CONTHO SURAT KETRANGAN

SURAT KETRANGAN

No: .........................

Kami yang bertanda tangan di bawah ini:

Nama                              : .................................................................

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

                                          Desa ........................................................

Menerangkan dengan sesungguhnya bahwa:

Nama                              : .................................................................

Alamat                            : .................................................................

Pekerjaan                        : Pengecer Bahan Bakar Minyak (BBM)

Tempat pembelian

/pengambilan                 : .................................................................

Lokasi penjualan             : .................................................................

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

Omzet                             : Premium   .................. liter/hari

                                          Solar          .................. liter/hari

Demikian Surat Keterangan ini dibuat agar bisa dipergunakan sebagaimana mestinya

Yang bersangkutan Pedagang/pengecer (                                                        )

..........................................2012 a.n Lurah Desa .................................... (                                                        )

a.n Camat

Kecamatan ....................................

(                                                        )