BIODATA A. IDENTITAS PEGAWAI PEGAWAI 1. 2. 3. &. !. (. +. %. $. 1. 11. 12. 13.
Nama NIP/No. KARPEG Tempa mpat/ Tangg nggal Lahir "e "eni' Kelamin Agama "eni' Kepega)aian Alamat R#mah Pang-at Tera-hir "aatan Tera-hir In'tan In'tan'i 'i Tempat mpat e-e e-er5a r5a 4nit Ker5a T6T. Pen'i#n Stat#' Per-a)inan
: : : : : : : : : : : : :
LIHER, S. Sos 19580605 198103 1 032 / C.0359977
FOTO
Sepang Kota, ta, ! "#n "#ni 1$!% Pria Kri'ten Prote'tan PNS *aerah "l. Kara K#ala K#r#n Pemina T-. I I0/ Kepala iang 4'aha Pertamangan Pemer Pemerint intah ah Ka#p Ka#pat aten en G#n# G#n#ng ng 6a' 6a' *ina' Pertamangan an Energi Ka#paten G#n#ng 6a' 1 "#li 21( Ka)in
B. RIWAY RIWAYAT PENDIDI PEND IDIKAN KAN UMUM No 1. 2.
3.
4.
"en5ang an "#r#'an Penii-an
STT/I5a7ah Nama Se-olah/A-aemi/ Perg#r#an Tinggi
Nama Kep'e-/*ire-t#r/ *e-en/Ket#a/ Re-tor
S*
S*N Sepang Kota
PIETER A. GANTI
8I8.A.a No. +3+&
$/12/1$+3
S6P
S6P Sepang Kota
NI9 S. NAAN
8I8.. No. +(111
(/12/1$+(
S6EA
S6EA Palang-a Raa
*r'. ;9ANES S4K9;9
No. 2! 9< 9S 3+22!
(/!/1$%2
STRA TRATA = 1
4ni 4ni>er' >er'it ita a' PG PGRI Palang-a Raa
. S4RIANS;A 64RAINI, S.,6
*.11!.1! %.2+
1!/$/2+
Nomor
Tanggal
C. RIWAY RIWAYAT KEP KE PANGKAT ANG KATAN AN
No
Pang-at Golongan / R#ang
T6T
S#rat Kep#t#'an Nomor
Pe5aat ang 6enetap-an
Tanggal
1.
"#r# 6#a / I/ PT
1/11/1$+%
P.2+?II?! / PT/1$+%
+/11/1$+%
G#ern#r Kalimantan Tengah
2.
"#r# 6#a / I/ @APEG
1/3/1$%1
3%(?II?3/
22/&/1$%1
G#ern#r Kalimantan Tengah
"#r# 6#a / I/ PNS Pengat#r 6#a / II/a Pene'#aia n Pengat#r 6#a T-. I / II/
1/!/1$%2
2(?&?1$%2
G#ern#r Kalimantan Tengah
$/12/1$%3
G#ern#r Kalimantan Tengah
2&/1/1$%!
G#ern#r Kalimantan Tengah
3. &.
!.
P*/%1
1/1/1$%2
133?0?3/P*/%2 12!+?II?3/ P*/%3
1/1/1$%!
%23.2/12% /III/%!
(.
+.
Pengat#r / II/<
1/1/1$%$
%23.2/$!$/
2/%/1$%$
G#ern#r Kalimantan Tengah
1(/%/1$$3
AKN
1(/%/1$$+
G#ern#r Kalimantan Tengah
2$/$/21
G#ern#r Kalimantan Tengah
III/%$
Pengat#r T-. I / II/
/1/1$$3
Penata 6#a / III/a
1/1/1$$+
Penata 6#a T-. I / III/
1/1/21
1.
Penata / III/<
1/1/2(
SK.%23/3+!/K PL*/II/2(
3/$/2(
#pati G#n#ng 6a'
11.
Penata T-.I / III/
1/1/21
SK.%23/13$/
2+/$/21
#pati G#n#ng 6a'
Pemina / I0/a
1/1/21&
2$/$/21&
G#ern#r Kalimantan Tengah
Pemina T-. I I0/
1/(/21(
1%?3?21(
AKN
%.
$.
12.
13.
!3?1!/+/ KEP/8/1$$3 SK.%23.3/112% /II.P*/$+ SK.%23.3/113 /I/K*
K*/II/21 %23.&/(& /21& 1/KEP/IT/2 (211/1(
D. RIWAYAT JABATAN
No
1.
$.
.
Jabatan
Wakil Sekretaris pada Sub Unit KORPRI Setda Prov. Kalteng Kepala Sub +agian Peng*argaan dan anda ,asa pada +iro Kepega-aian Setda Prov. Kalteng Kasi Inventarisasi dan Peetaan Wila0a* pada inas Pertabangan dan 2nergi Kab. 'unung Mas
%.
Kasi Pen0iapan Peri6inan dan Iuran pada inas Pertabangan dan 2nergi Kab. 'uas
.
Kasi Pebinaan Pengusa*aan dan Reklaasi pada inas Pertabangan dan 2nergi Kab.
Pan!a t Go"on an#R$a n
E%&" on
TMT
S$'at K&($t$%an
No+o'
Tana"
P&)abat *an M&n&ta( !an
Penata Muda / (III/a)
.b
!1/!"/1## #
SK."$1.$/$ %/III/##
!1/!&/1## #
'ubernur Kalianta n enga*
Penata Muda / (III/a)
.a
$/!"/$!! !
SK."$1.$/ %&/III/$!!!
$/!"/$!! !
'ubernur Kalianta n enga*
Penata / (III/3)
I.a
!/!&/$!! 4
"$!/!$/+ KP5.I/$!! 4
!%/!&/$!! 4
+upati 'unung Mas
Penata / (III/3)
I.a
$"/!"/$!! &
"$!/11/+ KP5/$!! &
!/!"/$!! &
+upati 'unung Mas
I.a
$4/#/$!!"
"$!/1&$/ +K/I/$!! "
$&/!#/$!! "
+upati 'unung Mas
Penata / (III/3)
'uas
,.
E.
Ka%- P&"a*anan an R&/ab-"-ta%So%-a"0 Paa D-na% So%-a" T&naa K&')a an T'an%+-'a%Kab$(at&n G$+a%
9.
K&(a"a B-an M-a%0 K&"-%t'-!an an En&'- (aa D-na% P&'ta+banan an En&'- Kab. G$+a%
8.
K&(a"a B-an U%a/a P&'ta+banan (aa D-na% P&'ta+banan an En&'Kab$(at&n G$+a%
P&nata # III#
I.a
56#56#25 57
825#129# BKD#I#25 57
56#56#25 57
B$(atG$n$n Ma%
P&nata T!. I# III#
III.b
21#58#25 15
825#136 # BKD#251 5
23#58#25 15
B$(atG$n$n Ma%
P&+bna# I#a
III.b
14#1#251 6
SK. 821.2#52 #BKD#I#25 16
13#51#25 16
B$(atG$n$n Ma%
RIWAYAT PENDIDIKAN DAN PE:ATI;AN a. P&n--!an an P&"at-/an K&(&+-+(-nan
No 1.
2.
Na+a D-!"at S&!o"a/ P-+(-nan A+-n-%t 'a%- TK Da%a' SEPADA D-!"at P-+ III
T&+(at an P&n*&"&na 'a D-!"at Pa"an!a Ra*a
An!ata n# Ta/$n
Ka"%&"#Ban)a' Ba'$
<:I# 2515
<#1774
:a+a P&n--! an 3 B$"an
48 ;a'-
STTPP No+o'
Tana"
472#DA=< 74#76
51#15#177 4
6.353#I.1,# DIK:ATPIM TK.III#:AN#2 515
17#12#251 5
b. P&n--!an an P&"at-/an F$n%-ona" T&+(at an P&n*&"&na'a D-!"at
An!at an# Ta/$n
:a+a P&n-!an
STTPP
No
Na+a D-!"at
1.
D-!"at Ko+-t+& n D-'$nt$! E%&"on III
Ka"%&"#Ban)a' Ba'$
2 ;a'-
2.
ASTIKOM
Ka"%&"#Ban)a' Ba'$
1 ;a'-
2592#%=B. In'-%#AST#
57#12#251 5
3.
MPEKPK
Ba"-
2 ;a'-
16,#PUSDIK: AT
17#53#251 1
No+o' 426#STR.1# DIK:AT#2515
Tana" 31#15#251 5
#PBN#III# 2511 4.
B-o&tano"
Pa"an!a Ra*a
3 ;a'-
559#D-!"at= B-o#Pan= PR#I#251,
5,#54# 251,
. P&n--!an an P&"at-/an T&!n-% No
Na+a D-!"at
1.
BENPRO
2.
A+-n-%t' a%K&(&a>a -an
T&+(at an P&n*&"&n a'a D-!"at
STTPP An!at an# Ta/$n
:a+a P&n-!an
No+o'
Tana"
Pa"an!a Ra*a
1776
45 ;a'-
3511181776
31#53#177 6
Pa"an!a Ra*a
1779
16 ;a'-
539#ADM.P&# I# II.3# D-!"at#P'o?#79
11#11#177 9
3.
BIMTEK
Pa"an!a Ra*a
2553
6 ;a'-
793#685#K&$. No.38
4.
BIMTEK P&'+&na '- No. 13 Ta/$n 255,
Ja!a'ta
255,
2 ;a'-
SK.DD.52#:PI K #II=255,
6.
Wo'!%/o( UU No. 4 Ta/$n 2557
Ja!a'ta
2557
2 ;a'-
5,6#WORKS; OP# :P3;ETCENTE R# 2557
,.
So%-a"-%a%P&'('&% No. 64 Ta/$n 2515
Pa"an!a Ra*a
2511
2 ;a'-
=
No
Na+a
1.
:a+a P&nata'an # K$'%$% # Wo'!%/o(
17#12#2553 59#59#255,
19#54#2557
21#54#2511
STTPP
T&+(at an P&n*&"&n a'a
Ta/$n
P&nata'an P= 4
Pa"an!a Ra*a
1781
4 ;a'-
2.
K$'%$% M&n&t-!@15 @ RAPI
Pa"an!a Ra*a
1798
3 B$"an
3.
Kon%$"ta%-# O'-&nta%Wa'ta>an
Pa"an!a Ra*a
1779
1 ;a'-
8,1#598#;M S
2,=52= 1779
4.
P&nata'an P= 4
Pa"an!a Ra*a
1779
6 ;a'-
19,#BP.9#III= 13#1779
58=58= 1779
6.
Kon%$"ta%-# O'-&nta%Wa'ta>an
Pa"an!a Ra*a
1778
1 ;a'-
8,1#2175#; MS
26=53= 1778
,.
K$'%$% Ja!a'ta S-%t&+ P&nata$%a/a an K&$anan Da&'a/ an P&n&"o"aan Ka%
255,
2 ;a'-
38#SK.DD.5 2#:AIK#II= 255,
No+o'
Tana"
571=I#
15=12= 1781
98399
59=53= 1798
59=59= 255,
9.
Wo'!%/o( Ja!a'ta Na%-ona" S-%t&+ P&nata$%a/a an K&$anan
255,
2 ;a'-
F. DAFTAR URUT KEPANGKATAN N o 1.
Ta/$n
U'$t# P&'-n!at a"a+ DUK
251,
3 t-a
G. DP= 3 TA;UN TERAK;IR No
Ta/$n
P&)abat P&n-"a-
Ata%an P&)abat P&n-"a-
1.
2514
K&(a"a D-na% P&'ta+banan an En&'- Kab. G$n$n Ma%
S&!'&ta'-% Da&'a/ Kab$(at&n G$n$n Ma%
2.
2516
K&(a"a D-na% P&'ta+banan an En&'- Kab. G$n$n Ma%
S&!'&ta'-% Da&'a/ Kab$(at&n G$n$n Ma%
N-"a87025
8702,
;. DISIP:IN No
Ta/$n
T-n!at P&n-"a-
1. 2.
2514 2516
Ba-! Ba-!
T-n!at ;$!$+an D-%-("-n = =
J&n-% ;$!$+an -%-("-n = =
I. RUANG :INGKUP PERJA:ANAN KARIER No
1.
2.
3.
Jabatan
P;T (aa B-'o P&'%ona"-a S&ta P'o?. Ka"t&n P&"a!%ana (aa S$b Ba-an P&n*a'-nan (aa Ba-an U+$+ B-'o K&(&a>a-an S&ta P'o?. Ka"t&n P&"a!%ana (aa S$b
E%&" on
TMT Jabatan
S$'at K&($t$%an No+o' Tana"
=
51=11= 1798
=
51=53= 1781
38,=II=3#PD#81
28=54= 1781
G$b&'n$' Ka"-+antan T&na/
=
51=52= 1774
154#855#;+%
24=52= 1774
G$b&'n$' Ka"-+antan
BP.29=II= 6#P;T#1798
59=11= 1798
P&)abat *an M&n&ta(!a n G$b&'n$' Ka"-+antan T&na/
4.
6.
,.
9.
Ba-an Tata U%a/a B-'o ;$+a% S&ta P'o?. Ka"t&n Wa!-" S&!'&ta'-% (aa Un-t Ko'('- S&ta P'o?. Ka"t&n K&(a"a S$b Ba-an P&n/a'aan an Tana Ja% (aa B-'o K&(&a>a-an S&ta P'o?. Ka"t&n P&"a!%ana (aa S$b Ba-an K&%&)a/t&'aan P&a>a- (aa BKD P'o?. Ka"t&n P"t. K&(a"a S$b Ba-an K&$anan an K&(&a>a-an (aa D-na% P&'ta+banan 0 En&'- an :-n!$nan ;-$( Kab. G$+a%
T&na/
.b
51=58= 1777
821.2#24#III#77
51=59= 1777
G$b&'n$' Ka"-+antan T&na/
.a
26=58= 2555
821.2#49#III#2555
26=58= 2555
G$b&'n$' Ka"-+antan T&na/
=
51=58= 2551
=
=
G$b&'n$' Ka"-+antan T&na/
56=56= 255,
568#,2#DPE= :;#255,
51=56= 255,
K&(a"a D-na% P&'ta+ban an0 En&'an :-n!$na n ;-$( Kab. G$+a%.
8
7.
15 .
11 .
12 .
13 .
14 .
Ka%In?&nta'-%a%an P&+&taan W-"a*a/ (aa D-na% P&'ta+banan an En&'Kab. G$+a% Ka%P&n*-a(an P&'--nan an I$'an (aa D-na% P&'ta+banan an En&'Kab. G$+a% Ka%P&+b-naan P&n$%a/aan an R&!"a+a%(aa D-na% P&'ta+banan an En&'Kab. G$+a% Ka%- P&"a*anan an Ra/ab-"-ta%So%-a" (aa D-na% So%-a"0 T&naa K&')a an T'an%+-'a%Kab. G$+a% K&(a"a B-an M-a%0 K&"-%t'-!an an En&'- (aa D-na% P&'ta+banan an En&'Kab. G$+a% P"t. K&(a"a B-an P&+b-naan an P&na>a%an P&'ta+banan K&(a"a B-an U%a/a P&'ta+banan (aa D-na% P&'ta+banan an En&'Kab. G$+a%
I.a
54=59= 255,
825#523#BP:D#I#2 55,
54=59= 255,
B$(atG$n$n Ma%
I.a
27=58= 2559
825#131#BKP:D# 2559
35=58= 2559
B$(atG$n$n Ma%
I.a
2,=57= 2558
825#192#BKD#I#2 557
29=58= 2558
B$(atG$n$n Ma%
I.a
54=56= 2557
825#129#BKD#I#2 557
56=56= 2557
B$(atG$$nn Ma%
III.b
21=58= 2515
825#136#BKD#251 5
23=58= 2515
B$(atG$n$n Ma%
=
5,=51= 2514
825#51#DPE#I#251 4
5,=51= 2514
III.b
14=51= 2516
821.2#52#BKD#I#2 516
13=51= 2516
K&(a"a D-na% P&'ta+ban an an En&'- Kab. G$+a% B$(atG$+a%.
J. PENGA:AMAN DIK:AT DA:AM NEGERI# :UAR NEGERI MENGENAI WAWASAN MANAJEMEN PEMERINTA;AN UMUM DAN DAERA; N o
Na+a D-!"at
1. 2. 3.
= = D%t.
T&+(at an P&n*&"&na'a D-!"at = = =
An!at an# Ta/$n = = =
:a+a P&n--!a n = = =
STTPP No+o' Tana" = = =
K. PENGA:AMAN SEBAGAI PENYAJI SEMINAR#:OKAKARYA#
= = =
DISKUSI TINGKAT NASIONA: MENGENAI WAWASAN MANAJEMEN PEMERINTA;AN UMUM DAN DAERA; N o.
T&+(at S&+-na'
J$$" Ma!a"a/
Ta/$n
1.
Pa"an!a Ra*a
1774
2. 3.
Pa"an!a Ra*a Pa"an!a Ra*a
Tata Ca'a A+-n-%t'a%P&'!anto'an So%-o"o- B$a*a P&+anaatan En&'-
P&'an a"a+ S&+-na' #:o!a!a'*a # D-%!$%P&n*a)-
2559 2515
P&n*a)P&n*a)-
:. POKOK=POKOK PIKIRAN STRATEGIS PO:ITIK DA:AM NEGERI N o. =
J$$" B$!$# Ka'*aT$"-%# Ma!a"a/
Ta/$n
=
=
M. ANGGOTA KE:UARGA N o. 1.
Na+a I%t'- an Ana! R$%-ana
S--0 1, = 54 = 1767
2.
Pa"an!a Ra*a0 24 = 57 = 1782
PNS
3.
S'- Wa/*$n-&0 S.So%.0 M.I.Ko+ S$"* D&>- Yant-&0 S.KM
Pa"an!a Ra*a0 24 = 51 = 1784
PNS
4.
Jon-"-anto0 S. Ko+
Pa"an!a Ra*a0 13 = 5, = 1787
S>a%ta
6.
A'-%ta Ratna%a'-
Pa"an!a Ra*a0 25 = 57 = 1776
S>a%ta
T&+(at :a/-'#T"#B"n#T/n
P&!&')aan P&n%-$nan PNS
K$a"a K$'$n0 35 J$n- 251,
M&n&ta/$- D-na% P&'ta+banan an En&'Kab$(at&n G$n$n Ma% K&(a"a0
Yan M&+b$at B-oata0
:I;ER0 S. So% NIP. 17685,56 178153 1 532
I'. CA:IN A. SA;AY.0 S.;.0 M.; P&+b-na Uta+a M$a NIP. 17671535 177253 1 552
DAFTAR
ISI
DATA ADMINISTRASI KEPEGAWAIAN AN. :I;ER :IWAN0 S.So% NIP. 17685,56 178153 1 532 KARPEG C. 53677799
1. KATA PENGANTAR ARTI ;IDUP 2. DAFTAR RIWAYAT ;IDUP # BIODATA 3. PENDIDIKAN UMUM 4. AKTE KE:A;IRAN 6. SK. RIWAYAT ;IDUP KEPANGKATAN GO:ONGAN RUANG GAJI ,. SK. PENSIUN 9. SK. MUTASI 8. SUMPA; JANJI PEGAWAI NEGERI 7. KARTU PEGAWAI NEGERI SIPI: KARPEG 15.
SK. JABATAB FUNGSIONA: # STRUKTURA: #
PE:ANTIKAN 11.
SK. BERKA:A
12.
PENDIDIKAN PENJENJANGAN
13.
PENG;ARGAAN DAN TANDA JASA
14.
DAFTAR PENI:AIAN PE:AKSANAAN PEKERJAAN PNS
16.
IMPASING # PERUBA;AN GAJI POKOK
1,.
PIAGAM PENATARAN # KURSUS PENDIDIKAN DAN
DP=3
:AIN=:AIN 19.
TABUNGAN DAN ASURANSI PEGAWAI NEGERI
TASPEN 18.
SURAT NIKA; # CATATAN SIPI:
17.
KARTU ISTRI KARIS DAN KARTU SUAMI KARSU
25.
ASURANSI KESE;ATAN ASKES
21.
:APORAN PAJAK
22.
ARSIP BERKAS USU: PENSIUN
23.
SURAT KEPUTUSAN DAN :AIN=:AIN
============================================================= 5O5 ==================================================
BIODATA A.
I&nt-ta% P&a>a-
1. Na+a
AGUS SUSI:O EDY0 ST
2. NIP#No. KARPEG
17965835 255853 1 551 # No. P 249866
3. T&+(at# Tana" :a/-'
Pa"an!a Ra*a0 35 A$%t$% 1796
4. J&n-% K&"a+-n
:a!-="a!-
6. Aa+a
K'-%t&n P'ot&%tan
,. J&n-% K&(&a>a-an P&a>a- Da&'a/ 9. A"a+at R$+a/
J". S. Pa'+an. B"o! C No. 1 K$a"a K$'$n
8. Pan!at T&'a!/-'
P&nata M$a III#a
7. Jabatan T&'a!/-'
P"t. Ka%- P&n$%a/aan M-n*a! an Ga%
15. In%tan%- T&+(at B&!&')a
B. No 1.
2.
11. Un-t K&')a
D-na% P&'ta+banan an En&'-
12. Stat$% P&'!a>-nan
Ka>-n
R->a*at K&(an!atan Pan!at Go"onan# R$an
TMT
P&nata M$a III#a CPNS
51=53= 2558
P&nata M$a III#a PNS
C.
R->a*at Jabatan
N o
Pan!at Go"onan#R$a n
1.
P&+&'-nta/ Kab$(at&n G$n$n Ma%
P&nata M$a III#a
51=15= 2557
E%&" on =
TMT
4 A('-" 2557
S$'at K&($t$%an No+o' Tana" SK.813#68#BKP:D#II#2558
SK.821.12#1,8#BKD#2557
31=53 2558
B$(atG$n$n Ma%
35=57= 2557
B$(atG$n$n Ma%
S$'at K&($t$%an No+o' Tana" 825#14,.b#DPE#I#25 11
P&)abat *an M&n&ta(!an
4 A('-" 2557
P&)abat *an M&n&ta(!an K&(a"a D-na% D-na% P&'ta+bana n an En&'-
D. R->a*at P&n--!an a. P&n--!an U+$+ No
J&n)an an J$'$%an P&n--! an
Na+a S&!o"a/#A!a& +-# P&'$'$an T-n-
Na+a K&(%&!#D-'&!t$'#D&!& n# K&t$a#R&!to'
STTB#I)aa/ No+o' Tana"
1.
SD
SD N&&'-
PAU:INE KAMIS
No.26 5A oa 5551216
23 J$n1788
2.
SMP#S:TP
STN Pa"an!a Ra*a
;ENNO; J. ;ARIWUNG0 BA
No. 26 5A o 551,719
8 J$n1771
3.
SMA#S:TA
STM 1 Pa"an!a Ra*a
D'%. DJ. DJOEJAKIN
No. 26 OB on 5536247
28 M&1774
4.
D III
AKADEMI TEKNO:OGI PEMBANGUNA N NASIONA: BANJAR BARU
I'. ;ARING SA:O;
5,7#ATPN#TE#D#D.I II#77
15 M&1777
6.
S1
UNIERSITAS BAPTIS SURABAYA
SAMUE: RAWANG BINTI0 S;
545#UBS#S#T#2552
b. P&n--!an Dan P&"at-/an K&(&+-+(-nan N o
Na+a D-!"at
T&+(at an P&n*&"&na'a D-!"at
An!ata n# Ta/$n
:a+a P&n-!an
STTPP No+o'
Tana"
=
=
=
=
=
=
=
. P&n--!an an P&"at-/an F$n%-ona" N o
Na+a D-!"at
T&+(at an P&n*&"&na'a D-!"at
An!ata n# Ta/$n
:a+a P&n-!an
STTPP No+o'
Tana"
=
=
=
=
=
=
=
. P&n--!an an P&"at-/an T&!n-% N o
Na+a D-!"at
T&+(at an P&n*&"&na'a D-!"at
1.
P&"at-/an T&naa P&n*$"$/ :a(anan P&n$naa n :(G 3 K
Pa"an!a Ra*a#Baan P&n--!an an P&"at-/an En&'an S$+b&'a*a M-n&'a"
An!ata n# Ta/$n
:a+a P&n-!an
2511
2 $a /a'-
STTPP No+o' 2295.%t#,9.53.BD :#2511
Tana" 28 =7=2511
E. Data' U'$t K&(an!atan N o 1.
Ta/$n
U'$t# P&'-n!at a"a+ DUK
2511
12 D$a b&"a%
F. DP=3 $nt$! 2 Ta/$n T&'a!/-' No
Ta/$n
P&)abat P&n-"a-
Ata%an P&)abat P&n-"a-
N-"a-
1.
2557
Ka%P&n$%a/aan K&"-%t'-!an an P&+anaatan En&'-
K&(a"a B-an M-a%0 K&"-%t'-!an an En&'-
97 Ba-!
2.
2515
Ka%P&n$%a/aan M-a%
K&(a"a B-an M-a%0 K&"-%t'-!an an En&'-
97027 Ba-!
G. D-%-("-n N o
Ta/$n
T-n!at P&n-"a-
T-n!at ;$!$+an D-%-("-n
J&n-% ;$!$+an -%-("-n
1.
2515
=
=
=
2.
2511
=
=
=
;. R$an :-n!$( P&')a"anan Ka'-&' N o
Jabatan
E%&" on
1.
P&"a!%ana In%(&!t$' K&"-%t'-!an
2.
P"t. Ka%P&n$%a/aan M-*a! an Ga%
TMT Jabatan
S$'at K&($t$%an No+o' Tana"
P&)abat *an M&n&ta(!a n
=
51=15= 2557
SK. 821.12#1,8#BKD#II#2 557
35=57= 2557
B$(atG$n$n Ma%
=
4 A('-" 2557
825#14,.b#DPE#I#25 11
4 A('-" 2557
K&(a"a D-na% D-%ta+b&n
I. P&na"a+an D-!"at Da"a+ N&&'-# :$a' N&&'- +&n&na- Wa>a%an Mana)&+&n P&+&'-nta/an U+$+ an Da&'a/ N o
Na+a D-!"at
1. 2.
= =
T&+(at an P&n*&"&na'a D-!"at = =
An!atan# Ta/$n = =
:a+a P&n--!a n = =
STTPP No+o' Tana" = =
= =
J. P&na"a+an S&baa- P&n*a)- S&+-na'# :o!a!a'*a# D-%!$%- T-n!at Na%-ona" M&n&naWa>a%an Mana)&+&n P&+&'-nta/an U+$+ an a&'a/ No.
T&+(at S&+-na'
J$$" Ma!a"a/
Ta/$n
1.
=
=
=
P&'an a"a+ S&+-na'# :o!a!a'*a# D-%!$%=
2.
=
=
=
=
K. Po!o!=Po!o! P-!-'an St'at&-% (o"-t-! a"a+ N&&'No. 1. 2.
J$$" B$!$# Ka'*aY$"-%# Ma!a"a/ = =
Ta/$n = =
:. Anota K&"$a'a
No.
Na+a I%t'-#S$a+-#Ana! *an t&'tan$n a"a+ ata' a)-
T&+(at :a/-'#T"#B"n#T/n
1.
IME:DA0 ST
K$a"a K$'$n0 5,=54=1796
2.
OST;IN C;RISTIAN ERICO
Pa"an!a Ra*a0 53=15=2558
P&!&')aan PNS =
K$a"a K$'$n0 2, O!tob&' 2511
AGUS SUSI:O EDY0 ST M&n&ta/$- K&(a"a D-na% P&'ta+banan an En&'Kab$(at&n G$n$n Ma%0
I'. CA:IN A. SA;AY P&+b-na Uta+a M$a NIP. 17671535 177253 1 552
