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BUKU INDUK PEGAWAI

SDN .BUKU INDUK PEGAWAI

NOMOR INDUK : ................................

1Nama Pegawai:a.Lengkap : ..........................................

b.Panggilan: ..........................................

2.Jenis Kelamin:Laki Laki / Perempuan

3Kelahiran:a. Tanggal: ..........................................

b. Tempat: ..........................................

4.Agama:Islam

5Kewarganegaraan:WNI

6Golangan Darah:.......................

7Jabatan:..........................................

8.Pangkat/Golongan/Ruang:..........................................

a. Tanggungan Keluarga

b. Yang Masuk Daftar Gaji

1. .................................

2. .................................

9.Nomor Petunjuk Pegawai:a. KTP: ............................

b. Karpeg/NIP: ............................

c. Kartu Taspen: ............................

d. Kartu Askes: ............................

e. Kartu Anggota PGRI: ............................

f. Kartu Anggota Koperasi: ............................

g. Nomor SK Angkatan: ............................

10.Alamat dan No Telp:Kampung: .................................

Rt / Rw: .................................

Desa: .................................

Kecamatan: .................................

11.Pendidikan:a. SDTahun Lulus:................

b. SMPTahun Lulus:................

c. SLTATahun Lulus:................

d. DIITahun Lulus:................

c. S-1Tahun Lulus:................

d. S-2Tahun Lulus:................

12.Mulai Masuk SD Ini:

13.Mutasi:a. Pindah DariSD:.........................

Kec:.........................

Thn:.........................

b. Pindah KeSD:.........................

Kec:.........................

Thn:.........................

14Lain -Lain / Catatan Yang Penting :....................................................................................................................................................


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