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Form Pengajuan Keberatan Informasi Publik
Data Pemohon
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* Indicates required question
Email
*
Your email
Nama
*
Your answer
Alamat
*
Your answer
Jenis Kelamin
*
Laki - Laki
Perempuan
Usia
*
Your answer
Pekerjaan
*
Your answer
Pendidikan
*
SD
SMP
SMA
Diploma
S-1
S-2
S-3
Lainnya
Nomor Telepon (* Whatssapp)
*
Your answer
Email
*
Your answer
Nomor Pendaftaran Permintaan Informasi Publik
*
Your answer
Tujuan Penggunaan Informasi Publik
*
Your answer
Alasan Pengajuan Keberatan
*
Your answer
Kasus Posisi (kronilogi)
*
Your answer
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