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PANITIA PEMUNGUTAN SUARA (PPS)

DESA TRIDHARMA
KECAMATAN PULUBALA
Jl. ………………………………….

Nomor : ……../PPS-TRD/ IV/2019


Tanggal : …… April 2019

Kepada Yth :
Kepala Ketua dan Anggota PPK
Kec.Pulubala
Di -
Tempat.
TANDA TERIMA

Asal Surat/Dokumen : ..............................................................................................


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Tanggal : ..............................................................................................
Perihal : ..............................................................................................
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Yang Menyerahkan Yang Menerima

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TANDA TERIMA

Asal Surat/Dokumen : ..............................................................................................


Nomor : ..............................................................................................
Tanggal : ..............................................................................................
Perihal : ..............................................................................................
..............................................................................................

Yang Menyerahkan Yang Menerima

………………………………………... ………………………………………...

TANDA TERIMA

Asal Surat/Dokumen : ..............................................................................................


Nomor : ..............................................................................................
Tanggal : ..............................................................................................
Perihal : ..............................................................................................
..............................................................................................

Yang Menyerahkan Yang Menerima

………………………………………... ………………………………………...