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Form Permohonan Informasi Publik
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Email
*
Your email
Nama
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Your answer
Alamat
*
Your answer
Nomor Telepon/Email
*
Your answer
Cara Memperoleh Informasi
*
Melihat/Membaca/Mendengarkan/Mencatat
Mendapatkan salinan informasi (hardcopy/softcopy)
Cara Mendapatkan Salinan Informasi
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Mengambil Langsung
Email
Tujuan Penggunaan Informasi
*
Your answer
Rincian Informasi Yang Dibutuhkan
*
Your answer
Tanggal Permohonan
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MM
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DD
/
YYYY
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