Contoh Tanda Bukti Pinjam Arsip

TANDA  BUKTI  PINJAMAN

Yang bertanda tangan dibawah  ini :

Nama NIP Unit Telepon Nomor

: : : :

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

Telah Meminjam Arsip :

Kode Nomor Perihal

: :

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

Dan akan mengembalikan pada tanggal : ......................................

    ......................, ............................ 2017

Petugas Yang Melayani : (.............................................)                      NIP. Mengetahui / Menyetujui : Kepala Unit Kearsipan, (..............................................)                     NIP.

Yang Meminjam, (...................................................)                   NIP.