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FORM RELAWAN PENGAWASAN PEMUTAKHIRAN DATA PEMILIH BERKELANJUTAN
DI GUNAKAN SEBAGAI BAHAN PENGAWASAN DATA PEMILIH BERKELANJUTAN
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NAMA PELAPOR
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NOMOR TELPON PELAPOR
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NAMA (Yang di Laporkan)
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KATEGORI
MENINGGAL
PINDAH KELUAR
PINDAH MASUK
MASUK USIA 17 TAHUN
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ALAMAT (Jalan/Dusun)
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DESA - KECAMATAN
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NO KTP
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NO KARTU KELUARGA
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JENIS KELAMIN
LAKI-LAKI
PEREMPUAN
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NO TPS
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KETERANGAN
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