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FORMULIR PERMINTAAN INFORMASI PUBLIK
FORMULIR 1
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Email *
Nama *
Jenis Kelamin *
Umur (tahun) *
NIK / Nomor KTP *
Instansi/Perguruan Tinggi
Alamat *
Pekerjaan *
Nomor Telepon/HP
*
E-mail *
Rincian Informasi yang dibutuhkan
*
Tujuan Penggunaan Informasi
*
Cara Memperoleh Informasi
*
Cara Mendapatkan Salinan Informasi
*
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