data arsip surat bawah nikah
1
PEMERINTAH KABUPATEN PEMALANG KECAMATAN RANDUDONGKAL DESA RANDUDONGKAL DATA DAN ARSIP SURAT BAWAH NIKAH No Lapor Hari Tanggal Bulan Tahun Akan menumpang nikah di Desa ................................................................... RT ...... RW ........... Kecamatan ......................................................... Kab .............................. Prov .......................... I. Calon Suami 1. Nama Lengkap dan alias : .................................................................................................. 2. Bin : .................................................................................................. 3. Tempat & Tgl Lahir : .................................................................................................. 4. Warganegara : .................................................................................................. 5. Agama : .................................................................................................. 6. Pekerjaan : .................................................................................................. 7. Tempat Tinggal : .................................................................................................. 8. Nama Ibu : .................................................................................................. 9. Status : .................................................................................................. II. Calon Istri 1. Nama Lengkap dan alias : .................................................................................................. 2. Bin : .................................................................................................. 3. Tempat & Tgl Lahir : .................................................................................................. 4. Warganegara : .................................................................................................. 5. Agama : .................................................................................................. 6. Pekerjaan : .................................................................................................. 7. Tempat Tinggal : .................................................................................................. 8. Nama Ibu : .................................................................................................. 9. Status : .................................................................................................. DATA DAN ARSIP SURAT BAWAH NIKAH No Lapor Hari Tanggal Bulan Tahun Akan menumpang nikah di Desa ................................................................... RT ...... RW ........... Kecamatan ......................................................... Kab .............................. Prov .......................... I. Calon Suami 1. Nama Lengkap dan alias : .................................................................................................. 2. Bin : .................................................................................................. 3. Tempat & Tgl Lahir : .................................................................................................. 4. Warganegara : .................................................................................................. 5. Agama : .................................................................................................. 6. Pekerjaan : .................................................................................................. 7. Tempat Tinggal : .................................................................................................. 8. Nama Ibu : .................................................................................................. 9. Status : .................................................................................................. II. Calon Istri 1. Nama Lengkap dan alias : .................................................................................................. 2. Bin : .................................................................................................. 3. Tempat & Tgl Lahir : .................................................................................................. 4. Warganegara : .................................................................................................. 5. Agama : .................................................................................................. 6. Pekerjaan : .................................................................................................. 7. Tempat Tinggal : .................................................................................................. 8. Nama Ibu : .................................................................................................. 9. Status : .................................................................................................. Pembatu Pegawai Pencatat Nikah (P3N) Randudongkal RT 01-19 & 63 (Kemiri Sewu) (Muhammad Bilalludin)
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PEMERINTAH KABUPATEN PEMALANG
KECAMATAN RANDUDONGKAL
DESA RANDUDONGKAL
DATA DAN ARSIP SURAT BAWAH NIKAH
No Lapor Hari Tanggal Bulan Tahun
Akan menumpang nikah di Desa ................................................................... RT ...... RW ........... Kecamatan ......................................................... Kab .............................. Prov ..........................
I. Calon Suami
1. Nama Lengkap dan alias : .................................................................................................. 2. Bin : .................................................................................................. 3. Tempat & Tgl Lahir : .................................................................................................. 4. Warganegara : .................................................................................................. 5. Agama : .................................................................................................. 6. Pekerjaan : .................................................................................................. 7. Tempat Tinggal : .................................................................................................. 8. Nama Ibu : .................................................................................................. 9. Status : ..................................................................................................
II. Calon Istri 1. Nama Lengkap dan alias : .................................................................................................. 2. Bin : .................................................................................................. 3. Tempat & Tgl Lahir : .................................................................................................. 4. Warganegara : .................................................................................................. 5. Agama : .................................................................................................. 6. Pekerjaan : .................................................................................................. 7. Tempat Tinggal : .................................................................................................. 8. Nama Ibu : .................................................................................................. 9. Status : ..................................................................................................
DATA DAN ARSIP SURAT BAWAH NIKAH
No Lapor Hari Tanggal Bulan Tahun
Akan menumpang nikah di Desa ................................................................... RT ...... RW ........... Kecamatan ......................................................... Kab .............................. Prov ..........................
I. Calon Suami 1. Nama Lengkap dan alias : .................................................................................................. 2. Bin : .................................................................................................. 3. Tempat & Tgl Lahir : .................................................................................................. 4. Warganegara : .................................................................................................. 5. Agama : .................................................................................................. 6. Pekerjaan : .................................................................................................. 7. Tempat Tinggal : .................................................................................................. 8. Nama Ibu : .................................................................................................. 9. Status : ..................................................................................................
II. Calon Istri 1. Nama Lengkap dan alias : .................................................................................................. 2. Bin : .................................................................................................. 3. Tempat & Tgl Lahir : .................................................................................................. 4. Warganegara : .................................................................................................. 5. Agama : .................................................................................................. 6. Pekerjaan : .................................................................................................. 7. Tempat Tinggal : .................................................................................................. 8. Nama Ibu : .................................................................................................. 9. Status : ..................................................................................................
Pembatu Pegawai Pencatat Nikah (P3N)
Randudongkal RT 01-19 & 63 (Kemiri Sewu)
(Muhammad Bilalludin)
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