JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Formulir Permohonan Informasi Kalurahan Karangwuni
Sign in to Google
to save your progress.
Learn more
Nama Pemohon
Your answer
Nomor Induk Penduduk
Your answer
Alamat
Your answer
Nomor HP/ Whatsapp
Your answer
Rincian Informasi yang Dibutuhkan
Your answer
Tujuan
Lurah
Carik
Panata Laksana Sarta Pangripta
Danarta
Jagabaya
Ulu-Ulu
Kamituwa
Dukuh Keboan
Dukuh Karangwuni
Dukuh Pancas
Dukuh Kriyan
Dukuh Karangrejo
Dukuh Karanganyar
Clear selection
Cara Memperoleh Informasi
Melihat/membaca/mendengarkan/mencatat
Mendapatkan salinan informasi (hardcopy/softcopy)
Clear selection
Cara Mendapat Salinan Informasi
Mengambil Langsung
Kurir
Pos
Email
Clear selection
Setelah mengisi form permohonan informasi ini, harap mengirimkan identitas berupa KTP/Surat Tugas/Akta Pendirian ke alamat email pemerintahdesakarangwuni@gmail.com, apakah bersedia?
Ya
Tidak
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report