Data Pegawai.docx
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A. DATA PEGAWAI Nama Pegawai NIP / NIK NPWP Alamat Pangkat/Gol Jabatan Jenis Kelamin Status Jumlah Anak Masa Penghasilan Tambahan Gaji 13 Kenaikan Gaji Berkala Perubahan Tunjangan Struktural / Fungsional Bulan Mulai Perubahan KGB / Tunjangan
: : : : : : : : : : : :
........................................................................ ........................................................................ ........................................................................ ........................................................................ ........................................................................ ........................................................................ ........................................................................ ........................................................................ .................................................................................. .................................................................................. Ya / Tidak Ya / Tidak
: Ya / Tidak : ..................................................................................
B. DATA GAJI 1 (SATU) BULAN 1. Gaji Pokok : ........................................................................ 2. Tunjangan Struktural / : ........................................................................ Fungsional 3. Tunjangan Khusus : ........................................................................ C. KENAIKAN GAJI BERKALA DAN TUNJANGAN STRUKTURAL / FUNGSIONAL 1. Nilai Kenaikan KGB (Selisih Dari gaji pokok lama) : ........................................................................ 2. Nilai kenaikan Tunjangan (Selisih dari tunjangan lama) : ........................................................................
1. 2.
3. 4. 5.
1. 2.
3. 4. 5.
D. DAFTAR HARTA KE 1 Jenis Harta Uraian (lokasi, luas, Tanah/bangunan;merek, Tahun pembuatan, dll) Tahun Perolehan Harga Perolehan Keterangan (NOP tanah dan Bangunan, No BPKB Kendaraan) E. DAFTAR HARTA KE 2 Jenis Harta Uraian (lokasi, luas, Tanah/bangunan;merek, Tahun pembuatan, dll) Tahun Perolehan Harga Perolehan Keterangan (NOP tanah dan Bangunan, No BPKB Kendaraan)
: ........................................................................ : ........................................................................ : ........................................................................ : ........................................................................ : ........................................................................
: ........................................................................ : ........................................................................ : ........................................................................ : ........................................................................ : ........................................................................
A. DATA PEGAWAI Nama Pegawai NIP / NIK NPWP Alamat Pangkat/Gol Jabatan Jenis Kelamin Status Jumlah Anak Masa Penghasilan Tambahan Gaji 13 Kenaikan Gaji Berkala Perubahan Tunjangan Struktural / Fungsional Bulan Mulai Perubahan KGB / Tunjangan
: : : : : : : : : : : :
........................................................................ ........................................................................ ........................................................................ ........................................................................ ........................................................................ ........................................................................ ........................................................................ ........................................................................ .................................................................................. .................................................................................. Ya / Tidak Ya / Tidak
: Ya / Tidak : ..................................................................................
B. DATA GAJI 1 (SATU) BULAN 1. Gaji Pokok : ........................................................................ 2. Tunjangan Struktural / : ........................................................................ Fungsional 3. Tunjangan Khusus : ........................................................................ C. KENAIKAN GAJI BERKALA DAN TUNJANGAN STRUKTURAL / FUNGSIONAL 1. Nilai Kenaikan KGB (Selisih Dari gaji pokok lama) : ........................................................................ 2. Nilai kenaikan Tunjangan (Selisih dari tunjangan lama) : ........................................................................
1. 2.
3. 4. 5.
1. 2.
3. 4. 5.
D. DAFTAR HARTA KE 1 Jenis Harta Uraian (lokasi, luas, Tanah/bangunan;merek, Tahun pembuatan, dll) Tahun Perolehan Harga Perolehan Keterangan (NOP tanah dan Bangunan, No BPKB Kendaraan) E. DAFTAR HARTA KE 2 Jenis Harta Uraian (lokasi, luas, Tanah/bangunan;merek, Tahun pembuatan, dll) Tahun Perolehan Harga Perolehan Keterangan (NOP tanah dan Bangunan, No BPKB Kendaraan)
: ........................................................................ : ........................................................................ : ........................................................................ : ........................................................................ : ........................................................................
: ........................................................................ : ........................................................................ : ........................................................................ : ........................................................................ : ........................................................................
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