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2. Nama
: WAHYU PRASETYA
Tempat/Tgl. Lahir
: Cilacap, 22 Oktober 1992
Alamat
: Jl. Jenderal Sudirman RT 21 RW 06 Desa Jepara Wetan
Nomor Pendaftaran
: 04
Catatan
:
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3. Nama
: MIFTAKHUL ANWAR
Tempat/Tgl. Lahir
: Cilacap, 22 Desember 1975
Alamat
: Jl. Jenderal Sudirman RT 13 RW 04 Desa Jepara Wetan
Nomor Pendaftaran
: 07
Catatan
:
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4. Nama
: IRFANTO SAFRUDIN AL FARIZI
Tempat/Tgl. Lahir
: Cilacap, 27 April 1982
Alamat
: Jl. Jenderal Sudirman RT 07 RW 02 Desa Jepara Wetan
Nomor Pendaftaran
: 09
Catatan
:
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5. Nama
: YUSUP
Tempat/Tgl. Lahir
: Cilacap, 11 Maret 1975
Alamat
: Jl. Sindujaya RT 25 RW 07 Desa Jepara Wetan
Nomor Pendaftaran
: 12
Catatan
:
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6. Nama
: EKO CIMANTO
Tempat/Tgl. Lahir
: Cilacap, 02 Januari 1991
Alamat
: Jl. Krikil RT 23 RW 06 Desa Jepara Wetan
Nomor Pendaftaran
: 13
Catatan
:
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7. Nama
: SAHONO
Tempat/Tgl. Lahir
: Cilacap, 26 Juni 1985
Alamat
: Jl. Jenderal Sudirman RT 15 RW 05 Desa Jepara Wetan
Nomor Pendaftaran
: 14
Catatan
:
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8. Nama
: TURIP
Tempat/Tgl. Lahir
: Cilacap, 14 Juni 1982
Alamat
: Jl. Sangkal Putung RT 09 RW 03 Desa Jepara Wetan
Nomor Pendaftaran
: 16
Catatan
:
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9. Nama
: WAWAN RIYADI
Tempat/Tgl. Lahir
: Cilacap, 11 Mei 1989
Alamat
: Jl. Sangkal Putung RT 09 RW 03 Desa Jepara Wetan
Nomor Pendaftaran
: 19
Catatan
:
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10.Nama
: VERRY BUDIARTO
Tempat/Tgl. Lahir
: Cilacap, 09 Februari 1992
Alamat
: Jl. Jenderal Sudirman RT 06 RW 02 Desa Jepara Wetan
Nomor Pendaftaran
: 20
Catatan
:
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11.Nama
: SRI BUDIARTI
Tempat/Tgl. Lahir
: Cilacap, 16 Oktober 1981
Alamat
: Jl. Krikil RT 13 RW 06 Desa Jepara Wetan
Nomor Pendaftaran
: 21
Catatan
:
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12.Nama
: SAMSI
Tempat/Tgl. Lahir
: Cilacap, 04 Januari 2016
Alamat
: Jl. Jenderal Sudirman RT 06 RW 02 Desa Jepara Wetan
Nomor Pendaftaran
: 23
Catatan
:
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13.Nama
: TARSIYEM
Tempat/Tgl. Lahir
: Cilacap, 15 Agustus 1986
Alamat
: RT 32 RW 03 Desa Jepara Wetan
Nomor Pendaftaran
: 24
Catatan
:
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14.Nama
: FITRIA RIA FATIMAH
Tempat/Tgl. Lahir
: Cilacap, 27 Maret 1993
Alamat
: Jl. Jenderal Sudirman RT 14 RW 04 Desa Jepara Wetan
Nomor Pendaftaran
: 25
Catatan
:
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Selanjutnya
untuk
kekurangan-kekurangan
sesuai
catatan
tersebut
diatas
diberikan waktu 6 (enam) hari kerja dari tanggal s.d untuk melengkapi berkas
persyaratan.
4
Demikian berita acara ini dibuat untuk dijadikan pedoman pelaksanaan tahap
selanjutnya.
PANITIA
1 WAWAN SUSENO
: ................
2 WAHYU PRASETYA
3 MIFTAKHUL ANWAR
: ................
IRFANTO SAFRUDIN
AL FARIZI
................
................
5 YUSUP
: ................
6 EKO CIMANTO
7 SAHONO
: ................
8 TURIP
9 WAWAN RIYADI
: ................
LEKHAN
................
................
10 VERRY BUDIARTO
................
11 SRI BUDIARTI
: ................
12 SAMSI
13 TARSIYEM
: ................
................
................
MENGETAHUI,
PANITIA PENGAWAS TINGKAT KECAMATAN BINANGUN
KETUA,
ANGGOTA,
ANGGOTA,