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Salinan FORMULIR SURAT KETERANGAN BELUM MEMILIKI RUMAH
Isilah Formulir Berikut Dengan Sebenar-benarnya.
Kesalahan Pengisian Bukan Tanggung Jawab desa.
Pengambilan Surat Dapat Dilakukan Pada Hari Kerja Senin -Jum'at Dikantor Desa.
Dengan Syarat :
1. Membawa Ktp Asli
2. Pengambilan Boleh Diwakilkan
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Nama
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Nik
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Tempat,tanggal lahir
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Pekerjaan
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Alamat
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RT
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RT.01
RT.02
RT.03
RT.04
RT.05
RT.06
Tanggal Pemohon
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MM
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DD
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YYYY
NO.HP/WA
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