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PENGAJUAN SK JPZIS
Energy of Zakat
Contact Person: GOZIS: 085731853274, Program: 08123463223
No. Rek. BSM a.n. Lazisnu Kota Pasuruan: (451) 7106839993
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NAMA PEMOHON
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JABATAN ORGANISASI
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NAMA JPZIS
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Disesuaikan dengan nama instansi/lembaga/majelis masing2
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JENIS JPZIS
MWCNU/Ranting NU
Banom/Lembaga NU
Masjid/Musholla
Majelis
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ALAMAT
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NO. TELEPON/WA
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Nomor telp./WA ketua/Sekretaris AKTIF
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KETUA
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Mohon diisi nama lengkap disertai gelar
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WAKIL KETUA
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Boleh lebih dari satu orang
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SEKRETARIS
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WAKIL SEKRETARIS
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BENDAHARA
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WAKIL BENDAHARA
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Boleh lebih dari satu orang
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ANGGOTA
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Maksimal 5 orang
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