH PINDAHAN TPS 016 TPS 017 TPS 018 TPS 019 TPS 020 JUMLAH AKHIR
A. JUMLAH SELURUH SUARA SAH 2.699 146 175 141 146 140 3.447
B. JUMLAH SUARA TIDAK SAH 646 27 55 49 89 41 907
C. JUMLAH SELURUH SUARA SAH DAN TIDAK SAH 3.345 173 230 190 235 181 4.354

1 2 3 4 5
……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

LAMPIRAN MODEL
Halaman 1 Lembar 1

KELURAHAN/DESA …......................: TEGALLEGA
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
A DATA PEMILIH
LK 132 104 68 91 119 143 116 113 124 142 165 158 114 150 91 1.830
JML 252 204 135 179 211 267 230 210 230 275 292 298 218 292 171 3.464
LK 132 96 55 73 92 107 110 103 97 111 134 103 82 112 71 1.478
JML 252 190 115 151 171 220 222 190 190 233 248 219 171 237 144 2.953
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LK 0 0 3 0 0 4 0 0 0 0 15 0 0 2 0 24
JML 0 0 5 0 1 9 0 0 0 0 26 0 0 4 0 45
LK 132 96 58 73 92 111 110 103 97 111 149 103 82 114 71 1.502
JML 252 190 120 151 172 229 222 190 190 233 274 219 171 241 144 2.998
NO. URAIAN RINCIAN

001 002 003 004 005 006 007 008 009 010 011 012 013 014 015 PINDAHAN
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4 6 19 18 32 45 45 13 25 45 48 24 85 52 55 31 543
cadangan
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
LK 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2
LAMPIRAN MODEL
Halaman 1 Lembar 2

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14
A DATA PEMILIH
LK 1.830 141 129 102 136 139 141 135 117 158 3.028
JML 3.464 260 265 188 269 271 242 237 215 293 5.704
LK 1.478 95 118 96 119 127 138 114 92 135 2.512
JML 2.953 199 239 170 233 249 236 206 180 253 4.918
LK 0 0 0 0 0 0 0 0 0 0 0
JML 0 0 0 0 0 0 0 0 0 0 0
LK 24 2 0 0 5 0 0 0 0 0 31
JML 45 3 0 0 6 0 0 0 0 0 54
LK 1.502 97 118 96 124 127 138 114 92 135 2.543
JML 2.998 202 239 170 239 249 236 206 180 253 4.972
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
4 Jumlah surat suara yang tidak digunakan/tidak terpakai, termasuk sisa surat suara cadangan 543 65 32 22 35 28 10 36 40 47 858
NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14
LK 0 0 0 0 3 0 0 0 0 0 3
JML 2 0 0 0 5 0 0 0 0 0 7
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
8. AGUS MULYADI, S.Pd. 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 2


3. UDI SUHANDORO 2 0 0 0 0 2 1 0 1 2 1 0 0 3 0 12
6. NIAR YUNIAR 0 0 0 0 1 1 0 0 1 1 0 0 3 1 0 8
8. SUTIYA ANJANI 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 3
10. YANTI TARYATI 0 0 0 0 0 0 2 0 1 1 0 0 0 0 1 5
11. CAHYO FITRIADI 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
8. AGUS MULYADI, S.Pd. 2 0 0 0 0 0 0 0 0 0 2


3. UDI SUHANDORO 12 1 0 0 2 0 2 3 2 0 22
6. NIAR YUNIAR 8 0 1 0 5 0 0 1 0 0 15
8. SUTIYA ANJANI 3 0 0 0 0 0 0 1 0 0 4
10. YANTI TARYATI 5 0 0 0 1 1 0 0 0 0 7
11. CAHYO FITRIADI 2 1 0 0 0 0 0 0 0 1 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
4. Hj. DIAN ROSITA 0 1 1 1 0 0 0 0 0 0 1 0 1 1 0 6
6. H. AGUS RIADI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
11. ALUN HIMAWAN 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 3

2. H. KUSNADI, S.I.P. 0 0 0 1 0 0 2 1 5 2 4 1 0 2 2 20
6. LINDA OCTAVIA 0 1 1 0 0 0 0 1 0 1 1 1 0 0 1 7
7. H. HELMI BUSTOMI 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
10. FAJAR SETIAWAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
4. Hj. DIAN ROSITA 6 0 0 0 0 0 1 0 1 0 8
6. H. AGUS RIADI 1 0 0 0 0 3 0 0 0 0 4
11. ALUN HIMAWAN 3 0 0 0 0 0 0 0 0 0 3

2. H. KUSNADI, S.I.P. 20 1 0 1 1 0 2 2 4 0 31
6. LINDA OCTAVIA 7 0 0 1 0 1 0 0 0 0 9
7. H. HELMI BUSTOMI 1 0 0 0 0 0 21 0 1 0 23
10. FAJAR SETIAWAN 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.1 5. Partai NasDem 1 2 1 1 0 3 1 0 5 2 3 1 2 7 1 30
A.2 1. M. RIZKY 0 0 1 0 2 1 1 0 2 1 0 1 0 0 0 9
2. DONDY DWIGUNTIA 0 0 0 1 1 0 0 0 0 1 1 1 0 2 0 7
5. DELLA PUSPITA 1 0 0 0 0 0 1 0 1 0 0 1 0 0 0 4
6. AJID, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. MUHAMAD RIDWAN 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 2
10. AWALUDDIN, S.T. 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 2
11. ARIFIN, S.Hut. 37 40 0 24 12 11 1 5 12 10 22 14 37 20 12 257
A.1 6. Partai Buruh 1 1 0 0 4 2 0 0 0 0 0 0 0 0 0 8

A.2 1. Komarudin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 2
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.1 5. Partai NasDem 30 1 7 5 7 6 5 10 4 19 94
A.2 1. M. RIZKY 9 1 0 1 3 4 3 6 0 6 33
2. DONDY DWIGUNTIA 7 1 48 19 39 49 20 13 1 2 199
5. DELLA PUSPITA 4 1 0 1 1 0 1 2 1 4 15
6. AJID, S.Ag. 0 0 0 0 1 0 0 1 1 1 4
7. UMMI NURAENI, S.H. 0 0 0 0 0 0 0 0 0 1 1
9. MUHAMAD RIDWAN 2 1 1 0 0 0 0 0 0 1 5
10. AWALUDDIN, S.T. 2 0 0 0 1 1 0 0 0 0 4
11. ARIFIN, S.Hut. 257 38 1 0 5 9 2 10 2 90 414
A.1 6. Partai Buruh 8 1 0 0 1 0 1 0 1 0 12

A.2 1. Komarudin 0 0 1 0 0 1 0 0 0 0 2
2. Krisdianto, S.H. 0 0 0 0 0 0 0 0 0 0 0
4. Agus Sarjanto, S.H. 0 0 0 0 0 0 0 0 0 0 0
5. Sugiarta 2 0 1 0 0 0 0 0 0 0 3
6. Lilis Minarni 0 0 0 0 0 0 0 0 0 0 0
7. Abdul Oir, S.H. 0 0 0 0 1 0 0 0 0 0 1
8. Ade Yuswandi 0 0 0 0 0 0 0 0 0 0 0
10. SAHRUL BAHRI 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. WIWID PURWAWAN 1 0 0 1 0 0 0 0 0 0 0 0 1 2 0 5
3. NASRUDDIN 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 3
4. NAFIZA 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. ABDURROKHIM, S.Pt. 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.2 1. WIWID PURWAWAN 5 0 0 0 0 0 1 0 0 0 6
3. NASRUDDIN 3 0 0 0 0 1 1 0 0 0 5
4. NAFIZA 1 0 0 0 0 0 0 0 0 0 1
5. FERRY ARDIAN AR. 0 0 0 0 0 0 0 0 0 0 0
8. LINA KADARMINI 0 0 0 0 0 0 0 0 0 0 0
10. ADE SAEPUL, S.Ag. 0 0 0 0 0 0 0 0 0 0 0
11. MUHTADIN 0 0 0 0 0 0 0 0 0 0 0

6. SOPIAN APIP, S.E. 0 0 0 1 0 0 0 0 0 0 1
8. ABDURROKHIM, S.Pt. 1 1 0 0 0 0 0 0 0 0 2
10. MURDOKO, S.H. 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 0 0 0 0 0 0 0 0 0 0 2 0 0 0 1 3
5. Imam Fauzi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2

A.2 1. ELIA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
3. ARIEF BUDIMAN 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.2 1. Neneng Rohimah 0 0 0 0 0 0 0 0 0 0 0
2. Irwan Yani 3 0 0 0 0 0 0 0 0 0 3
5. Imam Fauzi 0 0 0 0 0 0 0 0 1 0 1
6. Sri Rosmaryati 0 0 0 0 0 0 0 0 0 0 0
7. ALI MUNAJIB 0 0 0 0 0 1 0 0 0 0 1
8. Aprizal Hamid 0 0 0 0 0 0 0 0 0 0 0
9. Nadya Oktafiani 2 0 1 0 0 0 0 0 0 0 3

A.2 1. ELIA 0 0 0 0 0 0 0 2 2 0 4
1 0 0 0 0 0 0 1 0 0 2
3. ARIEF BUDIMAN 1 0 0 0 0 1 0 0 2 0 4
4. HERVINA LESTARI 0 0 0 0 0 0 0 0 1 0 1
6. DHEMAS PRADITYA 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
A.2 1. A. KHALIK 1 0 0 0 0 1 0 0 1 1 0 0 0 0 0 4

A.2 1. H. SUPONO 0 0 0 0 1 1 1 1 2 6 1 2 1 1 0 17
3. SARASWATI 0 2 0 0 0 0 1 1 0 0 0 0 0 0 0 4
6. ASTRI SARTIKA 0 2 0 1 1 0 0 0 0 0 0 0 0 0 0 4
9. MERRY APRIYANTI 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1
10. IIM SOLIHATI 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1
11. ANI NURMAYANTI 0 0 1 0 1 0 1 0 0 0 0 0 1 0 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
A.2 1. A. KHALIK 4 0 0 0 0 0 0 0 0 0 4

A.2 1. H. SUPONO 17 0 1 6 3 3 4 2 0 0 36
3. SARASWATI 4 0 1 1 2 1 0 0 1 0 10
6. ASTRI SARTIKA 4 0 1 0 2 0 0 0 0 0 7
9. MERRY APRIYANTI 1 0 0 0 0 2 0 0 0 0 3
10. IIM SOLIHATI 1 0 0 0 0 0 0 0 0 1 2
11. ANI NURMAYANTI 4 0 0 0 0 0 0 0 0 0 4
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. FITRIASARI 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 0 0 0 0 0 0 1 0 0 0 0 0 0 1 2 4
7. REDIKA SEGARA, S.E. 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1
8. KARDAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
3. FITRIASARI 2 0 0 0 0 0 0 1 0 0 3
8. Sanusi Permana 0 0 0 0 0 0 0 0 0 0 0

4. SAIFUL 4 0 0 0 2 1 0 0 0 0 7
7. REDIKA SEGARA, S.E. 1 0 0 0 0 0 0 0 0 0 1
8. KARDAN 0 1 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
3. SIANA RIA, S.E., M.M. 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
6. DIAH WINARSIH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1
A.1 16. PARTAI PERINDO 0 0 0 1 0 1 0 0 1 1 1 0 0 0 1 6

A.2 1. RESITA KANIYA 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1
2. AGUS WINARNO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. YURIZAL, S.E., M.M. 0 2 1 0 1 0 1 0 0 0 0 0 0 0 0 5
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
3. SIANA RIA, S.E., M.M. 1 0 0 0 1 0 0 1 0 0 3
6. DIAH WINARSIH 1 0 0 0 0 0 0 0 0 0 1
7. GUNADI, M.Ag. 0 0 0 0 0 0 0 0 0 0 0
8. DESI FITRI DIANA 1 0 0 0 0 0 0 0 0 0 1
A.1 16. PARTAI PERINDO 6 0 1 0 0 0 1 0 0 0 8

A.2 1. RESITA KANIYA 1 0 0 0 0 0 0 0 0 0 1
2. AGUS WINARNO 0 0 1 0 0 0 0 0 0 0 1
7. YURIZAL, S.E., M.M. 5 0 0 0 0 0 1 0 0 0 6
9. ELLY MARYANTI 0 0 0 0 0 0 0 0 0 0 0
10. RAHMAT HIDAYAT 0 0 0 0 0 0 0 0 0 0 0
11. MOHAMAD SATIBI 1 0 0 0 0 0 0 0 1 0 2
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
2. JUHANTA, S.T. 1 0 1 2 5 0 0 0 3 3 5 5 1 0 2 28
3. DWI ARYANTI, S.E. 3 2 3 2 4 2 1 4 5 4 2 4 2 2 0 40
4. IRFAN DARAJAT 0 0 0 0 0 0 2 0 1 1 0 1 1 1 0 7
5. FERRY PERDIAN 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 3
9. GUNAWAN 0 0 0 0 0 1 1 0 1 0 0 2 0 0 0 5
10. RIA ANWAR 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1
11. RIKE ISKANDAR 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 2
A.1 24. Partai Ummat 0 0 0 0 0 1 0 0 1 0 0 1 0 2 0 5

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LAMPIRAN MODEL

NO. URAIAN RINCIAN

1 2 3 4 5 6 7 8 9 10 11 12 13
2. JUHANTA, S.T. 28 1 0 0 3 3 0 1 0 0 36
3. DWI ARYANTI, S.E. 40 2 5 2 6 3 3 7 1 5 74
4. IRFAN DARAJAT 7 1 0 0 0 1 0 0 0 0 9
5. FERRY PERDIAN 3 3 0 0 1 0 1 1 0 0 9
9. GUNAWAN 5 0 1 0 0 1 0 0 0 0 7
10. RIA ANWAR 1 0 0 0 0 0 0 0 0 0 1
11. RIKE ISKANDAR 2 2 0 0 0 0 0 0 0 2 6
A.1 24. Partai Ummat 5 0 1 1 0 2 1 1 1 0 12

5. RITA HERLINA, S.E. 0 0 0 0 0 0 0 0 0 0 0
8. HERRY SUKARTA, S.E. 0 1 0 0 0 0 0 0 0 0 1
LAMPIRAN MODEL
NO. URAIAN RINCIAN
B. JUMLAH SUARA TIDAK SAH 92 81 46 57 62 96 100 93 56 64 117 93 53 95 46 1.151
NO. URAIAN RINCIAN

B. JUMLAH SUARA TIDAK SAH 1.151 85 58 38 27 32 69 59 55 39 1.613

1 2 3 4 5
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BERITA ACARA DAN SERTIFIKAT REKAPITULASI HASIL PENGHITUNGAN PEROLEHAN SUARA MODEL

NAMA DAN TANDA TANGAN PANITIA PEMILIHAN KECAMATAN

……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

REKAPITULASI TINGKAT KECAMATAN

A.1 2. Partai Gerakan Indonesia Raya 4.195

3. UDI SUHANDORO 396

A.1 4. Partai Golongan Karya 3.287

A.1 6. Partai Buruh 215

3. Mira Sari La Puppung, S.E. 15

A.1 8. Partai Keadilan Sejahtera 1.091

A.1 10. Partai Hati Nurani Rakyat 123

A.1 12. Partai Amanat Nasional 1.796

A.1 14. Partai Demokrat 819

5. Letkol (Purn.) USMAN SINAMBELA, S.E. 74

A.1 16. PARTAI PERINDO 164

7. YURIZAL, S.E., M.M. 68

A.1 24. Partai Ummat 104

NAMA DAN TANDA TANGAN PANITIA PEMILIHAN KECAMATAN

……………………………………… ……………………………………… ……………………………………… ……………………………………… ………………………………………

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

NO. URAIAN RINCIAN

NO. URAIAN RINCIAN

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

NO. URAIAN RINCIAN

NO. URAIAN RINCIAN

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 2. Partai Gerakan Indonesia Raya 14 9 10 12 15 9 14 13 9 10 14 7 13 11 15 175

2. Ir. PRASETYAWATI, M.M. 5 22 8 5 2 21 7 21 3 9 30 3 3 0 16 155

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 2. Partai Gerakan Indonesia Raya 175 15 13 9 13 18 3 16 16 9 7 6 6 306

2. Ir. PRASETYAWATI, M.M. 155 8 3 9 4 2 4 3 3 4 4 1 2 202

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 4. Partai Golongan Karya 12 3 7 5 10 7 3 16 12 17 3 10 5 11 8 129

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 4. Partai Golongan Karya 129 10 11 12 4 8 1 11 6 5 5 9 14 225

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 6. Partai Buruh 1 0 4 1 0 0 0 1 0 3 1 0 0 1 2 14

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 6. Partai Buruh 14 1 4 6 1 2 0 4 9 3 3 5 3 55

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 8. Partai Keadilan Sejahtera 4 1 4 10 5 6 8 11 2 3 6 6 3 2 3 74

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 8. Partai Keadilan Sejahtera 74 3 3 8 3 1 0 9 5 2 4 8 4 124

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 10. Partai Hati Nurani Rakyat 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 3

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 10. Partai Hati Nurani Rakyat 3 0 0 0 0 0 0 1 0 0 0 0 0 4

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN

A.1 12. Partai Amanat Nasional 11 0 1 3 7 1 0 7 5 4 3 6 4 2 2 56

REKAPITULASI HASIL PEROLEHAN SUARA TPS

NO. URAIAN RINCIAN