Form Pendaftaran Peserta BIMTEK/Sosialisasi Implementasi Perizinan Berusaha Berbasis Risiko 
Harap isi form sesuai dengan data diri sendiri.
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Nama Peserta *
Nama Usaha *
Alamat Usaha *
No. NPWP *
No. Rekening 
(Sesuai dengan rekening peserta)
*
No. Telepon
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