LAMBANG KOP NASKAH DINAS
DAERAH SEKRETARIAT DAERAH
NOTULEN
Sidang/Rapat : ..........................................................................................
Hari/Tanggal : ......................../ ${tanggal_naskah}
Waktu Panggilan : ..........................................................................................
Waktu sidang/rapat : ..........................................................................................
Acara : 1. ......................................................................................
2. dan seterusnya
3. Penutup.
Pimpinan Sidang/Rapat
Ketua : ..........................................................................................
Sekretaris : ..........................................................................................
Pencatat : ..........................................................................................
Peserta sidang/rapat : 1. ......................................................................................
2. dan seterusnya.
Kegiatan Sidang/Rapat : 1. ......................................................................................
2. dan seterusnya.
1. Kata Pembukaan : ..........................................................................................
2. Pembahasan : ..........................................................................................
3. Peraturan : ..........................................................................................
PIMPINAN SIDANG/RAPAT
${jabatan_pengirim}
${ttd_pengirim}
${nama_pengirim}
.....Pangkat (isi manual)
NIP. ${nip_pengirim}