FORM SURAT TUGAS SKPD JEMBRANA

FORMAT SURAT PERINTAH TUGAS SKPD

            KOP NASKAH DINAS PERANGKAT DAERAH

SURAT PERINTAH TUGAS

Nomor : .091/......./SKPD/2016

Dasar          :      .............................................................................................

                          .............................................................................................

MEMERINTAHKAN  :

Kepada              :         1.      Nama                 :        .......................................................

                                             Pangkat/Gol      :        .......................................................

                                             NIP                    :       .......................................................

                                             Jabatan              :        .......................................................

                                    2.      Nama                :        .......................................................

                                             Pangkat/Gol      :        .......................................................

                                             NIP                    :        .......................................................

                                             Jabatan              :        .......................................................

Untuk                :         1. ...................................................................................

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

                                    3. ...................................................................................

Demikian surat tugas ini dibuat untuk dapat dilaksanakan dan dipergunakan sebagaimana mestinya.

Ditetapkan di ..............................

pada tanggal ...............................

NAMA JABATAN YANG BERWENANG,

Nama Jelas

                                                                                         Pangkat

                                                                                         NIP.