Wa0021.
Wa0021.
Wa0021.
SERI :I
NO : 02715
0536
Nomor : ..................../ 2018
AC / ................... DPK
/ PA / Msy.*) ...........................
......................................................,
ASMIT BIN 54
umur.............................. tahun, Agama : Islam,
UWAN Karyawan swasta
Pekerjaan...........................................................
Jl. Pengasinan
Tempat tinggal di...............................................
...........................................................................
RT.002 RW.003
Kelurahan Pengasinan
...........................................................................
Kecamatan.........................................................
Sawangan
Kabupaten/Kota*).............................................
Depok
...........................................................................
dengan
IRA MAYA
......................................................, 44
umur.............................. tahun, Agama : Islam,
BINTI TOHIR Ibu Rumah Tangga
Pekerjaan...........................................................
Pengasinan
Tempat tinggal di...............................................
RT.002 RW.003
...........................................................................
Kelurahan Pengasinan
...........................................................................
Kecamatan.........................................................
Sawangan
Kabupaten/Kota*).............................................
Depok
...........................................................................
Panitera
sah dic 10 Kali