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Form Konsultasi Perizinan dan Non Perizinan
UP PMPTSTP KELURAHAN KEMBANGAN UTARA
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Nama
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Your answer
Nomer Handphone
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Your answer
AlamatÂ
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Your answer
Jenis Konsultasi Perizinan
*
Izin Penggunaan Tanah Makam (IPTM)
Izin Usaha/ Nomor Induk Berusaha (NIB)
Izin Mendirikan Bangunan (IMB)
Surat Keterangan Tidak Mampu (SKTM)
Surat Izin Praktik (SIP)
Surat Tidak Memiliki Rumah
PM1 Kelurahan (NIKAH, DOMISILI, ALAMAT & ORANG YANG SAMA)
DUKCAPIL
Tanggal Konsultasi
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DD
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YYYY
KRITIK dan SARAN
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