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langfe1033 \langfenp1033 \alang1025 Kepdirjen Bimas Islam Nomor 473 Tahun 2020}{\
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lin357 \rin0 \intbl \itap1 \ls1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \langnp1033 \
langfe1033 \langfenp1033 \alang1025 {\listtext \pard \plain \rtlch \fcs1 \af5 \
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2 1.\tab }{\
Nama}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
\cell }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum
\faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \
fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \
fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1057 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1 \af6 \afs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \
s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \
adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \
\langfe1033 \langfenp1033 \alang1025 \caps1 RIZAL AJI ARI WIBOWO}{\rtlch \fcs1 \af6
\afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \
loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 \cell }\
pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \
rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
ltrch \dbch \af0 \hich \af0 \loch \af0 \lang1033 \langnp1033 \langfe1033 \
langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \trautofit1 \
trwWidth10139 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \trpaddr108 \
trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \brdrnone \clbrdrr \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth4503 \clftsWidth3
\cellx4393 \clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
cltxlrtb \clwWidth5353 \clftsWidth3 \cellx10031 \row }\pard \plain \s29 \qj \fi-357
\li357 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \
Nomor Induk Kependudukan (NIK)}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \qj \li0 \ri0 \sl276 \
slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \intbl \
alang1025 :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \cell }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \
aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \
fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025
3521132511990001}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \
langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \
aspalpha \faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \
ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af0 \loch \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \
trleft-108 \trautofit1 \trwWidth10139 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \
trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalt \
cltxlrtb \clwWidth4503 \clftsWidth3 \cellx4393 \clvertalt \clbrdrl \brdrnone \
clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth283 \
clftsWidth3 \cellx4680 \clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth5353 \clftsWidth3 \cellx10031 \
row }\pard \plain \s29 \qj \fi-357 \li357 \ri0 \sl276 \slmult1 \widctlpar \aspalpha
\aspnum \faroman \adjustright \lin357 \rin0 \intbl \itap1 \ls1 \rtlch \fcs1 \af5 \
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \pard \
plain \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
alang1025 \f2 3.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch
\alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1033 \langnp1033 \
langfe1033 \langfenp1033 \alang1025 Jenis Kelamin}{\rtlch \fcs1 \af6 \afs22 \
langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \qj \li0 \ri0 \
sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \
intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 Laki-laki}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \widctlpar \
hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \
loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\trowd \
trql \trgaph0 \trleft-108 \trautofit1 \trwWidth10139 \trftsWidth3 \trftsWidthB3 \
trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \
clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \
brdrnone \cltxlrtb \clwWidth4503 \clftsWidth3 \cellx4393 \clvertalt \clbrdrl \
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \
clwWidth283 \clftsWidth3 \cellx4680 \clvertalt \clbrdrl \brdrnone \clbrdrr \
\cellx10031 \row }\pard \plain \s29 \qj \fi-357 \li357 \ri0 \sl276 \slmult1 \
widctlpar \aspalpha \aspnum \faroman \adjustright \lin357 \rin0 \intbl \itap1 \
ls1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0
\hich \af4 \loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\
listtext \pard \plain \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
\ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \langnp1033 \langfe1033 \
langfenp1033 \alang1025 \f2 4.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Tempat dan tanggal lahir}{\rtlch \fcs1 \af6 \
alang1025 Ngawi, 25-11-1999}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \fcs1 \af6 \afs22 \
alang1025 WNI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
alang1025 \cell }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \
trautofit1 \trwWidth10139 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \
trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth283 \
alang1025 \f2 6.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Agama}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
\af0 \hich \af4 \loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \
alang1025 ISLAM}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 Pekerjaan}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \fi-357
Pendidikan Terakhir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \fi-357 \li357 \ri0
\sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin357 \rin0 \
intbl \itap1 \ls1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 {\listtext \pard \plain \rtlch \fcs1 \af5 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2 9.\tab }{\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Bin/Binti}{\rtlch \fcs1 \
loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \
plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \ri0 \sl276 \
alang1025 \par }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 :}{\
cell }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
aspnum \faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22
\ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 KARYAWAN SWASTA}{\rtlch \
af4 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \par }\
pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 SLTA/Sederajat}{\rtlch \fcs1 \af6 \
qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \
lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 SAMINO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \widctlpar \
langfe1033 \langfenp1033 \alang1025 Alamat}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
aspalpha \aspnum \faroman
\adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22
\rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \langnp1033 \
langfe1033 \langfenp1033 \alang1025 Dsn. Kedungmiri RT 003 RW 006, Desa Sambirejo,
Kecamatan Mantingan, Kabupaten Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Status Perkawinan}{\rtlch \fcs1 \af6 \afs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \
loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \
}\pard \plain \s29 \qj \fi-360 \li717 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
aspnum \faroman \adjustright \lin717 \rin0 \intbl \itap1 \ls2 \rtlch \fcs1 \af5 \
alang1025 \f2 a.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Laki-laki }{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \af6 \afs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 : Jejaka, Duda atau
beristri ke 1}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
alang1025 \par }\pard \plain \s29 \qj \fi-360 \li717 \ri0 \sl276 \slmult1 \
langfenp1033 \alang1025 \f2 b.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Perempuan}{\rtlch \fcs1 \af6 \afs22 \ltrch \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 : Perawan, Janda}{\
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \ri0 \sl276 \
alang1025 Jejaka}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \
hich \af4 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 -}{\
cell }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
\langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \trautofit1 \
trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3
\clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \
langfe1033 \langfenp1033 \alang1025 Nama isteri / suami terdahulu}{\rtlch \fcs1 \
row }\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trwWidth10139 \trftsWidth3 \
trftsWidthB3 \trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3
\trpaddfr3 \clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
clbrdrb \brdrnone \cltxlrtb \clwWidth10137 \clftsWidth3 \cellx10031 \pard \plain \
langfe1033 \langfenp1033 \alang1025 Adalah benar-benar anak dari perkawinan seorang
pria :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
clwWidth10137 \clftsWidth3 \cellx10031 \row }\trowd \trql \trgaph0 \trleft-108 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Nama Lengkap}{\rtlch \fcs1 \af6 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 }{\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 dan alias}{\rtlch \fcs1 \
plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1
SAMINO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \caps1 \cell }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-
108 \trautofit1 \trwWidth10139 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \trpaddl108
\trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \
row }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Nomor Induk Kependudukan (NIK)}{\
rtlch \fcs1 \af6 \afs22 \ltrch
\fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1057 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 35211319046700014}{\rtlch \fcs1 \
alang1025 {\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trwWidth10139 \
cltxlrtb \clwWidth5353 \clftsWidth3 \cellx10031 \row }\pard \plain \s29 \qj \li0 \
ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \
langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \intbl \
alang1025 \cell }\pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Ngawi, 19 April 1967}{\rtlch \
af4 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\
langnp1057 \langfe1033 \langfenp1033 \alang1025 WNI}{\rtlch \fcs1 \af6 \afs22 \
cell }\pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \
langfe1033 \langfenp1033 \alang1025 ISLAM}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\cellx10031 \row }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Pekerjaan}
{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \
lin0
\rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
WIRASWASTA}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Alamat}{\rtlch \fcs1 \af6 \afs22 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Dsn. Kedungmiri RT 003 RW 006, Desa
Sambirejo, Kecamatan Mantingan, Kabupaten Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \
widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \intbl \itap1 \
trowd \trql \trgaph0 \trleft-108 \trautofit1 \trwWidth10139 \trftsWidth3 \
clftsWidth3 \cellx10031 \row }\trowd \trql \trgaph0 \trleft-108 \trautofit1 \
clftsWidth3 \cellx10031 \pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \
dengan seorang wanita}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22
brdrnone \cltxlrtb \clwWidth10137 \clftsWidth3 \cellx10031 \row }\trowd \trql \
trgaph0 \trleft-108 \trautofit1 \trwWidth10139 \trftsWidth3 \trftsWidthB3 \
\cellx10031 \pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nama Lengkap}{\rtlch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 }{\
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 dan
alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
\cell }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch
alang1025 \caps1 MAREM}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \caps1 \cell }\pard \plain \li0 \ri0 \widctlpar
\hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \
clwWidth283 \clftsWidth3 \cellx4680 \clvertalt \clbrdrl \brdrnone
\clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth5353 \
clftsWidth3 \cellx10031 \row }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \
langfe1033 \langfenp1033 \alang1025 3521135510700002}{\rtlch \fcs1 \af6 \afs22 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Ngawi, 15 Oktober 1970}{\rtlch \
langfe1033 \langfenp1033 \alang1025 ISLAM}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
fs22 \rtlch \alang1025
\ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Pekerjaan}{\rtlch \fcs1 \af6 \afs22
langnp1057 \langfe1033 \langfenp1033 \alang1025 WIRASWASTA}{\rtlch \fcs1 \af6 \
aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \
af4 \loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \
adjustright \lin0 \rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Demikian surat pengantar
ini dibuat dengan mengingat sumpah jabatan dan untuk dipergunakan sebagaimana
mestinya.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
adjustright \lin6480 \rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Kedungprahu, 02 Desember 2024}{\rtlch \fcs1 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \
plain \s29 \qj \li6480 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langfe1024 \langfenp1024 \alang1025 {\shp {\*\shpinst \shpleft919 \shptop212 \
shpright2149 \shpbottom1442 \shpfhdr0 \shpbxcolumn \shpbxignore \shpbypara \
shpbyignore \shpwr3 \shpwrk0 \shpfblwtxt0 \shpz0 \shplid1026 {\sp {\sn shapeType}{\
sv 75}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn
fLockAgainstGrouping}{\sv 0}}{\sp {\sn fLockVerticies}{\sv 0}}{\sp {\sn
fLockAspectRatio}{\sv 1}}{\sp {\sn fLockRotation}{\sv 0}}{\sp {\sn WrapText}{\sv
0}}{\sp {\sn pib}{\sv {\pict \piccropl0 \piccropr0 \piccropt0 \piccropb0 \
picscalex100 \picscaley100 \picw82 \pich82 \picwgoal1230 \pichgoal1230 \pngblip {\
*\blipuid
b8e907a2b8e907a2b8e907a2b8e907a2}89504e470d0a1a0a0000000d49484452000000320000003208
02000000915d1fe600000300504c5445000000ff000000ff00ffff000000ffff00ff00ffffffffffdbd
bdbb6b6b69292926d6d6d494949242424db0000b600009200006d000049000024000000db0000b60000
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000
db0000b600009200006d000049000024db00dbb600b69200926d006d49004924002400dbdb00b6b6009
292006d6d004949002424ffdbdbdbb6b6b69292926d6d6d4949492424ffb6b6db9292b66d6d9249496d
2424ff9292db6d6db64949922424ff6d6ddb4949b62424ff4949db2424ff2424dbffdbb6dbb692b6926
d926d496d49244924b6ffb692db926db66d499249246d2492ff926ddb6d49b6492492246dff6d49db49
24b62449ff4924db2424ff24dbdbffb6b6db9292b66d6d9249496d242449b6b6ff9292db6d6db649499
224246d9292ff6d6ddb4949b62424926d6dff4949db2424b64949ff2424db2424ffffffdbdbdbb6b6b6
9292926d6d6d49494924ffffb6dbdb92b6b66d9292496d6d24ffff92dbdb6db6b649929224ffff6ddbd
b49b6b624ffff49dbdb24ffff24ffdbffdbb6dbb692b6926d926d496d492449ffb6ffdb92dbb66db692
49926d246dff92ffdb6ddbb649b6922492ff6dffdb49dbb624b6ff49ffdb24dbff24ffdbffffb6dbdb9
2b6b66d9292496d6d244949b6ffff92dbdb6db6b6499292246d6d92ffff6ddbdb49b6b62492926dffff
49dbdb24b6b649ffff24dbdb24ffffffdbb6dbb692b6926d926d496d4924492400ffb692db926db66d4
99249246d2400ffb6dbdb92b6b66d9292496d6d2449490024ff92b6db6d92b6496d9224496d0024dbb6
ffb692db926db66d499249246d240049b692ff926ddb6d49b649249224006db6dbff92b6db6d92b6496
d9224496d00244992b6ff6d92db496db624499200246db6ffdb92dbb66db69249926d246d4900492492
ffb66ddb9249b66d249249006d24dbffb6b6db9292b66d6d9249496d24244900b6ff9292db6d6db6494
99224246d00ffb600db9200b66d00924900ff00b6db0092b6006d92004900b6ff0092db006db6004992
000000000000cf2a02040000003b4944415458c3edce31010000080320b57fe799c0df0312d049ea9fa
997b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b42e0b01280361842f17250000
000049454e44ae426082}}}{\sp {\sn fLineOK}{\sv 1}}{\sp {\sn f3DOK}{\sv 0}}{\sp {\sn
fShadowOK}{\sv 1}}{\sp {\sn fFilled}{\sv 0}}{\sp {\sn lineStyle}{\sv 0}}{\sp {\sn
fLine}{\sv 0}}{\sp {\sn wzName}{\sv Picture 1}}{\sp {\sn fLayoutInCell}{\sv 0}}}{\
shprslt {\pict }}}}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 Kepala Desa Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li6480
\ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin6480 \rin0 \
tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li6480 \ri0 \sl276
\slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin6480 \rin0 \tql \tx284 \
tql \tx3969 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 SUNARTO}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \ri0 \widctlpar \
hyphpar0 \aspalpha \aspnum \faauto \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \
af0 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \page }{\
}\pard \plain \s29 \fi194 \li5760 \ri-283 \widctlpar \aspalpha \aspnum \adjustright
\lin5760 \rin-283 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Lampiran VI}{\rtlch \fcs1 \af6 \afs18 \ltrch \
langnp14345 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \fi194 \
li5760 \ri-425 \widctlpar \aspalpha \aspnum \adjustright \lin5760 \rin-425 \itap0 \
Kepdirjen Bimas Islam Nomor 473 Tahun 2020}{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \fi194 \li5760 \ri-283
\widctlpar \aspalpha \aspnum \adjustright \lin5760 \rin-283 \itap0 \rtlch \fcs1 \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tentang }
}\pard \plain \s29 \li5954 \ri0 \widctlpar \aspalpha \aspnum \adjustright \
lin5954 \rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Petunjuk Teknis Pelaksanaan Pencatatan Nikah}{\
}\pard \plain \s29 \qc \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
alang1025 \par }\pard \plain \s29 \fi720 \li7797 \ri0 \widctlpar \aspalpha \
fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Model N2}{\rtlch \fcs1 \af6 \
afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \
f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \
s29 \fi720 \li7920 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin7920 \rin0 \
aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx284 \itap0 \rtlch \fcs1 \af5 \
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033
\alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 Perihal}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 : Permohonan Kehendak Nikah}{\rtlch \fcs1 \af6
\afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \
f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \
af4 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \tab }{\
Padas, 02 Desember 2024}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx284 \itap0 \
}\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
adjustright \lin0 \rin0 \tql \tx284 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \
ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \tql \
tx284 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 Kepada Yth.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
Kepala }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
alang1025 K}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 UA Kecamatan/PPN LN}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 di }
Padas}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
\par }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
aspnum \adjustright \lin0 \rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \
rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx851 \tql \
tx3969 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
\langfe1033 \langfenp1033 \alang1025 Dengan hormat, kami mengajukan}{\rtlch \fcs1 \
loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 permohonan}{\
kehendak nikah untuk atas nama:}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch
\langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \
widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx2410 \itap0 \rtlch \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Calon
Suami }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 : }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \caps1 RIZAL AJI ARI WIBOWO}{\rtlch \fcs1 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 }{\rtlch \fcs1
\f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \
s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
rin0 \tql \tx2410 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Calon Isteri }{\rtlch \fcs1 \af6 \afs22 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : }{\rtlch \
DITA SETIANI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
Hari/tanggal/jam}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
ltrch
langfe1033 \langfenp1033 \alang1025 Minggu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 / }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 22 Desember 2024}{\rtlch \fcs1 \af6 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 / }{\rtlch \fcs1 \af6 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 08:00}{\rtlch \fcs1 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 WIB }{\rtlch \
langnp14345 \langfe1033 \langfenp1033 \alang1025 Tempat akad nikah}{\rtlch \fcs1 \
loch \f6 \lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch
\fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6
\loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : }{\rtlch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 RT 004 /
RW 003 Dusun Mugu Raya}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
Maskawin}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfenp1033 \alang1025 : .....................................}{\rtlch \fcs1 \
plain \s29 \qj \li0 \ri0 \sb120 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
\langfe1033 \langfenp1033 \alang1025 Bersama ini kami sampaikan surat-surat yang
diperlukan untuk diperiksa sebagai berikut :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
\li360 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin360 \rin0
\itap0 \ls3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 {\listtext \pard \plain \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 \f2 1.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Surat Pengantar Nikah dari Desa /
Kelurahan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
widctlpar \aspalpha \aspnum \adjustright \lin360 \rin0 \itap0 \ls3 \rtlch \fcs1 \
loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \
pard \plain \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfe1033 \langfenp1033 \alang1025 Persetujuan Calon Mempelai}{\rtlch \fcs1 \af6 \
qj \fi-360 \li360 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \
lin360 \rin0 \itap0 \ls3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfenp1033 \alang1025 {\listtext \pard \plain \rtlch \fcs1 \af5 \afs22 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Fotokopi KTP
Elektronik /Suket}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \fi-360 \li360 \ri0 \sl276 \
slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin360 \rin0 \itap0 \ls3 \
langfe1033 \langfenp1033 \alang1025 Fotokopi Akta Kelahiran}{\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Fotokopi Kartu Keluarga
(KK)}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
\par }\pard \plain \s29 \qj \fi-360 \li360 \ri0 \sl276 \slmult1 \widctlpar \
aspalpha \aspnum \adjustright \lin360 \rin0 \itap0 \ls3 \rtlch \fcs1 \af5 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \pard \plain \
hich \af4 \loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2
6.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
alang1025 Fotokopi Ijazah Terakhir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
\sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin360 \rin0 \itap0 \ls3
\ltrch \dbch \af0 \hich \af4
\loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2 7.\tab }
Paspoto ukuran 2x3 dan 4x6 sebanyak 4 lembar berlatar belakang warna biru}{\rtlch \
pard \plain \s29 \qj \fi-360 \li360 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
aspnum \adjustright \lin360 \rin0 \itap0 \ls3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0
\fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \pard \plain \rtlch \
af4 \loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2 8.\
tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
af0 \hich \af6 \loch \f6 \lang14345 \langnp14345 \langfe1033 \langfenp1033 \
alang1025 Fotokopi KTP Elektronik Ayah dan Ibu calon pengantin}{\rtlch \fcs1 \af6 \
lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29
\qj \fi-360 \li360 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \
lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 Surat izin orangtua
(N5) bila umur kurang 21 Tahun *)}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Surat Keterangan Kematian Suami/Istri (N6) bila
Duda/Janda Mati *)}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 Akta Cerai bila Duda/Janda Hidup *)}{\rtlch \
aspnum \adjustright \lin360 \rin0 \itap0 \ls3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0
\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\
uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230
?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1
\u8230 ?}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfe1033 \langfenp1033 \alang1025 \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?}{\
adjustright \lin360 \rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch
\alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \langnp1033 \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \fi720 \li0 \ri0 \
Demikian permohonan ini kami sampaikan, kiranya dapat diperiksa, dihadiri dan
dicatat sesuai dengan ketentuan peraturan perundang-undangan.}{\rtlch \fcs1 \af6 \
qj \fi720 \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0
\rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \par }\pard \plain \s29 \qj \fi720 \li0 \ri0 \sl276 \slmult1 \widctlpar \
aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \
fi720 \li5760 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li851 \ri0 \
rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
alang1025 Diterima tanggal \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1
\u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?..}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
\langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 Wassalam,}{\rtlch \fcs1 \af6 \afs22 \ltrch \
li851 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin851 \
alang1025 Yang menerima,}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 Pemohon}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
alang1025 Kepala KUA/}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 PPN }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 LN,}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li851 \ri0 \sl276
\slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin851 \rin0 \itap0 \rtlch \
?\uc1 \u8230 ?\uc1 \u8230 ?}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1057 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 RIZAL AJI ARI WIBOWO}{\rtlch
\fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \
hich \af4 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \tab
}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \
\langfenp1024 \alang1025 {\shp {\*\shpinst \shpleft4650 \shptop281 \shpright5880 \
shpbottom1511 \shpfhdr0 \shpbxcolumn \shpbxignore \shpbypara \shpbyignore \shpwr3 \
shpwrk0 \shpfblwtxt0 \shpz1 \shplid1027 {\sp {\sn shapeType}{\sv 75}}{\sp {\sn
fFlipH}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}{\sp
{\sn fLockVerticies}{\sv 0}}{\sp {\sn fLockAspectRatio}{\sv 1}}{\sp {\sn
fLockRotation}{\sv 0}}{\sp {\sn WrapText}{\sv 0}}{\sp {\sn pib}{\sv {\pict \
piccropl0 \piccropr0 \piccropt0 \piccropb0 \picscalex100 \picscaley100 \picw82 \
pich82 \picwgoal1230 \pichgoal1230 \pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
00049000024db00dbb600b69200926d006d49004924002400dbdb00b6b6009292006d6d004949002424
ffdbdbdbb6b6b69292926d6d6d4949492424ffb6b6db9292b66d6d9249496d2424ff9292db6d6db6494
9922424ff6d6ddb4949b62424ff4949db2424ff2424dbffdbb6dbb692b6926d926d496d49244924b6ff
b692db926db66d499249246d2492ff926ddb6d49b6492492246dff6d49db4924b62449ff4924db2424f
f24dbdbffb6b6db9292b66d6d9249496d242449b6b6ff9292db6d6db649499224246d9292ff6d6ddb49
49b62424926d6dff4949db2424b64949ff2424db2424ffffffdbdbdbb6b6b69292926d6d6d49494924f
fffb6dbdb92b6b66d9292496d6d24ffff92dbdb6db6b649929224ffff6ddbdb49b6b624ffff49dbdb24
ffff24ffdbffdbb6dbb692b6926d926d496d492449ffb6ffdb92dbb66db69249926d246dff92ffdb6dd
bb649b6922492ff6dffdb49dbb624b6ff49ffdb24dbff24ffdbffffb6dbdb92b6b66d9292496d6d2449
49b6ffff92dbdb6db6b6499292246d6d92ffff6ddbdb49b6b62492926dffff49dbdb24b6b649ffff24d
bdb24ffffffdbb6dbb692b6926d926d496d4924492400ffb692db926db66d499249246d2400ffb6dbdb
92b6b66d9292496d6d244
9490024ff92b6db6d92b6496d9224496d0024dbb6ffb692db926db66d499249246d240049b692ff926d
db6d49b649249224006db6dbff92b6db6d92b6496d9224496d00244992b6ff6d92db496db6244992002
46db6ffdb92dbb66db69249926d246d4900492492ffb66ddb9249b66d249249006d24dbffb6b6db9292
b66d6d9249496d24244900b6ff9292db6d6db649499224246d00ffb600db9200b66d00924900ff00b6d
b0092b6006d92004900b6ff0092db006db6004992000000000000cf2a02040000003b4944415458c3ed
ce31010000080320b57fe799c0df0312d049ea9fa997b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b
4b4b4b4b4b4b4b4b42e0b01280361842f17250000000049454e44ae426082}}}{\sp {\sn fLineOK}
{\sv 1}}{\sp {\sn f3DOK}{\sv 0}}{\sp {\sn fShadowOK}{\sv 1}}{\sp {\sn fFilled}{\sv
0}}{\sp {\sn lineStyle}{\sv 0}}{\sp {\sn fLine}{\sv 0}}{\sp {\sn wzName}{\sv
Picture 3}}{\sp {\sn fLayoutInCell}{\sv 0}}}{\shprslt {\pict }}}}{\rtlch \fcs1 \af6
ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \
langfe1033 \langfenp1033 \alang1025 *) Coret bila tidak disertakan}{\rtlch \fcs1 \
plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \aspnum \faauto \adjustright \lin0 \
alang1025 \page }{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \s29 \fi194 \li5760 \ri-425 \widctlpar \
aspalpha \aspnum \adjustright \lin5760 \rin-425 \itap0 \rtlch \fcs1 \af5 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Lampiran VIII}{\rtlch \
pard \plain \s29 \fi194 \li5760 \ri-425 \widctlpar \aspalpha \aspnum \adjustright \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \cf13 \par }\pard \plain \s29 \
fi720 \li7920 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin7920 \rin0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Model N4}{\rtlch \fcs1 \af6 \
s29 \qc \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
alang1025 \ul1 \par }\pard \plain \s29 \qc \li0 \ri0 \sl276 \slmult1 \widctlpar \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 PERSETUJUAN CALON PENGANTIN}{\
\ul1 \par }\pard \plain \s29 \qc \li0 \ri0 \widctlpar \aspalpha \aspnum \
qc \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \rtlch \
pard \plain \s29 \qj \li0 \ri0
\sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Yang
bertanda tangan di bawah ini :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfenp1033 \alang1025 \f2 A.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \
\langfe1033 \langfenp1033 \alang1025 Calon suami :}{\rtlch \fcs1 \af6 \afs22 \ltrch
\fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\trowd \trql \
trgaph0 \trleft252 \trautofit1 \trwWidth9921 \trftsWidth3 \trftsWidthB3 \
\cellx10173 \pard \plain \s29 \qj \fi-360 \li349 \ri0 \sl276 \slmult1 \widctlpar \
aspalpha \aspnum \faroman \adjustright \lin349 \rin0 \intbl \itap1 \ls5 \ilvl3 \
langfe1033 \langfenp1033 \alang1025 Nama lengkap}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 }{\rtlch \fcs1 \af6 \afs22 \
\caps1 RIZAL AJI ARI WIBOWO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch
\langfenp1033 \alang1025 \cell }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \
trleft252 \trautofit1 \trwWidth9921 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \
\aspnum \faroman \adjustright \lin357 \rin0 \intbl \itap1 \ls5 \ilvl3 \rtlch \
af4 \loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\
langfe1033 \langfenp1033 \alang1025 Bin}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
trql \trgaph0 \trleft252 \trautofit1 \trwWidth9921 \trftsWidth3 \trftsWidthB3 \
ls5 \ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Nomor Induk Kependudukan}{\rtlch \
rtlch
\fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \
\aspnum \faroman \adjustright \lin357 \rin0 \intbl \itap1 \ls5 \ilvl3 \rtlch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Ngawi, 25-
11-1999}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft252 \trautofit1 \
lin357 \rin0 \intbl \itap1 \ls5 \ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \
Kewarganegaraan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1 \af6 \
langfe1033 \langfenp1033 \alang1025 WNI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Agama}{\rtlch \fcs1 \af6 \afs22 \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 ISLAM}{\
\langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft252 \trautofit1 \
cltxlrtb \clwWidth5778 \clftsWidth3
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 KARYAWAN
SWASTA}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
Alamat}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Status }{\rtlch \fcs1 \af6 \afs22 \
alang1025 \par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
alang1025 Dsn. Kedungmiri RT 003 RW 006, Desa Sambirejo, Kecamatan Mantingan,
Kabupaten Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
Jejaka}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
tx709 \tql \tx3828 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfenp1033 \alang1025 \f2 B.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Calon isteri :}{\rtlch \fcs1 \af6 \afs22 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\trowd \trql \trgaph0 \
pard \plain \s29 \qj \fi-357 \li357 \ri0 \sl276 \slmult1 \widctlpar \aspalpha
\aspnum \faroman \adjustright \lin357 \rin0 \intbl \itap1 \ls6 \ilvl3 \rtlch \fcs1
\af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \pard \
\caps1 DITA SETIANI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Bin}{\rtlch \fcs1 \af6 \afs22 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 SUKADI}{\rtlch \fcs1 \af6 \afs22 \
alang1025 {\trowd \trql \trgaph0 \trleft252 \trautofit1 \trwWidth9923 \
Nomor Induk Kependudukan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
Tempat dan tanggal lahir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
hyphpar0
\aspalpha \faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs24
\ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af0 \loch \af0 \
s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \
alang1025 Ngawi, 12 Maret 2000}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \fcs1 \
Agama}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
Islam}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
Pekerjaan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
Karyawan Swasta}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
aspalpha \faroman
\adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24
langnp1033 \langfe1033 \langfenp1033 \alang1025 Status}{\rtlch \fcs1 \af6 \afs22 \
hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 RT
004 RW 003 Desa Kedungprahu, Kecamatan Padas, Kabupaten Ngawi}{\rtlch \fcs1 \af6 \
qj \li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \
alang1025 Perawan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
row }\pard \plain \s29 \qj \li360 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum
\adjustright \lin360 \rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Menyatakan dengan sesungguhnya bahwa atas dasar
sukarela, dengan kesadaran sendiri, tanpa ada paksaan dari siapapun juga}{\rtlch \
af4 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 ,}{\
setuju untuk melangsungkan pernikahan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 .}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22
langfe1033 \langfenp1033 \alang1025 Demikian surat persetujuan ini dibuat untuk
digunakan seperlunya.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
alang1025
widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx284 \tql \tx3969 \
}\trowd \trql \trgaph0 \trleft567 \trautofit1 \trwWidth9748 \trftsWidth3 \
cltxlrtb \clwWidth4219 \clftsWidth3 \cellx10315 \pard \plain \s29 \qj \li0 \ri0 \
tql \tx284 \tql \tx3969 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \tql \
tx284 \tql \tx3969 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch
langfe1033 \langfenp1033 \alang1025 Calon Suami}{\rtlch \fcs1 \af6 \afs22 \ltrch \
rin0 \tql \tx284 \tql \tx3969 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \
\loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 \
aspnum \faroman \adjustright \lin0 \rin0 \tql \tx284 \tql \tx3969 \intbl \itap1 \
Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 , }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 02 Desember 2024}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
langfe1033 \langfenp1033 \alang1025 Calon Istri}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1
\af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \
clftsWidth3 \cellx10315 \row }\pard \plain \s29 \li5760 \ri-283 \widctlpar \
aspalpha \aspnum \adjustright \lin5760 \rin-283 \itap0 \rtlch \fcs1 \af5 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \
ri0 \widctlpar \hyphpar0 \aspalpha \aspnum \faauto \adjustright \lin0 \rin0 \
alang1025 {\shp {\*\shpinst \shpleft4485 \shptop884 \shpright5715 \shpbottom2114 \
shpfhdr0 \shpbxcolumn \shpbxignore \shpbypara \shpbyignore \shpwr3 \shpwrk0 \
shpfblwtxt0 \shpz2 \shplid1028 {\sp {\sn shapeType}{\sv 75}}{\sp {\sn fFlipH}{\sv
0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}{\sp {\sn
fLockVerticies}{\sv 0}}{\sp {\sn fLockAspectRatio}{\sv 1}}{\sp {\sn fLockRotation}
{\sv 0}}{\sp {\sn WrapText}{\sv 0}}{\sp {\sn pib}{\sv {\pict \piccropl0 \
piccropr0 \piccropt0 \piccropb0 \picscalex100 \picscaley100 \picw82 \pich82 \
picwgoal1230 \pichgoal1230 \pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
92b6b66d9292496d6d2449490024ff92b6db6d92b6496d9224496d0024dbb6ffb692db926db66d49924
9246d240049b692ff926ddb6d49b649249224006db6dbff92b6db6d92b6496d9224496d00244992b6ff
6d92db496db624499200246db6ffdb92dbb66db69249926d246d4900492492ffb66ddb9249b66d24924
9006d24dbffb6b6db9292b66d6d9249496d24244900b6ff9292db6d6db649499224246d00ffb600db92
00b66d00924900ff00b6db0092b6006d92004900b6ff0092db006db6004992000000000000cf2a02040
000003b4944415458c3edce31010000080320b57fe799c0df0312d049ea9fa997b4b4b4b4b4b4b4b4b4
b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b42e0b01280361842f17250000000049454e44ae426082}
}}{\sp {\sn fLineOK}{\sv 1}}{\sp {\sn f3DOK}{\sv 0}}{\sp {\sn fShadowOK}{\sv 1}}{\
sp {\sn fFilled}{\sv 0}}{\sp {\sn lineStyle}{\sv 0}}{\sp {\sn fLine}{\sv 0}}{\sp {\
sn wzName}{\sv Picture 5}}{\sp {\sn fLayoutInCell}{\sv 0}}}{\shprslt {\pict }}}}{\
page }{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \dbch \
\par }\pard \plain \s29 \li5760 \ri-283 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 Lampiran IX}{\rtlch \fcs1 \af6 \afs18 \ltrch \
ri-283 \widctlpar \aspalpha \aspnum \adjustright \lin5760 \rin-283 \itap0 \rtlch \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kepdirjen
Bimas Islam Nomor 473 Tahun 2020}{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \li5760 \ri-283 \
widctlpar \aspalpha \aspnum \adjustright \lin5760 \rin-283 \itap0 \rtlch \fcs1 \af5
\afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0
\lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tentang }{\rtlch \fcs1 \
plain \s29 \li5760 \ri-283 \widctlpar \aspalpha \aspnum \adjustright \lin5760 \rin-
283 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 Petunjuk Teknis Pelaksanaan Pencatatan Nikah}{\rtlch \fcs1 \af6 \afs18 \
}\pard \plain \s29 \li8640 \ri-283 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 Model N5}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
\b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qc \li0 \
\ul1 \par }\pard \plain \s29 \qc \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 SURAT IZIN ORANG TUA}{\rtlch \
pard \plain \s29 \qc \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
alang1025 \par }\pard
\plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \
alang1025 Yang bertanda tangan di bawah ini :}{\rtlch \fcs1 \af6 \afs22 \ltrch \
pard \plain \s29 \qj \fi-357 \li357 \ri0 \widctlpar \aspalpha \aspnum \faroman \
adjustright \lin357 \rin0 \intbl \itap1 \ls7 \rtlch \fcs1 \af5 \afs22 \ltrch \
af4 \loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2 A.\
1. Nama lengkap dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \qj \li0 \ri0 \
hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 :}{\
\langfe1033 \langfenp1033 \alang1025 \caps1 SAMINO}{\rtlch \fcs1 \af6 \afs22 \ltrch
clftsWidth3 \cellx10182 \row }\pard \plain \s29 \qj \li357 \ri0 \widctlpar \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 2. Bin}{\
hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 ATMO
NGALIDI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
row }\pard \plain \s29 \qj \li357 \ri0 \widctlpar \aspalpha \aspnum \faroman \
adjustright \lin357 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22
langfe1033 \langfenp1033 \alang1025 3. }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 Nomor Induk Kependudukan}{\rtlch \fcs1 \af6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 35211319046700014}{\rtlch \fcs1 \
cltxlrtb \clwWidth5785 \clftsWidth3 \cellx10182 \row }\pard \plain \s29 \qj \
li357 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin357 \rin0 \
alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch
langnp1057 \langfe1033 \langfenp1033 \alang1025 4.}{\rtlch \fcs1 \af6 \afs22 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 Tempat dan tanggal lahir}{\rtlch \
Ngawi, 19 April 1967}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
\langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \fcs1 \af6 \afs22 \
alang1025 6. }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
alang1025 Agama}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
alang1025 ISLAM}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 7. Pekerjaan}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langfe1033 \langfenp1033 \alang1025 WIRASWASTA}{\rtlch \fcs1 \af6 \afs22 \ltrch \
fcs0 \fs22 \rtlch \alang1025
langfe1033 \langfenp1033 \alang1025 8. Alamat}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \qj \li0 \
ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \intbl \itap1 \
\cellx10182 \row }\pard \plain \s29 \qj \fi-357 \li357 \ri0 \widctlpar \aspalpha \
alang1025 \f2 B.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 1. Nama lengkap dan alias}{\rtlch \fcs1 \af6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 MAREM}{\rtlch \fcs1 \af6 \
alang1025 2. Bin}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 ti}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 WARNO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\cellx10182 \row }\pard \plain \s29 \qj \li357 \ri0 \widctlpar \aspalpha \aspnum \
langnp1057 \langfe1033 \langfenp1033 \alang1025 3. }{\rtlch \fcs1 \af6 \afs22 \
ltrch \fcs0 \fs22 \rtlch
langfe1033 \langfenp1033 \alang1025 Nomor Induk Kependudukan}{\rtlch \fcs1 \af6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 3521135510700002}{\rtlch \fcs1 \af6
f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \
alang1025 4.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 Tempat dan tanggal lahir}{\rtlch \fcs1 \af6 \afs22 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Ngawi, 15 Oktober 1970}{\rtlch \
alang1025 Kewarganegaraan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Agama}{\rtlch \fcs1 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 ISLAM}{\rtlch \fcs1 \af6 \afs22 \
ltrch \fcs0 \fs22 \rtlch \alang1025
langfe1033 \langfenp1033 \alang1025 WIRASWASTA}{\rtlch \fcs1 \af6 \afs22 \ltrch \
clftsWidth3 \cellx10182 \row }\pard \plain \s29 \qj \li357 \ri0 \widctlpar \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 8. Alamat}
hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Dsn.
Kedungmiri RT 003 RW 006, Desa Sambirejo, Kecamatan Mantingan, Kabupaten Ngawi}{\
cltxlrtb \clwWidth5785 \clftsWidth3 \cellx10182 \row }\trowd \trql \trgaph0 \
trleft-108 \trautofit1 \trwWidth10290 \trftsWidth3 \trftsWidthB3 \trwWidthA8 \
brdrnone \cltxlrtb \clwWidth10282 \clftsWidth3 \cellx10174 \pard \plain \s29 \qj \
li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \intbl \
alang1025 adalah ayah dan ibu kandung dari :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
trftsWidthB3 \trwWidthA8 \trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \
cellx10174 \row }\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trwWidth10290 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nama lengkap dan alias}{\
\langfe1033 \langfenp1033 \alang1025 \cell
}\pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \
\langfe1033 \langfenp1033 \alang1025 \caps1 RIZAL AJI ARI WIBOWO}{\rtlch \fcs1 \af6
\afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \
\li720 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin720 \rin0 \intbl
langnp1057 \langfe1033 \langfenp1033 \alang1025 SAMINO}{\rtlch \fcs1 \af6 \afs22 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Nomor Induk Kependudukan}{\rtlch \
row }\pard \plain \s29 \qj \fi-360 \li720 \ri0 \widctlpar \aspalpha \aspnum \
faroman \adjustright \lin720 \rin0 \intbl \itap1 \ls8 \rtlch \fcs1 \af5 \afs22 \
alang1025 Tempat dan tanggal lahir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Ngawi, 25-11-1999}{\rtlch
\loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \
cellx4111 \clvertalt \clbrdrl \brdrnone
\clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth286 \
alang1025 Kewarganegaraan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 WNI}{\rtlch \fcs1 \af6 \
alang1025 Alamat}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Dsn.
li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \intbl \
alang1025 Memberikan izin kepada anak kami untuk melakukan pernikahan dengan :}{\
trwWidth10290 \trftsWidth3 \trftsWidthB3 \trwWidthA8 \trftsWidthA3 \trpaddl108 \
clwWidth10282 \clftsWidth3 \cellx10174 \row }\trowd \trql \trgaph0 \trleft-108 \
adjustright \lin720 \rin0 \intbl \itap1 \ls9 \rtlch \fcs1 \af5 \afs22 \ltrch \
Nama lengkap dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 \caps1 DITA SETIANI}{\rtlch \fcs1 \af6 \
f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 \cell }\pard \
cltxlrtb \clwWidth5785 \clftsWidth3 \cellx10182 \row }\pard \plain \s29
\qj \fi-360 \li720 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin720
\rin0 \intbl \itap1 \ls9 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nomor Induk Kependudukan}
alang1025 Tempat dan tanggal lahir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Ngawi, 12 Maret 2000}{\rtlch \fcs1 \af6 \
alang1025 :}{\rtlch \fcs1
\af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af0 \
plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \
langfe1033 \langfenp1033 \alang1025 Islam}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
langfe1033 \langfenp1033 \alang1025 Karyawan Swasta}{\rtlch \fcs1 \af6 \afs22 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 RT 004 RW 003 Desa Kedungprahu,
Kecamatan Padas, Kabupaten Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
alang1025 \ltrch \dbch \af0
\hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025
Demikian surat izin ini dibuat dengan kesadaran tanpa ada paksaan dari siapapun dan
untuk digunakan seperlunya.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
}\trowd \trql \trgaph0 \trleft567 \trautofit1 \trwWidth9322 \trftsWidth3 \
langfe1033 \langfenp1033 \alang1025 Ayah/wali/pengampu}{\rtlch \fcs1 \af6 \afs22 \
lin0 \rin0 \tql \tx284 \tql \tx3969 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \
ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \
adjustright \lin0 \rin0 \tql \tx284 \tql \tx3969 \intbl \itap1 \rtlch \fcs1 \af5 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Kedungprahu, 02 Desember
2024}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
Ibu/wali/pengampu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \tql \tx284 \tql \
tx3969 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033
\langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 MAREM}{\rtlch \fcs1 \
af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \
clbrdrb \brdrnone \cltxlrtb \clwWidth3652 \clftsWidth3 \cellx9889 \row }\pard \
plain \s29 \qc \li0 \ri-113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-
alang1025 \ul1 \par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \
aspnum \faauto \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \
langnp1024 \langfe1024 \langfenp1024 \alang1025 {\shp {\*\shpinst \shpleft4485 \
shptop15 \shpright5715 \shpbottom1245 \shpfhdr0 \shpbxcolumn \shpbxignore \
shpbypara \shpbyignore \shpwr3 \shpwrk0 \shpfblwtxt0 \shpz3 \shplid1029 {\sp {\sn
shapeType}{\sv 75}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn
*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
\ul1 \page }{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \b1 \fs24 \rtlch \alang1025 \
langfenp1033 \alang1025 \ul1 \par }\pard \plain \s29 \qc \li0 \ri-113 \widctlpar \
aspalpha \aspnum \adjustright \lin0 \rin-113 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch
\fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 SURAT PERNYATAAN STATUS}{\
}\pard \plain \s29 \li0 \ri-113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
rin-113 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
alang1025 \par }\pard \plain \s29 \li0 \ri-113 \widctlpar \aspalpha \aspnum \
adjustright \lin0 \rin-113 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 Yang bertanda tangan di bawah ini :}{\rtlch \
pard \plain \s29 \li0 \ri-113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-
alang1025 \par }\trowd \trql \trgaph0 \trleft-108 \trftsWidth1 \trftsWidthB3 \
clwWidth283 \clftsWidth3 \cellx3969 \clvertalb \clbrdrl \brdrnone \clbrdrr \
\cellx10490 \pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \aspalpha
\aspnum \adjustright \lin0 \rin-113 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Nama lengkap dan alias}{\rtlch \
pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \aspalpha \aspnum \
adjustright \lin0 \rin-113 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \
s29 \li0 \ri-113 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
rin-113 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
alang1025 {\trowd \trql \trgaph0 \trleft-108 \trftsWidth1 \trftsWidthB3 \
trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3
\clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \
\cellx10490 \row }\pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \
aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \itap1 \rtlch \fcs1 \af5 \afs22
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 N}{\rtlch \fcs1 \af6 \
lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 omor Induk
Kependudukan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \cell }\pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \
widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \itap1 \rtlch \
cell }\pard \plain \s29 \li0 \ri-113 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Jenis Kelamin}{\rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tempat dan tanggal lahir}
cell }\pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \aspalpha \
aspnum \adjustright \lin0 \rin-113 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \
langfe1033 \langfenp1033 \alang1025 Ngawi, 25-11-1999}{\rtlch \fcs1 \af6 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kewarganegaraan }{\
cell }\pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \aspalpha \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29
\li0 \ri-113 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-
113 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
trql \trgaph0 \trleft-108 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \
clftsWidth3 \cellx3969 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
row }\pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \aspalpha \
s29 \qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \
lin0 \rin-113 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \li0 \ri-113 \sl276 \
slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \itap1 \
ISLAM}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \trftsWidth1
\trftsWidthB3 \trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \
trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
brdrnone \cltxlrtb \clwWidth283 \clftsWidth3 \cellx3969 \clvertalb \clbrdrl \
clwWidth6521 \clftsWidth3 \cellx10490 \row }\pard \plain \s29 \qj \li0 \ri-113 \
sl360 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \
alang1025 Pekerjaan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \qj \li0 \ri-113 \
alang1025 \cell }\pard \plain \s29 \li0 \ri-113 \sl276 \slmult1 \widctlpar \
langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \trftsWidth1 \
cltxlrtb \clwWidth283 \clftsWidth3 \cellx3969 \clvertalb \clbrdrl \brdrnone \
clftsWidth3 \cellx10490 \row }\pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Pendidikan
terakhir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \cell }\pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \
langfe1033 \langfenp1033 \alang1025 SLTA/Sederajat}{\rtlch \fcs1 \af6 \afs22 \ltrch
trowd \trql \trgaph0 \trleft-108 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Alamat}{\rtlch
trql \trgaph0 \trleft-108 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \
row }\pard \plain \s29 \qj \li0 \ri-113 \widctlpar \aspalpha \aspnum \adjustright \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Dengan ini
menyatakan bahwa, Saya betul-betul pada saat ini berstatus Jejaka/Duda Mati/Duda
Cerai/Perawan/Janda Mati/Janda Cerai, dan surat pernyataan ini dibuat guna
persyaratan Pernikahan.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
Demikianlah surat pernyataan ini saya buat dengan sebenarnya, dalam keadaan sehat
jasmani dan rohani tanpa ada paksaan dari pihak manapun. Apabila di kemudian hari
menyalahi surat pernyataan ini, saya bersedia dituntut sesuai
Perundang-undangan/Hukum yang berlaku dan tidak akan melibatkan aparat setempat
( Resiko Sendiri).}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \ri-113 \sl360 \slmult1 \
widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \itap0 \rtlch \fcs1 \af5 \
af4 \lang1024 \langnp1024 \langfe1024 \langfenp1024 \alang1025 {\shp {\*\shpinst \
shpleft165 \shptop1047 \shpright1395 \shpbottom2277 \shpfhdr0 \shpbxcolumn \
shpbxignore \shpbypara \shpbyignore \shpwr3 \shpwrk0 \shpfblwtxt0 \shpz4 \
shplid1030 {\sp {\sn shapeType}{\sv 75}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fFlipV}
{\sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}{\sp {\sn fLockVerticies}{\sv 0}}{\
sp {\sn fLockAspectRatio}{\sv 1}}{\sp {\sn fLockRotation}{\sv 0}}{\sp {\sn
WrapText}{\sv 0}}{\sp {\sn pib}{\sv {\pict \piccropl0 \piccropr0 \piccropt0 \
piccropb0 \picscalex100 \picscaley100 \picw82 \pich82 \picwgoal1230 \pichgoal1230 \
pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
}\trowd \trql \trgaph0 \trleft6237 \trbrdrt \brdrs \brdrw10 \trbrdrb \brdrs \
brdrw10 \trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs \brdrw10 \trbrdrh \brdrs \
brdrw10 \trbrdrv \brdrs \brdrw10 \trwWidth4253 \trftsWidth3 \trftsWidthB3 \
li0 \ri-113 \sl360 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-
trql \trgaph0 \trleft6237 \trbrdrt \brdrs \brdrw10 \trbrdrb \brdrs \brdrw10 \
trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs \brdrw10 \trbrdrh \brdrs \brdrw10 \
trbrdrv \brdrs \brdrw10 \trwWidth4253 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \
ri-113 \sl360 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \
alang1025 Yang membuat pernyataan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033
trleft6237 \trbrdrt \brdrs \brdrw10 \trbrdrb \brdrs \brdrw10 \trbrdrl \brdrs \
brdrw10 \trbrdrr \brdrs \brdrw10 \trbrdrh \brdrs \brdrw10 \trbrdrv \brdrs \
brdrw10 \trwWidth4253 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \
clwWidth4253 \clftsWidth3 \cellx10490 \row }\pard \plain \s29 \li0 \ri-113 \
langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \i1 \fs22 \rtlch
langfe1033 \langfenp1033 \alang1025 Materai }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
\b1 \i1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1057 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 10.000}{\rtlch \fcs1 \af6 \afs22 \
ltrch \fcs0 \b1 \i1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \
s29 \li0 \ri-113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \
fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \f6 \
\li0 \ri-113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \itap1
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \li0 \ri-113 \widctlpar
\aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \itap1 \rtlch \fcs1 \af5 \
f6 \lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 \par }\pard \
plain \s29 \li0 \ri-113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft6237 \trbrdrt \
brdrs \brdrw10 \trbrdrb \brdrs \brdrw10 \trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs \
brdrw10 \trbrdrh \brdrs \brdrw10 \trbrdrv \brdrs \brdrw10 \trwWidth4253 \
cellx10490 \row }\pard \plain \s29 \li0 \ri-113 \sl276 \slmult1 \widctlpar \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \li0 \ri-
113 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \itap0
}\pard \plain \s29 \li0 \ri-113 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 Saksi-saksi :}{\rtlch \fcs1 \af6 \afs22 \
alang1025 \par }\trowd \trql \trgaph0 \trleft-108 \trwWidth10598 \trftsWidth3 \
\trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
clbrdrb \brdrnone \cltxlrtb \clwWidth468 \clftsWidth3 \cellx360 \clvertalb \clbrdrl
\brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \
pard \plain \s29 \fi-360 \li360 \ri-113 \sl480 \slmult1 \widctlpar \aspalpha \
aspnum \adjustright \lin360 \rin-113 \intbl \itap1 \ls10 \rtlch \fcs1 \af5 \afs22 \
lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 \uc1 \u8230 ?\uc1 \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \li0 \ri-113 \sl480 \
langnp1033 \langfe1033 \langfenp1033
\alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 ( \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?. )}
\langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \trwWidth10598 \
trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
cellx360 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
clbrdrb \brdrnone \cltxlrtb \clwWidth4460 \clftsWidth3 \cellx4820 \clvertalb \
clftsWidth3 \cellx10490 \row }\pard \plain \s29 \fi-360 \li360 \ri-113 \sl480 \
ls10 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \li0 \ri-
113 \sb240 \sl480 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113
\intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
\u8230 ?.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
s29 \li0 \ri-113 \sb240 \sl480 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 ( \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
\u8230 ?\uc1 \u8230 ?. )}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
trql \trgaph0 \trleft-108 \trwWidth10598 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \
trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \
cltxlrtb \clwWidth468 \clftsWidth3 \cellx360 \clvertalb \clbrdrl \brdrnone \clbrdrr
\brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth4460 \
brdrnone \cltxlrtb \clwWidth5245 \clftsWidth3 \cellx10490 \row }\pard \plain \s29 \
fi194 \li5760 \ri-425 \widctlpar \aspalpha \aspnum \adjustright \lin5760 \rin-425 \
alang1025 \par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \aspnum \
faauto \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \page }{\rtlch \fcs1 \af6 \afs18 \
alang1025 Lampiran IX}{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \fi194 \li5760 \ri-
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kepdirjen Bimas
Islam Nomor 473 Tahun 2020}{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \fi194 \li5760 \ri-
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tentang }{\
}\pard \plain \s29 \li5954 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
cf13 \par }\pard \plain \s29 \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \
lin0 \rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
af0 \hich \af4 \loch \af0
f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Model N6}{\rtlch \
pard \plain \s29 \fi720 \li7920 \ri0 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \li0 \ri0 \sl276 \
KANTOR DESA/KELURAHAN}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 \caps1 Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \
alang1025 KECAMATAN}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe2052 \langfenp2052 \alang1025 \caps1 Padas}{\rtlch \fcs1 \af6 \afs22 \
alang1025 KABUPATEN }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
langfe2052 \langfenp2052 \alang1025 \caps1 Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \
li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \rtlch \
pard \plain \s29 \qc \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 \ul1 SURAT KETERANGAN KEMATIAN}{\rtlch \fcs1 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 \par }\
langfe1033 \langfenp1033 \alang1025 Nomor : 474.2/489/404.606.10/2024}{\rtlch \fcs1
alang1025 \par }\pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 Yang bertanda tangan di bawah ini menerangkan
dengan sesungguhnya bahwa:}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\trowd \trql \trgaph0 \trleft-108 \
adjustright \lin357 \rin0 \intbl \itap1 \ls11 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0
\langfe1033 \langfenp1033 \alang1025 \caps1 [istri_dulu]}{\rtlch \fcs1
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 \
\itap1 \ls12 \ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Binti}{\rtlch \fcs1 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 [binti]}{\rtlch \fcs1 \af6 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nomor Induk Kependudukan}
[noktp_istri_dulu]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
faroman \adjustright \lin709 \rin0 \intbl \itap1 \ls12 \ilvl3 \rtlch \fcs1 \af5 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 [tempatlahir_istri_dulu],
[tanggallahir_istri_dulu]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
aspnum \faroman \adjustright \lin709 \rin0 \intbl \itap1 \ls12 \ilvl3 \rtlch \
fcs1 \af5 \afs22 \ltrch \fcs0 \fs22
alang1025 [wn_istri_dulu]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 [agama_istri_dulu]}{\rtlch \fcs1 \af6 \afs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Pekerjaan}{\rtlch \fcs1 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 [pek_istri_dulu]}{\rtlch \fcs1 \af6
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Alamat}{\rtlch \fcs1 \af6
alang1025 \cell
}\pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \
langfe1033 \langfenp1033 \alang1025 [alamat_istri_dulu]}{\rtlch \fcs1 \af6 \afs22 \
alang1025 Telah meninggal dunia pada tanggal}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
langfe1033 \langfenp1033 \alang1025 [tanggalmeninggal_istri_dulu]}{\rtlch \fcs1 \
alang1025 Di}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
alang1025 [tempatmeninggal_istri_dulu], [alamat_istri_dulu]}{\rtlch \fcs1 \af6 \
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Yang
bersangkutan adalah suami / isteri}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 \super1 *) }{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 dari :}{\rtlch \fcs1 \af6 \afs22 \
cellx10037 \row }\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trwWidth10145 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2 B.\tab }{\rtlch \fcs1 \af6 \
lang1057
\langnp1057 \langfe1033 \langfenp1033 \alang1025 1. }{\rtlch \fcs1 \af6 \afs22 \
langfe1033 \langfenp1033 \alang1025 Bin/Binti}{\rtlch \fcs1 \af6 \afs22 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tempat dan tanggal lahir}
dbch
alang1025 Ngawi, 25-11-1999}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 WNI}{\
brdrnone \clbrdrb \brdrnone
\cltxlrtb \clwWidth5353 \clftsWidth3 \cellx10037 \row }\pard \plain \s29 \qj \fi-
360 \li709 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin709 \rin0 \
intbl \itap1 \ls13 \ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
li720 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin720 \rin0 \tql \tx709 \tql
alang1025 \par }\pard \plain \s29 \qj \li426 \ri0 \widctlpar \aspalpha \aspnum \
adjustright \lin426 \rin0 \tql \tx4253 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 Demikian surat keterangan ini
dibuat dengan mengingat sumpah jabatan dan untuk digunakan seperlunya.}{\rtlch \
adjustright \lin6480 \rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \afs22
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Kedungprahu}{\rtlch \fcs1
\f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 ,}{\rtlch \fcs1 \af6
f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 02 Desember 2024}{\
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Kepala Desa Kedungprahu}
lang1024 \langnp1024 \langfe1024 \langfenp1024 \alang1025 {\shp {\*\shpinst \
pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
hich \af4 \loch \f6
\lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29
\qj \li6480 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin6480
\rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
hyphpar0 \aspalpha \aspnum \faauto \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \
par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \aspnum \faauto \
langfe1033 \langfenp1033 \alang1025 \caps1 \page }{\rtlch \fcs1 \af6 \afs32 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \caps1 \par }\pard \plain
\s28 \qc \li1260 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin1260
\rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs28 \rtlch \alang1025 \ltrch \
646ed728646ed728646ed728646ed728}89504e470d0a1a0a0000000d49484452000000640000006408
0600000070e2955400004bc749444154785eedbd077c95e5d93ffe3dfb9c24277b2764421220614fd91
b648aabb857ab56abb6b556adafd66aadb5d53ada6a6b557081035110101144a6ec19460224217bcfb3
c7f3fb5ef749d4fabeffd6686dede7f37ff098e49ce73ccf7ddfd77dadef351e1dfecb0e7797a6d3f40
8d374d0fb0330b93b105151d198131e6ef324a444d4186c70eb4df0e874f04599758effb2e941f75d1f
b0d31934ea349d45f3c3e8706a910d0d2d49672acee59c2a393da2f25c4d7675657d94cf1b306808686
111567f729f94aeccec3e677373530fe6e56495a626c6571a74f0ebf5f073b6aeb0089df7bb3ce7ef1c
413a1d9a596f80d1eb81ada5d11f5f7af26cdf9aeafa9c925367475656d767399d2e933718b006b4a04
dd37449565344240241bdcfef86cea8f3eb0da636bfdfdf6134e8ba2c067d3032ccec4d498eafcccbcf
3d9057907b382d23a5323ccad0acb7c065d4c369b7e9dcdf2502fd4709d2d1a519295a2c2480d6dcec8
92f2fab4ee7abefc91367c7f0679edbe1b305839a410bea2c7e7f30596f34c41a8d7ab337e0854e0f84
858521e80ba07f7e013a1d9da8acac805f031941cff7f508f8fc41ab517342a7d5699acf45311730984
dbab884e8ae8cbe2947d2d3138e15f42b38d5272db52c324ad7c42f064d06b82d169dff3f45a47f2b41
5c1d94fe3a84b57720baaca236b3baa621fdf8a9b3c3caca2a0a1b1b5aa310845eaf19c30c0653b85ed
327badc4ebbd94c89a5f79309dcb0da0c484f4b40764e3af2fa6621a34f3a32fb24c360e0f291405e2e
e3b973d528395d8673e58d28292d43434313c83108f883d08226b97d3040f96630fadb8d466397df83a
0d16cf1a7a4253565e6a41dc9c84c2ccecfcf3c9cd527ea94855c6408f07343d0690aa354fc371cdf3a
416aeb0291cd4dedc9e56555e967ce94e7949dad1a5d5fd798e772792c414d670de80c915c985804751
1c160d08000e0f37910116e437a6a12d2d39391df2f03fdf332911c6f47b885abafe349542a08521d78
9d5c264e83ab0cb21a4c26c0c897ce8660408766a707354dcd387da60c274b2a505ed68296e676f8031
e529fe7fbadd0484d6fd0cba168cd0693be95c4ef08b7193ad39212dafbe767176765a49c2ec8cb3998
94145961b0c043da7a6de1bae0b7419f7f3941ca4ff9e2cacb6afa9c3a5536e85c65eda4d395e7463bd
d9e148fd71b6134e90d069d8e022a00ca212e08175f64bf3e80d8d858646565a06fdf5cf4cbcb460609
61b31a10a6d7600afab8e0f2e2a2bb5c40732b402ef09e3d85d6d263a8395781a0391aa97df390929d0
95e0864232025a99b385c412ebb66b690de063434bb71e64c05aa2aaa70a6e40caaab6bd1d6ea20594d
086a46729281633371bf18dce4ab160dfe2ebd3ee8b0db2d5de9a9f1b5f979d9c5f9057d0fa5a42694c
7c65b6b0c4678495ab735e29b8bba6f4c90cddb4f475594d70c3f7de24c514d45cd88ae56f7005d509f
108431c617d4c235caec2065912663d5f938592fec6116f4cdea83dcac741472f1fba42572f7c786361
c772ec9440e100290033cb45ccf96a1b9a414cda7cfa2f9e41938ea1a60f5f811a179101e6ce6a96ef8
4cb1f06a1668b479bde41097cd06535a1262fb1720be6f361207f40b11c81ac1eb9bf9b2703cc249641
2eaa186c6769c3d574331479177a60a55b52de8747911d41bbb1941f82818d4eb025d065db082865bab
4ea775c627c5b6a4a625d4e5e5e51cef979775322d35b13232cada480efa5ad6dcd722c89f9fdc3ce77
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sp {\sn fLineOK}{\sv 1}}{\sp {\sn f3DOK}{\sv 0}}{\sp {\sn fShadowOK}{\sv 1}}{\sp {\
sn fFilled}{\sv 0}}{\sp {\sn lineStyle}{\sv 0}}{\sp {\sn fLine}{\sv 0}}{\sp {\sn
wzName}{\sv Picture 1}}{\sp {\sn fBehindDocument}{\sv 1}}{\sp {\sn fLayoutInCell}{\
sv 1}}}{\shprslt {\pict }}}}{\rtlch \fcs1 \af6 \afs32 \ltrch \fcs0 \fs32 \rtlch \
langfe1033 \langfenp1033 \alang1025 \caps1 PEMERINTAH kabupaten Ngawi}{\rtlch \
pard \plain \s27 \qc \li1080 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
langfe1033 \langfenp1033 \alang1025 \caps1 kecamatan Padas}{\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \caps1 \par }\pard \plain
\qc \li1260 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin1260 \
alang1025 \caps1 desa Kedungprahu}{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \fs24 \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \qc \li1260 \ri0 \
widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin1260 \rin0 \tql \tx1260 \
alang1025 Jl. Raya Caruban-Ngawi KM 12 Desa Kedungprahu, Kecamatan Padas Website
kedungprahu.desa.id Email: kedungprahu@ngawikab.id Kode Pos: 63281}{\rtlch \fcs1 \
plain \qc \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \
0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn WrapText}{\sv 0}}{\sp {\sn fFillOK}{\sv 0}}{\
sp {\sn fLineOK}{\sv 1}}{\sp {\sn fShadowOK}{\sv 1}}{\sp {\sn fFilled}{\sv 0}}{\sp
{\sn lineWidth}{\sv 57150}}{\sp {\sn lineStyle}{\sv 0}}{\sp {\sn fLine}{\sv 1}}{\sp
{\sn fArrowheadsOK}{\sv 1}}{\sp {\sn cxstyle}{\sv 0}}{\sp {\sn wzName}{\sv
AutoShape 9}}{\sp {\sn fLayoutInCell}{\sv 1}}}{\shprslt {\pict }}}}{\rtlch \fcs1 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \uc1 \u160 ?}{\
}\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trftsWidth1 \trftsWidthB3 \
\cellx9999 \pard \plain \qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \qj \li0 \ri0 \widctlpar \
pard \plain \qr \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
\langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs20 \ltrch \fcs0 \i1 \fs20 \rtlch \
alang1025 \ltrch \dbch \af0 \hich \af0 \loch \f6 \lang1057 \langnp1057
trql \trgaph0 \trleft-108 \trautofit1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth3369 \clftsWidth3 \cellx9999 \row }\
pard \plain \s3 \qc \li0 \ri0 \widctlpar \keepn1 \hyphpar0 \aspalpha \faroman \
\b1 \fs32 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af0 \loch \af0 \lang1033 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 {\rtlch \fcs1 \af6 \afs28 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \ul1 SURAT PENGANTAR
NUMPANG NIKAH}{\rtlch \fcs1 \af6 \afs28 \ltrch \fcs0 \b1 \fs28 \rtlch \alang1025 \
langfenp1033 \alang1025 \ul1 \par }\pard \plain \qc \li0 \ri0 \widctlpar \
hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nomor :
474.2/489/404.606.10/2024}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \ul1 \par }\pard \plain \qc \li0 \ri0 \
alang1025 \par }\pard \plain \s24 \qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \
faroman \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24
\langfe1033 \langfenp1033 \alang1025 Yang bertanda tangan di bawah ini}{\rtlch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Kepala
Desa }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
Kedungprahu, Kecamatan Padas, Kabupaten Ngawi, menerangkan dengan sebenarnya
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s24 \qj \fi-3420 \li4140 \
ri180 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin4140
\rin180 \tql \tx1260 \tql \tx3960 \tql \tx4140 \itap0 \ls14 \rtlch \fcs1 \af0 \
langfe1033 \langfenp1033 \alang1025 Nama}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \
plain \fi-3420 \li4140 \ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman
\adjustright \lin4140 \rin4 \tql \tx1260 \tql \tx3960 \tql \tx4140 \itap0 \ls14 \
langfe1033 \langfenp1033 \alang1025 Tempat/tanggal lahir}{\rtlch \fcs1 \af6 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1
\f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Ngawi /
25-11-1999}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \par }\pard \plain \fi-3420 \li4140 \ri4 \sl360 \slmult1 \widctlpar \
hyphpar0 \aspalpha \faroman \adjustright \lin4140 \rin4 \tql \tx1260 \tql \tx3960 \
tql \tx4140 \itap0 \ls14 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Jenis Kelamin}{\rtlch \
Laki-laki}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfenp1033 \alang1025 \par }\pard \plain \fi-3420 \li4140 \ri4 \widctlpar \
fcs0 \fs24 \rtlch \alang1025
langfe1033 \langfenp1033 \alang1025 Surat bukti diri}{\rtlch \fcs1 \af6 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li720
\ri4 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin720 \rin4 \tql \
tx1260 \tql \tx3960 \tql \tx4140 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24
\langfe1033 \langfenp1033 \alang1025 KTP }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi-3420 \li4140 \ri4 \sl360
\slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin4140 \rin4 \tql \
tx1260 \tql \tx3960 \tql \tx4140 \itap0 \ls14 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0
Warga negara}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
\langfe1033 \langfenp1033 \alang1025 WNI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi-3420 \li4140 \ri4 \
sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin4140 \
rin4 \tql \tx1260 \tql \tx3960 \tql \tx4140 \itap0 \ls14 \rtlch \fcs1 \af0 \afs24 \
alang1025 Agama}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
\langfe1033 \langfenp1033 \alang1025 ISLAM}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi-11 \li720 \ri4 \sl360 \
slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin720 \rin4 \tql \
Status Perkawinan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 : [status_pria]}{\rtlch \fcs1 \af6 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi-
3420 \li4140 \ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \
adjustright \lin4140 \rin4 \tql \tx1260 \tql \tx3960 \tql \tx4140 \itap0 \ls14 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 KARYAWAN
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tempat tinggal}{\rtlch \
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Dsn.
}\pard \plain \fi720 \li0 \ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha
\faroman \adjustright \lin0 \rin4 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Nama tersebut di atas }{\rtlch \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 betul
bermaksud akan menumpang Nikah / Kawin di :}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi709 \li0 \ri0
\sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \
alang1025 RT 004 RW 003 Desa Kedungprahu, Kecamatan Padas, Kabupaten Ngawi}{\rtlch
\fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \
}\pard \plain \fi720 \li0 \ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \
langfe1033 \langfenp1033 \alang1025 Kepada seorang perempuan yang bernama :}{\rtlch
plain \fi720 \li0 \ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \
langfe1033 \langfenp1033 \alang1025 \caps1 DITA SETIANI}{\rtlch \fcs1 \af6 \afs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Binti }{\rtlch \fcs1 \
loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 SUKADI}
}\pard \plain \fi720 \li0 \ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi720 \li0 \ri4 \sl360 \
slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin4 \itap0 \
Demikian Surat ini dibuat, untuk dipergunakan sebagaimana mestinya.}{\rtlch \fcs1 \
plain \s24 \qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0
\rin0 \tql \tx2880 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \tql \tx2880 \itap0
}\pard \plain \s24 \qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \tql \tx2880 \
alang1025 \par }\trowd \trql \trgaph0 \trrh2260 \trleft-108 \trautofit1 \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clpadt108 \clpadr108 \
clpadfl3 \clpadfb3 \clpadft3 \clpadfr3 \clwWidth4158 \clftsWidth3 \cellx4050 \
brdrnone \cltxlrtb \clpadt108 \clpadr108 \clpadfl3 \clpadfb3 \clpadft3 \clpadfr3 \
clpadfl3 \clpadfb3 \clpadft3 \clpadfr3 \clwWidth5130 \clftsWidth3 \cellx10080 \pard
\plain \s24 \qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
lin0 \rin0 \tql \tx1134 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
langfe1033 \langfenp1033 \alang1025 Nomor}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 : \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\
u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \tql \tx1134 \intbl
\itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch \dbch \
alang1025 Tanggal}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 : \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
alang1025 Mengetahui,}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 Camat Wedung,}{\rtlch \fcs1 \af6 \
qc \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \
tql \tx1134 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
alang1025 \par }\pard \plain \s24 \qc \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \
faroman \adjustright \lin0 \rin0 \tql \tx1134 \intbl \itap1 \rtlch \fcs1 \af0 \
?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?..}
cell }\pard \plain \s24 \qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
adjustright \lin0 \rin0 \tql \tx2880 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \
s24 \qc \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \
rin0 \tql \tx2880 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
langfe1033 \langfenp1033 \alang1025 Kedungprahu, 02 Desember 2024}{\rtlch \fcs1 \
plain \s24 \qc \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0
\rin0 \tql \tx2880 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch
alang1025 Kepala Desa Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
alang1025 SUNARTO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
alang1025 \cf18 [nip_pamong]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \cf18 \cell }\pard \plain \li0 \ri0 \
trowd \trql \trgaph0 \trrh2260 \trleft-108 \trautofit1 \trwWidth10188 \
trftsWidth3 \trftsWidthB3 \trftsWidthA3
\trpaddl10 \trpaddr10 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalt \
cltxlrtb \clpadt108 \clpadr108 \clpadfl3 \clpadfb3 \clpadft3 \clpadfr3 \
clpadfl3 \clpadfb3 \clpadft3 \clpadfr3 \clwWidth900 \clftsWidth3 \cellx4950 \
brdrnone \cltxlrtb \clpadt108 \clpadr108 \clpadfl3 \clpadfb3 \clpadft3 \clpadfr3 \
clwWidth5130 \clftsWidth3 \cellx10080 \row }\pard \plain \s24 \qj \li0 \ri0 \
plain \s29 \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 \sect }\sectd \sbknone \pgwsxn11906 \
pghsxn18709 \marglsxn851 \margrsxn851 \margtsxn709 \margbsxn851 \guttersxn0 \
headery708 \footery708 \pgbrdropt0 \sectlinegrid360 \sectdefaultcl \endnhere \
pard \plain \s29 \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 \sect }\sectd \sbknone \pgwsxn11906 \
pghsxn18709 \marglsxn851 \margrsxn851 \margtsxn567 \margbsxn680 \guttersxn0 \
headery709 \footery709 \pgbrdropt0 \sectlinegrid360 \sectdefaultcl \endnhere \
pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \aspnum \faauto \adjustright \
\langfenp1024 \alang1025 {\shp {\*\shpinst \shpleft4410 \shptop344 \shpright5640 \
shpbottom1574 \shpfhdr0 \shpbxcolumn \shpbxignore \shpbypara \shpbyignore \shpwr3 \
shpwrk0 \shpfblwtxt0 \shpz7 \shplid1034 {\sp {\sn shapeType}{\sv 75}}{\sp {\sn
fFlipH}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}{\sp
{\sn fLockVerticies}{\sv 0}}{\sp {\sn fLockAspectRatio}{\sv 1}}{\sp {\sn
fLockRotation}{\sv 0}}{\sp {\sn WrapText}{\sv 0}}{\sp {\sn pib}{\sv {\pict \
piccropl0 \piccropr0 \piccropt0 \piccropb0 \picscalex100 \picscaley100 \picw82 \
pich82 \picwgoal1230 \pichgoal1230 \pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
cf13 \page }{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \
alang1025 \cf13 \par }\pard \plain \s29 \li5670 \ri-283 \widctlpar \aspalpha \
aspnum \adjustright \lin5670 \rin-283 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Lampiran V}{\rtlch \fcs1 \af6 \
\li5670 \ri-425 \widctlpar \aspalpha \aspnum \adjustright \lin5670 \rin-425 \
alang1025 Kepdirjen Bimas Islam Nomor 473 Tahun 2020}{\rtlch \fcs1 \af6 \afs18 \
Tentang }{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \
alang1025 \par }\pard \plain \s29 \li5670 \ri0 \sl276 \slmult1 \widctlpar \aspalpha
\aspnum \adjustright \lin5670 \rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Petunjuk Teknis Pelaksanaan
Pencatatan Nikah}{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \
langfenp1033 \alang1025 \cf13 \par }\pard \plain \qr \li0 \ri0 \widctlpar \hyphpar0
\aspalpha \faroman \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \qr \
li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \itap0 \
Model N1}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch
alang1025 \par }\pard \plain \s29 \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
aspnum \adjustright \lin0 \rin0 \tql \tx3544 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 KANTOR DESA/KELURAHAN}{\rtlch \fcs1
\f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025
\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 : }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \caps1 Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \li0 \ri0 \sl276 \
KECAMATAN}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfe2052 \langfenp2052 \alang1025 \caps1 Padas}{\rtlch \fcs1 \af6 \afs22 \ltrch \
sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx3544 \
alang1025 KABUPATEN}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 /KOTA}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe2052 \langfenp2052 \alang1025 \caps1 Ngawi}{\rtlch \fcs1 \af6 \afs22 \
li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \itap0 \rtlch \
langfe1033 \langfenp1033 \alang1025 \ul1 SURAT PENGANTAR NIKAH}{\rtlch \fcs1 \af6 \
f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 \par }\pard \
plain \s29 \qc \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 Nomor :}{\rtlch \fcs1 \af6 \afs22 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025
400.12.3.2/535/404.606.10/2024}{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \fs24 \
alang1025 Yang bertanda tangan di bawah ini menjelaskan dengan sesungguhnya
alang1025 \par }\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trwWidth10233 \
li357 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \
lin357 \rin0 \intbl \itap1 \ls15 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch
cltxlrtb \clwWidth5353 \clftsWidth3 \cellx10125 \row }\pard \plain
\s29 \qj \fi-357 \li357 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman
\adjustright \lin357 \rin0 \intbl \itap1 \ls15 \rtlch \fcs1 \af5 \afs22 \ltrch \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s29 \qj \li0 \ri0 \sl276 \
alang1025 Perempuan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
widctlpar \aspalpha \aspnum \faroman \adjustright \lin357 \rin0 \intbl \itap1 \ls15
alang1025 Ngawi, 12 Maret 2000}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Islam}{\
lin357 \rin0 \intbl \itap1 \ls15 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch
Pekerjaan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfe1033 \langfenp1033 \alang1025 Pendidikan terakhir}{\rtlch \fcs1 \af6 \afs22 \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Karyawan
Swasta}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
SLTA/Sederajat}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
\aspnum \faroman \adjustright \lin357
\rin0 \intbl \itap1 \ls15 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
alang1025 Dusun Mugu Raya RT 004 RW 003 Desa Kedungprahu, Kecamatan Padas,
Kabupaten Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 Status Perkawinan}{\rtlch \fcs1 \af6 \afs22 \
alang1025 \f2 c.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Laki-laki }{\rtlch \fcs1 \af6 \afs22 \ltrch \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 : Jejaka, Duda atau
beristri ke .............}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \f2 d.\tab }{\rtlch \fcs1 \af6 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Perempuan}{\rtlch \fcs1 \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 : Perawan,
Janda}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
af0 \hich \af4 \loch \af0 \lang1033
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 -}{\rtlch \fcs1 \af6 \
langfe1033 \langfenp1033 \alang1025 Perawan}{\rtlch \fcs1 \af6 \afs22 \ltrch \
clftsWidth3 \cellx10125 \row }\pard \plain \s29 \qj \fi-357 \li357 \ri0 \sl276 \
itap1 \ls15 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Nama isteri / suami terdahulu}{\
\cellx10125 \row }\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trwWidth10233 \
trftsWidth3 \trftsWidthB3 \trwWidthA17 \trftsWidthA3 \trpaddl108 \trpaddr108 \
clftsWidth3 \cellx10108 \pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \
adalah benar-benar anak dari perkawinan seorang pria :}{\rtlch \fcs1 \af6 \afs22 \
alang1025 Nama Lengkap}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \
\ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 SUKADI}{\rtlch \
ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum
Ngawi, 04 Juli 1960}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Islam}{\rtlch \fcs1 \af6 \afs22 \
li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0
\intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch
langfe1033 \langfenp1033 \alang1025 Wiraswasta}{\rtlch \fcs1 \af6 \afs22 \ltrch \
clftsWidth3 \cellx10125 \row }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \
li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \
langfe1033 \langfenp1033 \alang1025 dengan seorang wanita}{\rtlch \fcs1 \af6 \afs22
alang1025 Nama Lengkap}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \
rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
YATMI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \caps1 \cell }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-
108 \trautofit1 \trwWidth10233 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \trpaddl108
\trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \
Ngawi, 31-12-1984}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \langnp1033
\langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 Agama}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Pekerjaan}
Mengurus Rumah Tangga}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Alamat}{\
Tidak diketahui tempat tinggalnya}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Demikian surat pengantar
ini dibuat dengan mengingat sumpah jabatan dan untuk dipergunakan sebagaimana
mestinya.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
aspalpha \aspnum \adjustright \lin6480 \rin0 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch
alang1025 Kedungprahu, 02 Desember 2024}{\rtlch
langfe1033 \langfenp1033 \alang1025 Kepala Desa Kedungprahu}{\rtlch \fcs1 \af6 \
qj \li6480 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \
lin6480 \rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0
shptop6 \shpright1230 \shpbottom1236 \shpfhdr0 \shpbxcolumn \shpbxignore \shpbypara
\shpbyignore \shpwr3 \shpwrk0 \shpfblwtxt0 \shpz8 \shplid1035 {\sp {\sn shapeType}
{\sv 75}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn
*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \ri0 \
widctlpar \hyphpar0 \aspalpha \aspnum \faauto \adjustright \lin0 \rin0 \itap0 \
\par }\pard \plain \s29 \fi194 \li5760 \ri-283 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 Lampiran VI}{\rtlch \fcs1 \af6 \afs18 \ltrch \
}\pard \plain \s29 \li5954 \ri0 \widctlpar \aspalpha \aspnum \adjustright \
}\pard \plain \s29 \qc \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Model N2}
{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \
\par }\pard \plain \s29 \fi720 \li7920 \ri0 \widctlpar \aspalpha \aspnum \
Perihal}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
langfenp1033 \alang1025 : Permohonan Kehendak Nikah}{\rtlch \fcs1 \af6 \afs22 \
Padas, 02 Desember 2024}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
tx284 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 Kepada Yth.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
Kepala }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
alang1025 K}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 UA Kecamatan }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Padas}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 di }
Padas}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
aspnum \adjustright \lin0 \rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \
rin0 \tql \tx284 \tql \tx3969 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
\langfe1033 \langfenp1033 \alang1025 Dengan hormat, kami mengajukan}{\rtlch \fcs1 \
loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 permohonan}{\
kehendak nikah untuk atas nama:}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch
\langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \
widctlpar \aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx2410 \itap0 \rtlch \
Suami }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
rin0 \tql \tx2410 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Calon Isteri }{\rtlch \fcs1 \af6 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \fcs1
Hari/tanggal/jam}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 Minggu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 / }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 / }{\rtlch \fcs1 \af6 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 08:00}{\rtlch \fcs1 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 WIB }{\rtlch \
langnp14345 \langfe1033 \langfenp1033 \alang1025 Tempat akad nikah}{\rtlch \fcs1 \
loch \f6 \lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch
\loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : }{\rtlch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 RT 004 /
RW 003 Dusun Mugu Raya}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
Maskawin}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfenp1033 \alang1025 : .....................................}{\rtlch \fcs1 \
plain \s29 \qj \li0 \ri0 \sb120 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
\langfe1033 \langfenp1033 \alang1025 Bersama ini kami sampaikan surat-surat yang
diperlukan untuk diperiksa sebagai berikut :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
langnp1033 \langfe1033 \langfenp1033 \alang1025 Surat Pengantar Nikah dari Desa /
Kelurahan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfe1033 \langfenp1033 \alang1025 Persetujuan Calon Mempelai}{\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Fotokopi KTP
Elektronik /Suket}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \fi-360 \li360 \ri0 \sl276 \
slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin360 \rin0 \itap0 \ls16 \rtlch
\loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \
langfe1033 \langfenp1033 \alang1025 Fotokopi Akta Kelahiran}{\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Fotokopi Kartu Keluarga
(KK)}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
\par }\pard \plain \s29 \qj \fi-360 \li360 \ri0
langnp14345 \langfe1033 \langfenp1033 \alang1025 Fotokopi Ijazah Terakhir}{\rtlch \
aspnum \adjustright \lin360 \rin0 \itap0 \ls16 \rtlch \fcs1 \af5 \afs22 \ltrch \
Paspoto ukuran 2x3 dan 4x6 sebanyak 4 lembar berlatar belakang warna biru}{\rtlch \
alang1025 Fotokopi KTP Elektronik Ayah dan Ibu calon pengantin}{\rtlch \fcs1 \af6 \
lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 Surat izin orangtua
(N5) bila umur kurang 21 Tahun *)}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langnp14345 \langfe1033 \langfenp1033 \alang1025 Surat Keterangan Kematian
Suami/Istri (N6) bila Duda/Janda Mati *)}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \lang14345 \
lang14345 \langnp14345 \langfe1033 \langfenp1033 \alang1025 Akta Cerai bila
Duda/Janda Hidup *)}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\u8230 ?}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?}{\
\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\
u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?}{\rtlch \fcs1 \af6 \afs22 \ltrch \
alang1025 \par }\pard \plain \s29 \qj \fi720 \li0 \ri0 \sl276 \slmult1 \widctlpar \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Demikian permohonan ini kami
sampaikan, kiranya dapat diperiksa, dihadiri dan dicatat sesuai dengan ketentuan
peraturan perundang-undangan.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \fi720 \li0 \ri0 \
rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
fi720 \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
alang1025 \par }\pard \plain \s29 \qj \fi720 \li5760 \ri0 \sl276 \slmult1 \
alang1025 Diterima tanggal \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1
\langfe1033 \langfenp1033 \alang1025 Wassalam,}{\rtlch \fcs1 \af6 \afs22 \ltrch \
alang1025 Yang menerima,}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 Pemohon}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
alang1025 Kepala KUA/}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 PPN }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 LN,}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li851 \ri0 \sl276
\slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin851 \rin0 \itap0 \rtlch \
langfe1033 \langfenp1033 \alang1025 Drs. ABU HELMI ROSYADI}{\rtlch \fcs1 \af6 \
caps1 DITA SETIANI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 NIP.
19670905 1994031003}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch
af4 \loch \af4 \lang1024 \langnp1024 \langfe1024 \langfenp1024 \alang1025 {\shp {\
*\shpinst \shpleft4485 \shptop26 \shpright5715 \shpbottom1256 \shpfhdr0 \
shpbxcolumn \shpbxignore \shpbypara \shpbyignore \shpwr3 \shpwrk0 \shpfblwtxt0 \
shpz10 \shplid1036 {\sp {\sn shapeType}{\sv 75}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn
fFlipV}{\sv 0}}{\sp {\sn fLockAgainstGrouping}{\sv 0}}{\sp {\sn fLockVerticies}{\sv
0}}{\sp {\sn fLockAspectRatio}{\sv 1}}{\sp {\sn fLockRotation}{\sv 0}}{\sp {\sn
pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
langfe1033 \langfenp1033 \alang1025 *) Coret bila tidak disertakan}{\rtlch \fcs1 \
alang1025 \cf13 \page }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \cf13 \par }\pard \plain \s29 \li0 \ri0 \
sect }\sectd \sbknone \pgwsxn11906 \pghsxn18709 \marglsxn851 \margrsxn851 \
margtsxn709 \margbsxn851 \guttersxn0 \headery708 \footery708 \pgbrdropt0 \
sectlinegrid360 \sectdefaultcl \endnhere \pard \plain \s29 \fi194 \li5760 \ri-425 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Lampiran VIII}{\rtlch \
pard \plain \s29 \fi194 \li5760 \ri-425 \widctlpar \aspalpha \aspnum \adjustright \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \cf13 \par }\pard \plain \s29 \
dbch \af0
\hich \af4 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \
par }\pard \plain \s29 \fi720 \li7920 \ri0 \widctlpar \aspalpha \aspnum \
\langfe1033 \langfenp1033 \alang1025 Model N4}{\rtlch \fcs1 \af6 \afs22 \ltrch \
\ul1 \par }\pard \plain \s29 \qc \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 PERSETUJUAN CALON PENGANTIN}{\
\ul1 \par }\pard \plain \s29 \qc \li0 \ri0 \widctlpar \aspalpha \aspnum \
tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \
alang1025 Calon suami :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\trowd \trql \trgaph0 \trleft252 \
adjustright \lin0 \rin0 \intbl
\itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 SAMINO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
lin357 \rin0 \intbl \itap1 \ls18 \ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Ngawi, 25-11-1999}{\rtlch
\loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \
brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb
\brdrnone \cltxlrtb \clwWidth284 \clftsWidth3 \cellx4397 \clvertalt \clbrdrl \
clwWidth5778 \clftsWidth3 \cellx10173 \row }\pard \plain \s29 \qj \fi-357 \li357 \
rin0 \intbl \itap1 \ls18 \ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
alang1025 Islam}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
Status}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \ri0 \widctlpar \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Karyawan Swasta}{\rtlch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Jejaka}{\rtlch \fcs1 \af6 \afs22 \
dbch \af0 \hich \af6 \loch \f6 \lang1033
\langnp1033 \langfe1033 \langfenp1033 \alang1025 Dsn. Kedungmiri RT 003 RW 006,
Desa Sambirejo, Kecamatan Mantingan, Kabupaten Ngawi}{\rtlch \fcs1 \af6 \afs22 \
tx709 \tql \tx3828 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \f2 B.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Calon istri :}{\rtlch \fcs1 \af6 \
trgaph0 \trleft252 \trautofit1 \trwWidth9923 \trftsWidth3 \trftsWidthB3 \
\cellx10175 \pard \plain \s29 \qj \fi-360 \li360 \ri0 \sl276 \slmult1 \widctlpar \
aspalpha \aspnum \faroman \adjustright \lin360 \rin0 \intbl \itap1 \ls19 \ilvl3 \
\caps1 DITA SETIANI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
\ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
Nomor Induk Kependudukan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
Islam}{\rtlch \fcs1 \af6 \afs22 \ltrch
trowd \trql \trgaph0 \trleft252 \trautofit1 \trwWidth9923 \trftsWidth3 \
clftsWidth3 \cellx10175 \row }\pard \plain \s29 \qj \fi-357 \li357 \ri0 \sl276 \
itap1 \ls19 \ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
plain \s29 \qj \fi-357 \li357 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 Status}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
}\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
Karyawan Swasta}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \ri0 \widctlpar \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Perawan}{\
\langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft252 \trautofit1 \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Menyatakan
dengan sesungguhnya bahwa atas dasar sukarela, dengan kesadaran sendiri, tanpa ada
paksaan dari siapapun juga}{\rtlch \fcs1 \af6
\afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \f6
\lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 ,}{\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 setuju untuk
melangsungkan pernikahan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 .}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
langfe1033 \langfenp1033 \alang1025 Demikian surat persetujuan ini dibuat untuk
digunakan seperlunya.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 \par }\trowd \trql \trgaph0 \trleft567 \
\cellx10315 \pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \
faroman \adjustright \lin0 \rin0 \tql \tx284 \tql \tx3969 \intbl \itap1 \rtlch \
Suami}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
RIZAL AJI ARI WIBOWO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
langfenp1033 \alang1025 \caps1 \cell }\pard \plain \s29 \qj \li0 \ri0 \sl276 \
langfe1033 \langfenp1033 \alang1025 Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 , }{\rtlch \fcs1 \af6 \afs22 \ltrch
langnp1057
langnp1057 \langfe1033 \langfenp1033 \alang1025 Calon Istri}{\rtlch \fcs1 \af6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 DITA SETIANI}{\rtlch \fcs1 \
clbrdrb \brdrnone \cltxlrtb \clwWidth4219 \clftsWidth3 \cellx10315 \row }\pard \
alang1025 \cf13 \par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \aspnum
\faauto \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24
shpbyignore \shpwr3 \shpwrk0 \shpfblwtxt0 \shpz11 \shplid1037 {\sp {\sn shapeType}
{\sv 75}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn
*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
cf13 \page }{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \
alang1025 \cf13 \par }\pard \plain \s29 \li5760 \ri-283 \widctlpar \aspalpha \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Lampiran IX}{\rtlch \fcs1 \af6 \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \li5760 \ri-283 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Tentang }{\rtlch \fcs1 \
plain \s29 \li5760 \ri-283 \widctlpar
\aspalpha \aspnum \adjustright \lin5760 \rin-283 \itap0 \rtlch \fcs1 \af5 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Petunjuk Teknis
Pelaksanaan Pencatatan Nikah}{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \li5040 \ri-283 \
Model N5}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \s29 \qc \li0 \ri0 \sl276 \slmult1 \
f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 \par }\pard \
plain \s29 \qc \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 \ul1 SURAT IZIN ORANG TUA}{\rtlch \fcs1 \af6 \
pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
alang1025 Yang bertanda tangan di bawah ini :}{\rtlch \fcs1 \af6 \afs22 \ltrch \
trleft-108 \trautofit1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \
\langfe1033 \langfenp1033 \alang1025 \caps1 SUKADI}{\rtlch \fcs1 \af6 \afs22 \ltrch
trowd \trql \trgaph0 \trleft-108 \trautofit1 \trftsWidth1 \trftsWidthB3 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 2. Bin}{\rtlch \fcs1 \af6 \afs22 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Mino}{\rtlch \fcs1 \af6 \afs22 \
alang1025 {\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trftsWidth1 \trftsWidthB3
\trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \
faroman \adjustright
\lin357 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 Nomor Induk Kependudukan}{\rtlch \fcs1 \af6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 4.}{\rtlch \fcs1 \af6 \afs22 \ltrch
Ngawi, 04 Juli 1960}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \fcs1 \af6 \afs22 \
faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch
langnp1057 \langfe1033 \langfenp1033 \alang1025 7. Pekerjaan}{\rtlch \fcs1 \af6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Wiraswasta}{\rtlch \fcs1 \af6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 8. Alamat}{\rtlch \fcs1 \af6 \afs22
B.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
alang1025 1. Nama lengkap dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
\langfe1033 \langfenp1033 \alang1025 \caps1 YATMI}{\rtlch \fcs1 \af6 \afs22 \
fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich
\af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 2. Bin}
alang1025 Nomor Induk Kependudukan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 4.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22
langnp1057 \langfe1033 \langfenp1033 \alang1025 , }{\rtlch \fcs1 \af6 \afs22 \ltrch
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \
clbrdrt \brdrnone \clbrdrb \brdrnone
\cltxlrtb \clwWidth4219 \clftsWidth3 \cellx4111 \clvertalt \clbrdrl \brdrnone \
\langfe1033 \langfenp1033 \alang1025 Agama}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
langfe1033 \langfenp1033 \alang1025 8. Alamat}{\rtlch \fcs1 \af6 \afs22 \ltrch \
row }\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trftsWidth1 \trftsWidthB3 \
trwWidthA6 \trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \
trpaddfr3 \clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
alang1025 adalah ayah dan ibu kandung dari :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
trowd \trql \trgaph0 \trleft-108 \trautofit1 \trftsWidth1 \trftsWidthB3 \trwWidthA6
brdrnone \cltxlrtb \clwWidth10281 \clftsWidth3 \cellx10173 \row }\trowd \trql \
trgaph0 \trleft-108 \trautofit1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \
clftsWidth3 \cellx4398 \clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone
\clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth5781 \clftsWidth3 \
cellx10179 \pard \plain \s29 \qj \fi-360 \li720 \ri0 \widctlpar \aspalpha \aspnum \
alang1025 Nama lengkap dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 SUKADI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
alang1025 Nomor Induk Kependudukan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
dbch \af0 \hich \af6
\loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 :}{\rtlch \
pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \
alang1025 Pekerjaan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt
\brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth4219 \clftsWidth3 \cellx4111 \
ri0 \widctlpar \aspalpha \aspnum \faroman \adjustright \lin720 \rin0 \intbl \
alang1025 Memberikan izin kepada anak kami untuk melakukan perkawinan dengan :}{\
alang1025 Bin}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
hich \af4 \loch \af0 \lang1033 \langnp1033
\langfe1033 \langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 SAMINO}{\rtlch \fcs1 \af6 \afs22 \ltrch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Ngawi, 25-
11-1999}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
trautofit1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \trpaddr108 \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 WNI}{\
\li720 \ri0 \widctlpar
\aspalpha \aspnum \faroman \adjustright \lin720 \rin0 \intbl \itap1 \ls22 \rtlch \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 ISLAM}{\rtlch \fcs1 \
langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trftsWidth1
hich \af4 \loch \f6 \lang1057 \langnp1057
row }\pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 Demikian surat izin ini dibuat dengan kesadaran
tanpa ada paksaan dari siapapun dan untuk digunakan seperlunya.}{\rtlch \fcs1 \
\langfe1033 \langfenp1033 \alang1025 \par }\trowd \trql \trgaph0 \trleft0 \
trautofit1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \trpaddr108 \
clbrdrb \brdrnone \cltxlrtb \clwWidth3652 \clftsWidth3 \cellx9889 \pard \plain \s29
\qj \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \faroman \adjustright \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Ayah/wali/pengampu}{\rtlch \fcs1 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Kedungprahu, 02 Desember
2024}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
Ibu/wali/pengampu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
widctlpar \aspalpha \aspnum \faroman \adjustright \lin0 \rin0 \tql \tx284 \tql \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qj \li0 \ri0
langfe1033 \langfenp1033 \alang1025 YATMI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
trql \trgaph0 \trleft0 \trautofit1 \trftsWidth1 \trftsWidthB3 \trftsWidthA3 \
clftsWidth3 \cellx9889 \row }\pard \plain \s29 \qc \li0 \ri-113 \widctlpar \
shptop266 \shpright5715 \shpbottom1496 \shpfhdr0 \shpbxcolumn \shpbxignore \
shpbypara \shpbyignore \shpwr3 \shpwrk0 \shpfblwtxt0 \shpz12 \shplid1038 {\sp {\sn
shapeType}{\sv 75}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn
*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
\ul1 \par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \aspnum \faauto \
langfe1033 \langfenp1033 \alang1025 \ul1 \page }{\rtlch \fcs1 \af6 \afs24 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 \par }\pard \plain \s29 \qc \
\ul1 \par }\pard \plain \s29 \qc \li0 \ri-113 \widctlpar \aspalpha \aspnum \
\langfe1033 \langfenp1033 \alang1025 \ul1 \par }\pard \plain \s29 \qc \li0 \ri-
113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \itap0 \rtlch \fcs1 \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 SURAT
PERNYATAAN STATUS}{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \s29 \li0 \ri-113 \widctlpar \aspalpha \
aspnum \adjustright \lin0 \rin-113 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \
113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \itap0 \rtlch \fcs1 \
dbch \af0 \hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033
\langfenp1033 \alang1025 \par }\trowd \trql \trgaph0 \trrh387 \trleft-108 \
cltxlrtb \clwWidth6521 \clftsWidth3 \cellx10490 \pard \plain \s29 \qj \li0 \ri-
113 \sl360 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl
alang1025 Nama lengkap dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 DITA SETIANI}{\
\langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh387 \trleft-108 \trwWidth10598
\trftsWidth3 \trftsWidthB3 \trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \
alang1025 N}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 omor Induk Kependudukan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 3521084903990001}{\
trrh388 \trleft-108 \trwWidth10598 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Jenis Kelamin}{\rtlch \fcs1 \af6 \
Perempuan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh388 \trleft-108 \
clftsWidth3
\cellx3969 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
Ngawi, 12 Maret 2000}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
langnp1033 \langfe1033 \langfenp1033 \alang1025 Kewarganegaraan }{\rtlch \fcs1 \af6
hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 WNI}
Islam}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh388 \trleft-108 \
\ltrch \fcs0 \fs22 \rtlch
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Karyawan Swasta}{\rtlch \
langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trrh387 \trleft-108 \
alang1025 Pendidikan terakhir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 [form_pendidikan_wanita]}
alang1025 {\trowd \trql \trgaph0 \trrh388 \trleft-108 \trwWidth10598 \trftsWidth3 \
cltxlrtb \clwWidth283 \clftsWidth3 \cellx3969 \clvertalb \clbrdrl \brdrnone \
clftsWidth3 \cellx10490 \row }\pard \plain \s29 \qj \li0 \ri-113 \widctlpar \
Dengan ini menyatakan bahwa, Saya betul-betul pada saat ini berstatus Jejaka/Duda
Mati/Duda Cerai/Perawan/Janda Mati/Janda Cerai, dan surat pernyataan ini dibuat
guna persyaratan Pernikahan.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
Demikianlah surat
pernyataan ini saya buat dengan sebenarnya, dalam keadaan sehat jasmani dan rohani
tanpa ada paksaan dari pihak manapun. Apabila di kemudian hari menyalahi surat
pernyataan ini, saya bersedia dituntut sesuai Perundang-undangan/Hukum yang berlaku
dan tidak akan melibatkan aparat setempat ( Resiko Sendiri).}{\rtlch \fcs1 \af6 \
qj \li0 \ri-113 \sl360 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
rin-113 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
}\trowd \trql \trgaph0 \trleft6237 \trbrdrt \brdrs \brdrw10 \trbrdrb \brdrs \
brdrw10 \trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs \brdrw10 \trbrdrh \brdrs \
brdrw10 \trbrdrv \brdrs \brdrw10 \trwWidth4253 \trftsWidth3 \trftsWidthB3 \
alang1025 Yang membuat pernyataan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
cltxlrtb \clwWidth4253 \clftsWidth3 \cellx10490 \row }\pard \plain \s29 \li0 \ri-
113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \itap1 \rtlch \
langfenp1033 \alang1025 {\rtlch \fcs1 \af6 \afs20 \ltrch \fcs0 \b1 \i1 \fs20 \rtlch
langfe1033 \langfenp1033 \alang1025 Materai }{\rtlch \fcs1 \af6 \afs20 \ltrch \fcs0
\b1 \i1 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \f6 \lang1057 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 10.000}{\rtlch \fcs1 \af6 \afs20 \
ltrch \fcs0 \b1 \i1 \fs20 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af6 \loch \
s29 \li0 \ri-113 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \intbl \
fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich \af4 \loch \f6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 DITA SETIANI}{\rtlch \fcs1 \
plain \s29 \li0 \ri-113 \widctlpar \aspalpha
\aspnum \adjustright \lin0 \rin-113 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \
langfe1033 \langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft6237 \trbrdrt \
brdrs \brdrw10 \trbrdrb \brdrs \brdrw10 \trbrdrl \brdrs \brdrw10 \trbrdrr \brdrs \
brdrw10 \trbrdrh \brdrs \brdrw10 \trbrdrv \brdrs \brdrw10 \trwWidth4253 \
cellx10490 \row }\pard \plain \s29 \li0 \ri-113 \sl276 \slmult1 \widctlpar \
113 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \itap0
}\pard \plain \s29 \li0 \ri-113 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 Saksi-saksi :}{\rtlch \fcs1 \af6 \afs22 \
alang1025 \par }\trowd \trql \trgaph0 \trleft-108 \trwWidth10598 \trftsWidth3 \
\trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
clbrdrb \brdrnone \cltxlrtb \clwWidth468 \clftsWidth3 \cellx360 \clvertalb \clbrdrl
\brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \
pard \plain \s29 \fi-360 \li360 \ri-113 \sl480 \slmult1 \widctlpar \aspalpha \
aspnum \adjustright \lin360 \rin-113 \intbl \itap1 \ls23 \rtlch \fcs1 \af5 \afs22 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 ( \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
\u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?. )}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
trql \trgaph0 \trleft-108 \trwWidth10598 \trftsWidth3 \trftsWidthB3 \trftsWidthA3 \
trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \
cltxlrtb \clwWidth468 \clftsWidth3 \cellx360 \clvertalb \clbrdrl \brdrnone \clbrdrr
\brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone \cltxlrtb \clwWidth4460 \
brdrnone \cltxlrtb \clwWidth5245 \clftsWidth3 \cellx10490 \row }\pard \plain \s29 \
fi-360 \li360 \ri-113 \sl480 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \
lin360 \rin-113 \intbl \itap1 \ls23 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \
cell }\pard \plain \s29 \li0 \ri-113 \sb240 \sl480 \slmult1 \widctlpar \aspalpha \
\u8230 ?\uc1 \u8230 ?.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
cell }\pard \plain \s29 \li0 \ri-113
\sb240 \sl480 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \rin-113 \
alang1025 ( \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?. )}
\langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \trwWidth10598 \
trpaddft3 \trpaddfb3 \trpaddfr3 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \
cellx360 \clvertalb \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \brdrnone \
clftsWidth3 \cellx10490 \row }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha
\aspnum \faauto \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \caps1 \par }\pard \plain \s29 \
qc \li0 \ri0 \sl276 \slmult1 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
alang1025 \ul1 \par }\pard \plain \s29 \qj \li0 \ri0 \sl276 \slmult1 \widctlpar \
widctlpar \hyphpar0 \aspalpha \aspnum \faauto \adjustright \lin0 \rin0 \itap0 \
super1 \page }{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \fs24 \rtlch \alang1025 \ltrch
alang1025 \super1 \par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \sect }\sectd \sbknone \
pgwsxn11906 \pghsxn18709 \marglsxn851 \margrsxn851 \margtsxn709 \margbsxn851 \
guttersxn0 \headery708 \footery708 \pgbrdropt0 \sectlinegrid360 \sectdefaultcl \
endnhere \pard \plain \s29 \li5954 \ri-425 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 Lampiran IX}{\rtlch \fcs1 \af6 \afs18 \ltrch \
cf13 \par }\pard \plain \s29 \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \fi720 \li7920 \ri0 \
f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Model N6}{\rtlch \
pard \plain \s29 \fi720 \li7920 \ri0 \widctlpar \aspalpha \aspnum \adjustright \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \li0 \ri0 \sl276 \
KANTOR DESA/KELURAHAN}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 \caps1 Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \
li0 \ri0 \sl276 \slmult1 \widctlpar
\aspalpha \aspnum \adjustright \lin0 \rin0 \tql \tx3544 \itap0 \rtlch \fcs1 \af5 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 KECAMATAN}{\rtlch \fcs1 \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : }{\rtlch
\loch \f6 \lang1057 \langnp1057 \langfe2052 \langfenp2052 \alang1025 \caps1 Padas}
langnp1033 \langfe1033 \langfenp1033 \alang1025 KABUPATEN }{\rtlch \fcs1 \af6 \
Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
\par }\pard \plain \s29 \li0 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin0 \
alang1025 \par }\pard \plain \s29 \li0 \ri0 \widctlpar \aspalpha \aspnum \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s29 \qc \li0 \ri0 \sl276 \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \ul1 SURAT
KETERANGAN KEMATIAN}{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \b1 \fs24 \rtlch \
langfe1033 \langfenp1033 \alang1025 \ul1 \par }\pard \plain \s29 \qc \li0 \ri0 \
Nomor : 474.2/489/404.606.10/2024}{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \fs24 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Yang bertanda tangan di
bawah ini menerangkan dengan sesungguhnya bahwa:}{\rtlch \fcs1 \af6 \afs22 \ltrch \
1. }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nama
lengkap dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \cell }\pard \plain \s29 \qj \li0 \ri0 \widctlpar \aspalpha
\aspnum \faroman \adjustright \lin0 \rin0 \intbl \itap1 \rtlch \fcs1 \af5 \afs22 \
alang1025 [nama_suami_dulu]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext
\pard \plain \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 Bin/Binti}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langfe1033 \langfenp1033 \alang1025 [bin_suami_dulu]}{\rtlch \fcs1 \af6 \afs22 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 [noktp_suami_dulu]}{\rtlch \fcs1 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 [tempatlahir_suami_dulu],
[tanggallahir_suami_dulu]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
faroman \adjustright \lin0 \rin0
\intbl \itap1 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch
alang1025 [wn_suami_dulu]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 [agama_suami_dulu]}{\rtlch \fcs1 \af6 \afs22 \
langfe1033 \langfenp1033 \alang1025 [pek_suami_dulu]}{\rtlch \fcs1 \af6 \afs22 \
langfe1033 \langfenp1033 \alang1025 [alamat_suami_dulu]}{\rtlch \fcs1 \af6 \afs22 \
brdrnone \clbrdrt \brdrnone \clbrdrb \brdrnone
\cltxlrtb \clwWidth5353 \clftsWidth3 \cellx10035 \row }\pard \plain \s29 \qj \
alang1025 Telah meninggal dunia pada tanggal}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0
langfe1033 \langfenp1033 \alang1025 [tanggalmeninggal_suami_dulu]}{\rtlch \fcs1 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Di}{\rtlch \fcs1 \af6 \afs22 \ltrch
langfe1033 \langfenp1033 \alang1025 [tempatmeninggal_suami_dulu],
[alamat_suami_dulu]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
alang1025 Yang bersangkutan adalah suami / isteri}{\rtlch \fcs1 \af6 \afs22 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \super1 *) }{\rtlch \fcs1
\f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 dari :}{\rtlch \fcs1
\f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \cell }\pard \
\trwWidthA7 \trftsWidthA3 \trpaddl108 \trpaddr108 \trpaddfl3 \trpaddft3 \
\cellx10035 \pard \plain \s29 \qj \fi-357 \li357 \ri0 \widctlpar \aspalpha \
alang1025 \f2 B.\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
\langfe1033 \langfenp1033 \alang1025 Nama lengkap dan alias}{\rtlch \fcs1 \af6 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 DITA SETIANI}{\rtlch
\fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \dbch \af0 \hich
\af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \caps1 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Bin/Binti}{\rtlch \fcs1 \
langnp1057 \langfe1033 \langfenp1033 \alang1025 Ngawi, 12 Maret 2000}{\rtlch \
langfenp1033 \alang1025 {\trowd \trql \trgaph0 \trleft-108 \trautofit1 \trftsWidth1
itap1 \ls26 \ilvl3 \rtlch \fcs1 \af5 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
ltrch \dbch \af0 \hich \af4 \loch \af0 \lang1033 \langnp1033 \langfe1033
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Kewarganegaraan}{\rtlch \
hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 WNI}
rtlch
langfe1033 \langfenp1033 \alang1025 RT 004 RW 003 Desa Kedungprahu, Kecamatan
Padas, Kabupaten Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
row }\pard \plain \s29 \qj \li720 \ri0 \widctlpar \aspalpha \aspnum \adjustright \
lin720 \rin0 \tql \tx709 \tql \tx4253 \itap0 \rtlch \fcs1 \af5 \afs22 \ltrch \
li426 \ri0 \widctlpar \aspalpha \aspnum \adjustright \lin426 \rin0 \tql \tx4253 \
alang1025 Demikian surat keterangan ini dibuat dengan mengingat sumpah jabatan dan
untuk digunakan seperlunya.}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 ,}{\rtlch \fcs1 \af6 \afs22 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 02 Desember 2024}{\rtlch
pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
ltrch \dbch
alang1025 SUNARTO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
hyphpar0 \aspalpha \aspnum \faauto \adjustright \lin5760 \rin0 \itap0 \rtlch \
af0 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \super1 \
Lampiran IX}{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \
alang1025 \par }\pard \plain \s29 \fi720 \li5040 \ri-425 \widctlpar \aspalpha \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Kepdirjen Bimas Islam Nomor 473
Tahun 2020}{\rtlch \fcs1 \af6 \afs18 \ltrch \fcs0 \fs18 \rtlch \alang1025 \ltrch \
alang1025 \par }\pard \plain \s29 \fi720 \li5040 \ri-283 \widctlpar \aspalpha \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Tentang }{\rtlch \fcs1 \af6 \
alang1025 Petunjuk Teknis Pelaksanaan Pencatatan Nikah}{\rtlch \fcs1 \af6 \afs18 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \li0 \
ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \itap0 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 KANTOR DESA/KELURAHAN}{\
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : }
caps1 Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha
\faroman \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 KECAMATAN}{\rtlch \fcs1 \af6 \afs22
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : }
caps1 Padas}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfe1033 \langfenp1033 \alang1025 KABUPATEN/KOTA}{\rtlch \fcs1 \af6 \afs22 \ltrch
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : }{\rtlch
\loch \f6 \lang1057 \langnp1057 \langfe2052 \langfenp2052 \alang1025 \caps1 Ngawi}
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \qc \li0 \ri0 \sl360 \
\ul1 \par }\pard \plain \qc \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
langfe1033 \langfenp1033 \alang1025 \ul1 SURAT KETERANGAN }{\rtlch
\fcs1 \af6 \afs24 \ltrch \fcs0 \b1 \fs24 \rtlch \alang1025 \ltrch \dbch \af0 \hich
\af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \ul1 WALI
NIKAH}{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \b1 \fs24 \rtlch \alang1025 \ltrch \
alang1025 \ul1 \par }\pard \plain \qc \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \
langfe1033 \langfenp1033 \alang1025 Nomor : 400.12.3.2/535/404.606.10/2024}{\
}\pard \plain \fi-76 \li2486 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \qj \li0 \ri0 \sb120 \
plain \qj \li0 \ri0 \sb120 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \
langfe1033 \langfenp1033 \alang1025 Yang bertanda tangan di bawah ini}{\rtlch \fcs1
\f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 , Kepala Desa }{\
Kedungprahu, Kecamatan Padas, Kabupaten Ngawi,}{\rtlch \fcs1 \af6 \afs22 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 menerangkan dengan
sesungguhnya bahwa :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
langfenp1033 \alang1025 \par }\pard \plain \qj \li288 \ri0 \sb120 \sl360 \slmult1 \
widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin288 \rin0 \itap0 \rtlch \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nama
lengkap dan alias}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
\langfe1033 \langfenp1033 \alang1025 : SUKADI}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \qj \li288 \
ri0 \sb120 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
\langfe1033 \langfenp1033 \alang1025 : MINO}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \qj \li288 \
ri0 \sb120 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
langfe1033 \langfenp1033 \alang1025 NIK}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 : 3521080407600003}{\rtlch \fcs1 \af6 \afs22 \
fi-142 \li426 \ri0 \sb0 \sl360 \slmult1 \widctlpar \keep1 \keepn1 \hyphpar0 \
loch \af0 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cf12 {\
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \cf0
Tempat tanggal lahir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
langfenp1033 \alang1025 \cf0 \tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
langfe1033 \langfenp1033 \alang1025 \cf0 \tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \cf0 : Ngawi, 04 Juli 1960}{\
hich \af4 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \cf0
\par }\pard \plain \fi-142 \li426 \ri0 \sl360 \slmult1 \widctlpar \hyphpar0 \
aspalpha \faroman \adjustright \lin426 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 Agama }{\rtlch \fcs1 \af6 \afs22 \
hich \af0
\loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch
\loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 : Islam}{\
}\pard \plain \fi-142 \li426 \ri0 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \
faroman \adjustright \lin426 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Pekerjaan Terakhir}{\rtlch \fcs1 \
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 :
Wiraswasta}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
terakhir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfenp1033 \alang1025 : RT 004 / RW 003 Dusun Mugu Raya}{\rtlch \fcs1 \af6 \afs22
langfe1033 \langfenp1033 \alang1025 Keperluan}{\rtlch \fcs1 \af6 \afs22 \ltrch \
hich \af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 :
Menjadi Wali Nikah}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \fi-142 \li3119 \ri0 \sl360 \slmult1 \
Pernikahan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
langfe1033 \langfenp1033 \alang1025 : }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \
langfe1033 \langfenp1033 \alang1025 Dengan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
plain \fi-142 \li3119 \ri0 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \
faroman \adjustright \lin3119 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \
langnp1033 \langfe1033 \langfenp1033 \alang1025 Hubungan Wali}{\rtlch \fcs1 \af6 \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Ayah
Kandung}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch
hich \af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 }
}{\rtlch \fcs1
qj \li0 \ri0 \sb120 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \
langfe1033 \langfenp1033 \alang1025 Demikianlah, surat keterangan ini dibuat dengan
mengingat sumpah jabatan dan untuk dipergunakan seperlunya.}{\rtlch \fcs1 \af6 \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi-142 \li426 \ri0 \sl360 \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Kedungprahu}{\rtlch \fcs1
\f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 ,}{\rtlch \fcs1 \af6
f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 02 Desember 2024}{\
pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \sect }\sectd \
sbknone \pgwsxn11906 \pghsxn18709 \marglsxn851 \margrsxn851 \margtsxn709 \
margbsxn851 \guttersxn0 \headery708 \footery708 \pgbrdropt0 \sectlinegrid360 \
sectdefaultcl \endnhere \pard \plain \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \
langfe1033
\langfenp1033 \alang1025 \par }\pard \plain \li0 \ri0 \widctlpar \hyphpar0 \
aspalpha \aspnum \faauto \adjustright \lin0 \rin0 \itap0 \rtlch \fcs1 \af0 \afs24 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \caps1 \page }{\rtlch \
par }\pard \plain \s28 \qc \li1260 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
shpbyignore \shpwr3 \shpwrk0 \shpfblwtxt0 \shpz9 \shplid1042 {\sp {\sn shapeType}{\
sv 75}}{\sp {\sn fFlipH}{\sv 0}}{\sp {\sn fFlipV}{\sv 0}}{\sp {\sn
*\blipuid
646ed728646ed728646ed728646ed728}89504e470d0a1a0a0000000d49484452000000640000006408
0600000070e2955400004bc749444154785eedbd077c95e5d93ffe3dfb9c24277b2764421220614fd91
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lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 \ul1 SURAT PENGANTAR
NUMPANG NIKAH}{\rtlch \fcs1 \af6 \afs28 \ltrch \fcs0 \b1 \fs28 \rtlch \alang1025 \
langfenp1033 \alang1025 \ul1 \par }\pard \plain \qc \li0 \ri0 \widctlpar \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Nomor :
474.2/489/404.606.10/2024}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \ul1 \par }\pard \plain \qc \li0 \ri0 \
langfe1033 \langfenp1033
\alang1025 \tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 Yang bertanda tangan di bawah ini}{\rtlch \fcs1 \af6 \afs22
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Kepala Desa }{\rtlch \
Kedungprahu, Kecamatan Padas, Kabupaten Ngawi, menerangkan dengan sebenarnya
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \s24 \qj \fi-567 \li1276 \
ri180 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin1276
\rin180 \tql \tx3960 \tql \tx4140 \itap0 \ls27 \rtlch \fcs1 \af0 \afs24 \ltrch \
\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
:}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \dbch \
\tab }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \
alang1025 DITA SETIANI}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
Tempat/tanggal lahir}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025
\langfe1033 \langfenp1033 \alang1025 Ngawi / 12 Maret 2000}{\rtlch \fcs1 \af6 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 :}{\rtlch \fcs1
\f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \tab }{\rtlch \
af6 \loch \f6 \lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Perempuan}
}\pard \plain \fi-3420 \li4140 \ri4 \widctlpar \hyphpar0 \aspalpha \faroman \
langfe1033 \langfenp1033 \alang1025 Surat bukti diri}{\rtlch \fcs1 \af6 \afs22 \
\langfe1033 \langfenp1033 \alang1025 KTP }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 : 3521084903990001}{\rtlch \fcs1 \af6 \
Warga negara}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
\langfe1033 \langfenp1033 \alang1025 WNI}{\rtlch \fcs1 \af6 \afs22 \ltrch
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi-3420 \li4140
\ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
lin4140 \rin4 \tql \tx1260 \tql \tx3960 \tql \tx4140 \itap0 \ls27 \rtlch \fcs1 \af0
\lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \pard \
\langfe1033 \langfenp1033 \alang1025 Islam}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi-11 \li720 \ri4 \sl360 \
slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin720 \rin4 \tql \
Status Perkawinan}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 : Perawan}{\rtlch \fcs1 \af6 \afs22 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi-3420 \li4140
\ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
lin4140 \rin4 \tql \tx1260 \tql \tx3960 \tql \tx4140 \itap0 \ls27 \rtlch \fcs1 \af0
\lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 {\listtext \pard \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 Karyawan
Swasta}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi720
\li0 \ri4 \sl360 \slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \
langfe1033 \langfenp1033 \alang1025 Nama tersebut di atas }{\rtlch \fcs1 \af6 \
lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 betul bermaksud akan
menumpang Nikah / Kawin di :}{\rtlch \fcs1 \af6 \afs24 \ltrch \fcs0 \fs24 \rtlch \
langfe1033 \langfenp1033 \alang1025 \par }\pard \plain \fi709 \li0 \ri-1 \sl360 \
slmult1 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin-1 \itap0 \
Dsn. Kedungmiri RT 003 RW 006, Desa Sambirejo, Kecamatan Mantingan, Kabupaten
Ngawi}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \ltrch \
alang1025 \par }\pard \plain \fi720 \li0 \ri4 \sl360 \slmult1 \widctlpar \
lang1057 \langnp1057 \langfe1033 \langfenp1033 \alang1025 Kepada seorang }{\rtlch \
af6 \loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 laki-laki}
yang bernama :}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 \par }\pard \plain \fi720 \li0 \ri4 \sl360 \slmult1 \
loch \f6 \lang1033 \langnp1033 \langfe1033 \langfenp1033 \alang1025 RIZAL AJI ARI
WIBOWO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \ltrch \
alang1025 Bin }{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \b1 \fs22 \rtlch \alang1025 \
langfenp1033 \alang1025 SAMINO}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
hich \af0 \loch \af0 \lang1033 \langnp1033 \langfe1033
Demikian Surat ini dibuat, untuk dipergunakan sebagaimana mestinya.}{\rtlch \fcs1 \
plain \s24 \qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0
\rin0 \tql \tx2880 \itap0 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \rtlch \
widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \tql \tx2880 \itap0
}\trowd \trql \trgaph0 \trrh2260 \trleft-108 \trautofit1 \trwWidth10188 \
trftsWidth3 \trftsWidthB3 \trftsWidthA3 \trpaddl10 \trpaddr10 \trpaddfl3 \trpaddft3
\trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
brdrnone \clbrdrb \brdrnone \cltxlrtb \clpadt108 \clpadr108 \clpadfl3 \clpadfb3 \
clpadft3 \clpadfr3 \clwWidth4158 \clftsWidth3 \cellx4050 \clvertalt \clbrdrl \
clpadt108 \clpadr108 \clpadfl3 \clpadfb3 \clpadft3 \clpadfr3 \clwWidth900 \
clpadft3 \clpadfr3 \clwWidth5130 \clftsWidth3 \cellx10080 \pard \plain \s24 \qj \
li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \tql \
langfe1033 \langfenp1033 \alang1025 Nomor}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \
\langfe1033 \langfenp1033 \alang1025 : \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\
u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
alang1025 Tanggal}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \alang1025 \
langfe1033 \langfenp1033 \alang1025 : \uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \
alang1025 Mengetahui,}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
alang1025 Camat Wedung,}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?\uc1 \u8230 ?..}{\rtlch \fcs1 \af6 \afs22 \
s24 \qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \
rin0 \tql \tx2880 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \ltrch \fcs0 \fs24 \
langfe1033 \langfenp1033 \alang1025 \cell }\pard \plain \s24 \qc \li0 \ri0 \
dbch \af0 \hich \af6 \loch \f6 \lang1033
\langnp1033 \langfe1033 \langfenp1033 \alang1025 Kedungprahu, 02 Desember 2024}{\
}\pard \plain \s24 \qc \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \
adjustright \lin0 \rin0 \tql \tx2880 \intbl \itap1 \rtlch \fcs1 \af0 \afs24 \
alang1025 Kepala Desa Kedungprahu}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \
ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \tql \tx2880 \
alang1025 \cf18 [nip_pamong]}{\rtlch \fcs1 \af6 \afs22 \ltrch \fcs0 \fs22 \rtlch \
langfe1033 \langfenp1033 \alang1025 \cf18 \cell }\pard \plain \li0 \ri0 \
trowd \trql \trgaph0 \trrh2260 \trleft-108 \trautofit1 \trwWidth10188 \
trftsWidth3 \trftsWidthB3 \trftsWidthA3 \trpaddl10 \trpaddr10 \trpaddfl3 \trpaddft3
\trpaddfb3 \trpaddfr3 \clvertalt \clbrdrl \brdrnone \clbrdrr \brdrnone \clbrdrt \
clpadft3 \clpadfr3 \clwWidth4158 \clftsWidth3 \cellx4050 \clvertalt \clbrdrl \
clpadt108 \clpadr108 \clpadfl3 \clpadfb3 \clpadft3 \clpadfr3 \clwWidth900 \
clpadft3 \clpadfr3 \clwWidth5130 \clftsWidth3 \cellx10080 \row }\pard \plain \s24 \
qj \li0 \ri0 \widctlpar \hyphpar0 \aspalpha \faroman \adjustright \lin0 \rin0 \
pngblip {\*\blipuid
9200006d00004900002400dbdb00b6b6009292006d6d004949002424000000db0000b600009200006d0
b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b4b42
e0b01280361842f17250000000049454e44ae426082}}}{\sp {\sn fLineOK}{\sv 1}}{\sp {\sn
f3DOK}{\sv 0}}{\sp {\sn fShadowOK}{\sv 1}}{\sp {\sn fFilled}{\sv 0}}{\sp {\sn
lineStyle}{\sv 0}}{\sp {\sn fLine}{\sv 0}}{\sp {\sn wzName}{\sv Picture 18}}{\sp {\
sn fLayoutInCell}{\sv 0}}}{\shprslt {\pict }}}}{\rtlch \fcs1 \af6 \afs24 \ltrch \
langnp1033 \langfe1033 \langfenp1033 \alang1025 \par }}

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{\rtf1 \ansi \ansicpg1252 \deff0 \stshfdbch2 \stshfloch0 \stshfhich0 \deflang1033 \

deflangfe1033 {\fonttbl {\f0 \froman \fcharset0 \fprq2 {\*\panose

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