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PEMERINTAH KABUPATEN JEPARA

ORGANISASI PERANGKAT DAERAH


Jl. …………. No. ….. Telp. Fax. …….
Kode Pos…….. website………. e-mail……

Kepada
Yth. ${jabatan_tujuan}

di –
...................................

SURAT PENGANTAR
Nomor : ${nomor_naskah}

No Jenis yang dikirim Banyaknya Keterangan

Tempat, ${tanggal_naskah}
${jabatan_pengirim}
${ttd_pengirim}
${nama_pengirim}
Pangkat
NIP ${nip_pengirim}

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