INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(225, 1, 'Keterangan Penghasilan Orang Tua', 'surat-keterangan-penghasilan-orang-tua', 'S-42', NULL, 0, 0, 3, 0, 1, 'M', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]</p>\r\n<p style=\"margin: 0; text-align: center;\"> </p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 90px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[TtL]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">NIK</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[NiK]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\">[Jenis_kelamin]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">Nomor Induk Siswa/Mahasiswa</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[Form_nomor_induk_siswamahasiswA]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">6.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">Jurusan/Fakultas/Prodi</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[Form_jurusanfakultasprodI]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">Sekolah/Perguruan Tinggi</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[Form_sekolahperguruan_tinggI]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">Kelas/Semester</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[Form_kelassemesteR]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">9.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[AgamA]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">10.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[PekerjaaN]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">11.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">Alamat</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], [Nama_provinsI]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Adalah benar penduduk yang berdomisili di [AlamaT], [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], [Nama_provinsI], dan merupakan <strong>Anak </strong>dari:</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 310px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 18px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Nama Ayah</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; height: 18px; text-align: justify; vertical-align: top;\">[Nama_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 18px; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; height: 18px; text-align: justify; vertical-align: top;\">[Ttl_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 18px; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">NIK</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; height: 18px; text-align: justify; vertical-align: top;\">[Nik_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; text-align: justify; height: 18px; vertical-align: top;\">[Jenis_kelamin_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 59.1624%; text-align: justify; height: 18px; vertical-align: top;\">[Agama_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; text-align: justify; height: 18px; vertical-align: top;\">[Pekerjaan_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 36px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 36px; text-align: left; vertical-align: top;\"><br><br></td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 36px; vertical-align: top;\">Alamat<br><br></td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 36px; vertical-align: top;\">:<br><br></td>\r\n<td style=\"width: 59.1624%; height: 36px; text-align: justify; vertical-align: top;\">[Alamat_ayaH] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], [Nama_provinsI]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.33944%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; vertical-align: top;\">Penghasilan</td>\r\n<td style=\"width: 1.44509%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; text-align: justify; vertical-align: top;\">[Form_penghasilan_ayaH] <em>([Terbilang][[Form_penghasilan_ayaH]])</em></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"text-align: center; width: 99.9518%; height: 18px; vertical-align: top;\" colspan=\"5\"> </td>\r\n</tr>\r\n<tr style=\"height: 22px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 22px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 18px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Nama Ibu</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; height: 18px; text-align: justify; vertical-align: top;\">[Nama_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 18px; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; height: 18px; text-align: justify; vertical-align: top;\">[Ttl_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 18px; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">NIK</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; height: 18px; text-align: justify; vertical-align: top;\">[Nik_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; text-align: justify; height: 18px; vertical-align: top;\">[Jenis_kelamin_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 59.1624%; text-align: justify; height: 18px; vertical-align: top;\">[Agama_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 18px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; text-align: justify; height: 18px; vertical-align: top;\">[Pekerjaan_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 36px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 36px; text-align: left; vertical-align: top;\"><br><br></td>\r\n<td style=\"width: 31.0993%; text-align: left; height: 36px; vertical-align: top;\">Alamat<br><br></td>\r\n<td style=\"width: 1.44509%; text-align: center; height: 36px; vertical-align: top;\">:<br><br></td>\r\n<td style=\"width: 59.1624%; height: 36px; text-align: justify; vertical-align: top;\">[Alamat_ibU] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], [Nama_provinsI]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.33944%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 31.0993%; text-align: left; vertical-align: top;\">Penghasilan</td>\r\n<td style=\"width: 1.44509%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 59.1624%; text-align: justify; vertical-align: top;\">[Form_penghasilan_ibU] <em>([Terbilang][[Form_penghasilan_ibU]])</em></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Dengan penghasilan rata-rata <strong>Orang Tua [HitunG][[Form_penghasilan_ayaH]+[Form_penghasilan_ibU]] <em>([Terbilang][[HitunG][[Form_penghasilan_ayaH]+[Form_penghasilan_ibU]]])</em> </strong><strong> </strong>setiap bulannya.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian Surat Keterangan Penghasilan Orangtua ini dibuat dengan sebenarnya agar dapat dipergunakan sebagaimana mestinya.</p>\r\n<p> </p>\r\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Atas_namA]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"><br><br><br><br></td>\r\n<td style=\"width: 35%;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[\"4\"]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_nomor_induk_siswamahasiswa]\",\"nama\":\"Nomor Induk Siswa\\/Mahasiswa\",\"deskripsi\":\"Masukkan Nomor Induk Siswa\\/Mahasiswa\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_jurusanfakultasprodi]\",\"nama\":\"Jurusan\\/Fakultas\\/Prodi\",\"deskripsi\":\"Masukkan Jurusan\\/Fakultas\\/Prodi\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_sekolahperguruan_tinggi]\",\"nama\":\"Sekolah\\/Perguruan Tinggi\",\"deskripsi\":\"Masukkan Sekolah\\/Perguruan Tinggi\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_kelassemester]\",\"nama\":\"Kelas\\/Semester\",\"deskripsi\":\"Masukkan Kelas\\/Semester\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_penghasilan_ayah]\",\"nama\":\"Penghasilan Ayah\",\"deskripsi\":\"Masukkan Penghasilan Ayah\",\"atribut\":\"class=\\\" rupiah\\\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_penghasilan_ibu]\",\"nama\":\"Penghasilan Ibu\",\"deskripsi\":\"Masukkan Penghasilan Ibu\",\"atribut\":\"class=\\\" rupiah\\\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_penghasilan_orang_tua_ayah_ibu]\",\"nama\":\"Penghasilan Orang Tua (Ayah + Ibu)\",\"deskripsi\":\"Masukkan Penghasilan Orang Tua (Ayah + Ibu)\",\"atribut\":\"class=\\\" rupiah\\\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-26 17:08:13', 1),
(226, 1, 'Biodata Penduduk', 'surat-biodata-penduduk', 'S-03', 'F-1.01,F-1.02', 0, 0, 3, 1, 1, 'M', 0, 0, 0, '[\"3\",\"4\"]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n            <p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br /><br /></p>\r\n            <p style=\"text-align: justify; text-indent: 30px;\"><strong>I. DATA KELURGA</strong></p>\r\n            <table style=\"border-collapse: collapse; width: 100%; height: 79px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n            <tbody>\r\n            <tr style=\"height: 25px;\">\r\n            <td style=\"width: 4.32489%; text-align: center; height: 25px;\"> </td>\r\n            <td style=\"width: 3.90295%; height: 25px; text-align: left;\">1.</td>\r\n            <td style=\"width: 30.4852%; text-align: left; height: 25px;\">Nama Kepala Keluarga</td>\r\n            <td style=\"width: 1.26582%; text-align: center; height: 25px;\">:</td>\r\n            <td style=\"width: 60.0211%; height: 25px; text-align: justify;\">[KePala_kk]</td>\r\n            </tr>\r\n            <tr style=\"height: 18px;\">\r\n            <td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n            <td style=\"width: 3.90295%; text-align: left; height: 18px;\">2.</td>\r\n            <td style=\"width: 30.4852%; text-align: left; height: 18px;\">Nomor Kartu Keluarga</td>\r\n            <td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n            <td style=\"width: 60.0211%; text-align: justify; height: 18px;\">[No_kk]</td>\r\n            </tr>\r\n            <tr style=\"height: 36px;\">\r\n            <td style=\"width: 4.32489%; text-align: center; height: 36px;\"> </td>\r\n            <td style=\"width: 3.90295%; text-align: left; height: 36px;\">3.</td>\r\n            <td style=\"width: 30.4852%; text-align: left; height: 36px;\">Alamat Keluarga</td>\r\n            <td style=\"width: 1.26582%; text-align: center; height: 36px;\">:</td>\r\n            <td style=\"width: 60.0211%; text-align: justify; height: 36px;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n            </tr>\r\n            </tbody>\r\n            </table>\r\n            <p style=\"text-align: justify; text-indent: 30px;\"><strong>II. DATA INDIVIDU</strong></p>\r\n            <table style=\"border-collapse: collapse; width: 100%; height: 519px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n            <tbody>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; height: 25.9375px; text-align: left;\">1.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Nama Lengkap</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; height: 25.9375px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; height: 25.9375px; text-align: left;\">2.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">NIK</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; height: 25.9375px; text-align: justify;\">[NiK]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; height: 25.9375px; text-align: left;\">3.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Alamat Sebelumnya</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; height: 25.9375px; text-align: justify;\">[AlAmat_sebelumnya]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; height: 25.9375px; text-align: left;\">4.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Nomor Paspor</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; height: 25.9375px; text-align: justify;\">[DoKumen_pasport]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; height: 25.9375px; text-align: left;\">5.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Tanggal Berakhir Paspor</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; height: 25.9375px; text-align: justify;\">[TaNggal_akhir_paspor]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; height: 25.9375px; text-align: left;\">6.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Jenis Kelamin</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; height: 25.9375px; text-align: justify;\">[Jenis_kelamin]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">7.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Tempat Lahir</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[TeMpatlahir]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">8.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Tanggal Lahir</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[TtL]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">9.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Akta Kelahiran / Surat Kelahiran</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[AkTa_lahir]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">10.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Golongan Darah</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[GoL_darah]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">11.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Agama</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[AgAma]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">12.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Status Perkawinan</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[StAtus_kawin]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">13.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Akta Perkawinan / Buku Nikah</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[AkTa_perkawinan]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">14.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Tanggal Akta Perkawinan / Buku Nikah</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[TaNggalperkawinan]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">15.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Akta Perceraian</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[AkTa_perceraian]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">16.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Tanggal Perceraian</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[TaNggalperceraian]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">17.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Status Hubungan Dalam Keluarga</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[HuBungan_kk]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">18.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Kelainan Fisik / Mental</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[CaCat]</td>\r\n            </tr>\r\n            <tr style=\"height: 25.9375px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 25.9375px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 25.9375px;\">19.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 25.9375px;\">Pendidikan Akhir</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 25.9375px;\">:</td>\r\n            <td style=\"width: 60.0206%; text-align: justify; height: 25.9375px;\">[PeNdidikan_kk]</td>\r\n            </tr>\r\n            <tr style=\"height: 26.1875px;\">\r\n            <td style=\"width: 4.31655%; text-align: center; height: 26.1875px;\"> </td>\r\n            <td style=\"width: 3.90545%; text-align: left; height: 26.1875px;\">20.</td>\r\n            <td style=\"width: 30.5242%; text-align: left; height: 26.1875px;\">Pekerjaan</td>\r\n            <td style=\"width: 1.2333%; text-align: center; height: 26.1875px;\">:</td>\r\n            <td style=\"width: 60.0206%; height: 26.1875px; text-align: justify;\">[PeKerjaan]</td>\r\n            </tr>\r\n            </tbody>\r\n            </table>\r\n            <p style=\"text-align: justify; text-indent: 30px;\"><strong>III. DATA ORANG TUA<br /></strong></p>\r\n            <table style=\"border-collapse: collapse; width: 100%; height: 83px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n            <tbody>\r\n            <tr style=\"height: 25px;\">\r\n            <td style=\"width: 4.32489%; text-align: center; height: 25px;\"> </td>\r\n            <td style=\"width: 3.90295%; height: 25px; text-align: left;\">1.</td>\r\n            <td style=\"width: 30.4852%; text-align: left; height: 25px;\">Nama Ibu</td>\r\n            <td style=\"width: 1.26582%; text-align: center; height: 25px;\">:</td>\r\n            <td style=\"width: 60.0211%; height: 25px; text-align: justify;\">[Nama_ibu]</td>\r\n            </tr>\r\n            <tr style=\"height: 18px;\">\r\n            <td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n            <td style=\"width: 3.90295%; text-align: left; height: 18px;\">2.</td>\r\n            <td style=\"width: 30.4852%; text-align: left; height: 18px;\">NIK Ibu</td>\r\n            <td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n            <td style=\"width: 60.0211%; text-align: justify; height: 18px;\">[nik_ibu]</td>\r\n            </tr>\r\n            <tr style=\"height: 22px;\">\r\n            <td style=\"width: 4.32489%; text-align: center; height: 22px;\"> </td>\r\n            <td style=\"width: 3.90295%; text-align: left; height: 22px;\">3.</td>\r\n            <td style=\"width: 30.4852%; text-align: left; height: 22px;\">Nama Ayah</td>\r\n            <td style=\"width: 1.26582%; text-align: center; height: 22px;\">:</td>\r\n            <td style=\"width: 60.0211%; text-align: justify; height: 22px;\">[Nama_ayah]</td>\r\n            </tr>\r\n            <tr style=\"height: 18px;\">\r\n            <td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n            <td style=\"width: 3.90295%; text-align: left; height: 18px;\">4.</td>\r\n            <td style=\"width: 30.4852%; text-align: left; height: 18px;\">NIK Ayah</td>\r\n            <td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n            <td style=\"width: 60.0211%; text-align: justify; height: 18px;\">[nik_ayah]</td>\r\n            </tr>\r\n            </tbody>\r\n            </table>\r\n            <p style=\"text-align: justify; text-indent: 30px;\"> </p>\r\n            <table style=\"border-collapse: collapse; width: 100%; height: 199.906px;\" border=\"0\">\r\n            <tbody>\r\n            <tr style=\"height: 28.625px;\">\r\n            <td style=\"width: 35.0462%; text-align: center; height: 28.625px;\"> </td>\r\n            <td style=\"width: 30.0103%; height: 28.625px;\"> </td>\r\n            <td style=\"width: 35.0462%; text-align: center; height: 28.625px;\">[NaMa_desa], [TgL_surat]</td>\r\n            </tr>\r\n            <tr style=\"height: 22.625px;\">\r\n            <td style=\"width: 35.0462%; text-align: center; height: 22.625px;\"> </td>\r\n            <td style=\"width: 30.0103%; height: 22.625px;\"> </td>\r\n            <td style=\"width: 35.0462%; text-align: center; height: 22.625px;\">[Atas_namA]</td>\r\n            </tr>\r\n            <tr style=\"height: 96.3438px;\">\r\n            <td style=\"width: 35.0462%; text-align: center; height: 96.3438px;\"> </td>\r\n            <td style=\"width: 30.0103%; height: 96.3438px;\"><br /><br /><br /><br /></td>\r\n            <td style=\"width: 35.0462%; height: 96.3438px;\"> </td>\r\n            </tr>\r\n            <tr style=\"height: 21.625px;\">\r\n            <td style=\"width: 35.0462%; text-align: center; height: 21.625px;\"> </td>\r\n            <td style=\"width: 30.0103%; height: 21.625px;\"> </td>\r\n            <td style=\"width: 35.0462%; text-align: center; height: 21.625px;\">[Nama_pamonG]</td>\r\n            </tr>\r\n            <tr style=\"height: 30.6875px;\">\r\n            <td style=\"width: 35.0462%; height: 30.6875px;\"> </td>\r\n            <td style=\"width: 30.0103%; height: 30.6875px;\"> </td>\r\n            <td style=\"width: 35.0462%; text-align: center; height: 30.6875px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n            </tr>\r\n            </tbody>\r\n            </table>\r\n            <div style=\"text-align: center;\"> </div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-26 17:08:13', 1);
INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(227, 1, 'Perintah Perjalanan Dinas', 'surat-perintah-perjalanan-dinas', 'S-46', NULL, 0, 0, 3, 0, 1, 'M', 0, 0, 0, '[]', '<table style=\"border-collapse: collapse; width: 51.5896%; height: 133px;\" border=\"0\" align=\"right\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 25.2792%; height: 18.75px;\">Lembar Ke</td>\r\n<td style=\"width: 74.6193%; height: 18.75px;\">: </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 25.2792%; height: 18.75px;\">Kode Ke</td>\r\n<td style=\"width: 74.6193%; height: 18.75px;\">: </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 25.2792%; height: 18.75px;\">Nomor</td>\r\n<td style=\"width: 74.6193%; height: 18.75px;\">: [Format_nomor_suraT]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p> </p>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<div> </div>\r\n<table style=\"border-collapse: collapse; width: 100%; height: auto; border-width: 1px; margin-left: auto; margin-right: auto;\" border=\"1\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">Pengguna Anggaran</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Sebutan_kepala_desA] [Nama_desA]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">Nama pegawai yang diperintah</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\"><strong>[NamA]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">a. Pangkat dan Golongan</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">a</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Form_pangkat_dan_golongaN]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">b. Jabatan/Instansi</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">b</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Form_jabataninstansI]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">c. Tingkat Biaya Perjalanan</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">c</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Form_tingkat_biaya_perjalanaN]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">Maksud Perjalanan Dinas</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\"><strong>[Form_maksud_perjalanan_dinaS]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">a. Tempat Berangkat</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">a.</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">Kantor [Sebutan_desA] [Nama_desA]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">b. Tempat Tujuan</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">b.</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Form_tempat_tujuaN]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">6.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">a. Tanggal Berangkat</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">a.</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Form_tanggal_berangkaT]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">b. Tanggal Kembali</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">b.</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Form_tanggal_kembalI]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">Alat angkut yang dipergunakan</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Form_alat_angkut_yang_digunakaN]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">Pengikut Nama</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 99.8071%; vertical-align: top;\" colspan=\"4\">\r\n<table style=\"border-collapse: collapse; width: 100.125%;\" border=\"1\"><colgroup><col style=\"width: 6.37636%;\"><col style=\"width: 39.6509%;\"><col style=\"width: 5.60576%;\"><col style=\"width: 48.367%;\"></colgroup>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: right;\">1.</td>\r\n<td>[Form_nama_pengikut_I]</td>\r\n<td style=\"text-align: right;\">4.</td>\r\n<td>[Form_nama_pengikut_iV]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"text-align: right;\">2.</td>\r\n<td>[Form_nama_pengikut_iI]</td>\r\n<td style=\"text-align: right;\">5.</td>\r\n<td>[Form_nama_pengikut_V]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"text-align: right;\">3.</td>\r\n<td>[Form_nama_pengikut_iiI]</td>\r\n<td style=\"text-align: right;\">6.</td>\r\n<td>[Form_nama_pengikut_vI]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">9.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">Pembebanan Anggaran</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">a. Instansi</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">a. Kantor [Sebutan_desA] [Nama_desA]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">b. Mata Anggaran</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">b. APBKam  Tahun [TahuN]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.91803%; vertical-align: top;\">10.</td>\r\n<td style=\"width: 30.81%; height: 18.75px; vertical-align: top;\">Keterangan lain-lain</td>\r\n<td style=\"width: 2.74971%; height: 18.75px; vertical-align: top; text-align: center;\">:</td>\r\n<td style=\"width: 61.3294%; height: 18.75px; vertical-align: top;\">[Form_keterangan_laiN]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<table style=\"border-collapse: collapse; width: 97.4463%; height: 192px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 67.8329%; text-align: left;\"> </td>\r\n<td style=\"width: 32.1882%; text-align: left; height: 18.75px;\">Ditetapkan di : [NaMa_desa]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 67.8329%; text-align: left;\"> </td>\r\n<td style=\"width: 32.1882%; text-align: left;\">Pada Tanggal :  [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 67.8329%; text-align: left;\"> </td>\r\n<td style=\"width: 32.1882%; text-align: left; height: 18.75px;\">[Sebutan_kepala_desA] [Nama_desA]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 67.8329%; text-align: center;\"> </td>\r\n<td style=\"width: 32.1882%; text-align: center; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 75px;\">\r\n<td style=\"width: 67.8329%;\"> </td>\r\n<td style=\"width: 32.1882%; height: 75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 67.8329%; text-align: center;\"> </td>\r\n<td style=\"width: 32.1882%; text-align: center; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 67.8329%; text-align: left;\"><strong> </strong></td>\r\n<td style=\"width: 32.1882%; text-align: left; height: 18.75px;\"><strong>[Nama_pamonG]</strong></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\"> </span></h4>\r\n<table style=\"border-collapse: collapse; width: 95%; margin-left: auto; margin-right: auto; height: 977.29px;\" border=\"1\">\r\n<tbody>\r\n<tr style=\"height: 160.445px;\">\r\n<td style=\"height: 160.445px;\" colspan=\"2\">\r\n<table style=\"width: 100.29%;\" align=\"left\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 64.8654%;\">\r\n<table style=\"border-collapse: collapse; width: 48.2556%;\" width=\"100%\">\r\n<tbody>\r\n<tr style=\"height: 18.5px;\">\r\n<td style=\"width: 29.6649%; text-align: right; height: 18.5px;\" width=\"105\">I. Berangkat dari</td>\r\n<td style=\"text-align: left; width: 70.2443%; height: 18.5px;\" width=\"304\">: Kantor [Sebutan_desA] [Nama_desA]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 29.6649%; height: 18.75px; text-align: right;\" width=\"105\">Ke</td>\r\n<td style=\"text-align: left; width: 70.2443%; height: 18.75px;\" width=\"304\">: [Form_tempat_tujuaN]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 29.6649%; height: 18.75px; text-align: right;\" width=\"105\">Pada Tanggal</td>\r\n<td style=\"text-align: left; width: 70.2443%; height: 18.75px;\" width=\"304\">: [Form_tanggal_berangkaT]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td style=\"width: 35.2169%;\">\r\n<div style=\"width: 200px;\"> </div>\r\n</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 100.082%;\" colspan=\"2\">\r\n<table style=\"border-collapse: collapse; height: 68.2422px;\" width=\"100%\" align=\"center\">\r\n<tbody>\r\n<tr style=\"height: 68.2422px;\">\r\n<td style=\"text-align: center; height: 68.2422px;\">[Sebutan_kepala_desA] [Nama_desA]\r\n<p><br><br><strong>( [Nama_pamonG]</strong><strong> )</strong></p>\r\n</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n</tr>\r\n<tr style=\"height: 177.188px;\">\r\n<td style=\"width: 47.3086%; height: 185.172px;\" width=\"315\">\r\n<table style=\"border-collapse: collapse; width: 100%; height: 177.188px;\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\">II.</td>\r\n<td style=\"width: 31.335%; height: 18.75px;\">Tiba di </td>\r\n<td style=\"width: 63.765%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 31.335%; height: 18.75px;\">Pada Tanggal</td>\r\n<td style=\"width: 63.765%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 31.335%; height: 18.75px;\"> </td>\r\n<td style=\"width: 63.765%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 31.335%; height: 18.75px;\">Kepala</td>\r\n<td style=\"width: 63.765%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 31.335%; height: 18.75px;\"> </td>\r\n<td style=\"width: 63.765%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 31.335%; height: 18.75px;\"> </td>\r\n<td style=\"width: 63.765%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"height: 18.75px; width: 95.1%;\" colspan=\"2\">( ................................... )</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td style=\"width: 52.6865%; height: 177.188px;\" width=\"351\">\r\n<table style=\"border-collapse: collapse; width: 100.85%; height: 177.188px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9707%; height: 18.75px;\">Berangkat dari </td>\r\n<td style=\"width: 66.5695%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9707%; height: 18.75px;\">Ke</td>\r\n<td style=\"width: 66.5695%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9707%; height: 18.75px;\">Pada Tanggal</td>\r\n<td style=\"width: 66.5695%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9707%; height: 18.75px;\">Kepala</td>\r\n<td style=\"width: 66.5695%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9707%; height: 18.75px;\"> </td>\r\n<td style=\"width: 66.5695%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9707%; height: 18.75px;\"> </td>\r\n<td style=\"width: 66.5695%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"height: 18.75px; width: 95.5402%;\" colspan=\"2\">( ................................... )</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n</tr>\r\n<tr style=\"height: 177.188px;\">\r\n<td style=\"width: 47.3086%; height: 177.188px;\" width=\"315\">\r\n<table style=\"border-collapse: collapse; width: 100%; height: 177.188px;\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\">III.</td>\r\n<td style=\"width: 30.7993%; height: 18.75px;\">Tiba di </td>\r\n<td style=\"width: 64.3008%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.7993%; height: 18.75px;\">Pada Tanggal</td>\r\n<td style=\"width: 64.3008%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.7993%; height: 18.75px;\"> </td>\r\n<td style=\"width: 64.3008%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.7993%; height: 18.75px;\">Kepala</td>\r\n<td style=\"width: 64.3008%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.7993%; height: 18.75px;\"> </td>\r\n<td style=\"width: 64.3008%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.7993%; height: 18.75px;\"> </td>\r\n<td style=\"width: 64.3008%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"height: 18.75px; width: 95.1%;\" colspan=\"2\">( ................................... )</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td style=\"width: 52.6865%; height: 177.188px;\" width=\"351\">\r\n<table style=\"border-collapse: collapse; width: 100.85%; height: 177.188px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\">Berangkat dari </td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\">Ke</td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\">Pada Tanggal</td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\">Kepala</td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\"> </td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\"> </td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%;\"> </td>\r\n<td style=\"height: 18.75px; width: 95.5402%;\" colspan=\"2\">( ................................... )</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n</tr>\r\n<tr style=\"height: 177.188px;\">\r\n<td style=\"width: 47.3086%; height: 177.188px;\" width=\"315\">\r\n<table style=\"border-collapse: collapse; width: 100%; height: 177.188px;\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\">IV.</td>\r\n<td style=\"width: 30.2693%; height: 18.75px;\">Tiba di </td>\r\n<td style=\"width: 64.6516%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.2693%; height: 18.75px;\">Pada Tanggal</td>\r\n<td style=\"width: 64.6516%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.2693%; height: 18.75px;\"> </td>\r\n<td style=\"width: 64.6516%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.2693%; height: 18.75px;\">Kepala</td>\r\n<td style=\"width: 64.6516%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.2693%; height: 18.75px;\"> </td>\r\n<td style=\"width: 64.6516%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"width: 30.2693%; height: 18.75px;\"> </td>\r\n<td style=\"width: 64.6516%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 5.01469%; height: 18.75px;\"> </td>\r\n<td style=\"height: 18.75px; width: 94.9209%;\" colspan=\"2\">( ................................... )</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td style=\"width: 52.6865%; height: 177.188px;\" width=\"351\">\r\n<table style=\"border-collapse: collapse; width: 100.85%; height: 177.188px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\">Berangkat dari </td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\">Ke</td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\">Pada Tanggal</td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\">Kepala</td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\"> </td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"width: 28.9805%; height: 18.75px;\"> </td>\r\n<td style=\"width: 66.5597%; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 4.45854%; height: 18.75px;\"> </td>\r\n<td style=\"height: 18.75px; width: 95.5402%;\" colspan=\"2\">( ................................... )</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n</tr>\r\n<tr style=\"height: 41.1133px;\">\r\n<td style=\"width: 47.3086%; height: 41.1133px;\" width=\"315\">V. Tiba di : Kantor [Sebutan_desA] [Nama_desA] <br>Pada Tanggal : [Form_tanggal_kembalI]</td>\r\n<td style=\"width: 52.6865%; height: 41.1133px;\" width=\"351\"><em>Telah diperiksa dengan keterangan bahwa perjalan tersebut atas perintahnya dan semata-mata untuk kepentingan jabatan dalam waktu yang sesingkat-singkatnya</em></td>\r\n</tr>\r\n<tr style=\"height: 80.988px;\">\r\n<td style=\"text-align: center; width: 99.9951%; height: 80.988px;\" colspan=\"2\" width=\"666\">[Sebutan_kepala_desA] [Nama_desA] <br><br><br><br><strong>( [Nama_pamonG]</strong><strong> )</strong></td>\r\n</tr>\r\n<tr style=\"height: 58.2422px;\">\r\n<td style=\"width: 99.9951%; height: 58.2422px;\" colspan=\"2\" width=\"666\">VI. <u>PERHATIAN </u> <br>Pengguna Anggaran yang menerbitkan SPD, pegawai yang melakukan perjalanan dinas, para pejabat yang mengesahkan tanggal berangkat/tiba,    serta bendahara pengeluaran bertanggungjawab berdasarkan Peraturan Keuangan Negara. Apabila Negara menderita  rugi akibat  kesalahan, kelalaian dan kealpaannya.</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"> </h4>\r\n<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]</p>\r\n<p style=\"text-indent: 30px; text-align: center;\"><strong>MEMERINTAHKAN</strong></p>\r\n<table style=\"border-collapse: collapse; width: 95%; margin-left: auto; margin-right: auto;\">\r\n<tbody>\r\n<tr>\r\n<td width=\"20\">1.</td>\r\n<td width=\"50\">Nama</td>\r\n<td width=\"5\">:</td>\r\n<td width=\"600\"><strong>[NaMA]</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"20\"> </td>\r\n<td width=\"50\">Jabatan</td>\r\n<td width=\"5\">:</td>\r\n<td width=\"600\">[Form_jabataninstansI]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"20\"> </td>\r\n<td width=\"50\">Alamat</td>\r\n<td width=\"5\">:</td>\r\n<td width=\"600\">[AlamaT] [Sebutan_desA] [Nama_desA] : [Kode_desA]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"20\"> </td>\r\n<td width=\"50\"> </td>\r\n<td width=\"5\"> </td>\r\n<td width=\"600\">[Sebutan_kecamataN] [Nama_kecamataN] : [Kode_kecamataN]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"20\">2.</td>\r\n<td width=\"50\">Maksud Tugas</td>\r\n<td width=\"5\">:</td>\r\n<td width=\"600\"><strong>[Form_maksud_perjalanan_dinaS]</strong></td>\r\n</tr>\r\n<tr>\r\n<td width=\"20\"> </td>\r\n<td width=\"50\">Tujuan</td>\r\n<td width=\"5\">:</td>\r\n<td width=\"600\">[Form_tempat_tujuaN]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"20\"> </td>\r\n<td width=\"50\">Tanggal</td>\r\n<td width=\"5\">:</td>\r\n<td width=\"600\">[Form_tanggal_berangkaT] s/d [Form_tanggal_kembalI]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"20\"> </td>\r\n<td width=\"50\">Pengikut</td>\r\n<td width=\"5\">:</td>\r\n<td width=\"600\">\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td>\r\n<table width=\"100%\">\r\n<tbody>\r\n<tr>\r\n<td width=\"23\">1.</td>\r\n<td width=\"283\">[Form_nama_pengikut_I]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"23\">2.</td>\r\n<td width=\"283\">[Form_nama_pengikut_iI]</td>\r\n</tr>\r\n<tr>\r\n<td width=\"23\">3.</td>\r\n<td width=\"283\">[Form_nama_pengikut_iiI]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td>\r\n<table style=\"width: 59.6213%;\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 8.73963%;\" width=\"25\">4.</td>\r\n<td style=\"width: 91.258%;\" width=\"262\">[Form_nama_pengikut_iV]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 8.73963%;\" width=\"25\">5.</td>\r\n<td style=\"width: 91.258%;\" width=\"262\">[Form_nama_pengikut_V]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 8.73963%;\" width=\"25\">6.</td>\r\n<td style=\"width: 91.258%;\" width=\"262\">[Form_nama_pengikut_vI]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p> </p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian Surat Tugas ini dikeluarkan untuk dilaksanakan sebagaimana mestinya.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">.</p>\r\n<table style=\"border-collapse: collapse; width: 32.5353%;\" border=\"0\" align=\"right\">\r\n<tbody>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 100%; text-align: left;\">[Nama_desA], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 100%; height: 18.75px; text-align: left;\">[Sebutan_kepala_desA] [Nama_desA]</td>\r\n</tr>\r\n<tr style=\"height: 75px;\">\r\n<td style=\"width: 100%; height: 75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 100%; text-align: center; height: 18.75px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.75px;\">\r\n<td style=\"width: 100%; text-align: left; height: 18.75px;\"><strong>[Nama_pamonG]</strong></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br></p>\r\n<p> </p>\r\n<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">HASIL BIMTEK/PELATIHAN/KONSULTASI/MONEV/PENGIRIMAN DATA, DLL</span></h4>\r\n<div><br>Sebagai berikut :<br><br>1.<br>2.<br>3.</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_pangkat_dan_golongan]\",\"nama\":\"Pangkat dan Golongan\",\"deskripsi\":\"Pangkat dan Golongan\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_jabataninstansi]\",\"nama\":\"Jabatan\\/Instansi\",\"deskripsi\":\"Jabatan\\/Instansi\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_tingkat_biaya_perjalanan]\",\"nama\":\"Tingkat Biaya Perjalanan\",\"deskripsi\":\"Tingkat Biaya Perjalanan\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"textarea\",\"kode\":\"[form_maksud_perjalanan_dinas]\",\"nama\":\"Maksud Perjalanan Dinas\",\"deskripsi\":\"Maksud Perjalanan Dinas\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_tempat_tujuan]\",\"nama\":\"Tempat Tujuan\",\"deskripsi\":\"Tempat Tujuan\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_alat_angkut_yang_digunakan]\",\"nama\":\"Alat Angkut Yang Digunakan\",\"deskripsi\":\"Alat Angkut Yang Digunakan\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_pengikut_i]\",\"nama\":\"Nama Pengikut I\",\"deskripsi\":\"Nama Pengikut I\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_pengikut_ii]\",\"nama\":\"Nama Pengikut II\",\"deskripsi\":\"Nama Pengikut II\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_pengikut_iii]\",\"nama\":\"Nama Pengikut III\",\"deskripsi\":\"Nama Pengikut III\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_pengikut_iv]\",\"nama\":\"Nama Pengikut IV\",\"deskripsi\":\"Nama Pengikut IV\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_pengikut_v]\",\"nama\":\"Nama Pengikut V\",\"deskripsi\":\"Nama Pengikut V\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_pengikut_vi]\",\"nama\":\"Nama Pengikut VI\",\"deskripsi\":\"Nama Pengikut VI\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"textarea\",\"kode\":\"[form_keterangan_lain]\",\"nama\":\"Keterangan Lain\",\"deskripsi\":\"Keterangan Lain\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_berangkat]\",\"nama\":\"Tanggal Berangkat\",\"deskripsi\":\"Tanggal Berangkat\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_kembali]\",\"nama\":\"Tanggal Kembali\",\"deskripsi\":\"Tanggal Kembali\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-26 17:08:13', 1),
(228, 1, 'Permohonan Duplikat Surat Nikah', 'surat-permohonan-duplikat-surat-nikah', 'S-33', NULL, 0, 0, 3, 0, 1, 'M', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 251.4px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 19.7625px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.7625px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.7625px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.7625px;\">Nama Lengkap</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.7625px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.7625px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 19.7625px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.7625px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.7625px; text-align: left;\">2.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.7625px;\">NIK / No. KTP</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.7625px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.7625px; text-align: justify;\">[Nik]</td>\r\n</tr>\r\n<tr style=\"height: 25.8125px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 25.8125px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 25.8125px;\">3.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 25.8125px;\">Nomor KK</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 25.8125px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 25.8125px;\">[No_kK]</td>\r\n</tr>\r\n<tr style=\"height: 21.8125px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 21.8125px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 21.8125px;\">4.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 21.8125px;\">Kepala Keluarga</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 21.8125px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 21.8125px;\">[Kepala_kK]</td>\r\n</tr>\r\n<tr style=\"height: 19.7625px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.7625px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.7625px; text-align: left;\">5.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.7625px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.7625px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.7625px; text-align: justify;\">[Jenis_kelamin]</td>\r\n</tr>\r\n<tr style=\"height: 19.7625px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.7625px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.7625px; text-align: left;\">6.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.7625px;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.7625px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.7625px; text-align: justify;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 43.4875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 43.4875px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 43.4875px;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 43.4875px;\">Alamat / Tempat Tinggal</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 43.4875px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 43.4875px;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n<tr style=\"height: 21.825px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 21.825px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 21.825px;\">8.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 21.825px;\">Agama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 21.825px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 21.825px;\">[AgAma]</td>\r\n</tr>\r\n<tr style=\"height: 19.7625px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.7625px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.7625px; text-align: left;\">9.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.7625px;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.7625px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.7625px; text-align: justify;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 19.7625px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.7625px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.7625px; text-align: left;\">10.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.7625px;\">Pendidikan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.7625px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.7625px; text-align: justify;\">[Pendidikan_kk]</td>\r\n</tr>\r\n<tr style=\"height: 19.8875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.8875px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.8875px; text-align: left;\">11.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.8875px;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.8875px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.8875px; text-align: justify;\">[WArga_negara]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang namanya tersebut di atas memang benar warga kami dan telah menikah di KUA [Form_kecamatan_kuA] pada [Form_tanggal_nikaH] dengan seseorang yang bernama [Form_nama_pasangaN]. Berdasarkan data di atas mohon untuk dibuatkan Duplikat Surat Nikah orang tersebut di atas.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya, untuk dipergunakan sebagaimana mestinya.<br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Atas_namA]</td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"width: 35%; text-align: center; height: 72px;\"> </td>\r\n<td style=\"width: 30%; height: 72px;\"><br><br><br><br></td>\r\n<td style=\"width: 35%; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_kecamatan_kua]\",\"nama\":\"Kecamatan KUA\",\"deskripsi\":\"Isi Kecamatan KUA\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_nikah]\",\"nama\":\"Tanggal Nikah\",\"deskripsi\":\"Isi Tanggal Nikah\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_pasangan]\",\"nama\":\"Nama Pasangan\",\"deskripsi\":\"Isi Nama Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-26 17:08:13', 1);
INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(229, 1, 'Keterangan Kepemilikan Tanah', 'surat-keterangan-kepemilikan-tanah', 'S-49', NULL, 0, 0, 3, 0, 1, 'd', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-indent: 30px; text-align: justify;\">Yang bertanda tangan di bawah ini :</p>\r\n<table style=\"border-collapse: collapse; width: 100.114%; height: 42px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 21px;\">\r\n<td style=\"width: 30px; text-align: center; height: 21px;\"> </td>\r\n<td style=\"width: 20.5239%; text-align: left; height: 21px;\">Nama</td>\r\n<td style=\"width: 1.14525%; height: 21px; text-align: left;\">:</td>\r\n<td style=\"width: 76.445%; height: 21px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 21px;\">\r\n<td style=\"width: 30px; text-align: center; height: 21px;\"> </td>\r\n<td style=\"width: 20.5239%; text-align: left; height: 21px;\">Jabatan</td>\r\n<td style=\"width: 1.14525%; height: 21px; text-align: left;\">:</td>\r\n<td style=\"width: 76.445%; text-align: justify; height: 21px;\">[JabataN]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Dengan ini menerangkan bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 118.922px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 19.8125px;\">\r\n<td style=\"width: 30px; text-align: center; height: 19.8125px;\"> </td>\r\n<td style=\"width: 20.6571%; text-align: left; height: 19.8125px;\">Nama</td>\r\n<td style=\"width: 1.03204%; height: 19.8125px; text-align: left;\">:</td>\r\n<td style=\"width: 76.5364%; height: 19.8125px; text-align: justify;\">[NamA]</td>\r\n</tr>\r\n<tr style=\"height: 19.8125px;\">\r\n<td style=\"width: 30px; text-align: center; height: 19.8125px;\"> </td>\r\n<td style=\"width: 20.6571%; text-align: left; height: 19.8125px;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.03204%; height: 19.8125px; text-align: left;\">:</td>\r\n<td style=\"width: 76.5364%; height: 19.8125px; text-align: justify;\">[TempatlahiR] / [TanggallahiR]</td>\r\n</tr>\r\n<tr style=\"height: 19.8125px;\">\r\n<td style=\"width: 30px; text-align: center; height: 19.8125px;\"> </td>\r\n<td style=\"width: 20.6571%; text-align: left; height: 19.8125px;\">Umur</td>\r\n<td style=\"width: 1.03204%; height: 19.8125px; text-align: left;\">:</td>\r\n<td style=\"width: 76.5364%; text-align: justify; height: 19.8125px;\">[UsiA]</td>\r\n</tr>\r\n<tr style=\"height: 19.8125px;\">\r\n<td style=\"width: 30px; text-align: center; height: 19.8125px;\"> </td>\r\n<td style=\"width: 20.6571%; text-align: left; height: 19.8125px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.03204%; height: 19.8125px; text-align: left;\">:</td>\r\n<td style=\"width: 76.5364%; height: 19.8125px; text-align: justify;\">[Jenis_kelamiN]</td>\r\n</tr>\r\n<tr style=\"height: 19.8125px;\">\r\n<td style=\"width: 30px; text-align: center; height: 19.8125px;\"> </td>\r\n<td style=\"width: 20.6571%; text-align: left; height: 19.8125px;\">Pekerjaan</td>\r\n<td style=\"width: 1.03204%; height: 19.8125px; text-align: left;\">:</td>\r\n<td style=\"width: 76.5364%; text-align: justify; height: 19.8125px;\">[PekerjaaN]</td>\r\n</tr>\r\n<tr style=\"height: 19.8594px;\">\r\n<td style=\"width: 30px; text-align: center; height: 19.8594px;\"> </td>\r\n<td style=\"width: 20.6571%; text-align: left; height: 19.8594px;\">Alamat</td>\r\n<td style=\"width: 1.03204%; height: 19.8594px; text-align: left;\">:</td>\r\n<td style=\"width: 76.5364%; text-align: justify; height: 19.8594px;\">[AlamaT]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-indent: 30px; text-align: justify;\">Adalah benar-benar penduduk [Sebutan_desA] [NaMa_desa], yang memiliki/menguasai tanah/lahan berupa <strong>[FOrm_jenis_tanah]</strong> atas nama <strong>[Form_atas_namA]</strong>, yang berada di [Sebutan_desA] [NaMa_desa]. Tercatat dalam <strong>[FOrm_bukti_kepemilikan]</strong>, Nomor : <strong>[Form_nomor_bukti_kepemilikaN]</strong>, Luas :<strong>[Form_luas_tanaH]</strong>M<sup>2</sup>, dengan batas-batas :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 72px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 30px; height: 18px;\"> </td>\r\n<td style=\"width: 20.2564%; height: 18px;\">Sebelah Utara</td>\r\n<td style=\"width: 1.14646%; height: 18px;\">:</td>\r\n<td style=\"width: 76.5937%; height: 18px;\">[Form_batas_sebelah_utarA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 30px; height: 18px;\"> </td>\r\n<td style=\"width: 20.2564%; height: 18px;\">Sebelah Timur</td>\r\n<td style=\"width: 1.14646%; height: 18px;\">:</td>\r\n<td style=\"width: 76.5937%; height: 18px;\">[Form_batas_sebelah_timuR]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 30px; height: 18px;\"> </td>\r\n<td style=\"width: 20.2564%; height: 18px;\">Sebelah Selatan</td>\r\n<td style=\"width: 1.14646%; height: 18px;\">:</td>\r\n<td style=\"width: 76.5937%; height: 18px;\">[Form_batas_sebelah_selataN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 30px; height: 18px;\"> </td>\r\n<td style=\"width: 20.2564%; height: 18px;\">Sebelah Barat</td>\r\n<td style=\"width: 1.14646%; height: 18px;\">:</td>\r\n<td style=\"width: 76.5937%; height: 18px;\">[Form_batas_sebelah_baraT]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<ol>\r\n<li style=\"text-align: justify;\">Tanah tersebut benar-benar <em>MILIK</em> yang bersangkutan dan <strong>tidak dalam keadaan sengketa</strong>.</li>\r\n<li style=\"text-align: justify;\">Tanah tersebut berasal dari <strong>[FOrm_asal_kepmilikan_tanah]</strong> dan sampai dengan sekarang belum terdaftar / didaftarkan Hak nya ke BPN (belumditerbitkan : SIIM / SIIGB / SIIGU / LAINNYA)</li>\r\n<li style=\"text-align: justify;\">Bukti pendukung kepemilikan sementara ini berupa <strong>[Form_bukti_pendukung_kepemilikan]</strong>.</li>\r\n</ol>\r\n<p style=\"text-indent: 30px;\">Demikian surat ini dibuat, untuk dipergunakan sebagaimana mestinya.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\"><br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\">Pemilih</td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Atas_namA]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"><br><br><br><br></td>\r\n<td style=\"width: 35%;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\">[NAma]</td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"select-manual\",\"kode\":\"[form_jenis_tanah]\",\"nama\":\"Jenis Tanah\",\"deskripsi\":\"- Pilih Jenis Tanah -\",\"atribut\":\"\",\"pilihan\":[\"Tanah Sawah\",\"Tanah Darat\",\"Tanah Bangunan\"],\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"number\",\"kode\":\"[form_luas_tanah]\",\"nama\":\"Luas Tanah\",\"deskripsi\":\"Luas Tanah (dalam M2)\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"select-manual\",\"kode\":\"[form_bukti_kepemilikan]\",\"nama\":\"Bukti Kepemilikan\",\"deskripsi\":\"- Pilih Bukti Kepemilikan Tanah -\",\"atribut\":\"\",\"pilihan\":[\"Petok lama\",\"Petok baru\",\"Sit segel\",\"Akta\",\"Copy\",\"Buku Krawangan Desa\",\"Lainnya\"],\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nomor_bukti_kepemilikan]\",\"nama\":\"Nomor Bukti Kepemilikan\",\"deskripsi\":\"- Nomor Bukti Kepemilikan -\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_atas_nama]\",\"nama\":\"Atas Nama\",\"deskripsi\":\"Atas Nama\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"select-manual\",\"kode\":\"[form_asal_kepmilikan_tanah]\",\"nama\":\"Asal Kepmilikan Tanah\",\"deskripsi\":\"- Pilih Asal Kepemilikan Tanah -\",\"atribut\":\"\",\"pilihan\":[\"Yayasan\",\"Warisan\",\"Hibah\",\"Jual Beli\",\"Lainnya\"],\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_bukti_pendukung_kepemilikan]\",\"nama\":\"Bukti Pendukung Kepemilikan\",\"deskripsi\":\"Bukti Pendukung Kepemilikan\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_batas_sebelah_utara]\",\"nama\":\"Batas Sebelah Utara\",\"deskripsi\":\"Batas Sebelah Utara\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_batas_sebelah_timur]\",\"nama\":\"Batas Sebelah Timur\",\"deskripsi\":\"Batas Sebelah Timur\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_batas_sebelah_selatan]\",\"nama\":\"Batas Sebelah Selatan\",\"deskripsi\":\"Batas Sebelah Selatan\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_batas_sebelah_barat]\",\"nama\":\"Batas Sebelah Barat\",\"deskripsi\":\"Batas Sebelah Barat\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-26 17:08:13', 1),
(230, 1, 'Permohonan Duplikat Kelahiran', 'surat-permohonan-duplikat-kelahiran', 'S-20', NULL, 0, 0, 3, 0, 1, 'd', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">YDengan ini kami mengajukan orang untuk mengadakan [Judul_suraT] seperti tersebut di bawah ini  :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 481.547px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">NIK / No KTP</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[NiK]</td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Jenis Kelamin / Agama</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[Jenis_kelamiN] / [AgamA]</td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Alamat/Tempat Tinggal</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[AlamaT]</td>\r\n</tr>\r\n<tr style=\"height: 39.75px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 39.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 39.75px; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 39.75px; vertical-align: top;\"><strong><br>Telah Lahir Pada :</strong></td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 39.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 60.0289%; height: 39.75px; text-align: justify; vertical-align: top;\"> </td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Hari, Tanggal, Pukul</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[HaRi_kelahiran], [TaNggal_kelahiran], [JaM_kelahiran] WIB</td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">6.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Bertempat di</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[TeMpat_dilahirkan]</td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\"><strong><br>Dengan orang tua</strong>:</td>\r\n<td style=\"width: 1.30183%; height: 19.375px; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\"> </td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Nama Ibu</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[NAma_ibu]</td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">NIK / Tanggal Lahir Ibu</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[Nik_ibU] / [Tempatlahir_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">9.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Pekerjaan Ibu</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[Pekerjaan_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.375px; text-align: left; vertical-align: top;\">10.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Alamat Ibu</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.375px; text-align: justify; vertical-align: top;\">[Alamat_ibU] [Sebutan_desA] [Nama_desA], [Sebutan_kecamataN] [Nama_kecamataN], [Sebutan_kabupateN] [Nama_kabupateN]</td>\r\n</tr>\r\n<tr style=\"height: 19.4219px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.4219px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; height: 19.4219px; text-align: left; vertical-align: top;\">11.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.4219px; vertical-align: top;\">Nama Ayah</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.4219px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; height: 19.4219px; text-align: justify; vertical-align: top;\">[NAma_ayah]</td>\r\n</tr>\r\n<tr style=\"height: 19.2344px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 19.2344px; vertical-align: top;\">12.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.2344px; vertical-align: top;\">NIK / Tanggal Lahir Ayah</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.2344px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 19.2344px; vertical-align: top;\">[Nik_ayaH] / [Tanggallahir_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 19.2344px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 19.2344px; vertical-align: top;\">13.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.2344px; vertical-align: top;\">Pekerjaan Ayah</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.2344px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 19.2344px; vertical-align: top;\">[Pekerjaan_ayaH] </td>\r\n</tr>\r\n<tr style=\"height: 36px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 36px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 36px; vertical-align: top;\">14.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 36px; vertical-align: top;\">Alamat Ayah</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 36px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 36px; vertical-align: top;\">[Alamat_ayaH] [Sebutan_desA] [Nama_desA], [Sebutan_kecamataN] [Nama_kecamataN], [Sebutan_kabupateN] [Nama_kabupateN]</td>\r\n</tr>\r\n<tr style=\"height: 19.2344px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 19.2344px; vertical-align: top;\"> </td>\r\n</tr>\r\n<tr style=\"height: 19.2344px;\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"text-align: left; height: 19.2344px; width: 95.757%; vertical-align: top;\" colspan=\"4\">Surat Keterangan ini dibuat berdasarkan keterangan pelapor:</td>\r\n</tr>\r\n<tr style=\"height: 19.2344px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 19.2344px; vertical-align: top;\">15.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.2344px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.2344px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 19.2344px; vertical-align: top;\">[NAma_pelapor]</td>\r\n</tr>\r\n<tr style=\"height: 19.2344px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 19.2344px; vertical-align: top;\">16.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.2344px; vertical-align: top;\">NIK / Jenis Kelamin</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.2344px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 19.2344px; vertical-align: top;\">[Nik_pelapoR] / [Jenis_kelamin_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 19.2344px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 19.2344px; vertical-align: top;\">17.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.2344px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.2344px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 19.2344px; vertical-align: top;\">[Ttl_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 19.2344px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.2344px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 19.2344px; vertical-align: top;\">18.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.2344px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.2344px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 19.2344px; vertical-align: top;\">[Pekerjaan_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 19.375px;\" valign=\"top\">\r\n<td style=\"width: 4.33944%; text-align: center; height: 19.375px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.9055%; text-align: left; height: 19.375px; vertical-align: top;\">19.</td>\r\n<td style=\"width: 30.5207%; text-align: left; height: 19.375px; vertical-align: top;\">Alamat</td>\r\n<td style=\"width: 1.30183%; text-align: center; height: 19.375px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0289%; text-align: justify; height: 19.375px; vertical-align: top;\">[Alamat_pelapoR]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya, atas perhatian dan terkabulnya diucapkan terima kasih.<br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 415.985px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 38.2344px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 38.2344px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 38.2344px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 38.2344px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 22.4688px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 22.4688px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 22.4688px;\">[Nama_desA], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 22.4688px;\">\r\n<td style=\"width: 35.0462%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 22.4688px;\">[Sebutan_kepala_desA] [Nama_desA]</td>\r\n</tr>\r\n<tr style=\"height: 22.4688px;\">\r\n<td style=\"width: 35.0462%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 22.4688px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 22.4688px;\">\r\n<td style=\"width: 35.0462%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 22.4688px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 22.4688px;\">\r\n<td style=\"width: 35.0462%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 22.4688px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 22.4688px;\">\r\n<td style=\"width: 35.0462%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 30.0103%; text-align: center; height: 22.4688px;\"> </td>\r\n<td style=\"width: 35.0462%; height: 22.4688px; text-align: center;\"><strong>Nama_pamonG</strong></td>\r\n</tr>\r\n<tr style=\"height: 22.4688px;\">\r\n<td style=\"width: 35.0462%; height: 22.4688px;\"> </td>\r\n<td style=\"width: 30.0103%; text-align: center; height: 22.4688px;\"> </td>\r\n<td style=\"width: 35.0462%; height: 22.4688px; text-align: center;\">NIP : [Nip_kepala_camaT]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 92px;\">\r\n<td style=\"width: 35.0462%; height: 92px;\"> </td>\r\n<td style=\"width: 30.0103%; text-align: center; height: 92px;\">[qr_code]</td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 92px;\"> </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"> </div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_hari_lahir]\",\"nama\":\"Hari Lahir\",\"deskripsi\":\"Hari Lahir\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"time\",\"kode\":\"[form_jam_lahir]\",\"nama\":\"Jam Lahir\",\"deskripsi\":\"Jam Lahir\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_tempat_lahir]\",\"nama\":\"Tempat Lahir\",\"deskripsi\":\"Tempat Lahir\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_pelapor]\",\"nama\":\"Nama Pelapor\",\"deskripsi\":\"Nama Pelapor\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir_pelapor]\",\"nama\":\"Tanggal Lahir Pelapor\",\"deskripsi\":\"Tanggal Lahir Pelapor\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nik_pelapor]\",\"nama\":\"Nik Pelapor\",\"deskripsi\":\"Nik Pelapor\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"select-otomatis\",\"kode\":\"[form_jenis_kelamin_pelapor]\",\"nama\":\"Jenis Kelamin Pelapor\",\"deskripsi\":\"Jenis Kelamin Pelapor\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":\"tweb_penduduk_sex\",\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_tempat_lahir_pelapor]\",\"nama\":\"Tempat Lahir Pelapor\",\"deskripsi\":\"Tempat Lahir Pelapor\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir_pelapor]\",\"nama\":\"Tanggal Lahir Pelapor\",\"deskripsi\":\"Tanggal Lahir Pelapor\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_pekerjaan_pelapor]\",\"nama\":\"Pekerjaan Pelapor\",\"deskripsi\":\"Pekerjaan Pelapor\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"textarea\",\"kode\":\"[form_alamat_pelapor]\",\"nama\":\"Alamat Pelapor\",\"deskripsi\":\"Alamat Pelapor\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-26 17:08:13', 1),
(231, 1, 'Permohonan Kartu Keluarga', 'surat-permohonan-kartu-keluarga', 'S-36', 'F-1.15,F-1.01,F-1.02', 0, 0, 3, 0, 1, 'M', 1, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br /><br /></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 270px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Nama</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">2.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">3.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Umur</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[UsIa]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">4.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Warga Negara</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">5.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Agama</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[AgAma]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">6.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[Jenis_kelamin]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">7.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Pekerjaan</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 36px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 36px; text-align: left;\">8.<br /><br /></td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 36px;\">Tempat Tinggal<br /><br /></td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 36px;\">:<br /><br /></td>\r\n<td style=\"width: 60.0211%; height: 36px; text-align: justify;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">9.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Surat bukti diri</td>\r\n<td style=\"width: 1.26582%; height: 18px; text-align: center;\"> </td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\"> </td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">KTP</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[Nik]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\"> </td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">KK</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[No_kk]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">10.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Keperluan</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">Permohonan Kartu Keluarga baru WNI.</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">11.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Berlaku</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">[Mulai_berlaku] s/d [Berlaku_sampai]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.32489%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90295%; height: 18px; text-align: left;\">12.</td>\r\n<td style=\"width: 30.4852%; text-align: left; height: 18px;\">Keterangan lain-lain</td>\r\n<td style=\"width: 1.26582%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0211%; height: 18px; text-align: justify;\">Orang tersebut di atas adalah benar-benar penduduk [SeButan_desa] kami dan ada istiadat baik.</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat ini dibuat, untuk dipergunakan sebagaimana mestinya.<br /><br /></p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 324px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">Pemegang Surat</td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">[Atas_namA]</td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 72px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 72px;\"><br /><br /><br /><br /></td>\r\n<td style=\"width: 35.0462%; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\"><strong>[NAma]</strong></td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\">No</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\">Tanggal</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; text-align: center; height: 18px;\">Mengetahui,</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; text-align: center; height: 18px;\">Camat - [NaMa_kecamatan]</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"height: 72px; width: 35.0462%;\" rowspan=\"2\">[qr_code]</td>\r\n<td style=\"width: 30.0103%; height: 72px;\"><br /><br /><br /></td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 30.0103%; text-align: center; height: 18px;\">..............................................</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\"> </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"> </div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[\"1\"]}}', '[{\"tipe\":\"select-manual\",\"kode\":\"[form_alasan_permohonan]\",\"nama\":\"Alasan Permohonan\",\"deskripsi\":\"Alasan Permohonan\",\"atribut\":null,\"pilihan\":[\"KARENA MEMBENTUK RUMAH TANGGA BARU\",\"KARENA KARTU KELUARGA HILANG\\/RUSAK\",\"LAINNYA\"],\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nomor_kartu_keluarga_semula]\",\"nama\":\"Nomor Kartu Keluarga Semula\",\"deskripsi\":\"Nomor Kartu Keluarga Semula\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"textarea\",\"kode\":\"[form_keterangan]\",\"nama\":\"Keterangan\",\"deskripsi\":\"Keterangan\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-27 00:08:12', 1);
INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(232, 1, 'Keterangan Pengantar Rujuk/Cerai', 'surat-keterangan-pengantar-rujukcerai', 'S-35', NULL, 0, 0, 3, 0, 1, 'd', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\n            <p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br /><br /></p>\n            <p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan bahwa berdasarkan keterangan dari :</p>\n            <table style=\"border-collapse: collapse; width: 100%; height: 154px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n            <tbody>\n            <tr style=\"height: 19.25px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 19.25px;\"> </td>\n            <td style=\"width: 2.98047%; text-align: center; height: 19.25px;\">1.</td>\n            <td style=\"width: 29.9075%; text-align: left; height: 19.25px;\">Nama Lengkap</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 19.25px;\">:</td>\n            <td style=\"width: 62.4872%; height: 19.25px; text-align: justify;\"><strong>[NAma]</strong></td>\n            </tr>\n            <tr style=\"height: 19.25px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 19.25px;\"> </td>\n            <td style=\"width: 2.98047%; text-align: center; height: 19.25px;\">2.</td>\n            <td style=\"width: 29.9075%; text-align: left; height: 19.25px;\">Bin</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 19.25px;\">:</td>\n            <td style=\"width: 62.4872%; height: 19.25px; text-align: justify;\">[NaMa_ayah]</td>\n            </tr>\n            <tr style=\"height: 19.25px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 19.25px;\"> </td>\n            <td style=\"width: 2.98047%; text-align: center; height: 19.25px;\">3.</td>\n            <td style=\"width: 29.9075%; text-align: left; height: 19.25px;\">Tempat / Tanggal Lahir</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 19.25px;\">:</td>\n            <td style=\"width: 62.4872%; height: 19.25px; text-align: justify;\">[TtL]</td>\n            </tr>\n            <tr style=\"height: 19.25px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 19.25px;\"> </td>\n            <td style=\"width: 2.98047%; text-align: center; height: 19.25px;\">4.</td>\n            <td style=\"width: 29.9075%; text-align: left; height: 19.25px;\">Kewarganegaraan</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 19.25px;\">:</td>\n            <td style=\"width: 62.4872%; text-align: justify; height: 19.25px;\">[WArga_negara]</td>\n            </tr>\n            <tr style=\"height: 19.25px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 19.25px;\"> </td>\n            <td style=\"width: 2.98047%; text-align: center; height: 19.25px;\">5.</td>\n            <td style=\"width: 29.9075%; text-align: left; height: 19.25px;\">Agama</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 19.25px;\">:</td>\n            <td style=\"width: 62.4872%; height: 19.25px; text-align: justify;\">[AgAma]</td>\n            </tr>\n            <tr style=\"height: 19.25px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 19.25px;\"> </td>\n            <td style=\"width: 2.98047%; text-align: center; height: 19.25px;\">6.</td>\n            <td style=\"width: 29.9075%; text-align: left; height: 19.25px;\">Pekerjaan</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 19.25px;\">:</td>\n            <td style=\"width: 62.4872%; text-align: justify; height: 19.25px;\">[PeKerjaan]</td>\n            </tr>\n            <tr style=\"height: 38.5px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 38.5px;\"> </td>\n            <td style=\"width: 2.98047%; text-align: center; height: 38.5px;\">7.</td>\n            <td style=\"width: 29.9075%; text-align: left; height: 38.5px;\">Alamat / Tempat Tinggal</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 38.5px;\">:</td>\n            <td style=\"width: 62.4872%; text-align: justify; height: 38.5px;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\n            </tr>\n            </tbody>\n            </table>\n            <p style=\"text-align: justify; text-indent: 30px;\">Telah rujuk/cerai *) dengan :<strong><br /></strong></p>\n            <table style=\"border-collapse: collapse; width: 100%; height: 163px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n            <tbody>\n            <tr style=\"height: 23.2812px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 23.2812px;\"> </td>\n            <td style=\"width: 2.8777%; text-align: center; height: 23.2812px;\">8.</td>\n            <td style=\"width: 30.0103%; height: 23.2812px;\">Nama Lengkap</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 23.2812px;\">:</td>\n            <td style=\"width: 62.4872%; height: 23.2812px;\">[FoRm_nama_lengkap]</td>\n            </tr>\n            <tr style=\"height: 23.2812px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 23.2812px;\"> </td>\n            <td style=\"width: 2.8777%; text-align: center; height: 23.2812px;\">9.</td>\n            <td style=\"width: 30.0103%; height: 23.2812px;\">Binti</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 23.2812px;\">:</td>\n            <td style=\"width: 62.4872%; height: 23.2812px;\">[FoRm_nama_ayah]</td>\n            </tr>\n            <tr style=\"height: 23.2812px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 23.2812px;\"> </td>\n            <td style=\"width: 2.8777%; text-align: center; height: 23.2812px;\">10.</td>\n            <td style=\"width: 30.0103%; height: 23.2812px;\">Tempat dan Tanggal Lahir</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 23.2812px;\">:</td>\n            <td style=\"width: 62.4872%; height: 23.2812px;\">[FoRm_tempat_lahir], [FoRm_tanggal_lahir]</td>\n            </tr>\n            <tr style=\"height: 23.2812px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 23.2812px;\"> </td>\n            <td style=\"width: 2.8777%; text-align: center; height: 23.2812px;\">11.</td>\n            <td style=\"width: 30.0103%; height: 23.2812px;\">Kewarganegaraan</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 23.2812px;\">:</td>\n            <td style=\"width: 62.4872%; height: 23.2812px;\">[FoRm_warganegara]</td>\n            </tr>\n            <tr style=\"height: 23.2812px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 23.2812px;\"> </td>\n            <td style=\"width: 2.8777%; text-align: center; height: 23.2812px;\">12.</td>\n            <td style=\"width: 30.0103%; height: 23.2812px;\">Agama</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 23.2812px;\">:</td>\n            <td style=\"width: 62.4872%; height: 23.2812px;\">[FoRm_agama]</td>\n            </tr>\n            <tr style=\"height: 23.2812px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 23.2812px;\"> </td>\n            <td style=\"width: 2.8777%; text-align: center; height: 23.2812px;\">13.</td>\n            <td style=\"width: 30.0103%; height: 23.2812px;\">Pekerjaan</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 23.2812px;\">:</td>\n            <td style=\"width: 62.4872%; height: 23.2812px;\">[FoRm_pekerjaan]</td>\n            </tr>\n            <tr style=\"height: 23.3125px;\">\n            <td style=\"width: 3.39157%; text-align: center; height: 23.3125px;\"> </td>\n            <td style=\"width: 2.8777%; text-align: center; height: 23.3125px;\">14.</td>\n            <td style=\"width: 30.0103%; height: 23.3125px;\">Alamat</td>\n            <td style=\"width: 1.2333%; text-align: center; height: 23.3125px;\">:</td>\n            <td style=\"width: 62.4872%; height: 23.3125px;\">[FoRm_tempat_tinggal]</td>\n            </tr>\n            </tbody>\n            </table>\n            <p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya, untuk dipergunakan sebagaimana mestinya.</p>\n            <p style=\"text-align: justify; text-indent: 30px;\"> </p>\n            <table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\">\n            <tbody>\n            <tr style=\"height: 18px;\">\n            <td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\n            <td style=\"width: 30%; height: 18px;\"> </td>\n            <td style=\"width: 35%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\n            </tr>\n            <tr style=\"height: 18px;\">\n            <td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\n            <td style=\"width: 30%; height: 18px;\"> </td>\n            <td style=\"width: 35%; text-align: center; height: 18px;\">[Atas_namA]</td>\n            </tr>\n            <tr style=\"height: 72px;\">\n            <td style=\"width: 35%; text-align: center; height: 72px;\"> </td>\n            <td style=\"width: 30%; height: 72px;\"><br /><br /><br /><br /></td>\n            <td style=\"width: 35%; height: 72px;\"> </td>\n            </tr>\n            <tr style=\"height: 18px;\">\n            <td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\n            <td style=\"width: 30%; height: 18px;\"> </td>\n            <td style=\"width: 35%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\n            </tr>\n            <tr style=\"height: 18px;\">\n            <td style=\"width: 35%; height: 18px;\"> </td>\n            <td style=\"width: 30%; height: 18px;\"> </td>\n            <td style=\"width: 35%; text-align: center; height: 18px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\n            </tr>\n            </tbody>\n            </table>\n            <div style=\"text-align: center;\"> </div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_nama_lengkap]\",\"nama\":\"Nama Lengkap\",\"deskripsi\":\"Nama Lengkap Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_tempat_lahir]\",\"nama\":\"Tempat Lahir\",\"deskripsi\":\"Tempat Lahir Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir]\",\"nama\":\"Tanggal Lahir\",\"deskripsi\":\"Tanggal Lahir Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_warganegara]\",\"nama\":\"Warganegara\",\"deskripsi\":\"Warganegara Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_ayah]\",\"nama\":\"Nama Ayah\",\"deskripsi\":\"Nama Ayah Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_agama]\",\"nama\":\"Agama\",\"deskripsi\":\"Agama Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_pekerjaan]\",\"nama\":\"Pekerjaan\",\"deskripsi\":\"Pekerjaan Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_tempat_tinggal]\",\"nama\":\"Tempat Tinggal\",\"deskripsi\":\"Tempat Tinggal Pasangan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-27 00:08:12', 1),
(233, 1, 'Permohonan Perubahan Kartu Keluarga', 'surat-permohonan-perubahan-kartu-keluarga', 'S-41', 'F-1.01,F-1.02,F-1.16', 0, 0, 3, 0, 1, 'M', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify;\">      Yang bertanda tangan di bawah ini [Jabatan] [Nama_desa], Kecamatan [Nama_kecamatan], [Sebutan_kabupaten] [Nama_kabupaten], Provinsi [Nama_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 270px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">1.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Nama</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">2.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Tempat/tanggal lahir</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">3.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Umur</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">[UsIa]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">4.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Warga negara</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">5.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">[AgAma]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">6.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">[JeNis_kelamin]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">7.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">[Pekerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\">\r\n<td style=\"width: 5%; text-align: center; height: 36px; vertical-align: top;\">8.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 36px; vertical-align: top;\">Tempat tinggal</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 36px; vertical-align: top;\">[AlamaT] [Sebutan_desa] [Nama_desa], Kecamatan [Nama_kecamatan], [Sebutan_kabupaten] [Nama_kabupaten]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">9.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Surat bukti diri</td>\r\n<td style=\"width: 1.22703%; text-align: left; vertical-align: top;\"> </td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">KTP</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">[Nik]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">KK</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">[No_kk]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">10.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Keperluan</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">Permohonan Perubahan Kartu Keluarga WNI.</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 5%; text-align: center; height: 18px; vertical-align: top;\">11.</td>\r\n<td style=\"width: 33.773%; text-align: left; height: 18px; vertical-align: top;\">Keterangan lain-lain</td>\r\n<td style=\"width: 1.22703%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60%; text-align: left; height: 18px; vertical-align: top;\">Orang tersebut di atas adalah benar benar penduduk desa kami dan adat istiadat baik.</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify;\">             </p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat ini dibuat, untuk dipergunakan sebagaimana mestinya.<br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 324px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">Pemegang Surat</td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">[Atas_namA]</td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 72px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 72px;\"><br><br><br><br></td>\r\n<td style=\"width: 35.0462%; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\"><strong>[NAma]</strong></td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\"> </td>\r\n<td style=\"width: 35.0462%; text-align: center; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\">No</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; height: 18px;\">Tanggal</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\">:</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; text-align: center; height: 18px;\">Mengetahui,</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35.0462%; height: 18px;\"> </td>\r\n<td style=\"width: 30.0103%; text-align: center; height: 18px;\">Camat - [NaMa_kecamatan]</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"height: 72px; width: 35.0462%;\" rowspan=\"2\">[qr_code]</td>\r\n<td style=\"width: 30.0103%; height: 72px;\"><br><br><br></td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 30.0103%; text-align: center; height: 18px;\">..............................................</td>\r\n<td style=\"width: 35.0462%; text-align: left; height: 18px;\"> </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"> </div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[\"1\"]}}', '[{\"tipe\":\"select-manual\",\"kode\":\"[form_alasan_permohonan]\",\"nama\":\"Alasan Permohonan\",\"deskripsi\":\"Pilih Alasan Permohonan\",\"required\":\"0\",\"atribut\":\"\",\"pilihan\":[\"Karena Penambahan Anggota Keluarga (Kelahiran, Kedatangan)\",\"Karena Pengurangan Anggota Keluarga (Kematian, Kepindahan)\",\"Lainnya\"],\"refrensi\":null},{\"tipe\":\"textarea\",\"kode\":\"[form_alasan_lainnya]\",\"nama\":\"Alasan Lainnya\",\"deskripsi\":\"Alasan Lainnya\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-26 17:08:13', 1),
(234, 1, 'Keterangan Penghasilan Ayah', 'surat-keterangan-penghasilan-ayah', 'S-44', NULL, 0, 0, 3, 0, 1, 'M', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 166.734px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22.3906px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.3906px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22.3906px; text-align: justify; vertical-align: top;\"><strong>[NaMa_ayah]</strong></td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22.3906px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.3906px; vertical-align: top;\">NIK / No. KTP</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22.3906px; text-align: justify; vertical-align: top;\">[Nik_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 22.3906px; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.3906px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 22.3906px; vertical-align: top;\">[TtL_ayah]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 22.3906px; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.3906px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 22.3906px; vertical-align: top;\">[JeNis_kelamin_ayah]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22.3906px; text-align: left; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.3906px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22.3906px; text-align: justify; vertical-align: top;\">[AgAma_ayah]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 22.3906px; vertical-align: top;\">6</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.3906px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 22.3906px; vertical-align: top;\">[PeKerjaan_ayah]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22.3906px; text-align: left; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.3906px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22.3906px; text-align: justify; vertical-align: top;\">[WArga_negara_ayah]</td>\r\n</tr>\r\n<tr style=\"height: 10px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 10px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 10px; vertical-align: top;\">8.<br><br></td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 10px; vertical-align: top;\">Alamat / Tempat Tinggal<br><br></td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 10px; vertical-align: top;\">:<br><br></td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 10px; vertical-align: top;\">[AlAmat_ayah] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Orang yang tersebut di atas adalah benar-benar warga kami yang bertempat tinggal di [AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten] dan tercatat dalam No. KK : [No_kK] dengan NIK [Nik_ayaH] Kepala Keluarga : [Kepala_kK] dan menurut sepengetahuan kami memang benar berpenghasilan rata-rata [Form_penghasilan_ayaH] ([TerbilanG][[Form_penghasilan_ayaH]]) / Perbulan.<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Surat Keterangan ini dibuat atas permintaan yang bersangkutan untuk keperluan anaknya untuk [Form_keperluaN] di<strong> [Form_nama_sekolaH]</strong><strong> </strong>atas nama :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 269.297px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\"><strong>[NAma] </strong></td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">NIK / No. KTP</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[Nik]</td>\r\n</tr>\r\n<tr style=\"height: 25.8125px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 25.8125px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 25.8125px; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 25.8125px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 25.8125px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 25.8125px; vertical-align: top;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 21.8125px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 21.8125px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 21.8125px; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 21.8125px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 21.8125px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 21.8125px; vertical-align: top;\">[Jenis_kelamin]</td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[AgAma]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.3222%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; vertical-align: top;\">6</td>\r\n<td style=\"width: 30.5174%; text-align: left; vertical-align: top;\">Status</td>\r\n<td style=\"width: 1.24427%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; vertical-align: top;\">[Status_kawiN]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.3222%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; vertical-align: top;\">Pendidikan</td>\r\n<td style=\"width: 1.24427%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; vertical-align: top;\">[Pendidikan_sedanG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px; vertical-align: top;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">9.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 43.4844px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 43.4844px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 43.4844px; vertical-align: top;\">10.<br><br></td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 43.4844px; vertical-align: top;\">Alamat / Tempat Tinggal<br><br></td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 43.4844px; vertical-align: top;\">:<br><br></td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 43.4844px; vertical-align: top;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya, untuk dipergunakan sebagaimana mestinya.<br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Atas_namA]</td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"width: 35%; text-align: center; height: 72px;\"> </td>\r\n<td style=\"width: 30%; height: 72px;\"><br><br><br><br></td>\r\n<td style=\"width: 35%; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_penghasilan_ayah]\",\"nama\":\"Penghasilan Ayah\",\"deskripsi\":\"Isi Jumlah Penghasilan Ayah Perbulan\",\"required\":\"0\",\"atribut\":\"class=\\\" rupiah\\\"\",\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"textarea\",\"kode\":\"[form_keperluan]\",\"nama\":\"Keperluan\",\"deskripsi\":\"Isi Keperluan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_sekolah]\",\"nama\":\"Nama Sekolah\",\"deskripsi\":\"Isi Nama Sekolah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-03 19:24:49', NULL, '2025-09-26 17:08:13', 1);
INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(235, 1, 'Kuasa', 'surat-kuasa', 'S-47', NULL, 0, 0, 3, 0, 1, 'd', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 171px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 19px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 19px;\">Nama</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 19px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 19px; text-align: left;\">2.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 19px;\">NIK</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 19px; text-align: justify;\">[NiK]</td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 19px;\">3..</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 19px;\">Tempat/tanggal lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 19px;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 19px; text-align: left;\">4.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 19px;\">Umur</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 19px; text-align: justify;\">[UsiA]</td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 19px;\">5.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 19px;\">Warga Negara</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 19px;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 19px;\">6.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 19px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 19px;\">[Jenis_kelamiN]</td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 19px;\">7.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 19px;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 19px;\">[PekerjaaN]</td>\r\n</tr>\r\n<tr style=\"height: 38px;\" valign=\"top\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 38px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 38px; text-align: left;\">8.<br><br></td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 38px;\">Tempat Tinggal<br><br></td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 38px;\">:<br><br></td>\r\n<td style=\"width: 60.0206%; height: 38px; text-align: justify;\">[AlamaT] [Sebutan_desA] [Nama_desA], [Sebutan_kecamataN] [Nama_kecamataN], [Sebutan_kabupateN] [Nama_kabupateN]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Dengan ini memberi kuasa penuh kepada :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 198px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Nama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18px; text-align: justify;\"><strong>[NAma_penerima_kuasa]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">2.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">NIK</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Nik_penerima_kuasA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\">3.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Tempat/tanggal lahir</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18px; text-align: justify;\">[Tempat_tgl_lahir_penerima_kuasA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">4.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Umur</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Usia_penerima_kuasA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">5.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Warga Negara</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\">6.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18px; text-align: justify;\">[Jenis_kelamin_penerima_kuasA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Pekerjaan_penerima_kuasA]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\" valign=\"top\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 36px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 36px; text-align: left;\">8.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 36px;\">Tempat tinggal</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 36px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 36px; text-align: justify;\">[Alamat_penerima_kuasA] [Sebutan_desA] [Nama_desA], [Sebutan_kecamataN] [Nama_kecamataN], [Sebutan_kabupateN] [Nama_kabupateN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"height: 18px; width: 38.7688%; text-align: left;\" colspan=\"3\">Untuk keperluan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Form_untuk_keperluaN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"height: 18px; width: 38.7688%; text-align: left;\" colspan=\"5\">\r\n<p style=\"text-align: justify;\">Demikianlah surat kuasa ini saya buat, agar dapat digunakan sebagaimana mestinya.</p>\r\n</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 257px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 23.8594px;\">\r\n<td style=\"width: 33.3333%; text-align: center; height: 23.8594px;\"> </td>\r\n<td style=\"width: 9.62595%; height: 23.8594px;\"> </td>\r\n<td style=\"width: 13.8842%; height: 23.8594px;\"> </td>\r\n<td style=\"width: 10.1506%; height: 23.8594px;\"> </td>\r\n<td style=\"width: 32.9404%; text-align: center; height: 23.8594px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 23.8594px;\">\r\n<td style=\"width: 33.3333%; text-align: center; height: 23.8594px;\">Yang Menerima Kuasa</td>\r\n<td style=\"width: 9.62595%; height: 23.8594px;\"> </td>\r\n<td style=\"width: 13.8842%; height: 23.8594px;\"> </td>\r\n<td style=\"width: 10.1506%; height: 23.8594px;\"> </td>\r\n<td style=\"width: 32.9404%; text-align: center; height: 23.8594px;\">Yang Memberi Kuasa</td>\r\n</tr>\r\n<tr style=\"height: 66.0781px;\">\r\n<td style=\"width: 33.3333%; text-align: center; height: 66.0781px;\"> </td>\r\n<td style=\"width: 9.62595%; text-align: center; height: 66.0781px;\"> </td>\r\n<td style=\"width: 13.8842%; height: 66.0781px; text-align: center;\"><br>\r\n<table style=\"border-collapse: collapse; width: 100.822%; height: 5px;\" border=\"1\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 100%; text-align: center;\">Materai</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td style=\"width: 10.1506%; text-align: center; height: 66.0781px;\"> </td>\r\n<td style=\"width: 32.9404%; height: 66.0781px; text-align: center;\"> </td>\r\n</tr>\r\n<tr style=\"height: 23.8594px;\">\r\n<td style=\"width: 33.3333%; text-align: center; height: 23.8594px;\"><strong>( <span style=\"text-decoration: underline;\">[NAma_penerima_kuasa]</span> )</strong></td>\r\n<td style=\"width: 9.62595%; text-align: center; height: 23.8594px;\"> </td>\r\n<td style=\"width: 13.8842%; height: 23.8594px; text-align: center;\"> </td>\r\n<td style=\"width: 10.1506%; text-align: center; height: 23.8594px;\"> </td>\r\n<td style=\"width: 32.9404%; text-align: center; height: 23.8594px;\"><strong>( <span style=\"text-decoration: underline;\">[NAma]</span> )</strong></td>\r\n</tr>\r\n<tr style=\"height: 23.8594px;\">\r\n<td style=\"width: 33.3333%; text-align: center; height: 23.8594px;\"><strong> </strong></td>\r\n<td style=\"text-align: center; width: 33.6608%; height: 23.8594px;\" colspan=\"3\">Mengetahui</td>\r\n<td style=\"width: 32.9404%; text-align: center; height: 23.8594px;\"><strong> </strong></td>\r\n</tr>\r\n<tr style=\"height: 23.8594px;\">\r\n<td style=\"width: 33.3333%; text-align: center; height: 23.8594px;\"><strong> </strong></td>\r\n<td style=\"text-align: center; width: 33.6608%; height: 23.8594px;\" colspan=\"3\">[Sebutan_kepala_desA] [Nama_desA]</td>\r\n<td style=\"width: 32.9404%; text-align: center; height: 23.8594px;\"><strong> </strong></td>\r\n</tr>\r\n<tr style=\"height: 23.8594px;\">\r\n<td style=\"width: 33.3333%; height: 23.8594px;\"> </td>\r\n<td style=\"width: 9.62595%; text-align: center; height: 23.8594px;\"> </td>\r\n<td style=\"width: 13.8842%; height: 23.8594px; text-align: center;\"> </td>\r\n<td style=\"width: 10.1506%; text-align: center; height: 23.8594px;\"> </td>\r\n<td style=\"width: 32.9404%; text-align: center; height: 23.8594px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 23.8594px;\">\r\n<td style=\"width: 33.3333%; height: 23.8594px;\"> </td>\r\n<td style=\"width: 9.62595%; text-align: center; height: 23.8594px;\"> </td>\r\n<td style=\"width: 13.8842%; text-align: center; height: 23.8594px;\"> </td>\r\n<td style=\"width: 10.1506%; text-align: center; height: 23.8594px;\"> </td>\r\n<td style=\"width: 32.9404%; text-align: center; height: 23.8594px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 23.9062px;\">\r\n<td style=\"width: 33.3333%; height: 23.9062px;\"> </td>\r\n<td style=\"text-align: center; width: 33.6608%; height: 23.9062px;\" colspan=\"3\"><strong>[NAma_pamong]</strong></td>\r\n<td style=\"width: 32.9404%; text-align: center; height: 23.9062px;\"> </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br><br></div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Penerima_Kuasa\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_untuk_keperluan]\",\"nama\":\"Untuk \\/ Keperluan\",\"deskripsi\":\"Untuk \\/ Keperluan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1),
(236, 1, 'Keterangan Domisili Non Warga', 'surat-keterangan-domisili-non-warga', '041.1', NULL, 0, 0, 4, 0, 1, 'M', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100.012%; height: 336.8px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 23.2px;\">\r\n<td style=\"width: 4.34783%; text-align: center; height: 23.2px;\"> </td>\r\n<td style=\"width: 3.92512%; height: 23.2px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.4952%; text-align: left; height: 23.2px;\">Nama Lengkap</td>\r\n<td style=\"width: 1.26812%; text-align: center; height: 23.2px;\">:</td>\r\n<td style=\"width: 59.9638%; height: 23.2px; text-align: justify;\"><strong>[Form_nama_non_wargA]</strong></td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.34783%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92512%; height: 22.4px; text-align: left;\">2.</td>\r\n<td style=\"width: 30.4952%; text-align: left; height: 22.4px;\">NIK / No. KTP</td>\r\n<td style=\"width: 1.26812%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 59.9638%; height: 22.4px; text-align: justify;\">[Form_nik_non_wargA]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.34783%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92512%; height: 22.4px; text-align: left;\">3.</td>\r\n<td style=\"width: 30.4952%; text-align: left; height: 22.4px;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.26812%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 59.9638%; height: 22.4px; text-align: justify;\">[form_tempat_lahir], [form_tanggal_lahir]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.34783%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92512%; height: 22.4px; text-align: left;\">4.</td>\r\n<td style=\"width: 30.4952%; text-align: left; height: 22.4px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.26812%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 59.9638%; height: 22.4px; text-align: justify;\">[form_jenis_kelamin]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.34783%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92512%; text-align: left; height: 22.4px;\">5.</td>\r\n<td style=\"width: 30.4952%; text-align: left; height: 22.4px;\">Agama</td>\r\n<td style=\"width: 1.26812%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 59.9638%; text-align: justify; height: 22.4px;\">[form_agama]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.34783%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92512%; text-align: left; height: 22.4px;\">6.</td>\r\n<td style=\"width: 30.4952%; text-align: left; height: 22.4px;\">Status</td>\r\n<td style=\"width: 1.26812%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 59.9638%; text-align: justify; height: 22.4px;\">[form_status_perkawinan]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.34783%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92512%; height: 22.4px; text-align: left;\">7.</td>\r\n<td style=\"width: 30.4952%; text-align: left; height: 22.4px;\">Pekerjaan</td>\r\n<td style=\"width: 1.26812%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 59.9638%; height: 22.4px; text-align: justify;\">[form_pekerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.34783%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92512%; height: 22.4px; text-align: left;\">8.</td>\r\n<td style=\"width: 30.4952%; text-align: left; height: 22.4px;\">Asal</td>\r\n<td style=\"width: 1.26812%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 59.9638%; height: 22.4px; text-align: justify;\">[form_asal]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22.4px; text-align: left;\">9.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.4px;\">Tempat Tinggal Sekarang</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22.4px; text-align: justify;\">[form_tempat_tinggal_sekarang]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22.4px; text-align: left;\">10.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.4px;\">Tujuan / Keperluan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22.4px; text-align: justify;\">[form_tujuan_keperluan]</td>\r\n</tr>\r\n<tr style=\"height: 22.4px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22.4px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22.4px; text-align: left;\">11.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22.4px;\">Keterangan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22.4px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22.4px; text-align: justify;\">[form_keterangan]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dan diberikan kepada yang bersangkutan untuk dipergunakan sebagaimana mestinya dan di ketahui oleh pihak yang bertanggung jawab.<br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Atas_namA]</td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"width: 35%; text-align: center; height: 72px;\"> </td>\r\n<td style=\"width: 30%; height: 72px;\"><br><br><br><br></td>\r\n<td style=\"width: 35%; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"2\"]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_tempat_lahir]\",\"nama\":\"Tempat Lahir\",\"deskripsi\":\"Masukkan tempat lahir\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir]\",\"nama\":\"Tanggal Lahir\",\"deskripsi\":\"Masukkan tanggal lahir\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"select-otomatis\",\"kode\":\"[form_jenis_kelamin]\",\"nama\":\"Jenis Kelamin\",\"deskripsi\":\"Pilih jenis kelamin\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":\"tweb_penduduk_sex\"},{\"tipe\":\"select-otomatis\",\"kode\":\"[form_status_perkawinan]\",\"nama\":\"Status Perkawinan\",\"deskripsi\":\"Pilih status perkawinan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":\"tweb_penduduk_kawin\"},{\"tipe\":\"select-otomatis\",\"kode\":\"[form_agama]\",\"nama\":\"Agama\",\"deskripsi\":\"Pilih agama\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":\"tweb_penduduk_agama\"},{\"tipe\":\"select-otomatis\",\"kode\":\"[form_pekerjaan]\",\"nama\":\"Pekerjaan\",\"deskripsi\":\"pilih pekerjaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":\"tweb_penduduk_pekerjaan\"},{\"tipe\":\"textarea\",\"kode\":\"[form_asal]\",\"nama\":\"Asal\",\"deskripsi\":\"Masukkan kota asal\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"textarea\",\"kode\":\"[form_tempat_tinggal_sekarang]\",\"nama\":\"Tempat Tinggal Sekarang\",\"deskripsi\":\"Masukkan tempat tinggal sekarang\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_tujuan_keperluan]\",\"nama\":\"Tujuan \\/ Keperluan\",\"deskripsi\":\"Masukkan tujuan \\/ keperluan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"textarea\",\"kode\":\"[form_keterangan]\",\"nama\":\"Keterangan\",\"deskripsi\":\"Masukkan keterangan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-27 00:08:12', 1),
(237, 1, 'Keterangan Izin Orang Tua Suami Istri', 'surat-keterangan-izin-orang-tua-suami-istri', 'S-39', NULL, 0, 0, 3, 0, 1, 'd', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan / cap jempol di bawah ini :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 118px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 10px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 10px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 10px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 10px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 10px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 10px; text-align: justify; vertical-align: top;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px; vertical-align: top;\">3..</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px; vertical-align: top;\">[AgAma]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Warga Negara</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px; vertical-align: top;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 36px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 36px; text-align: left; vertical-align: top;\">6.<br><br></td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 36px; vertical-align: top;\">Alamat / Tempat Tinggal<br><br></td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 36px; vertical-align: top;\">:<br><br></td>\r\n<td style=\"width: 60.0206%; height: 36px; text-align: justify; vertical-align: top;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Saya selaku sebagai [Form_memberi_izin_selakU] dengan ini secara tulus dan ikhlas mengizinkan serta menyetujui [Form_hubungan_dengan_pemberi_iziN] saya di bawah ini :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\"><strong>[Nama_penerima_iziN]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\">[Ttl_penerima_iziN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px; vertical-align: top;\">[Agama_penerima_iziN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Warga Negara</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px; vertical-align: top;\">[Warga_negara_penerima_iziN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\">[Pekerjaan_penerima_iziN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px; vertical-align: top;\">6.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Alamat / Tempat Tinggal</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px; vertical-align: top;\">[Alamat_penerima_iziN] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Untuk melamar pekerjaan / bekerja ke [Form_negara_tujuaN], melalui [Form_nama_pptkiS] sebagai [Form_status_pekerjaan_tki_tkW] dengan masa kontrak [Form_masa_kontrak_tahuN] tahun.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Segala akibat yang timbul di kemudian hari dari perbuatan dan penggunaan surat izin ini sepenuhnya menjadi tanggung jawab saya baik secara hukum ataupun secara moril tanpa melibatkan pihak lainnya.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Segala akibat yang timbul di kemudian hari dari pembuatan dan penggunaan surat izin ini sepenuhnya menjadi tanggung jawab saya baik secara hukum ataupun secara moril dan materi tanpa melibatkan pihak lainnya.</p>\r\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"><strong>Yang Diberi Izin,</strong></td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\"><strong>Yang Memberi Izin,</strong></td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"><br><br><br><br></td>\r\n<td style=\"width: 35%;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"><strong>[Nama_penerima_iziN]</strong></td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"> </div>\r\n<div style=\"text-align: center;\">\r\n<table style=\"border-collapse: collapse; width: 100%; height: 202.4px; border-width: 0px;\" border=\"0\"><colgroup><col style=\"width: 100%;\"></colgroup>\r\n<tbody>\r\n<tr>\r\n<td>Mengetahui,</td>\r\n</tr>\r\n<tr>\r\n<td>[Atas_namA]</td>\r\n</tr>\r\n<tr>\r\n<td><br><br><br><br></td>\r\n</tr>\r\n<tr>\r\n<td><strong>[Nama_pamonG]</strong></td>\r\n</tr>\r\n<tr>\r\n<td>[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Penerima_Izin\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"select-otomatis\",\"kode\":\"[form_memberi_izin_selaku]\",\"nama\":\"Memberi Izin Selaku\",\"deskripsi\":\"Pilih Selaku\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":\"tweb_penduduk_hubungan\"},{\"kategori\":\"Penerima_Izin\",\"tipe\":\"text\",\"kode\":\"[form_negara_tujuan]\",\"nama\":\"Negara Tujuan\",\"deskripsi\":\"Diisi dengan Negara yang dituju sprt: Malaysia, Korea, dll\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Penerima_Izin\",\"tipe\":\"text\",\"kode\":\"[form_nama_pptkis]\",\"nama\":\"Nama PPTKIS\",\"deskripsi\":\"*) Nama PT atau Perusahaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Penerima_Izin\",\"tipe\":\"number\",\"kode\":\"[form_masa_kontrak_tahun]\",\"nama\":\"Masa Kontrak (Tahun)\",\"deskripsi\":\"2\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Penerima_Izin\",\"tipe\":\"select-otomatis\",\"kode\":\"[form_hubungan_dengan_penerima_izin]\",\"nama\":\"Hubungan Dengan Pemberi Izin\",\"deskripsi\":\"Pilih Hubungan Dengan Pemberi Izin\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":\"tweb_penduduk_hubungan\"},{\"kategori\":\"Penerima_Izin\",\"tipe\":\"select-manual\",\"kode\":\"[form_status_pekerjaan_tki_tkw]\",\"nama\":\"Status Pekerjaan TKI TKW\",\"deskripsi\":\"Pilih Status Pekerjaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"Tenaga Kerja Indonesia (TKI)\",\"Tenaga Kerja Wanita (TKW)\"],\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1);
INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(238, 1, 'Keterangan Untuk Nikah Warga Non Muslim', 'surat-keterangan-untuk-nikah-warga-non-muslim', 'S-50', 'F-2.12', 0, 0, 3, 0, 1, 'M', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 198px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Nama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 18px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\">2.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 18px; text-align: justify;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">3.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px;\">[Jenis_kelamiN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\">4.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Surat Bukti Diri</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 60.0524%; height: 18px; text-align: justify;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">KTP</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px;\">[NiK]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">KK</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px;\">[No_kK]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">5.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Warga Negara</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px;\">[Warga_negarA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">6.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Agama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px;\">[AgamA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px;\">[PekerjaaN]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\" valign=\"top\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 36px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 36px; text-align: left;\">8.<br><br></td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 36px;\">Alamat<br><br></td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 36px;\">:<br><br></td>\r\n<td style=\"width: 60.0524%; height: 36px; text-align: justify;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Nama tersebut di atas betul telah menikah dengan seorang perempuan yang bernama :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 294.188px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18.6875px; text-align: left;\">9.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">Nama</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18.6875px; text-align: justify;\">[Nama_cpW]</td>\r\n</tr>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18.6875px;\">10.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">Tempat/tanggal lahir</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18.6875px;\">[Ttl_cpW]</td>\r\n</tr>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18.6875px; text-align: left;\">11.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">Jenis Kelamin</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18.6875px; text-align: justify;\">[Jenis_kelamin_cpW]</td>\r\n</tr>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18.6875px;\">12.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">Surat Bukti Diri</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18.6875px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">KTP</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18.6875px;\">[Nik_cpW]</td>\r\n</tr>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18.6875px; text-align: left;\"> </td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">KK</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18.6875px; text-align: justify;\">[No_kk_cpW]</td>\r\n</tr>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18.6875px;\">13.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">Warga Negara</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18.6875px;\">[Warga_negara_cpW]</td>\r\n</tr>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18.6875px; text-align: left;\">14.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">Agama</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18.6875px; text-align: justify;\">[Agama_cpW]</td>\r\n</tr>\r\n<tr style=\"height: 18.6875px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18.6875px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18.6875px;\">15.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18.6875px;\">Pekerjaan</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18.6875px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18.6875px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18.6875px;\">[Pekerjaan_cpW]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 36px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 36px;\">16.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 36px;\">Alamat</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 36px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 36px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 36px;\">[Alamat_cpW] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18px;\">Di:</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">17.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18px;\">Tempat</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Form_nama_badan_peradilaN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">18.</td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18px;\">Tanggal</td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Form_tanggal_putusan_penetapan_pengadilaN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 26.1952%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 4.3222%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\"> </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat ini dibuat untuk dipergunakan sebagaimana mestinya.</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> [Sebutan_desA] [Kode_desA]</td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"width: 35%; text-align: center; height: 72px;\">[qr_code]</td>\r\n<td style=\"width: 30%; height: 72px;\"><br><br><br></td>\r\n<td style=\"width: 35%; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> NIP : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br><br></div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"1\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"data_orang_tua\":\"1\",\"data_pasangan\":\"0\"},\"Calon_Pasangan_Wanita\":{\"data\":[1],\"sex\":\"2\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Saksi_I\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Saksi_II\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"number\",\"kode\":\"[form_jika_beristri_istri_ke]\",\"nama\":\"Jika beristri, istri ke\",\"deskripsi\":\"Jika beristri, istri ke\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"number\",\"kode\":\"[form_anak_ke]\",\"nama\":\"Anak ke\",\"deskripsi\":\"Anak ke\",\"required\":\"0\",\"atribut\":\"min=1 max=10 class=\\\"\\\"\",\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"number\",\"kode\":\"[form_perkawinan_ke]\",\"nama\":\"Perkawinan ke\",\"deskripsi\":\"Perkawinan ke\",\"required\":\"0\",\"atribut\":\"min=1 max=10 class=\\\"\\\"\",\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"number\",\"kode\":\"[form_paspor]\",\"nama\":\"Paspor\",\"deskripsi\":\"Paspor\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"number\",\"kode\":\"[form_telepon]\",\"nama\":\"Telepon\",\"deskripsi\":\"Telepon\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_kebangsaan_bagi_wna]\",\"nama\":\"Kebangsaan (Bagi WNA)\",\"deskripsi\":\"Kebangsaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan_ayah]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan Ayah\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan Ayah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"number\",\"kode\":\"[form_telepon_ayah]\",\"nama\":\"Telepon Ayah\",\"deskripsi\":\"Telepon Ayah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan_ibu]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan Ibu\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan Ibu\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"number\",\"kode\":\"[form_telepon_ibu]\",\"nama\":\"Telepon Ibu\",\"deskripsi\":\"Telepon Ibu\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"hari-tanggal\",\"kode\":\"[form_hari_tanggal_menikah]\",\"nama\":\"Hari, Tanggal Menikah\",\"deskripsi\":\"Hari, Tanggal Menikah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"time\",\"kode\":\"[form_jam_menikah]\",\"nama\":\"Jam Menikah\",\"deskripsi\":\"Jam Menikah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_pemberkatan_perkawinan]\",\"nama\":\"Tanggal Pemberkatan Perkawinan\",\"deskripsi\":\"Tanggal Pemberkatan Perkawinan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"select-otomatis\",\"kode\":\"[form_agamapenghayat_kepercayaan]\",\"nama\":\"Agama\\/Penghayat Kepercayaan\",\"deskripsi\":\"Agama\\/Penghayat Kepercayaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":\"tweb_penduduk_agama\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan_kawin]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan Kawin\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan Kawin\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_badan_peradilan]\",\"nama\":\"Nama Badan Peradilan\",\"deskripsi\":\"Nama Badan Peradilan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nomor_putusan_penetapan_pengadilan]\",\"nama\":\"Nomor Putusan Penetapan Pengadilan\",\"deskripsi\":\"Nomor Putusan Penetapan Pengadilan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_putusan_penetapan_pengadilan]\",\"nama\":\"Tanggal Putusan Penetapan Pengadilan\",\"deskripsi\":\"Tanggal Putusan Penetapan Pengadilan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_pemuka_agamapghyt_kepercayaan]\",\"nama\":\"Nama Pemuka Agama\\/Pghyt Kepercayaan\",\"deskripsi\":\"Nama Pemuka Agama\\/Pghyt Kepercayaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_ijin_perwakilan_bagi_wna_nomor]\",\"nama\":\"Ijin Perwakilan bagi WNA \\/ Nomor\",\"deskripsi\":\"Ijin Perwakilan bagi WNA \\/ Nomor\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_jumlah_anak_yang_telah_diakui_dan_disahkan]\",\"nama\":\"Jumlah Anak Yang Telah Diakui dan Disahkan\",\"deskripsi\":\"Jumlah Anak Yang Telah Diakui dan Disahkan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_anak_pertama]\",\"nama\":\"Nama Anak Pertama\",\"deskripsi\":\"Nama Anak Pertama\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_no_akta_lahir_anak_pertama]\",\"nama\":\"No Akta Lahir Anak Pertama\",\"deskripsi\":\"No Akta Lahir Anak Pertama\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir_anak_pertama]\",\"nama\":\"Tanggal Lahir Anak Pertama\",\"deskripsi\":\"Tanggal Lahir Anak Pertama\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_anak_kedua]\",\"nama\":\"Nama Anak Kedua\",\"deskripsi\":\"Nama Anak Kedua\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_no_akta_lahir_anak_kedua]\",\"nama\":\"No Akta Lahir Anak Kedua\",\"deskripsi\":\"No Akta Lahir Anak Kedua\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir_anak_kedua]\",\"nama\":\"Tanggal Lahir Anak Kedua\",\"deskripsi\":\"Tanggal Lahir Anak Kedua\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_anak_ketiga]\",\"nama\":\"Nama Anak Ketiga\",\"deskripsi\":\"Nama Anak Ketiga\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_no_akta_lahir_anak_ketiga]\",\"nama\":\"No Akta Lahir Anak Ketiga\",\"deskripsi\":\"No Akta Lahir Anak Ketiga\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir_anak_ketiga]\",\"nama\":\"Tanggal Lahir Anak Ketiga\",\"deskripsi\":\"Tanggal Lahir Anak Ketiga\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_anak_ke_empat]\",\"nama\":\"Nama Anak Ke Empat\",\"deskripsi\":\"Nama Anak Ke Empat\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_no_akta_lahir_anak_ke_empat]\",\"nama\":\"No Akta Lahir Anak Ke Empat\",\"deskripsi\":\"No Akta Lahir Anak Ke Empat\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir_anak_ke_empat]\",\"nama\":\"Tanggal Lahir Anak Ke Empat\",\"deskripsi\":\"Tanggal Lahir Anak Ke Empat\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_anak_ke_lima]\",\"nama\":\"Nama Anak Ke Lima\",\"deskripsi\":\"Nama Anak Ke Lima\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_no_akta_lahir_anak_ke_lima]\",\"nama\":\"No Akta Lahir Anak Ke Lima\",\"deskripsi\":\"No Akta Lahir Anak Ke Lima\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir_anak_ke_lima]\",\"nama\":\"Tanggal Lahir Anak Ke Lima\",\"deskripsi\":\"Tanggal Lahir Anak Ke Lima\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_anak_ke_enam]\",\"nama\":\"Nama Anak Ke Enam\",\"deskripsi\":\"Nama Anak Ke Enam\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"number\",\"kode\":\"[form_no_akta_lahir_anak_ke_enam]\",\"nama\":\"No Akta Lahir Anak Ke Enam\",\"deskripsi\":\"No Akta Lahir Anak Ke Enam\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_lahir_anak_ke_enam]\",\"nama\":\"Tanggal Lahir Anak Ke Enam\",\"deskripsi\":\"Tanggal Lahir Anak Ke Enam\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"number\",\"kode\":\"[form_anak_ke]\",\"nama\":\"Anak ke\",\"deskripsi\":\"Anak ke-\",\"required\":\"0\",\"atribut\":\"min=1 max=10 class=\\\"\\\"\",\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"number\",\"kode\":\"[form_perkawinan_ke]\",\"nama\":\"Perkawinan ke\",\"deskripsi\":\"Perkawinan ke-\",\"required\":\"0\",\"atribut\":\"min=1 max=10 class=\\\"\\\"\",\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"number\",\"kode\":\"[form_passport]\",\"nama\":\"passport\",\"deskripsi\":\"passport\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"number\",\"kode\":\"[form_telepon]\",\"nama\":\"Telepon\",\"deskripsi\":\"Telepon\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"text\",\"kode\":\"[form_kebangsaan_bagi_wna]\",\"nama\":\"Kebangsaan (Bagi WNA)\",\"deskripsi\":\"Kebangsaan (Bagi WNA)\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan_ayah]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan Ayah\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan Ayah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"number\",\"kode\":\"[form_telepon_ayah]\",\"nama\":\"Telepon Ayah\",\"deskripsi\":\"Telepon Ayah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan_ibu]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan Ibu\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan Ibu\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Calon_Pasangan_Wanita\",\"tipe\":\"number\",\"kode\":\"[form_telepon_ibu]\",\"nama\":\"Telepon Ibu\",\"deskripsi\":\"Telepon Ibu\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Saksi_I\",\"tipe\":\"number\",\"kode\":\"[form_telepon]\",\"nama\":\"Telepon\",\"deskripsi\":\"Telepon\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Saksi_I\",\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Saksi_II\",\"tipe\":\"number\",\"kode\":\"[form_telepon]\",\"nama\":\"Telepon\",\"deskripsi\":\"Telepon\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"kategori\":\"Saksi_II\",\"tipe\":\"text\",\"kode\":\"[form_nama_organisasi_penghayat_kepercayaan]\",\"nama\":\"Nama Organisasi Penghayat Kepercayaan\",\"deskripsi\":\"Nama Organisasi Penghayat Kepercayaan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1),
(239, 1, 'Keterangan Kematian', 'surat-keterangan-kematian', 'S-21', 'F-2.01', 0, 0, 3, 0, 1, 'M', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 118px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px;\">Nama</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px;\">2.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px;\">NIK / No. KTP</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px;\">[Nik]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left;\">3.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify;\">[Jenis_kelamin]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left;\">4.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 10px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 10px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 10px;\">5.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 10px;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 10px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 10px;\">[Pekerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 36px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 36px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 36px; text-align: left;\">6.<br><br></td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 36px;\">Alamat / Tempat Tinggal<br><br></td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 36px;\">:<br><br></td>\r\n<td style=\"width: 60.0206%; height: 36px; text-align: justify;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Telah meninggal dunia pada:</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 63px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 22px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22px; text-align: left;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22px;\">Hari / Tanggal / Jam</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22px; text-align: justify;\">[Hari_kematiaN], [Tanggal_kematiaN], [Jam_kematiaN]</td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 19px;\">8.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19px;\">Bertempat di</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 19px;\">[Tempat_kematiaN]</td>\r\n</tr>\r\n<tr style=\"height: 22px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22px; text-align: left;\">9.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22px;\">Penyebab Kematian</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22px;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22px; text-align: justify;\">[Penyebab_kematiaN]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Surat keterangan ini dibuat berdasarkan keterangan pelapor:</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 109.688px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18.6719px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18.6719px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18.6719px; text-align: left;\">10.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18.6719px;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18.6719px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18.6719px; text-align: justify;\">[NAma_pelapor]</td>\r\n</tr>\r\n<tr style=\"height: 18.6719px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18.6719px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18.6719px;\">11.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18.6719px;\">NIK / No. KTP</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18.6719px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18.6719px;\">[Nik_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 18.6719px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18.6719px;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18.6719px; text-align: left;\">12.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18.6719px;\">Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18.6719px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18.6719px; text-align: justify;\">[Tanggallahir_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 18.6719px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18.6719px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18.6719px;\">13.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18.6719px;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18.6719px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18.6719px;\">[Pekerjaan]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left;\">14.</td>\r\n<td style=\"width: 30.5242%; text-align: left;\">Alamat / Tempat Tinggal</td>\r\n<td style=\"width: 1.2333%; text-align: center;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify;\">[Alamat_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px;\">15.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px;\">Hubungan dengan yang mati</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px;\">[Form_hubungan_pelapor_dengan_yang_matI]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya agar dapat dipergunakan sebagaimana mestinya.<br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Atas_namA]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"><br><br><br><br></td>\r\n<td style=\"width: 35%;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"data_orang_tua\":\"1\"},\"Pelapor\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Saksi_I\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Saksi_II\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"kategori\":\"Pelapor\",\"tipe\":\"text\",\"kode\":\"[form_hubungan_pelapor_dengan_yang_mati]\",\"nama\":\"Hubungan pelapor dengan yang mati\",\"deskripsi\":\"Hubungan pelapor dengan yang mati\",\"atribut\":\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"1\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1),
(240, 1, 'Keterangan Beda Identitas KIS', 'surat-keterangan-beda-identitas-kis', 'S-38', NULL, 0, 0, 3, 0, 1, 'M', 0, 0, 0, '[]', '<h3 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h3>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa : <br><br>[Pengikut_kiS]</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Nama tersebut di atas merupakan identitas yang tertera pada KTP dan Kartu Keluarga (KK) sedangkan pada Kartu Indonesia Sehat (KIS) tertulis :<br><br>[Pengikut_kartu_kiS]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Menurut pengamatan dan pengetahuan kami hingga saat dikeluarkannya surat keterangan ini bahwa yang namanya di atas merupakan orang yang satu / sama.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Surat keterangan ini dibuat untuk keperluan : <strong>[Form_keperluaN]</strong>.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya, untuk dapat dipergunakan sebagaimana mestinya.</p>\r\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Atas_namA]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"><br><br><br><br></td>\r\n<td style=\"width: 35%;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', NULL, 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1);
INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(241, 1, 'Keterangan Penghasilan Ibu', 'surat-keterangan-penghasilan-ibu', 'S-45', NULL, 0, 0, 3, 0, 1, 'd', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 269.297px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\"><strong>[NaMa_ibu]</strong></td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">NIK / No. KTP</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[NiK_ibu]</td>\r\n</tr>\r\n<tr style=\"height: 25.8125px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 25.8125px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 25.8125px; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 25.8125px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 25.8125px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 25.8125px; vertical-align: top;\">[TtL_ibu]</td>\r\n</tr>\r\n<tr style=\"height: 21.8125px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 21.8125px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 21.8125px; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 21.8125px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 21.8125px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 21.8125px; vertical-align: top;\">[JeNis_kelamin_ibu]</td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[AgAma_ibu]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px; vertical-align: top;\">6</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px; vertical-align: top;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 43.4844px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 43.4844px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 43.4844px; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 43.4844px; vertical-align: top;\">Alamat / Tempat Tinggal</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 43.4844px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 43.4844px; vertical-align: top;\">[AlAmat_ibu] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Orang yang tersebut di atas adalah benar-benar warga kami yang bertempat tinggal di [AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten] dan tercatat dalam No. KK : [No_kK] dengan NIK [NiK_ibu] Kepala Keluarga : [Kepala_kK] dan menurut sepengetahuan kami memang benar berpenghasilan rata-rata [Form_jumlah_penghasilan_ibu] / Perbulan.<br><br></p>\r\n<p>Surat Keterangan ini dibuat atas permintaan yang bersangkutan untuk keperluan anaknya untuk [Form_keperluaN] di<strong> [Form_nama_sekolaH]</strong><strong> </strong>atas nama :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 269.297px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\"><strong>[NAma] </strong></td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">NIK / No. KTP</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[Nik]</td>\r\n</tr>\r\n<tr style=\"height: 25.8125px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 25.8125px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 25.8125px; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 25.8125px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 25.8125px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 25.8125px; vertical-align: top;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 21.8125px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 21.8125px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 21.8125px; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 21.8125px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 21.8125px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 21.8125px; vertical-align: top;\">[Jenis_kelamin]</td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[AgAma]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.3222%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; vertical-align: top;\">6</td>\r\n<td style=\"width: 30.5174%; text-align: left; vertical-align: top;\">Status</td>\r\n<td style=\"width: 1.24427%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; vertical-align: top;\">[Status_kawiN]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.3222%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; vertical-align: top;\">Pendidikan</td>\r\n<td style=\"width: 1.24427%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; vertical-align: top;\">[Pendidikan_sedanG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 18px; vertical-align: top;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 19.75px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19.75px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 19.75px; text-align: left; vertical-align: top;\">9.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19.75px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19.75px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 19.75px; text-align: justify; vertical-align: top;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 43.4844px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 43.4844px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 43.4844px; vertical-align: top;\">10.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 43.4844px; vertical-align: top;\">Alamat / Tempat Tinggal</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 43.4844px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 43.4844px; vertical-align: top;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya, untuk dipergunakan sebagaimana mestinya.<br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Atas_namA]</td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"width: 35%; text-align: center; height: 72px;\"> </td>\r\n<td style=\"width: 30%; height: 72px;\"><br><br><br><br></td>\r\n<td style=\"width: 35%; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_jumlah_penghasilan_ibu]\",\"nama\":\"Jumlah Penghasilan Ibu\",\"deskripsi\":\"Penghasilan Ibu dalam Rupiah\",\"atribut\":\"class=\\\" rupiah\\\"\",\"pilihan\":null,\"refrensi\":null,\"required\":\"1\"},{\"tipe\":\"textarea\",\"kode\":\"[form_keperluan]\",\"nama\":\"Keperluan\",\"deskripsi\":\"Isi Keperluan\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"},{\"tipe\":\"text\",\"kode\":\"[form_nama_sekolah]\",\"nama\":\"Nama Sekolah\",\"deskripsi\":\"Isi Nama Sekolah\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"required\":\"0\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1),
(242, 1, 'Pernyataan Penguasaan Fisik Bidang Tanah (SPORADIK)', 'surat-pernyataan-penguasaan-fisik-bidang-tanah-sporadik', 'S-40', NULL, 0, 0, 3, 0, 1, 'd', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<br>\r\n<div style=\"text-align: justify;\">Yang bertanda tangan di bawah ini :</div>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 106px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Nama Lengkap</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 18px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Tempat &amp; Tgl. Lahir</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 18px; text-align: justify;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Umur</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[UsiA]</td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 19px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 19px;\">Pekerjaan</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 19px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 19px; text-align: justify;\">[PekerjaaN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Nomor KTP</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[NiK]</td>\r\n</tr>\r\n<tr style=\"height: 15px;\" valign=\"top\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 15px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 15px;\">Alamat</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 15px;\">:<br><br></td>\r\n<td style=\"width: 62.4754%; height: 15px; text-align: justify;\">[AlamaT] [Sebutan_desA] [Nama_desA], [Sebutan_kecamataN] [Nama_kecamataN], [Sebutan_kabupateN] [Nama_kabupateN]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: justify;\"><br>Dengan ini menyatakan bahwa saya dengan itikad baik telah menguasai sebidang tanah yang terletak :</div>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 162px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Jalan / RT</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 18px; text-align: justify;\">[Form_jalaN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Dusun</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[Form_rt_rW]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Desa/ Kelurahan</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 18px; text-align: justify;\">[Form_desa_kelurahaN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Kecamatan</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[Form_kecamataN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Kabupaten</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[Form_kabupaten_kotA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">NIB</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 18px; text-align: justify;\">[Form_niB]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Status Tanah</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[Form_status_tanaH]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Dipergunakan untuk</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 18px; text-align: justify;\">[Form_dipergunakaN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Luas</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[Form_luas_tanah_m2]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: justify;\"><br>Batas-Batas Tanah :</div>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 72px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Sebelah Utara</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 18px; text-align: justify;\">[Form_batas_sebelah_utarA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Sebelah Selatan</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[Form_batas_sebelah_selataN]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Sebelah Timur</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; height: 18px; text-align: justify;\">[Form_batas_sebelah_timuR]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.51866%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 31.7616%; text-align: left; height: 18px;\">Sebelah Barat</td>\r\n<td style=\"width: 1.30976%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 62.4754%; text-align: justify; height: 18px;\">[Form_batas_sebelah_baraT]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: justify;\"><br>Bidang Tanah tersebut saya peroleh dari [Form_tanah_diperoleh_dari_] tahun [Form_diperoleh_sejak_tahuN] dengan jalan [Form_jalaN] / terlampir yang sampai saat ini saya kuasai secara terus menerus dan</div>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 89.5624px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 3.0303%; height: 22.3906px; text-align: right;\">-</td>\r\n<td style=\"width: 1.77693%; text-align: left; height: 22.3906px;\"> </td>\r\n<td style=\"width: 95.1928%; height: 22.3906px; text-align: justify;\">Tidak diajukan/ menjadi jaminan hutang</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 3.0303%; height: 22.3906px; text-align: right;\">-</td>\r\n<td style=\"width: 1.77693%; text-align: left; height: 22.3906px;\"> </td>\r\n<td style=\"width: 95.1928%; height: 22.3906px; text-align: justify;\">Tidak dalam keadaan sengketa</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 3.0303%; height: 22.3906px; text-align: right;\">-</td>\r\n<td style=\"width: 1.77693%; text-align: left; height: 22.3906px;\"> </td>\r\n<td style=\"width: 95.1928%; height: 22.3906px; text-align: justify;\">Tidak merupakan tanah warisan yang belum di bagi</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 3.0303%; height: 22.3906px; text-align: right;\">-</td>\r\n<td style=\"width: 1.77693%; text-align: left; height: 22.3906px;\"> </td>\r\n<td style=\"width: 95.1928%; height: 22.3906px; text-align: justify;\">Belum bersertifikat</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 3.0303%; text-align: right;\">-</td>\r\n<td style=\"width: 1.77693%; text-align: left;\"> </td>\r\n<td style=\"width: 95.1928%; text-align: justify;\">Penggunaannya tidak pernah di ganggu gugat</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: justify;\"><br>Surat pernyataan ini saya bubuhkan cap jempol setelah saya dibacakan dan mengerti isi/ maksud, dibuat dengan sebenarnya dengan penuh tanggung jawab dan saya bersedia untuk mengangkat sumpah bila diperlukan.<br><br>Demikian dan apabila ini tidak benar, saya bersedia dituntut di hadapan pihak berwenang.<br><br>SAKSI-SAKSI</div>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 208px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Nama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18px; text-align: justify;\">[Nama_saksi_I]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Umur</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Usia_saksi_I]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18px; text-align: justify;\">[Pekerjaan_saksi_I]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Alamat</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Alamat_saksi_I]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Tanda Tangan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 59.9869%; height: 18px; text-align: justify;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\">2.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Nama</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Nama_saksi_iI]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; height: 18px; text-align: left;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Umur</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; height: 18px; text-align: justify;\">[Usia_saksi_iI]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Pekerjaan_saksi_iI]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Alamat</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\">[Alamat_saksi_iI]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 18px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 18px;\">Tanda Tangan</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 18px;\">:</td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 10px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 10px;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 10px;\"> </td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 10px;\"> </td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 10px;\"> </td>\r\n<td style=\"width: 59.9869%; text-align: justify; height: 10px;\"> </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 180px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">Reg No: ____________________</td>\r\n<td style=\"width: 30%; height: 18px; text-align: center;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">Tanggal : ____________________</td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">Hormat Kami,</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">Mengetahui / Membenarkan</td>\r\n<td style=\"width: 30%; height: 18px; text-align: center;\">[qr_code]</td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Sebutan_kepala_desA] [Nama_desA]</td>\r\n<td style=\"width: 30%; height: 18px; text-align: center;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 54px;\">\r\n<td style=\"width: 35%; text-align: center; height: 54px;\"> </td>\r\n<td style=\"width: 30%; height: 54px;\"> </td>\r\n<td style=\"width: 35%; height: 54px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[NamA]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br><br></div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"data_orang_tua\":\"0\"},\"Saksi_I\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Saksi_II\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"tipe\":\"text\",\"kode\":\"[form_jalan]\",\"nama\":\"Jalan\",\"deskripsi\":\"Jalan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_rt_rw]\",\"nama\":\"RT \\/ RW\",\"deskripsi\":\"RT \\/ RW\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_desa_kelurahan]\",\"nama\":\"Desa \\/ Kelurahan\",\"deskripsi\":\"Desa \\/ Kelurahan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_kecamatan]\",\"nama\":\"Kecamatan\",\"deskripsi\":\"Kecamatan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_kabupaten_kota]\",\"nama\":\"Kabupaten \\/ Kota\",\"deskripsi\":\"Kabupaten \\/ Kota\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nib]\",\"nama\":\"NIB\",\"deskripsi\":\"NIB\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_luas_tanah_m2]\",\"nama\":\"Luas Tanah (m2)\",\"deskripsi\":\"Luas Tanah (m2)\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_status_tanah]\",\"nama\":\"Status Tanah\",\"deskripsi\":\"Status Tanah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_dipergunakan]\",\"nama\":\"Dipergunakan\",\"deskripsi\":\"Dipergunakan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_batas_sebelah_utara]\",\"nama\":\"Batas Sebelah Utara\",\"deskripsi\":\"Batas Sebelah Utara\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_batas_sebelah_timur]\",\"nama\":\"Batas Sebelah Timur\",\"deskripsi\":\"Batas Sebelah Timur\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_batas_sebelah_selatan]\",\"nama\":\"Batas Sebelah Selatan\",\"deskripsi\":\"Batas Sebelah Selatan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_batas_sebelah_barat]\",\"nama\":\"Batas Sebelah Barat\",\"deskripsi\":\"Batas Sebelah Barat\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_tanah_diperoleh_dari_]\",\"nama\":\"Tanah Diperoleh Dari \",\"deskripsi\":\"Tanah Diperoleh Dari \",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_diperoleh_sejak_tahun]\",\"nama\":\"Diperoleh Sejak Tahun\",\"deskripsi\":\"Sejak Tahun\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_dengan_jalan]\",\"nama\":\"Dengan Jalan\",\"deskripsi\":\"Dengan Jalan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1);
INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(243, 1, 'Keterangan Kelahiran', 'surat-keterangan-kelahiran', 'S-17', 'F-2.01', 0, 0, 3, 1, 1, 'M', 0, 0, 0, '[\"2\",\"3\"]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 156.771px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 22.3958px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Hari</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3958px; text-align: justify; vertical-align: top;\">[Hari_kelahiraN]</td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3958px; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Tanggal</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3958px; vertical-align: top;\">[Tanggal_kelahiraN]</td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 22.3958px; text-align: left; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Pukul</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3958px; text-align: justify; vertical-align: top;\">[Jam_kelahiraN]</td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 22.3958px; text-align: left; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Tempat</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3958px; text-align: justify; vertical-align: top;\">[Tempat_dilahirkanN]</td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3958px; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Telah lahir seorang anak</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3958px; vertical-align: top;\">[NAma]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Dari seorang ibu:</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 63px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 22px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22px; text-align: left; vertical-align: top;\">6.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22px; text-align: justify; vertical-align: top;\"><strong>[NAma_ibu]</strong></td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 19px; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19px; vertical-align: top;\">NIK / No KTP</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 19px; vertical-align: top;\">[Nik_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 22px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22px; text-align: left; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22px; vertical-align: top;\">Umur</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22px; text-align: justify; vertical-align: top;\">[Usia_ibU]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.3222%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; vertical-align: top;\">9.</td>\r\n<td style=\"width: 30.5174%; text-align: left; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; vertical-align: top;\">[Pekerjaan_ibU]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.3222%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; vertical-align: top;\">10.</td>\r\n<td style=\"width: 30.5174%; text-align: left; vertical-align: top;\">Alamat/Tempat Tinggal</td>\r\n<td style=\"width: 1.24427%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; vertical-align: top;\">[Alamat_ibU]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Istri dari:</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 63px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 22px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22px; text-align: left; vertical-align: top;\">11.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22px; text-align: justify; vertical-align: top;\"><strong>[NAma_ayah]</strong></td>\r\n</tr>\r\n<tr style=\"height: 19px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 19px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; height: 19px; vertical-align: top;\">12.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 19px; vertical-align: top;\">NIK / No KTP</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 19px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; height: 19px; vertical-align: top;\">[Nik_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 22px;\">\r\n<td style=\"width: 4.3222%; text-align: center; height: 22px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; height: 22px; text-align: left; vertical-align: top;\">13.</td>\r\n<td style=\"width: 30.5174%; text-align: left; height: 22px; vertical-align: top;\">Umur</td>\r\n<td style=\"width: 1.24427%; text-align: center; height: 22px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; height: 22px; text-align: justify; vertical-align: top;\">[Usia_ayaH]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.3222%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; vertical-align: top;\">14.</td>\r\n<td style=\"width: 30.5174%; text-align: left; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.24427%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; vertical-align: top;\">[Pekerjaan_ayaH]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.3222%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.92927%; text-align: left; vertical-align: top;\">15.</td>\r\n<td style=\"width: 30.5174%; text-align: left; vertical-align: top;\">Alamat/Tempat Tinggal</td>\r\n<td style=\"width: 1.24427%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0524%; text-align: justify; vertical-align: top;\">[Alamat_ayaH]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Surat keterangan ini dibuat berdasarkan keterangan pelapor:</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 134.375px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 22.3958px; text-align: left; vertical-align: top;\">16.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3958px; text-align: justify; vertical-align: top;\"><strong>[NAma_pelapor]</strong></td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3958px; vertical-align: top;\">17.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">NIK</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3958px; vertical-align: top;\">[Nik_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 22.3958px; text-align: left; vertical-align: top;\">18.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Umur</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3958px; text-align: justify; vertical-align: top;\">[Usia_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3958px; vertical-align: top;\">19.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3958px; vertical-align: top;\">[Pekerjaan_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3958px; vertical-align: top;\">20.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Alamat / Tempat Tinggal</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3958px; vertical-align: top;\">[Alamat_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3958px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3958px; vertical-align: top;\">21.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3958px; vertical-align: top;\">Hubungan pelapor dengan bayi</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3958px; vertical-align: top;\">[Form_hubungan_pelapor_dengan_bayI]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya agar dapat dipergunakan sebagaimana mestinya.<br><br></p>\r\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Atas_namA]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"><br><br><br><br></td>\r\n<td style=\"width: 35%;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div> </div>\r\n<div> </div>\r\n<table style=\"border-collapse: collapse; width: 99.9875%; height: 50.5832px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 10.3958;\">\r\n<td style=\"width: 8.50757%;\">Perihal :</td>\r\n<td style=\"text-align: left; width: 40.6481%;\">Permohonan Penyelesaian</td>\r\n<td style=\"width: 4.91468%;\"> </td>\r\n<td style=\"text-align: left; width: 45.9409%;\"><strong>Kepada</strong></td>\r\n</tr>\r\n<tr style=\"height: 10.3958;\">\r\n<td style=\"width: 8.50757%;\"> </td>\r\n<td style=\"text-align: left; width: 40.6481%;\">Akta Kelahiran</td>\r\n<td style=\"width: 4.91468%;\"><strong>Yth,</strong></td>\r\n<td style=\"text-align: left; width: 45.9409%;\"><strong>Kepala Dinas Kependudukan dan Pencatatan</strong></td>\r\n</tr>\r\n<tr style=\"height: 10.3958;\">\r\n<td style=\"width: 8.50757%;\"> </td>\r\n<td style=\"text-align: left; width: 40.6481%;\"> </td>\r\n<td style=\"width: 4.91468%;\"> </td>\r\n<td style=\"text-align: left; width: 45.9409%;\"><strong>Sipil [Sebutan_kabupateN] [Nama_kabupateN]</strong></td>\r\n</tr>\r\n<tr style=\"height: 10.3958;\">\r\n<td style=\"width: 8.50757%;\"> </td>\r\n<td style=\"text-align: left; width: 40.6481%;\"> </td>\r\n<td style=\"width: 4.91468%;\"> </td>\r\n<td style=\"text-align: left; width: 45.9409%;\"><strong>Di [Nama_kabupateN]</strong></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: justify;\">Yang bertanda tangan di bawah ini :</div>\r\n<table style=\"border-collapse: collapse; width: 99.9875%; height: 134.375px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.274%; text-align: left; height: 14.3958px; vertical-align: top;\">NIK</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.3192%; height: 14.3958px; text-align: justify; vertical-align: top;\">[Nik_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.274%; text-align: left; height: 14.3958px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.3192%; text-align: justify; height: 14.3958px; vertical-align: top;\"><strong>[NAma_pelapor]</strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.274%; text-align: left; height: 14.3958px; vertical-align: top;\">Tempat tanggal lahir / umur</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.3192%; height: 14.3958px; text-align: justify; vertical-align: top;\">[Tempat_tgl_lahir_pelapoR] / [Usia_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.274%; text-align: left; height: 14.3958px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.3192%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Pekerjaan_pelapoR]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.274%; text-align: left; height: 14.3958px; vertical-align: top;\">Alamat / Tempat Tinggal</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.3192%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Alamat_pelapoR]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: left;\"><strong>Mohon dicatatkan kelahiran dalam register Akta Kelahiran dan diterbitkan kutipan Akta Kelahiran :</strong></div>\r\n<table style=\"border-collapse: collapse; width: 99.9875%; height: 77.1875px; border: 1px solid rgb(0, 0, 0);\" border=\"1\"><colgroup> <col style=\"width: 3.87567%;\"> <col style=\"width: 24.861%;\"> <col style=\"width: 21.2689%;\"> <col style=\"width: 16.637%;\"> <col style=\"width: 16.637%;\"> <col style=\"width: 16.637%;\"> </colgroup>\r\n<tbody>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\"><strong>No</strong></td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\"><strong>Nama / Jenis Kelamin</strong></td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\"><strong>Tempat Lahir</strong></td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\"><strong>Tanggal Lahir</strong></td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\"><strong>Anak Ke</strong></td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\"><strong>No dan Tanggal Pendaftaran</strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\">1.</td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\"><strong>[NAma] </strong>/ [Jenis_kelamiN]</td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\">[Tempat_dilahirkanN]</td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\">[Tanggal_kelahiraN]</td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\">[Kelahiran_anaK]</td>\r\n<td style=\"height: 14.3958px; border-color: rgb(0, 0, 0);\"> </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<br>\r\n<table style=\"border-collapse: collapse; width: 99.9875%; height: 134.375px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 33.1795%; text-align: left; vertical-align: top;\"><strong>Dari seorang ibu :</strong></td>\r\n<td style=\"width: 1.41793%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 65.4137%; text-align: justify; vertical-align: top;\"><strong> </strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; height: 14.3958px; text-align: justify; vertical-align: top;\"><strong>[NAma_ibu]</strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">NIK / No KTP</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Nik_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Tempat dan tanggal lahir / Umur</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; height: 14.3958px; text-align: justify; vertical-align: top;\">[Tempat_tgl_lahir_ibU] / [Usia_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[WArga_negara_ibu]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Pekerjaan_ibU]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Alamat/Tempat Tinggal</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Alamat_ibU]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<table style=\"border-collapse: collapse; width: 99.9875%; height: 111.979px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 33.1795%; text-align: left; vertical-align: top;\"><strong>Istri dari :</strong></td>\r\n<td style=\"width: 1.41793%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 65.4137%; text-align: justify; vertical-align: top;\"><strong> </strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; height: 14.3958px; text-align: justify; vertical-align: top;\"><strong>[NAma_ayah]</strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">NIK / No KTP</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Nik_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Tempat dan tanggal lahir / Umur</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; height: 14.3958px; text-align: justify; vertical-align: top;\">[Tempat_tgl_lahir_ayaH] / [Usia_ayaH]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 33.1795%; text-align: left; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.41793%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; vertical-align: top;\">[Warga_negara_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Pekerjaan_ayaH]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Alamat/Tempat Tinggal</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Alamat_ayaH]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<table style=\"border-collapse: collapse; width: 99.9875%; height: 134.375px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 33.1795%; text-align: left; vertical-align: top;\"><strong>Saksi 1 :</strong></td>\r\n<td style=\"width: 1.41793%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 65.4137%; text-align: justify; vertical-align: top;\"><strong> </strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; height: 14.3958px; text-align: justify; vertical-align: top;\"><strong>[Nama_saksi_I]</strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">NIK / No KTP</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Nik_saksi_I]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Tempat dan tanggal lahir / Umur</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; height: 14.3958px; text-align: justify; vertical-align: top;\">[Tempat_tgl_lahir_saksi_I] / [Usia_saksi_I]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[WArga_negara_saksi_i]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Pekerjaan_saksi_I]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Alamat/Tempat Tinggal</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Alamat_saksi_I]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<table style=\"border-collapse: collapse; width: 99.9875%; height: 134.375px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 33.1795%; text-align: left; vertical-align: top;\"><strong>Saksi 2 :</strong></td>\r\n<td style=\"width: 1.41793%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 65.4137%; text-align: justify; vertical-align: top;\"><strong> </strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; height: 14.3958px; text-align: justify; vertical-align: top;\"><strong>[NAma_saksi_ii]</strong></td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">NIK / No KTP</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Nik_saksi_iI]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Tempat dan tanggal lahir / Umur</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; height: 14.3958px; text-align: justify; vertical-align: top;\">[Tempat_tgl_lahir_saksi_iI] / [Usia_saksi_iI]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[WArga_negara_saksi_ii]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Pekerjaan_saksi_iI]</td>\r\n</tr>\r\n<tr style=\"height: 14.3958px;\">\r\n<td style=\"width: 33.1795%; text-align: left; height: 14.3958px; vertical-align: top;\">Alamat/Tempat Tinggal</td>\r\n<td style=\"width: 1.41793%; text-align: center; height: 14.3958px; vertical-align: top;\">:</td>\r\n<td style=\"width: 65.4137%; text-align: justify; height: 14.3958px; vertical-align: top;\">[Alamat_saksi_iI]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"> </div>\r\n<table style=\"width: 100%; height: 43.979px;\">\r\n<tbody>\r\n<tr style=\"height: 8.3958px;\">\r\n<td style=\"width: 94.4397%; height: 8.3958px;\"><span style=\"font-size: 10px;\"><strong>Terlampir persyaratan sebagai berikut :</strong></span></td>\r\n</tr>\r\n<tr style=\"height: 8.3958px;\">\r\n<td>\r\n<div style=\"font-size: 10px;\">1. Surat keterangan kelahiran dari penolong atau dari Desa/Lurah</div>\r\n<div style=\"font-size: 10px;\">2. Fotocopy KTP dan kartu keluarga orang tua</div>\r\n<div style=\"font-size: 10px;\">3. Fotocopy Buku Nikah / akta perkawinan orang tua yang telah dilegalisir (bagi yang memiliki)</div>\r\n<div style=\"font-size: 10px;\">4. Fotocopy KTP 2 orang saksi yang masih berlaku</div>\r\n<div style=\"font-size: 10px;\">5. Fotocopy Ijazah / Raport (bagi yang memiliki)</div>\r\n</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<table style=\"border-collapse: collapse; width: 99.9875%; height: 99.5833px;\"><colgroup> <col style=\"width: 32.8014%;\"> <col style=\"width: 33.9357%;\"> <col style=\"width: 33.274%;\"> </colgroup>\r\n<tbody>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"height: 22.3958px;\"> </td>\r\n<td style=\"height: 22.3958px;\"> </td>\r\n<td style=\"text-align: center; height: 22.3958px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 10px;\">\r\n<td style=\"height: 54.7917px;\" rowspan=\"2\">\r\n<table style=\"border-collapse: collapse; width: 100.415%; border: 1px solid rgb(0, 0, 0);\" border=\"1\"><colgroup> <col style=\"width: 33.6245%;\"> <col style=\"width: 66.2547%;\"> </colgroup>\r\n<tbody>\r\n<tr>\r\n<td style=\"text-align: center; border-color: rgb(0, 0, 0);\" rowspan=\"2\"><strong>Verifikasi</strong></td>\r\n<td style=\"text-align: left; border-color: rgb(0, 0, 0);\"><strong>Kasi</strong></td>\r\n</tr>\r\n<tr>\r\n<td style=\"text-align: left; border-color: rgb(0, 0, 0);\"><strong>Kabid</strong></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td style=\"height: 54.7917px;\" rowspan=\"2\"> </td>\r\n<td style=\"text-align: center; height: 10px;\">Pelapor</td>\r\n</tr>\r\n<tr style=\"height: 44.7917px;\">\r\n<td style=\"height: 44.7917px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 22.3958px;\">\r\n<td style=\"height: 22.3958px;\"> </td>\r\n<td style=\"height: 22.3958px;\"> </td>\r\n<td style=\"text-align: center; height: 22.3958px;\"><strong>[Nama_pelapoR]</strong></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"> </div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"data_orang_tua\":\"1\",\"data_pasangan\":\"0\"},\"Pelapor\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Saksi_I\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]},\"Saksi_II\":{\"data\":[1],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11]}}', '[{\"kategori\":\"Pelapor\",\"tipe\":\"text\",\"kode\":\"[form_hubungan_pelapor_dengan_bayi]\",\"nama\":\"Hubungan Pelapor dengan Bayi\",\"deskripsi\":\"Hubungan Pelapor dengan Bayi\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1);
INSERT INTO `tweb_surat_format` (`id`, `config_id`, `nama`, `url_surat`, `kode_surat`, `lampiran`, `kunci`, `favorit`, `jenis`, `mandiri`, `masa_berlaku`, `satuan_masa_berlaku`, `qr_code`, `logo_garuda`, `kecamatan`, `syarat_surat`, `template`, `template_desa`, `form_isian`, `kode_isian`, `orientasi`, `ukuran`, `margin`, `margin_global`, `footer`, `header`, `format_nomor`, `format_nomor_global`, `sumber_penduduk_berulang`, `created_at`, `created_by`, `updated_at`, `updated_by`) VALUES
(244, 1, 'Keterangan Pindah Penduduk', 'surat-keterangan-pindah-penduduk', 'S-04', 'F-1.03,F-1.08,F-1.25,F-1.27', 0, 0, 3, 1, 1, 'd', 0, 0, 0, '[\"2\",\"3\",\"1\"]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan / cap jempol di bawah ini :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 201.515px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 22.3906px; text-align: left; vertical-align: top;\">1.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3906px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3906px; text-align: justify; vertical-align: top;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 22.3906px; text-align: left; vertical-align: top;\">2.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3906px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3906px; text-align: justify; vertical-align: top;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3906px; vertical-align: top;\">3.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3906px; vertical-align: top;\">Umur</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px; vertical-align: top;\">[UsiA]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3906px; vertical-align: top;\">4.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3906px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px; vertical-align: top;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3906px; vertical-align: top;\">5.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3906px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px; vertical-align: top;\">[AgAma]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 22.3906px; text-align: left; vertical-align: top;\">6.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3906px; vertical-align: top;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3906px; text-align: justify; vertical-align: top;\">[Jenis_kelamiN]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 22.3906px; vertical-align: top;\">7.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 22.3906px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px; vertical-align: top;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 4.31655%; text-align: center; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.5242%; text-align: left; vertical-align: top;\">No. KTP</td>\r\n<td style=\"width: 1.2333%; text-align: center; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; vertical-align: top;\">[NiK]</td>\r\n</tr>\r\n<tr style=\"height: 44.7812px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 44.7812px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 44.7812px; text-align: left; vertical-align: top;\">9.<br><br></td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 44.7812px; vertical-align: top;\">Tempat Tinggal<br><br></td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 44.7812px; vertical-align: top;\">:<br><br></td>\r\n<td style=\"width: 60.0206%; height: 44.7812px; text-align: justify; vertical-align: top;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Akan pindah dengan keterangan sebagai berikut:</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">10.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Alamat yang dituju</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\">RT [Form_rt_tujuaN], RW [Form_rw_tujuaN], [Sebutan_dusun] [Form_dusun_tujuaN], [Sebutan_desa] [Form_desa_atau_kelurahan_tujuan], Kecamatan [Form_kecamatan_tujuan], [Sebutan_kabupaten] [Form_kabupaten_tujuan]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; height: 18px; text-align: left; vertical-align: top;\">11.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Alasan Pindah</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; height: 18px; text-align: justify; vertical-align: top;\">[Form_alasan_pindah]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px; vertical-align: top;\">12.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Tanggal Pindah</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px; vertical-align: top;\">[Form_tanggal_pindaH]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 18px; vertical-align: top;\"> </td>\r\n<td style=\"width: 3.90545%; text-align: left; height: 18px; vertical-align: top;\">13.</td>\r\n<td style=\"width: 30.5242%; text-align: left; height: 18px; vertical-align: top;\">Jumlah Pengikut</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 18px; vertical-align: top;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 18px; vertical-align: top;\">[Form_jumlah_pengikuT]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\"><br>[Pengikut_pindaH]</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Surat keterangan ini diterbitkan sebagai [Form_keterangaN].</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat ini dibuat, untuk dipergunakan sebagaimana mestinya.</p>\r\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\">Pemegang Surat,</td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[AtAs_nama]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"><br><br><br><br></td>\r\n<td style=\"width: 35%;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\">[Nama]</td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[NaMa_pamong]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35%; text-align: center;\"> </td>\r\n<td style=\"width: 30%;\"> </td>\r\n<td style=\"width: 35%; text-align: center;\">[Nip_pamonG]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"> </div>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[1,2,3,4,6,9],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"data_orang_tua\":\"0\",\"data_pasangan\":\"0\"}}', '[{\"tipe\":\"text\",\"kode\":\"[form_telepon_pemohon]\",\"nama\":\"Telepon Pemohon\",\"deskripsi\":\"Nomor Telepon Pemohon\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"select-manual\",\"kode\":\"[form_gunakan_format]\",\"nama\":\"Gunakan Format\",\"deskripsi\":\"Pilih Format Lampiran Surat\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"F-1.08 (pindah pergi)\",\"F-1.23, F-1.25, F-1.29, F-1.34 (sesuai tujuan)\",\"F-1.03 (pindah datang)\",\"F-1.27, F-1.31, F-1.39 (sesuai tujuan)\"],\"refrensi\":null},{\"tipe\":\"select-manual\",\"kode\":\"[form_jenis_permohonan]\",\"nama\":\"Jenis Permohonan\",\"deskripsi\":\"Pilih Jenis Permohonan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"SURAT KETERANGAN KEPENDUDUKAN\",\"SURAT KETERANGAN PINDAH\",\"SURAT KETERANGAN PINDAH LUAR NEGERI (SKPLN)\",\"SURAT KETERANGAN TEMPAT TINGGAL (SKTT)\",\"BAGI ORANG ASING TINGGAL TERBATAS\"],\"refrensi\":null},{\"tipe\":\"select-manual\",\"kode\":\"[form_alasan_pindah]\",\"nama\":\"Alasan Pindah\",\"deskripsi\":\"Pilih Alasan Pindah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"PEKERJAAN\",\"PENDIDIKAN\",\"KEAMANAN\",\"KESEHATAN\",\"PERUMAHAN\",\"KELUARGA\",\"LAINNYA\"],\"refrensi\":null},{\"tipe\":\"select-manual\",\"kode\":\"[form_klasifikasi_pindah]\",\"nama\":\"Klasifikasi Pindah\",\"deskripsi\":\"Pilih Klasifikasi Pindah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"DALAM SATU DESA\\/KELURAHAN\",\"ANTAR DESA\\/KELURAHAN\",\"ANTAR KECAMATAN\",\"ANTAR KAB\\/KOTA\",\"ANTAR PROVINSI\"],\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_alamat_tujuan]\",\"nama\":\"Alamat Tujuan\",\"deskripsi\":\"Alamat Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_rt_tujuan]\",\"nama\":\"RT Tujuan\",\"deskripsi\":\"RT Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_rw_tujuan]\",\"nama\":\"RW Tujuan\",\"deskripsi\":\"RW Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_dusun_tujuan]\",\"nama\":\"Dusun Tujuan\",\"deskripsi\":\"Dusun Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_desa_atau_kelurahan_tujuan]\",\"nama\":\"Desa atau Kelurahan Tujuan\",\"deskripsi\":\"Desa atau Kelurahan Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_kecamatan_tujuan]\",\"nama\":\"Kecamatan Tujuan\",\"deskripsi\":\"Kecamatan Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_kabupaten_tujuan]\",\"nama\":\"Kabupaten Tujuan\",\"deskripsi\":\"Kabupaten Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_provinsi_tujuan]\",\"nama\":\"Provinsi Tujuan\",\"deskripsi\":\"Provinsi Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_kode_pos_tujuan]\",\"nama\":\"Kode Pos Tujuan\",\"deskripsi\":\"Kode Pos Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_telepon_tujuan]\",\"nama\":\"Telepon Tujuan\",\"deskripsi\":\"Telepon Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"select-manual\",\"kode\":\"[form_jenis_kepindahan]\",\"nama\":\"Jenis Kepindahan\",\"deskripsi\":\"Pilih Jenis Kepindahan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"KEP. KELUARGA\",\"KEP. KELUARGA DAN SELURUH ANGG. KELUARGA\",\"KEP. KELUARGA DAN SBG. ANGG. KELUARGA\",\"ANGG. KELUARGA\"],\"refrensi\":null},{\"tipe\":\"select-manual\",\"kode\":\"[form_status_kk_bagi_yang_tidak_pindah]\",\"nama\":\"Status KK Bagi Yang Tidak Pindah\",\"deskripsi\":\"Pilih Status KK Bagi Yang Tidak Pindah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"NUMPANG KK\",\"MEMBUAT KK BARU\",\"TIDAK ADA ANGG. KELUARGA YANG DITINGGAL\",\"NOMOR KK TETAP\"],\"refrensi\":null},{\"tipe\":\"select-manual\",\"kode\":\"[form_status_kk_bagi_yang_pindah]\",\"nama\":\"Status KK Bagi Yang Pindah\",\"deskripsi\":\"Pilih Status KK Bagi Yang Pindah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"NUMPANG KK\",\"MEMBUAT KK BARU\",\"NOMOR KK TETAP\"],\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_negara_tujuan]\",\"nama\":\"Negara Tujuan\",\"deskripsi\":\"Negara Tujuan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_kode_negara]\",\"nama\":\"Kode Negara\",\"deskripsi\":\"Kode Negara\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_alamat_tujuan_luar_negeri]\",\"nama\":\"Alamat Tujuan (Luar Negeri)\",\"deskripsi\":\"Alamat Tujuan (Luar Negeri)\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_penanggung_jawab]\",\"nama\":\"Penanggung Jawab\",\"deskripsi\":\"Penanggung Jawab\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nama_sponsor]\",\"nama\":\"Nama Sponsor\",\"deskripsi\":\"Nama Sponsor\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"select-manual\",\"kode\":\"[form_tipe_sponsor]\",\"nama\":\"Tipe Sponsor\",\"deskripsi\":\"Pilih Tipe Sponsor\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"ORGANISASI INTERNASIONAL\",\"PERORANGAN\",\"PEMERINTAH\",\"TANPA SPONSOR\",\"PERUSAHAAN\"],\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_alamat_sponsor]\",\"nama\":\"Alamat Sponsor\",\"deskripsi\":\"Alamat Sponsor\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_nomor_itas_&_itap]\",\"nama\":\"Nomor ITAS & ITAP\",\"deskripsi\":\"Nomor ITAS & ITAP\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_itas_&_itap]\",\"nama\":\"Tanggal ITAS & ITAP\",\"deskripsi\":\"Tanggal ITAS & ITAP\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"date\",\"kode\":\"[form_tanggal_pindah]\",\"nama\":\"Tanggal Pindah\",\"deskripsi\":\"Tanggal Pindah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_keterangan]\",\"nama\":\"Keterangan\",\"deskripsi\":\"Keterangan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null},{\"tipe\":\"text\",\"kode\":\"[form_jumlah_pengikut]\",\"nama\":\"Jumlah Pengikut\",\"deskripsi\":\"Jumlah Pengikut\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:48', NULL, '2025-09-26 17:08:13', 1),
(245, 1, 'Keterangan Nikah', 'surat-keterangan-nikah', 'S-23', 'N-1,N-2,N-4,N-5,N-6,SPS,SWN', 0, 0, 3, 0, 0, 'M', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">SURAT PENGANTAR NUMPANG NIKAH</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan dengan sebenarnya bahwa :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 231.297px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px;\"> </td>\r\n<td style=\"width: 3.90429%; height: 22.3906px; text-align: left;\">1.</td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 22.3906px;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3906px; text-align: justify;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px;\"> </td>\r\n<td style=\"width: 3.90429%; height: 22.3906px; text-align: left;\">2.</td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 22.3906px;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3906px; text-align: justify;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px;\"> </td>\r\n<td style=\"width: 3.90429%; height: 22.3906px; text-align: left;\">3.</td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 22.3906px;\">Jenis Kelamin</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px;\">:</td>\r\n<td style=\"width: 60.0206%; height: 22.3906px; text-align: justify;\">[JeNis_kelamin]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px;\"> </td>\r\n<td style=\"width: 3.90429%; text-align: left; height: 22.3906px;\">4.</td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 22.3906px;\">Surat bukti diri KTP</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px;\">[NiK]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px;\"> </td>\r\n<td style=\"width: 3.90429%; text-align: left; height: 22.3906px;\">5.</td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 22.3906px;\">Warga Negara</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px;\"> </td>\r\n<td style=\"width: 3.90429%; text-align: left; height: 22.3906px;\">6.</td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 22.3906px;\">Agama</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px;\">[AgAma]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px;\"> </td>\r\n<td style=\"width: 3.90429%; text-align: left; height: 22.3906px;\">7.</td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 22.3906px;\">Status Perkawinan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px;\">[Form_status_kawin_priA]</td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 22.3906px;\"> </td>\r\n<td style=\"width: 3.90429%; text-align: left; height: 22.3906px;\">8.</td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 22.3906px;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 22.3906px;\">:</td>\r\n<td style=\"width: 60.0206%; text-align: justify; height: 22.3906px;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 29.7812px;\">\r\n<td style=\"width: 4.31655%; text-align: center; height: 29.7812px;\"> </td>\r\n<td style=\"width: 3.90429%; height: 29.7812px; text-align: left;\">9.<br><br></td>\r\n<td style=\"width: 30.5253%; text-align: left; height: 29.7812px;\">Alamat / Tempat Tinggal<br><br></td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 29.7812px;\">:<br><br></td>\r\n<td style=\"width: 60.0206%; height: 29.7812px; text-align: justify;\">[ALamat] [SeButan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Nama tersebut di atas betul bermaksud akan menumpang Nikah / Kawin di : <strong>RT [NAma_rt] RW [NaMa_rw] [NaMa_dusun] [Sebutan_desa] [NaMa_desa] Kecamatan [NaMa_kecamatan] Kabupaten [NaMa_kabupaten]</strong></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Kepada seorang [JeNis_kelamin_dcpw] yang bernama :</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\"><strong>[NAma_dcpw] </strong>Bin <strong>[Form_binti_wanitA]</strong></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian Surat ini dibuat, untuk dipergunakan sebagaimana mestinya.</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 178.5px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 21.7656px;\">\r\n<td style=\"width: 35.0099%; text-align: center; height: 21.7656px;\">\r\n<table style=\"border-collapse: collapse; width: 100.353%; height: 44.7812px; border-width: 1px;\" border=\"0\"><colgroup><col style=\"width: 15.9175%;\"><col style=\"width: 6.59994%;\"><col style=\"width: 77.4522%;\"></colgroup>\r\n<tbody>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"height: 22.3906px; text-align: left;\">Nomor</td>\r\n<td style=\"height: 22.3906px;\">:</td>\r\n<td style=\"height: 22.3906px; text-align: left;\">..................................................................................</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td style=\"width: 29.9801%; height: 21.7656px;\"> </td>\r\n<td style=\"width: 35.0099%; text-align: center; height: 21.7656px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35.0099%; text-align: center;\">\r\n<table style=\"border-collapse: collapse; width: 100.156%; border-width: 1px;\" border=\"0\"><colgroup><col style=\"width: 15.7277%;\"><col style=\"width: 6.99119%;\"><col style=\"width: 77.2781%;\"></colgroup>\r\n<tbody>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"height: 22.3906px; text-align: left;\">Tanggal</td>\r\n<td style=\"height: 22.3906px;\">:</td>\r\n<td style=\"height: 22.3906px; text-align: left;\">..................................................................................</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n</td>\r\n<td style=\"width: 29.9801%;\"> </td>\r\n<td style=\"width: 35.0099%; text-align: center;\"> </td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 35.0099%; text-align: center; height: 22.3906px;\">Mengetahui,</td>\r\n<td style=\"width: 29.9801%; height: 22.3906px;\"> </td>\r\n<td style=\"width: 35.0099%; text-align: center; height: 22.3906px;\"> </td>\r\n</tr>\r\n<tr>\r\n<td style=\"width: 35.0099%; text-align: center;\">[SeButan_camat] [NaMa_kecamatan]</td>\r\n<td style=\"width: 29.9801%;\"> </td>\r\n<td style=\"width: 35.0099%; text-align: center;\">[Atas_namA]</td>\r\n</tr>\r\n<tr style=\"height: 89.5625px;\">\r\n<td style=\"width: 35.0099%; text-align: center; height: 89.5625px;\"> </td>\r\n<td style=\"width: 29.9801%; height: 89.5625px;\"><br><br><br><br></td>\r\n<td style=\"width: 35.0099%; height: 89.5625px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 35.0099%; text-align: center; height: 22.3906px;\"><strong>[NaMa_kepala_camat]</strong></td>\r\n<td style=\"width: 29.9801%; height: 22.3906px;\"> </td>\r\n<td style=\"width: 35.0099%; text-align: center; height: 22.3906px;\"><strong>[Nama_pamonG]</strong></td>\r\n</tr>\r\n<tr style=\"height: 22.3906px;\">\r\n<td style=\"width: 35.0099%; height: 22.3906px; text-align: center;\"><strong>....................................................................................</strong></td>\r\n<td style=\"width: 29.9801%; height: 22.3906px;\"> </td>\r\n<td style=\"width: 35.0099%; text-align: center; height: 22.3906px;\"><strong>[SEbutan_nip_desa] : [nip_pamong]</strong></td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"><br>[qr_code]</div>', NULL, '{\"individu\":{\"sumber\":1,\"data\":[\"1\",\"3\"],\"sex\":\"1\",\"status_dasar\":[\"1\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"data_orang_tua\":\"1\",\"data_pasangan\":\"0\",\"judul\":\"Pasangan Pria\",\"label\":\"A.1 DATA CALON PASANGAN PRIA\",\"hubungan\":null},\"dapp\":{\"sumber\":\"1\",\"data\":[\"3\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Ayah Pasangan Pria\",\"label\":\"A.2 DATA AYAH PASANGAN PRIA\",\"hubungan\":\"\"},\"dipp\":{\"sumber\":\"1\",\"data\":[\"3\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Ibu Pasangan Pria\",\"label\":\"A.3 DATA IBU PASANGAN PRIA\",\"hubungan\":\"\"},\"dcpw\":{\"sumber\":\"1\",\"data\":[\"1\",\"3\"],\"sex\":\"2\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Pasangan Wanita\",\"label\":\"B1. DATA CALON PASANGAN WANITA\",\"hubungan\":\"\"},\"dapw\":{\"sumber\":\"1\",\"data\":[\"3\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Ayah Pasangan Wanita\",\"label\":\"B.2 DATA AYAH PASANGAN WANITA\",\"hubungan\":\"\"},\"dibpw\":{\"sumber\":\"1\",\"data\":[\"3\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Ibu Pasangan Wanita\",\"label\":\"B.3 DATA IBU PASANGAN WANITA\",\"hubungan\":\"\"},\"dst\":{\"sumber\":\"1\",\"data\":[\"3\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Suami Terdahulu\",\"label\":\"B.4 DATA SUAMI TERDAHULU \",\"hubungan\":\"\"},\"dwn\":{\"sumber\":\"1\",\"data\":[\"3\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Wali Nikah\",\"label\":\"B.5 DATA WALI NIKAH \",\"hubungan\":\"\"},\"dpn\":{\"sumber\":\"0\",\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Pernikahan\",\"label\":\"C. DATA PERNIKAHAN \",\"hubungan\":\"\"}}', '[{\"tipe\":\"text\",\"kode\":\"[form_bin_pria]\",\"nama\":\"Bin Pria\",\"deskripsi\":\"Bin Pasangan Pria\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Bin Pasangan Pria\",\"kaitkan_kode\":\"\"},{\"tipe\":\"select-manual\",\"kode\":\"[form_status_kawin_pria]\",\"nama\":\"Status Kawin Pria\",\"deskripsi\":\"Pilih Status Kawin\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"Jejaka\",\"Duda\",\"Beristri\"],\"refrensi\":null,\"kolom\":\"5\",\"label\":\"Status Kawin Pria\",\"kaitkan_kode\":\"[{\\\"nilai_isian\\\":[\\\"Beristri\\\"],\\\"kode_isian_terkait\\\":[\\\"IstriKe\\\"]}]\"},{\"tipe\":\"number\",\"kode\":\"[form_istrike]\",\"nama\":\"IstriKe\",\"deskripsi\":\"Istri Keberapa\",\"required\":\"0\",\"atribut\":\"min=\\\"1\\\"\\r\\nmax=\\\"10\\\"\",\"pilihan\":null,\"refrensi\":null,\"kolom\":\"5\",\"label\":\"Jika beristri, istri ke-\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dapp\",\"tipe\":\"text\",\"kode\":\"[form_bin_ayah_pria]\",\"nama\":\"Bin Ayah Pria\",\"deskripsi\":\"Bin Ayah Pria\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Bin Ayah Pria\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dipp\",\"tipe\":\"text\",\"kode\":\"[form_binti_ibu_pria]\",\"nama\":\"Binti Ibu Pria\",\"deskripsi\":\"Binti Ibu Pria\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Binti Ibu Pria\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dcpw\",\"tipe\":\"text\",\"kode\":\"[form_binti_wanita]\",\"nama\":\"Binti Wanita\",\"deskripsi\":\"Binti Pasangan Wanita\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Binti Pasangan Wanita\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dcpw\",\"tipe\":\"select-manual\",\"kode\":\"[form_status_kawin_wanita]\",\"nama\":\"Status Kawin Wanita\",\"deskripsi\":\"Pilih Status Kawin\",\"required\":\"0\",\"atribut\":null,\"pilihan\":[\"Perawan\",\"Janda\",\"Bersuami\"],\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Status Kawin Wanita\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dapw\",\"tipe\":\"text\",\"kode\":\"[form_bin_ayah_wanita]\",\"nama\":\"Bin Ayah Wanita\",\"deskripsi\":\"Bin Ayah Wanita\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Bin Ayah Wanita\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dibpw\",\"tipe\":\"text\",\"kode\":\"[form_binti_ibu_wanita]\",\"nama\":\"Binti Ibu Wanita\",\"deskripsi\":\"Binti Ibu Wanita\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"\",\"label\":\"Binti Ibu Wanita\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dst\",\"tipe\":\"date\",\"kode\":\"[form_tanggal_meninggal_suami_terdahulu]\",\"nama\":\"Tanggal Meninggal Suami Terdahulu\",\"deskripsi\":\"Tanggal Meninggal\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"4\",\"label\":\"Meninggal Dunia Pada Tanggal \\/ Tempat\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dst\",\"tipe\":\"text\",\"kode\":\"[form_tempat_meninggal_suami_terdahulu]\",\"nama\":\"Tempat Meninggal Suami Terdahulu\",\"deskripsi\":\"Tempat Meninggal\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dst\",\"tipe\":\"text\",\"kode\":\"[form_bin_suami_terdahulu]\",\"nama\":\"Bin Suami Terdahulu\",\"deskripsi\":\"Bin Suami Terdahulu\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Bin Suami Terdahulu\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dwn\",\"tipe\":\"text\",\"kode\":\"[form_bin_wali_nikah]\",\"nama\":\"Bin Wali Nikah\",\"deskripsi\":\"Bin Wali Nikah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Bin Wali Nikah\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dwn\",\"tipe\":\"text\",\"kode\":\"[form_hubungan_dengan_wali]\",\"nama\":\"Hubungan Dengan Wali\",\"deskripsi\":\"Hubungan Dengan Wali\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"6\",\"label\":\"Hubungan Dengan Wali\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dpn\",\"tipe\":\"text\",\"kode\":\"[form_hari_nikah]\",\"nama\":\"Hari nikah\",\"deskripsi\":\"hari nikah\",\"required\":\"0\",\"atribut\":\"class=\\\" hari\\\"\\r\\nreadonly\",\"pilihan\":null,\"refrensi\":null,\"kolom\":\"3\",\"label\":\"Hari, Tanggal, Jam\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dpn\",\"tipe\":\"date\",\"kode\":\"[form_tanggal_nikah]\",\"nama\":\"Tanggal Nikah\",\"deskripsi\":\"Tanggal Nikah\",\"required\":\"0\",\"atribut\":\"class=\\\" datepicker data_hari\\\"\",\"pilihan\":null,\"refrensi\":null,\"kolom\":\"3\",\"label\":\"Hari, Tanggal, Jam\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dpn\",\"tipe\":\"time\",\"kode\":\"[form_jam_nikah]\",\"nama\":\"Jam Nikah\",\"deskripsi\":\"Jam Nikah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"3\",\"label\":\"Hari, Tanggal, Jam\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dpn\",\"tipe\":\"text\",\"kode\":\"[form_tempat_nikah]\",\"nama\":\"Tempat Nikah\",\"deskripsi\":\"Tempat Nikah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"12\",\"label\":\"Tempat Nikah\",\"kaitkan_kode\":\"\"},{\"kategori\":\"dpn\",\"tipe\":\"text\",\"kode\":\"[form_maskawin_nikah]\",\"nama\":\"Maskawin Nikah\",\"deskripsi\":\"Maskawin Nikah\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"12\",\"label\":\"Maskawin Nikah\",\"kaitkan_kode\":\"\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:49', NULL, '2025-09-26 17:08:12', 1),
(246, 1, 'Keterangan Pengantar Rujuk atau Cerai', 'surat-keterangan-pengantar-rujuk-atau-cerai', 'S-35', NULL, 0, 0, 3, 0, 1, 'd', 0, 0, 0, '[]', '<h4 style=\"margin: 0; text-align: center;\"><span style=\"text-decoration: underline;\">[JUdul_surat]</span></h4>\r\n<p style=\"margin: 0; text-align: center;\">Nomor : [Format_nomor_suraT]<br><br></p>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Yang bertanda tangan di bawah ini [JaBatan] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten], Provinsi [NaMa_provinsi] menerangkan bahwa berdasarkan keterangan dari :</p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 154px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 19.25px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 19.25px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.98047%; text-align: center; height: 19.25px; vertical-align: top;\">1.</td>\r\n<td style=\"width: 29.9075%; text-align: left; height: 19.25px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19.25px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 19.25px; text-align: justify; vertical-align: top;\"><strong>[NAma]</strong></td>\r\n</tr>\r\n<tr style=\"height: 19.25px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 19.25px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.98047%; text-align: center; height: 19.25px; vertical-align: top;\">2.</td>\r\n<td style=\"width: 29.9075%; text-align: left; height: 19.25px; vertical-align: top;\">Bin</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19.25px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 19.25px; text-align: justify; vertical-align: top;\">[NaMa_ayah]</td>\r\n</tr>\r\n<tr style=\"height: 19.25px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 19.25px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.98047%; text-align: center; height: 19.25px; vertical-align: top;\">3.</td>\r\n<td style=\"width: 29.9075%; text-align: left; height: 19.25px; vertical-align: top;\">Tempat / Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19.25px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 19.25px; text-align: justify; vertical-align: top;\">[TtL]</td>\r\n</tr>\r\n<tr style=\"height: 19.25px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 19.25px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.98047%; text-align: center; height: 19.25px; vertical-align: top;\">4.</td>\r\n<td style=\"width: 29.9075%; text-align: left; height: 19.25px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19.25px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; text-align: justify; height: 19.25px; vertical-align: top;\">[WArga_negara]</td>\r\n</tr>\r\n<tr style=\"height: 19.25px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 19.25px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.98047%; text-align: center; height: 19.25px; vertical-align: top;\">5.</td>\r\n<td style=\"width: 29.9075%; text-align: left; height: 19.25px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19.25px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 19.25px; text-align: justify; vertical-align: top;\">[AgAma]</td>\r\n</tr>\r\n<tr style=\"height: 19.25px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 19.25px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.98047%; text-align: center; height: 19.25px; vertical-align: top;\">6.</td>\r\n<td style=\"width: 29.9075%; text-align: left; height: 19.25px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 19.25px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; text-align: justify; height: 19.25px; vertical-align: top;\">[PeKerjaan]</td>\r\n</tr>\r\n<tr style=\"height: 38.5px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 38.5px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.98047%; text-align: center; height: 38.5px; vertical-align: top;\">7.</td>\r\n<td style=\"width: 29.9075%; text-align: left; height: 38.5px; vertical-align: top;\">Alamat / Tempat Tinggal</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 38.5px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; text-align: justify; height: 38.5px; vertical-align: top;\">[AlamaT] [Sebutan_desa] [NaMa_desa], Kecamatan [NaMa_kecamatan], [SeButan_kabupaten] [NaMa_kabupaten]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Telah rujuk/cerai *) dengan :<strong><br></strong></p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 162.963px;\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\r\n<tbody>\r\n<tr style=\"height: 23.275px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 23.275px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.8777%; text-align: center; height: 23.275px; vertical-align: top;\">8.</td>\r\n<td style=\"width: 30.0103%; height: 23.275px; vertical-align: top;\">Nama Lengkap</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 23.275px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 23.275px; vertical-align: top;\"><strong>[NAma_pasangan]</strong></td>\r\n</tr>\r\n<tr style=\"height: 23.275px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 23.275px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.8777%; text-align: center; height: 23.275px; vertical-align: top;\">9.</td>\r\n<td style=\"width: 30.0103%; height: 23.275px; vertical-align: top;\">Binti</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 23.275px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 23.275px; vertical-align: top;\">[FoRm_nama_ayah]</td>\r\n</tr>\r\n<tr style=\"height: 23.275px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 23.275px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.8777%; text-align: center; height: 23.275px; vertical-align: top;\">10.</td>\r\n<td style=\"width: 30.0103%; height: 23.275px; vertical-align: top;\">Tempat dan Tanggal Lahir</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 23.275px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 23.275px; vertical-align: top;\">[TeMpatlahir_pasangan], [Tanggallahir_pasangaN]</td>\r\n</tr>\r\n<tr style=\"height: 23.275px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 23.275px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.8777%; text-align: center; height: 23.275px; vertical-align: top;\">11.</td>\r\n<td style=\"width: 30.0103%; height: 23.275px; vertical-align: top;\">Kewarganegaraan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 23.275px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 23.275px; vertical-align: top;\">[WArga_negara_pasangan]</td>\r\n</tr>\r\n<tr style=\"height: 23.275px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 23.275px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.8777%; text-align: center; height: 23.275px; vertical-align: top;\">12.</td>\r\n<td style=\"width: 30.0103%; height: 23.275px; vertical-align: top;\">Agama</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 23.275px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 23.275px; vertical-align: top;\">[AgAma_pasangan]</td>\r\n</tr>\r\n<tr style=\"height: 23.275px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 23.275px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.8777%; text-align: center; height: 23.275px; vertical-align: top;\">13.</td>\r\n<td style=\"width: 30.0103%; height: 23.275px; vertical-align: top;\">Pekerjaan</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 23.275px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 23.275px; vertical-align: top;\">[PeKerjaan_pasangan]</td>\r\n</tr>\r\n<tr style=\"height: 23.3125px;\">\r\n<td style=\"width: 3.39157%; text-align: center; height: 23.3125px; vertical-align: top;\"> </td>\r\n<td style=\"width: 2.8777%; text-align: center; height: 23.3125px; vertical-align: top;\">14.</td>\r\n<td style=\"width: 30.0103%; height: 23.3125px; vertical-align: top;\">Alamat</td>\r\n<td style=\"width: 1.2333%; text-align: center; height: 23.3125px; vertical-align: top;\">:</td>\r\n<td style=\"width: 62.4872%; height: 23.3125px; vertical-align: top;\">[AlAmat_pasangan] </td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<p style=\"text-align: justify; text-indent: 30px;\">Demikian surat keterangan ini dibuat dengan sebenarnya, untuk dipergunakan sebagaimana mestinya.</p>\r\n<p style=\"text-align: justify; text-indent: 30px;\"> </p>\r\n<table style=\"border-collapse: collapse; width: 100%; height: 144px;\" border=\"0\">\r\n<tbody>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[NaMa_desa], [TgL_surat]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Atas_namA]</td>\r\n</tr>\r\n<tr style=\"height: 72px;\">\r\n<td style=\"width: 35%; text-align: center; height: 72px;\"> </td>\r\n<td style=\"width: 30%; height: 72px;\"><br><br><br><br></td>\r\n<td style=\"width: 35%; height: 72px;\"> </td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; text-align: center; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[Nama_pamonG]</td>\r\n</tr>\r\n<tr style=\"height: 18px;\">\r\n<td style=\"width: 35%; height: 18px;\"> </td>\r\n<td style=\"width: 30%; height: 18px;\"> </td>\r\n<td style=\"width: 35%; text-align: center; height: 18px;\">[SEbutan_nip_desa] : [nip_pamong]</td>\r\n</tr>\r\n</tbody>\r\n</table>\r\n<div style=\"text-align: center;\"> </div>', NULL, '{\"individu\":{\"sumber\":1,\"data\":[\"1\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"data_orang_tua\":\"0\",\"data_pasangan\":\"0\",\"judul\":\"Utama\",\"label\":\"Keterangan Pemohon\",\"hubungan\":null},\"pasangan\":{\"sumber\":\"1\",\"data\":[\"1\",\"3\"],\"sex\":\"\",\"status_dasar\":[\"1\",\"2\",\"3\",\"4\",\"5\",\"6\",\"7\",\"8\",\"9\"],\"kk_level\":[1,2,3,4,5,6,7,8,9,10,11],\"judul\":\"Pasangan\",\"label\":\"Data Pasangan\",\"hubungan\":\"\"}}', '[{\"kategori\":\"pasangan\",\"tipe\":\"text\",\"kode\":\"[form_nama_ayah]\",\"nama\":\"Nama Ayah\",\"deskripsi\":\"Nama Ayah Pasangan\",\"required\":\"0\",\"atribut\":null,\"pilihan\":null,\"refrensi\":null,\"kolom\":\"\",\"label\":\"Nama Ayah\",\"kaitkan_kode\":\"\"}]', 'Potrait', 'F4', '{\"kiri\":1.78,\"atas\":0.63,\"kanan\":1.78,\"bawah\":1.37}', 0, 1, 1, NULL, 1, 0, '2025-09-26 17:05:50', NULL, '2025-09-26 17:08:12', 1);

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