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FORMULIR PERMOHONAN INFORMASI
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Name
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Your answer
Nomor KTP
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Your answer
Alamat Email
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Your answer
Jenis Kelamin
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Laki-laki
Perempuan
Alamat
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Your answer
Pekerjaan
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Nomor Tlp./Hp
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Your answer
Rincian Informasi yangdibutuhkan(tambahan kertas bila perlu)
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Tujuan Penggunaan Data
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Cara Memperoleh Informasi
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Melihat/Membaca/Mendengarkan
Mendapatkan Salinan Informasi (Softcopy/Hardcopy)
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Cara Mendapatkan SalinanInformasi
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