tag:blogger.com,1999:blog-68041690920283985522024-03-13T11:11:40.514-07:00FORMULIR PENDAFTARAN BAKAL CALON KADES 2013Anonymoushttp://www.blogger.com/profile/17542722354373685102noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-6804169092028398552.post-51003662120172785942013-06-29T02:16:00.002-07:002013-06-29T09:11:20.638-07:00FORMAT FORMULIR PENDAFTARAN<div style="text-align: center;">
<b><span style="font-size: large;">FORMAT FORMULIR PENDAFTARAN </span></b></div>
<div style="text-align: center;">
<b><span style="font-size: large;">BAKAL CALON KEPALA DESA PAKISTAJI</span></b></div>
<div style="text-align: center;">
<b><span style="font-size: large;">TAHUN 2013</span></b></div>
<div style="text-align: center;">
<br /></div>
<div style="text-align: center;">
<br /></div>
<ol style="text-align: left;">
<li><span style="font-size: large;"><a class="GIL3GQOBOB" href="http://formulirdaftarbalonkades.blogspot.com/2013/06/permohonan-pendaftaran-pencalonan.html">PERMOHONAN PENDAFTARAN PENCALONAN KEPALA DESA</a> </span></li>
<li><span style="font-size: large;"><a href="http://formulirdaftarbalonkades.blogspot.com/2013/06/pernyataan-bersedia-dicalonkan-menjadi.html">SURAT PERNYATAAN BERSEDIA DICALONKAN MENJADI KEPALA DESA</a></span></li>
<li><span style="font-size: large;"><a href="http://formulirdaftarbalonkades.blogspot.com/2013/06/pernyataan-tidak-akan-mengundurkan-diri.html">SURAT PERNYATAAN TIDAK AKAN MENGUNDURKAN DIRI SEBAGAI CALON KEPALA DESA YANG BERHAK DIPILIH</a></span></li>
<li><span style="font-size: large;"><a href="http://formulirdaftarbalonkades.blogspot.com/2013/06/pernyataan-belum-pernah-menjabat-kepala.html">SURAT PERNYATAAN BELUM PERNAH MENJABAT KEPALA DESA PALING LAMA 10 (SEPULUH) TAHUN ATAU 2 (DUA) KALI MASA JABATAN BAIK SECARA BERTURUT-TURUT MAUPUN TIDAK</a></span></li>
<li><span style="font-size: large;"><a href="http://formulirdaftarbalonkades.blogspot.com/2013/06/daftar-riwayat-hidup-bakal-calon.html">DAFTAR RIWAYAT HIDUP BAKAL CALON KEPALA DESA PAKISTAJI KECAMATAN KABAT</a></span></li>
</ol>
Anonymoushttp://www.blogger.com/profile/17542722354373685102noreply@blogger.comtag:blogger.com,1999:blog-6804169092028398552.post-6369819575765808952013-06-29T02:06:00.000-07:002013-06-29T02:06:07.042-07:00DAFTAR RIWAYAT HIDUP BAKAL CALON<!--[if gte mso 9]><xml>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">3) ........................................*)</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; letter-spacing: -.8pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>c. <span style="mso-spacerun: yes;"> </span>Jumlah
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..............................................................</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; letter-spacing: -.8pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">b. ..............................................................</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">c.
..............................................................</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; letter-spacing: -.8pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">d. ..............................................................</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; letter-spacing: -.8pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">e. ..............................................................</span></div>
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..............................................................</span></div>
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..............................................................</span></div>
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..............................................................</span></div>
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..............................................................</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;"><span style="mso-spacerun: yes;"> </span>c. ..............................................................</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; letter-spacing: -.8pt; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Daftar riwayat
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persyaratan pencalonan Kepala Desa.</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Pakistaji,
................................... 2013</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Pembuat Pernyataan Bakal Calon</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Kepala Desa Pakistaji Kecamatan Kabat</span></div>
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<br /></div>
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<br /></div>
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<i style="mso-bidi-font-style: normal;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">Tanda tangan
& Materai</span></i></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt;">(
NAMA LENGKAP )</span><span style="font-size: 13.0pt; mso-bidi-font-size: 11.0pt;"></span></div>
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<![endif]-->Anonymoushttp://www.blogger.com/profile/17542722354373685102noreply@blogger.comtag:blogger.com,1999:blog-6804169092028398552.post-58431301233897035592013-06-29T01:50:00.000-07:002013-06-29T01:50:07.787-07:00PERNYATAAN BELUM PERNAH MENJABAT KEPALA DESA<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">SURAT PERNYATAAN </span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 13.0pt; mso-bidi-font-size: 11.0pt;">BELUM PERNAH MENJABAT KEPALA
DESA PALING LAMA 10 (SEPULUH) TAHUN ATAU 2 (DUA) KALI MASA JABATAN </span></b></div>
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<b style="mso-bidi-font-weight: normal;"><u><span style="font-size: 13.0pt; mso-bidi-font-size: 11.0pt;">BAIK SECARA BERTURUT-TURUT
MAUPUN TIDAK</span></u></b></div>
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<br /></div>
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<span style="font-size: 12.0pt; line-height: 115%;">Yang bertanda tangan
dibawah ini :</span></div>
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<span style="font-size: 12.0pt; line-height: 115%;">Nama<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>________________________________________</span></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Desa Pakistaji Kecamatan Kabat Kab.
Banyuwangi.</span><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;"></span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Menyatakan dengan sebenarnya bahwa saya belum pernah
menjabat Sebagai Kepala Desa Pakistaji Kecamatan Kabat Kab. Banyuwangi paling
lama 10 (sepuluh) tahun atau 2 (dua0 kali masa jabatan baik secara berturut-turut
maupun tidak.</span></div>
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persyaratan sebagai Calon Kepala Desa Pakistaji Kecamatan Kabat Kab.
Banyuwangi.</span><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;"></span></div>
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<br /></div>
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<br /></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Pakistaji,
................................... 2013</span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt;">Pembuat Pernyataan Bakal Calon</span></div>
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<span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt;">Kepala Desa Pakistaji Kecamatan Kabat</span></div>
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<br /></div>
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<br /></div>
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<i style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt;">Tanda tangan & Materai</span></i><i style="mso-bidi-font-style: normal;"><span style="font-size: 13.0pt; mso-bidi-font-size: 11.0pt;"></span></i></div>
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<br /></div>
<span style="font-family: "Calibri","sans-serif"; font-size: 13.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">( NAMA
LENGKAP )</span>Anonymoushttp://www.blogger.com/profile/17542722354373685102noreply@blogger.comtag:blogger.com,1999:blog-6804169092028398552.post-64472488739661552732013-06-29T01:47:00.002-07:002013-06-29T01:47:50.296-07:00PERNYATAAN TIDAK AKAN MENGUNDURKAN DIRI SEBAGAI CALON KEPALA DESA YANG BERHAK DIPILIH<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">SURAT PERNYATAAN </span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">TIDAK AKAN MENGUNDURKAN DIRI SEBAGAI CALON</span></b></div>
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<b style="mso-bidi-font-weight: normal;"><u><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">KEPALA DESA YANG BERHAK DIPILIH</span></u></b></div>
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<span style="font-size: 12.0pt; line-height: 115%;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Desa Pakistaji Kecamatan Kabat Kab.
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<span style="font-size: 12.0pt;">( NAMA LENGKAP )</span><span style="font-size: 13.0pt; mso-bidi-font-size: 11.0pt;"></span></div>
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Anonymoushttp://www.blogger.com/profile/17542722354373685102noreply@blogger.comtag:blogger.com,1999:blog-6804169092028398552.post-6668286086663030062013-06-29T01:44:00.000-07:002013-06-29T01:44:26.411-07:00PERNYATAAN BERSEDIA DICALONKAN MENJADI KEPALA DESA<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">SURAT
PERNYATAAN </span></b></div>
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<b style="mso-bidi-font-weight: normal;"><u><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">BERSEDIA
DICALONKAN MENJADI KEPALA DESA</span></u></b></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Yang bertanda tangan dibawah ini :</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Desa Pakistaji Kecamatan Kabat Kab.
Banyuwangi.</span></div>
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<br /></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Menyatakan dengan sebenarnya bahwa saya sanggup dan
bersedi menjadi Calon Kepala Desa Pakistaji Kecamatan Kabat Kab. Banyuwangi</span></div>
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<span style="font-size: 12.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Demikian Surat Pernyataan ini saya buat guna memenuhi
persyaratan sebagai Calon Kepala Desa Pakistaji Kecamatan Kabat Kab. Banyuwangi.</span><span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;"></span></div>
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<span style="font-size: 13.0pt; line-height: 115%; mso-bidi-font-size: 11.0pt;">Pakistaji,
................................... 2013</span></div>
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<span style="font-size: 13.0pt; mso-bidi-font-size: 11.0pt;">Pembuat Pernyataan Bakal Calon</span></div>
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<span style="font-size: 13.0pt; mso-bidi-font-size: 11.0pt;">Kepala Desa Pakistaji Kecamatan Kabat</span></div>
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<i style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt;">Tanda tangan & Materai</span></i><i style="mso-bidi-font-style: normal;"><span style="font-size: 13.0pt; mso-bidi-font-size: 11.0pt;"></span></i></div>
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<br /></div>
<span style="font-family: "Calibri","sans-serif"; font-size: 13.0pt; line-height: 115%; mso-ansi-language: IN; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 11.0pt; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">( NAMA
LENGKAP )</span>Anonymoushttp://www.blogger.com/profile/17542722354373685102noreply@blogger.comtag:blogger.com,1999:blog-6804169092028398552.post-388300458873035192013-06-29T01:27:00.002-07:002013-06-30T01:18:28.671-07:00PERMOHONAN PENDAFTARAN PENCALONAN KEPALA DESA<!--[if gte mso 9]><xml>
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<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<br /></div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 14.2pt; mso-border-insideh: none; mso-border-insidev: none; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 1184;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; mso-yfti-lastrow: yes;">
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 55.0pt;" valign="top" width="73"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<br /></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 14.2pt;" valign="top" width="19"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<br /></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 212.6pt;" valign="top" width="283"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<br /></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 213.5pt;" valign="top" width="285"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Times New Roman","serif";">Pakistaji, ......................................
2013</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<span style="font-family: "Times New Roman","serif";"><span style="mso-spacerun: yes;"> </span>Kepada </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<span style="font-family: "Times New Roman","serif";">Yth.
Panitia Pemilihan Kepala Desa </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<span style="font-family: "Times New Roman","serif";"> Pakistaji<span style="mso-spacerun: yes;"> </span>Tahun 2013</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<span style="font-family: "Times New Roman","serif";">di-</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 70.9pt;">
<span style="font-family: "Times New Roman","serif";"><span style="mso-spacerun: yes;"> </span><b style="mso-bidi-font-weight: normal;"><u>Pakistaji</u></b></span></div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 70.9pt;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center; text-indent: 42.55pt;">
<b style="mso-bidi-font-weight: normal;"><u><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; letter-spacing: -.9pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">PERMOHONAN
PENDAFTARAN PENCALONAN KEPALA DESA</span></u></b></div>
<div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center; text-indent: 42.55pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: justify; text-indent: 42.55pt;">
<span style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">Memenuhi ketentuan dalam Pengumumam Pendaftaran Bakal
Calon Kepala Desa Nomor 02/P2KD-P/VI/2013 <span style="mso-spacerun: yes;"> </span>tanggal 23 Juni 2013, dengan ini saya
sampaikan bahwa saya:</span><span style="font-family: "Times New Roman","serif";"></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif";">Nama Lengkap <span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>_______________________________________________________</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif";">Tempat, Tgl. Lahir/Umur<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;">
</span>________________________________________ / ________ Tahun</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif";">Jenis Kelamin<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;"> </span>_______________________________________________________</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif";">Pekerjaan<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;">
</span>_______________________________________________________</span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif";">Alamat<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;">
</span>Dusun ............................................................<span style="mso-spacerun: yes;"> </span>RT. _____<span style="mso-spacerun: yes;">
</span>RW. _____</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif";"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>Desa Pakistaji Kec. Kabat Kab. Banyuwangi.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif";">Nomor Telpon/HP<span style="mso-tab-count: 1;"> </span>:<span style="mso-spacerun: yes;">
</span>_______________________________________________________</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; tab-stops: 5.0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: IN;">dengan ini mengajukan diri untuk
mendaftar sebagai bakal calon Kepala Desa Pakistaji Kecamatan Kabat Sebagai
bahan pertimbangan, berikut surat ini saya lampirkan:</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-indent: 42.55pt;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-indent: 42.55pt;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-layout-alt: fixed; mso-yfti-tbllook: 1184; width: 680px;">
<tbody>
<tr style="height: 21.8pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="border: solid black 1.0pt; height: 21.8pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";">No.</span></b></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: solid black 1.0pt; height: 21.8pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" width="539"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";">Nama Persyaratan</span></b></div>
</td>
<td style="border-left: none; border: solid black 1.0pt; height: 21.8pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" width="76"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";">Jumlah</span></b></div>
</td>
<td style="border-left: none; border: solid black 1.0pt; height: 21.8pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" width="28"><div align="center" class="MsoListParagraph" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.7pt; margin-right: -3.25pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; tab-stops: 5.0cm; text-align: center; text-indent: -3.85pt;">
<span style="font-family: Wingdings; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ă¼<span style="font: 7.0pt "Times New Roman";"> </span></span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Times New Roman","serif";"> </span></b></div>
</td>
</tr>
<tr style="mso-yfti-irow: 1;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">1</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
Pernyataan tidak mengundurkan diri sebagai calon Kepala Desa yang berhak
dipilih</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 2;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">2</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
pernyataan kesanggupan pengunduran diri dari jabatannya, bagi yang berasal
dari PNS</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 3;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">3</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
pernyataan non aktif dari kepengurusan/keanggotaan, bagi yang berasal dari
partai politik dan surat keterangan dari pimpinan partai politik yang
bersangkutan</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 4;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">4</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
keterangan dokter pemerintah yang menyatakan sehat jasmani dan rohani</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 5;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">5</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
keterangan Ketua Pengadilan yang menyatakan tidak pernah dihukum penjara
karena melakukan tindak pidana yang diancam dengan pidana penjara paling
singkat 5 (lima) tahun.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 6;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">6</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
keterangan Ketua Pengadilan yang menyatakan tidak dicabut hak pilihnya
berdasarkan putusan pegadilan yang mempunyai kekuatan hukum tetap</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 7;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">7</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
pernyataan belum pernah menjabat menjadi Kepala Desa paling lama 10 (sepuluh)
tahun atau dua kali masa jabatan baik secara berturut-turut maupun tidak</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 8;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">8</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
ijin dari pejabat yang berwenang bagi yang berasal dari PNS, Pegawai lainnya.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 9;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">9</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
pernyataan pengunduran diri dari keanggotaan bagi yang berasal dari anggota
BPD</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 10;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">10</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
pernyataan pengunduran diri bagi yang berasal dari unsur perangkat desa.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 11;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">11</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
pernyataan kesediaan dicalonkan menjadi kepala desa.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 12;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">12</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Surat
keterangan catatan<span style="mso-spacerun: yes;"> </span>kriminal dan surat
keterangan bebas narkoba dari kepolisian.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 13;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">13</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Foto
copy Kartu Tanda Penduduk (KTP) dan foto copy akte kelahiran yang dilegalisir
atau disahkan oleh pejabat yang berwenang.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 14;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">14</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Daftar
riwayat hidup</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 15;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">15</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Foto
copy surat tanda lulus (Ijasah) yang dimiliki dan dilegalisir oleh pejabat
yang berwenang dengan menunjukkan aslinya.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
</tr>
<tr style="mso-yfti-irow: 16;">
<td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">16</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Naskah
Visi Misi dan program dari calon secara tertulis.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
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<tr style="height: 11.15pt; mso-yfti-irow: 17; mso-yfti-lastrow: yes;">
<td style="border-top: none; border: solid black 1.0pt; height: 11.15pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 28.15pt;" width="38"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">17</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 11.15pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-alt: solid windowtext .5pt; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 404.2pt;" valign="top" width="539"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<span style="font-family: "Times New Roman","serif"; font-size: 10.0pt;">Past
photo ukuran 4 x 6 berwarna dan hitam putih masing –masing 6 (enam) lembar.</span></div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 11.15pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 2.0cm;" valign="top" width="76"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
4 Lembar</div>
</td>
<td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 11.15pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 21.25pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; tab-stops: 5.0cm;">
<br /></div>
</td>
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<br /></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 42.55pt;">
<span class="a"><span style="font-family: "Times New Roman","serif";">Demikian
surat ini saya buat untuk dipergunakan sebagaimana mestinya.</span></span><span style="font-family: "Times New Roman","serif";">.</span></div>
<div align="center">
<table border="0" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: -1.7pt; mso-border-insideh: none; mso-border-insidev: none; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 1184;">
<tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; mso-yfti-lastrow: yes;">
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 255.6pt;" valign="top" width="341"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
</td>
<td style="padding: 0cm 5.4pt 0cm 5.4pt; width: 255.6pt;" valign="top" width="341"><div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif";">Bakal
Calon Kepala Desa Pakistaji,</span></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<br /></div>
<div align="center" class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<span style="font-family: "Times New Roman","serif";">(
...................................... )</span></div>
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<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm;">
<b>Catatan :</b><br />
<b>>> 4 Lembat = 1 asli 3 foto copy</b></div>
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<![endif]-->Anonymoushttp://www.blogger.com/profile/17542722354373685102noreply@blogger.com