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Formulir Pernyataan Keberatan Atas Permintaan Informasi Publik
Formulir Pernyataan Keberatan Atas Permintaan Informasi Publik
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A. Informasi Pengaju Keberatan
Nomor Registrasi Keberatan* (diisi Petugas)
*
Your answer
Nomor Pendaftaran Permintaan Informasi
*
Your answer
Tujuan Penggunaan Informasi
*
Your answer
Identitas Pemohon
Nama
*
Your answer
Alamat
*
Your answer
Pekerjaan
*
Your answer
Identitas Kuasa Pemohon
Nama
*
Your answer
Alamat
*
Your answer
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