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Formulis pengaduan
- 1. FORMULIR PENGADUAN MASYARAKAT
NO: ………………………………..
Nama : .............................................................................................................
Alamat : .............................................................................................................
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Nomor Telepon : .............................................................................................................
Pekerjaan : .............................................................................................................
Hal Yang diadukan :
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Arjasa, …………….20….
Pengadu,
(…………………………………)
- 2. TANDA BUKTI PENGADUAN
NO: ………………………………..
Telah diterima Pengaduan dari:
Nama : .............................................................................................................
Alamat : .............................................................................................................
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Rincian Pengaduan :
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Arjasa, …………….20….
Petugas,
(…………………………………)