Form Pendataan Kendaraan Bermotor Asn.xlsx
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PENDATAAN KENDARAAN BERMOTOR APARATUR SIPIL NEGARA (ASN) NO.
NAMA ASN
ALAMAT
NIP
GOL
NIK/KTP
IDENTITAS KENDARAAN NOPOL NAMA SESUAI STNK
MASA LAKU PAJAK
CATATAN : 1. Melampirkan Foto Copy KTP ASN 2. Melampirkan Foto Copy STNK 3. Melampirkan Foto Copy Buku Tabungan Bank NTB 4. Identitas Kendaraan Diisi Berdasarkan Jumlah Kendaraan yang Dimiliki dan/atau Dikuasai oleh ASN
BERMOTOR APARATUR SIPIL NEGARA (ASN) NO HP AKTIF
TANDA TANGAN
NAMA ASN
ALAMAT
NIP
GOL
NIK/KTP
IDENTITAS KENDARAAN NOPOL NAMA SESUAI STNK
MASA LAKU PAJAK
CATATAN : 1. Melampirkan Foto Copy KTP ASN 2. Melampirkan Foto Copy STNK 3. Melampirkan Foto Copy Buku Tabungan Bank NTB 4. Identitas Kendaraan Diisi Berdasarkan Jumlah Kendaraan yang Dimiliki dan/atau Dikuasai oleh ASN
BERMOTOR APARATUR SIPIL NEGARA (ASN) NO HP AKTIF
TANDA TANGAN
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