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Formulir Pengajuan Keberatan atas Permohonan Informasi
Formulir ini digunakan untuk melakukan pengajuan keberatan atas permohonan informasi yang telah disampaikan sebelumnya ke Badan Pusat Statistik Provinsi Banten.
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Nomor Pendaftaran Permohonan Informasi:
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Your answer
Tujuan Penggunaan Informasi:
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Your answer
IDENTITAS PEMOHON
Nama:
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Your answer
Alamat:
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Your answer
Pekerjaan:
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Your answer
Nomor Telepon/HP:
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Your answer
Alamat email:
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Your answer
IDENTITAS KUASA PEMOHON
Identitas kuasa pemohon diisi jika ada kuasa pemohonnya dan melampirkan Surat Kuasa.
Nama:
Your answer
Alamat:
Your answer
Nomor Telepon/HP:
Your answer
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