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PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
BERITA ACARA PEMBENTUKAN TIM PERUMUS RPJM DESA Berkaitan dengan pelaksanaan musyawarah RPJM Desa di Desa Cijolang kecamatan Bl. Limbangan kabupaten/kota Garut provinsi Jawa barat dalam rangka penyusunan rancangan RPJM - Desa, maka pada hari ini : Hari dan Tanggal Jam Tempat
: …………………………………. : …………………………………. : ………………………………….
telah diselesaikan pembentukan Tim Perumus RPJM Desa oleh Pemerintah Desa, BPD, dan Tokoh Masyarakat sebagaimana daftar hadir terlampir. Agenda kegiatan yang dilakukan: 1. Pembentukan Tim Perumus RPJM Desa, 2. Sosialisasi RPJM Desa dan Pelatihan Tim Perumus, 3. Rencana Kerja dan Tindak Lanjut (RKTL) Hasil kegiatan berupa Pembentukan Tim Perumus RPJM Desa sebagaimana terlampir. Demikian Berita Acara ini dibuat dengan penuh tanggungjawabagar dapat dipergunakan sebagaimana mestinya. Cijolang, ……………….………… 2015 Ketua BPD
Kepala Desa
(……………………………)
(……………………………)
Wakil/Tokoh Masyarakat
(……………………………)
PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
Lampiran Hasil Keputusan Musyawarah Pembentukan Tim Perumus RPJM Desa Cijolang: TIM PERUMUS RPJM Desa CIJOLANG 2015 No. 1 2 3 4 5 6 7 8 9 10 11
Nama Lili Ahmad Senjaya Yusuf Haeruman Apip Saepuloh Usep Oneng Ruslan, S.Pd.I. Eli Nuraeni, S.Pd. Ai Ela Wawan Heri Dadang
Alamat
Jabatan
Kp. Cijolang Kp. Pulosari Kp. Pulosari Kp. Cipicung Kp. Sudi Kp. Karya Laksana Kp. Cijolang Kp. Cisaat Kp. Cijolang Kp. Cijolang Kp. Cijolang
Ketua Sekretaris Anggota Anggota Anggota Anggota Anggota Anggota Anggota Anggota Anggota
Unsur Sekdes Ketua LPM Kaur Ekbang Anggota LPM Anggota TP PKK Tokoh Pemuda Anggota TP PKK Anggota TP PKK Tokoh Masyarakat Tokoh Pemuda Tokoh Masyarakat
Cijolang, ……………….………… 2015 Ketua BPD
(……………………………)
Kepala Desa
(……………………………)
PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
NOTULA MUSYAWARAH Jenis Kegiatan Hari / Tgl Pelaksanaan Tempat Pelaksanaan Peserta Yang Hadir
: ............................................................................................ : ............................................................................................ : ............................................................................................ : Laki-laki ________ Orang, Perempuan ______ Orang : Jumlah ________ Orang
............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ...............................................................................................................................................................
PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... 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PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... 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PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... 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PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
DAFTAR HADIR
No.
Acara pelaksanann
: ..................................................................................................
Hari / Tanggal pelaksanaan
: ..................................................................................................
Tempat pelaksanaan
: ..................................................................................................
Nama
Jenis Kelamin L
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
P
Jabatan
Alamat
Tanda Tangan
PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 44 45 46 47 48 49 50
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
BERITA ACARA PEMBENTUKAN TIM PERUMUS RPJM DESA Berkaitan dengan pelaksanaan musyawarah RPJM Desa di Desa Cijolang kecamatan Bl. Limbangan kabupaten/kota Garut provinsi Jawa barat dalam rangka penyusunan rancangan RPJM - Desa, maka pada hari ini : Hari dan Tanggal Jam Tempat
: …………………………………. : …………………………………. : ………………………………….
telah diselesaikan pembentukan Tim Perumus RPJM Desa oleh Pemerintah Desa, BPD, dan Tokoh Masyarakat sebagaimana daftar hadir terlampir. Agenda kegiatan yang dilakukan: 1. Pembentukan Tim Perumus RPJM Desa, 2. Sosialisasi RPJM Desa dan Pelatihan Tim Perumus, 3. Rencana Kerja dan Tindak Lanjut (RKTL) Hasil kegiatan berupa Pembentukan Tim Perumus RPJM Desa sebagaimana terlampir. Demikian Berita Acara ini dibuat dengan penuh tanggungjawabagar dapat dipergunakan sebagaimana mestinya. Cijolang, ……………….………… 2015 Ketua BPD
Kepala Desa
(……………………………)
(……………………………)
Wakil/Tokoh Masyarakat
(……………………………)
PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
Lampiran Hasil Keputusan Musyawarah Pembentukan Tim Perumus RPJM Desa Cijolang: TIM PERUMUS RPJM Desa CIJOLANG 2015 No. 1 2 3 4 5 6 7 8 9 10 11
Nama Lili Ahmad Senjaya Yusuf Haeruman Apip Saepuloh Usep Oneng Ruslan, S.Pd.I. Eli Nuraeni, S.Pd. Ai Ela Wawan Heri Dadang
Alamat
Jabatan
Kp. Cijolang Kp. Pulosari Kp. Pulosari Kp. Cipicung Kp. Sudi Kp. Karya Laksana Kp. Cijolang Kp. Cisaat Kp. Cijolang Kp. Cijolang Kp. Cijolang
Ketua Sekretaris Anggota Anggota Anggota Anggota Anggota Anggota Anggota Anggota Anggota
Unsur Sekdes Ketua LPM Kaur Ekbang Anggota LPM Anggota TP PKK Tokoh Pemuda Anggota TP PKK Anggota TP PKK Tokoh Masyarakat Tokoh Pemuda Tokoh Masyarakat
Cijolang, ……………….………… 2015 Ketua BPD
(……………………………)
Kepala Desa
(……………………………)
PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
NOTULA MUSYAWARAH Jenis Kegiatan Hari / Tgl Pelaksanaan Tempat Pelaksanaan Peserta Yang Hadir
: ............................................................................................ : ............................................................................................ : ............................................................................................ : Laki-laki ________ Orang, Perempuan ______ Orang : Jumlah ________ Orang
............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ...............................................................................................................................................................
PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... 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PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... 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PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... 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PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
DAFTAR HADIR
No.
Acara pelaksanann
: ..................................................................................................
Hari / Tanggal pelaksanaan
: ..................................................................................................
Tempat pelaksanaan
: ..................................................................................................
Nama
Jenis Kelamin L
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
P
Jabatan
Alamat
Tanda Tangan
PEMERINTAH KABUPATEN GARUT
KECAMATAN BL. LIMBANGAN
DESA CIJOLANG Jl. Desa Cijolang No.1, Kp Cijolang RT. 01 RW. 01 Kec. Bl. Limbangan - Garut
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 44 45 46 47 48 49 50
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