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MODEL A1 - KWK.KPU DAFTAR PEMILIH SEMENTARA PEMILIHAN GUBERNUR DAN WAKIL GUBERNUR JAWA BARAT TAHUN 2013 TPS DESA/KELUARAHAN 1) KECAMATAN NO. URUT 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

NOMOR PEMILIH PEMILIH KARTU KELUARGA 2 0 0 0 0 3207080604810003 3207080109070033 3207084807900003 3207080109070033 3207081601600003 3207080209080002 3207084310790002 3207080209080002 3207080708900006 3207080312100004 3207085203910002 3207080312100004 3207080707810003 3207080509070098 3207081812940001 3207080509070098 3207085006690002 3207080509070098 3207080607780011 3207081102080034 3207086609740001 3207081102080034 3207080107750062 3207081102080036 3207085002770003 3207081102080036 3207081310780001 3207081201090010 3207086804890002 3207081201090010

: 001 : PANJALU : PANJALU NAMA PEMILIH 3 LENI HIDAYATI ANDRY SETIAWAN RAMDAN KARTINI ASEP SULAEMAN RIKA DIAN NOORJANAH ACENG RAMLI MIMIN AMINAH IYAN SURYANA ELA NURLELA YAYAT FUJA SUZANA ONOK DENI AAY HARYATI ACENG JUJU JUMSIH YUYUS SITI JULAEHA

KAB/KOTA 1) PROVINSI Halaman

: CIAMIS : JAWA BARAT : ...

TEMPAT DAN TANGGAL LAHIR JENIS KELAMIN ALAMAT/TEMPAT TINGGAL STATUS UMUR/USIA PERKAWINAN (B/S/P) KETERANGAN 2) TEMPAT TANGGAL L P ALAMAT RT RW DUSUN 4 9 5 6 7 8 10 CIAMIS 26-06-1989 23 S P PABUARAN 001 001 PABUARAN CIAMIS 20-02-1988 25 S L PABUARAN 001 001 PABUARAN BANDUNG 04-04-1991 21 B L PABUARAN 001 001 PABUARAN BANDUNG 20-02-1970 43 S P PABUARAN 001 001 PABUARAN CIAMIS 06-04-1981 31 S L PABUARAN 001 001 PABUARAN CIAMIS 08-07-1990 22 S P PABUARAN 001 001 PABUARAN CIAMIS 16-01-1960 53 S L PABUARAN 001 001 PABUARAN CIAMIS 03-10-1979 33 S P PABUARAN 001 001 PABUARAN CIAMIS 07-08-1990 22 S L PABUARAN 001 001 PABUARAN CIAMIS 12-03-1991 21 S P PABUARAN 001 001 PABUARAN CIAMIS 07-07-1981 31 S L PABUARAN 001 001 PABUARAN CIAMIS 18-12-1994 18 B L PABUARAN 001 001 PABUARAN CIAMIS 10-06-1969 43 S P PABUARAN 001 001 PABUARAN CIAMIS 06-07-1978 34 S L PABUARAN 001 001 PABUARAN CIAMIS 26-09-1974 38 S P PABUARAN 001 001 PABUARAN CIAMIS 01-07-1975 37 S L PABUARAN 001 001 PABUARAN CIAMIS 10-02-1977 36 S P PABUARAN 001 001 PABUARAN CIAMIS 13-10-1978 34 S L PABUARAN 001 001 PABUARAN CIAMIS 28-04-1989 23 S P PABUARAN 001 001 PABUARAN

20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53

3207081004570001 3207081901950001 3207084404900002 3207085103590001 3207080805780002 3207084506740005 3207081410760001 3207084904810004 3207080211800002 3207084805390002 3207344205800001 3207080708870004 3207084401910001 3207084809810003 3207090704820003 3207081805870002 3207084112590002 3207082506890004 3207086606900004 3207082001890001 3207085511890002 3207080707780006 3207084311790001 3207085108570002 3207081204660005 3207082707650001 3207085502650002 3207080603770001 3207084102590001 3207084312470001 3207082008690001 3207084206450003 3207080211860002 3207084512860001

3207081205080003 3207081205080003 3207081205080003 3207081205080003 3207081205080011 3207081205080011 3207081205080035 3207081205080035 3207081509110008 3207081509110008 3207081509110008 3207081608100004 3207081608100004 3207081705100003 3207081705100003 3207081912110011 3207081912110011 3207082010080002 3207082010080002 3207082103120001 3207082103120001 3207082402110039 3207082402110039 3207082402110040 3207082402110042 3207082508070550 3207082508070550 3207082708070278 3207082708070278 3207082708070278 3207082708070286 3207082708070286 3207082708070291 3207082708070291

AIP RUSDIAN RIZAL MAULANA MUBAROQ FITRI SRI NURHAYATI P ESIH SETIASIH DEDE RAHMAT PARIKAH JAJA SUJANA SUMIATI AGUS SURAHMAN S.PD DJUARIAH MULYANI TRISNA SUTRISNA DESI TITA LESMANA EKA PRIMULA RUDI RAMDHANI FIRMANSYAH ETI RUSMIATI DIAN ROSDIANA RIKA ROHAYANI DIAN NURDIANSAH ERNI RISDIAWATI YANA DARSANA YULI SULASTRI NANI SUMARNI AYEP HIMAWAN KALIS CATUR PRABOWO YUYUN YUNIASIH MULYANA YEYET SUMIATI OOM ROMLAH DAYAT ODAH DENI MULYADI DINI HANDRIANI

CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BREBES CIAMIS GARUT CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS KENDAL CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS

10-04-1957 19-01-1995 04-04-1990 11-03-1959 08-05-1978 05-06-1974 14-10-1976 09-04-1981 02-11-1980 08-05-1939 02-05-1980 07-08-1987 04-01-1991 08-09-1981 07-04-1982 18-05-1987 01-12-1959 25-06-1989 26-06-1990 20-01-1989 15-11-1989 07-07-1978 03-11-1979 11-08-1957 12-04-1966 27-07-1965 15-02-1965 06-03-1977 01-02-1959 03-12-1947 20-08-1969 02-06-1945 02-11-1986 05-12-1986

55 18 22 53 34 38 36 31 32 73 32 25 22 31 30 25 53 23 22 24 23 34 33 55 46 47 48 35 54 65 43 67 26 26

S B B S S S S S S P S S S S S B P S S S S S S B S S S B B P S S S S

L L P P L P L P L P P L P P L L P L P L P L P P L L P L P P L P L P

PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87

3207080107310007 3207084107370034 3207080702950002 3207081212860002 3207082304540001 3207084903550001 3207081805870001 3207085107520002 3207081205760003 3207085910820001 3207080203510001 3207084302600003 3207080908750001 3207084907810001 3207080404570001 3207081404810001 3207081804910001 3207084507650002 3207086605940001 3207081407770001 3207084808860004 3207081103770002 3207085304810001 3207082608800001 3207085707590001 3207082712740002 3207084805930001 3207084508470002 3207084304400001 3207080211300001 3207081808810001 3207085208850001 3207080808600002 3207085403590002

3207082708070294 3207082708070294 3207082708070299 3207082708070299 3207082708070299 3207082708070299 3207082708070312 3207082708070312 3207082708070315 3207082708070315 3207082708070323 3207082708070323 3207082708070330 3207082708070330 3207082708070335 3207082708070335 3207082708070335 3207082708070335 3207082708070335 3207082708070338 3207082708070338 3207082708070339 3207082708070339 3207082708070340 3207082708070340 3207082708070341 3207082708070341 3207082708070342 3207082708070345 3207082708070346 3207082708070474 3207082708070474 3207082708070491 3207082708070491

II JUMRI ENI DADAN PEBRIAN MAMAT ROHIMAT RUSDI DEDEH KURNIATI UJANG RAHMAT HIDAYAT INAH SUPRIATIN AIP SARIPUDIN ENUNG NURHAYATI IKIN SUPRIADI SUKAESIH DAHLAN SUSI DHANIAWATI ENGKUS YAYAN ERIS SUHARDI EUIS ELIS SOLIHAH CUCU SURYA NENDAH SUMIATI ADE SUPRIADI SARI ARA SUHARA SITI ROHAYATI DIDIN ROSIDIN NUNUNG SETIAWATI ATJAH ADIARESMI NEWI ISRO OSID ROSIDIN HERAWATI MAMAN SUHERMAN UPI SUPIAH

CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS CIAMIS TASIKMALAYA MAJALENGKA CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS

01-07-1931 01-07-1937 07-02-1995 12-12-1986 23-04-1954 09-03-1955 18-05-1987 11-07-1952 12-05-1976 19-10-1982 02-03-1951 03-02-1960 09-08-1975 09-07-1981 04-04-1957 14-04-1981 18-04-1991 05-07-1965 26-05-1994 14-07-1977 08-08-1986 11-03-1977 13-04-1981 26-08-1980 17-07-1959 27-12-1974 08-05-1993 05-08-1947 03-04-1940 02-11-1930 18-08-1981 12-08-1985 08-08-1960 14-03-1959

81 75 18 26 58 57 25 60 36 30 61 53 37 31 55 31 21 47 18 35 26 35 31 32 53 38 19 65 72 82 31 27 52 53

S S B B S S B P S S S S S S S B B S B S S S S B P S S P P P S S S S

L P L L L P L P L P L P L P L L L P P L P L P L P L P P P L L P L P

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121

3207081003640001 3207084702950001 3207084902670001 3207080604760003 3207086912790002 3207080311650001 3207086707770002 3207082304740002 3207084511770001 3207082003330001 3207084506450001 3207080107750036 3207087009770003 3207082508950002 3207082809690002 3207084107720033 3207085710910004 3207080305710001 3207084112410001 3207081707600001 3207084306660001 3207085609940004 3207086510890003 3207080211850001 3207081510630002 3207082407940001 3207085112920002 3207086603620001 3207080107500054 3207082812870001 3207085009570002 3207085409910002 3207085204540002 3207086801930001

3207082708070502 3207082708070502 3207082708070502 3207082708070514 3207082708070514 3207082708070533 3207082708070533 3207082708070544 3207082708070544 3207082708070552 3207082708070552 3207082708070556 3207082708070556 3207082708070563 3207082708070563 3207082708070563 3207082708070563 3207082708070574 3207082708070574 3207082708070584 3207082708070584 3207082708070584 3207082708070584 3207082708070593 3207082708070593 3207082708070593 3207082708070593 3207082708070593 3207082808070008 3207082808070008 3207082808070008 3207082808070008 3207082808070019 3207082808070019

NANA SUHARYANA YANI CAHYANI ESIN KARMINI DUDUNG ABUBAKAR CICIH WIDANINGSIH MAMAT EMPAT PATIMAH IYAN SOPYAN WIWIN WIDIYAWATI SAHRI ESIH NANA ROMANSYAH HELI SUSANTI ATEP HERMAWAN DADANG HERMAWAN ANIH HANI SULASTRI HERMAWAN HUSEN MIMIN MAMAD ADE SUSANTO WAWAT SUMIATI WIYANTI RATNA RUBIYANTI SANDRA ROSDIANA OSID ROSYADIN DIKI ARIS ROSDIANA MIRA DELIS ROSDIANA TATI SITI AMINAH DAYAT SUJANA HERI HERNAWAN ERAM RAMSIH WINDANINGSIH AMI INDALASARI

CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS CIAMIS CIAMIS GARUT CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BEKASI CIAMIS CIAMIS GARUT CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS

10-03-1964 07-02-1995 09-02-1967 06-04-1976 29-12-1979 03-11-1965 27-07-1977 23-04-1974 05-11-1977 20-03-1933 05-06-1945 01-07-1975 30-09-1977 25-08-1995 28-09-1969 01-07-1972 17-10-1991 03-05-1971 01-12-1941 17-07-1960 03-06-1966 16-09-1994 25-10-1989 02-11-1985 15-10-1963 24-07-1994 11-12-1992 26-03-1962 01-07-1950 28-12-1987 10-09-1957 14-09-1991 12-04-1954 28-01-1993

48 18 46 36 33 47 35 38 35 79 67 37 35 17 43 40 21 41 71 52 46 18 23 27 49 18 20 50 62 25 55 21 58 20

S B S S S S S S S S S S S B S S B B P S S B B B S B S S S B S B P B

L P P L P L P L P L P L P L L P P L P L P P P L L L P P L L P P P P

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155

3207081108660001 3207081412940001 3207085207700001 3207081407730001 3207084906780003 3207080305910002 3207081209610001 3207084506670002 3207080601470001 3207080607800001 3207084705900001 3207085101520001 3207082510720001 3207084107790039 3207080305580002 3207084107640085 3207081606320001 3207080705780002 3207082004760001 3207084806810003 3207081902570001 3207085304660001 3207082612760001 3207084408760004 3207081709600001 3207083112920003 3207087004720001 3207080211850002 3207081609590001 3207082310900001 3207086712620002 3207080804460002 3207084508480001 3207082212750002

3207082808070022 3207082808070022 3207082808070022 3207082808070042 3207082808070042 3207082808070049 3207082808070049 3207082808070049 3207082808070065 3207082808070065 3207082808070065 3207082808070065 3207082808070078 3207082808070078 3207082808070088 3207082808070088 3207082808070094 3207082808070098 3207082808070105 3207082808070105 3207082808070128 3207082808070128 3207082808070147 3207082808070147 3207082808070156 3207082808070156 3207082808070156 3207082808070167 3207082808070167 3207082808070167 3207082808070167 3207082808070182 3207082808070182 3207082808070186

YUYU YUNUS PANDU TRULYAN LINA HERLINA NANA SAHDI YENI SUMARNI DEDI SUPRIADI MEMET IRAWAN NANI SUMARNI ERI JUHAERI DEDI CANDRA NENI NURAENI ESIN KURAESIN INAN SURYAMAN ENOK SITI HODIKOH UU TARYU ERAT RATNANINGSIH UHO IWAN HERMAWAN AGUS SETIAWAN ROSITA DARSA EROS ROSMIATI DADANG AHMAN HIDAYAT NIN GARTINI JUMAN MUHLIS JAOHARUDIN DEDEH AISAH BULDAN FARJAMAN SUHERMAN ERLI ARIA NUGRAHA NINA NURHASANAH EMAN SULAEMAN MIMIN AMINAH YEYENG

CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS

11-08-1966 14-12-1994 12-07-1970 14-07-1973 09-06-1978 03-05-1991 12-09-1961 05-06-1967 06-01-1947 06-07-1980 07-05-1990 11-01-1952 25-10-1972 01-07-1979 03-05-1958 01-07-1964 16-06-1932 07-05-1978 20-04-1976 08-06-1981 19-02-1957 13-04-1966 26-12-1976 04-08-1976 17-09-1960 31-12-1992 30-04-1972 02-11-1985 16-09-1959 23-10-1990 27-12-1962 08-04-1946 05-08-1948 22-12-1975

46 18 42 39 34 21 51 45 66 32 22 61 40 33 54 48 80 34 36 31 56 46 36 36 52 20 40 27 53 22 50 66 64 37

S B S S S B S S S B B S S S S S P P S S S S S S S B S B S B S S S S

L L P L P L L P L L P P L P L P L L L P L P L P L L P L L L P L P L

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189

3207085007820001 3207081511720001 3207085410950002 3207086005740003 3207082009720003 3207084203780002 3207082002860001 3207087101850001 3207080109730002 3207084705790002 3207081404850002 3207084503800002 3207080107490042 3207082210890001 3207084107580046 3207330802770001 3207334408780003 3207081204810002 3207084512860003 3207080111670002 3207086506790001 3207080202720001 3207083004950001 3207084403770001 3207081008860003 3207084101870002 3207080306590002 3207082808940002 3207082911890001 3207085003680002 3207080602570001 3207085212750002 3207080501800002 3207085608810002

3207082808070186 3207082808070199 3207082808070199 3207082808070199 3207082812100003 3207082812100003 3207082908070179 3207082908070179 3207083010070036 3207083010070036 3207080109090002 3207080109090002 3207080609070090 3207080609070090 3207080609070090 3207080905110003 3207080905110003 3207081009080003 3207081009080003 3207081205080005 3207081205080005 3207081205080010 3207081205080010 3207081205080010 3207081205080015 3207081205080015 3207081205080036 3207081205080036 3207081205080036 3207081205080036 3207081206080001 3207081206080001 3207081303120006 3207081303120006

TETI SULASTRI MOMO SUDARMO MONITA OKTAVIANI NIA KURNIA HENDRA GUNAWAN S.SOS HJ MERSIYANA HERAWATI AJAT SUDRAJAT MYA MERLIAN YADI HARYADI NURKAMILA ENGKOS LIA SUNIASIH SAID ADE YONO SUGIONO JUJU JUHANAH OLIH SOLIHIN TITIN HASANAH ADING IRAWATI MAMAN ROYANDI RINI SUMARTINI DIDIN ROSIDIN PIKI ABDUROHMAN IMAS INDRA DETI NURAENI OMO SUDARMO PAHMI NURJAMAN ERDI HERDIANA NANI NARSIH IIN SOLIHIN WANGSIH ENGKUS KUSTIAWAN YATI NURAJIJAH

CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS MAGELANG CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG GARUT CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS CIAMIS

10-07-1982 15-11-1972 14-10-1995 20-05-1974 20-09-1972 02-03-1978 20-02-1986 31-01-1985 01-09-1973 07-05-1979 14-04-1985 05-03-1980 01-07-1949 22-10-1989 01-07-1958 08-02-1977 04-08-1978 12-04-1981 05-12-1986 01-11-1967 25-06-1979 02-02-1972 30-04-1995 04-03-1977 10-08-1986 01-01-1987 03-06-1959 28-08-1994 29-11-1989 10-03-1968 06-02-1957 12-12-1975 05-01-1980 16-08-1981

30 40 17 38 40 34 27 28 39 33 27 32 63 23 54 36 34 31 26 45 33 41 17 35 26 26 53 18 23 44 56 37 33 31

S S B S S S S S S S S S S B S S S S S S S S B S S S S B B S S S S S

P L P P L P L P L P L P L L P L P L P L P L L P L P L L L P L P L P

001 001 001 001 001 001 001 001 001 001 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223

3207081707710003 3207086512800004 3207081307660004 3207084904680003 3207080302610001 3207085801810001 3207082302840002 3207334407900001 3207084107310011 3207084603520002 3207081504890001 3207084212920002 3207086107550001 3207082004590001 3207085909600002 3207081206510001 3207085708460001 3207081708820006 3207085903820001 3207081608480001 3207080801960001 3207081004910001 3207081405690001 3207085707700001 3207084206450002 3207084107250007 3207081603730001 3207085008740001 3207084502320001 3207080608870004 3207081401780001 3207081405930003 3207081505490001 3207086008650001

3207081305080026 3207081305080026 3207081307080007 3207081307080007 3207081509110007 3207081509110007 3207081904100005 3207081904100005 3207082010090001 3207082202110026 3207082202110031 3207082202110031 3207082202110031 3207082202110061 3207082202110061 3207082308070218 3207082308070218 3207082308070232 3207082308070232 3207082308070248 3207082308070259 3207082308070259 3207082308070259 3207082308070259 3207082308070277 3207082308070293 3207082308070332 3207082308070332 3207082308070345 3207082308070384 3207082308070384 3207082308070384 3207082308070384 3207082308070384

KUSNADI YAYAH CECEP ROJAK MAULIDIN YAYAN CAHYANI ENCENG TATA SUDARTO IMAS MASITOH FEBI DWI CAHYA YATI ROHAYATI ONIH POPONG PEPEN HANAPIAH RITA JUWITA DEWI ENI ROHAENI ARIP SUKMANA ADE WARTI NINGRUM ESO WISNU EBAH ANAN WAHYUNI SARONI HENDRI HERDIANSYAH HENDAR IMAN ROMDONI NANA SUHANA NANI SUMARNI UNEH IJAH DARYO NUNING SURYANI SITI ARUM RAHMAT HIDAYAT OSIM KOSIM ENJANG SUMARNA IKIN ASIKIN WIWIN WINIGSIH

CIAMIS CIAMIS BANDUNG BANDUNG CIAMIS TASIKMALAYA CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS PURWEREJO CIAMIS CIAMIS CIAMIS TASIKMALAYA CIAMIS CIAMIS PEMALANG CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS

17-07-1971 25-12-1980 13-07-1966 09-04-1968 03-02-1961 18-01-1981 23-02-1984 04-07-1990 01-07-1931 06-03-1952 15-04-1989 02-12-1992 21-07-1955 20-04-1959 19-09-1960 12-06-1951 17-08-1946 17-08-1982 19-03-1982 16-08-1948 08-01-1996 10-04-1991 14-05-1969 17-07-1970 02-06-1945 01-07-1925 16-03-1973 10-08-1974 05-02-1932 06-08-1987 14-01-1978 14-05-1993 15-05-1949 20-08-1965

41 32 46 44 52 32 29 22 81 60 23 20 57 53 52 61 66 30 30 64 17 21 43 42 67 87 39 38 81 25 35 19 63 47

S S S S S S S S P P B B P S S S S S S S B B S S S P S S P B B B S S

L P L P L P L P P P L P P L P L P L P L L L L P P P L P P L L L L P

002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257

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3207082308070398 3207082308070398 3207082308070398 3207082308070437 3207082308070437 3207082308070437 3207082308070453 3207082308070453 3207082308070462 3207082308070477 3207082308070490 3207082308070490 3207082308070501 3207082308070501 3207082308070501 3207082308070516 3207082308070523 3207082308070523 3207082308070545 3207082308070545 3207082401110001 3207082401110001 3207082407090001 3207082408070097 3207082408070108 3207082408070108 3207082408070124 3207082408070124 3207082408070124 3207082408070138 3207082408070138 3207082408070138 3207082408070144 3207082408070144

ACENG MAMAN DEWI LISNAWATI PRIYATI PRIYAMAN RESTI DAMAYANTI PRIYESTI SURYATI AHMAD SYARIP DEDEH MAHMUDIN JAENUDIN YANA SUPRIATNA IKA ISMAYA JAJANG KURNIAWAN AGUS SUMARNA TINI KARTINI ADIS PRIYATA HERMIYATI DJUARIAH KARMUDIN SAPEI CEPI GUNTARA ELIS SIRLI NURENDAH ODAH SAADAH HENDRA SITI PATIMAH TATI KURNIAWATI GUSNARA SITI AISAH SITI UTARA DEDI NELI VITRIANI NANI SUMARNI WAKIDI CUCU KURNIATI

CIAMIS CIAMIS CIAMIS MAJALENGKA TASIKMALAYA TASIKMALAYA CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS CIAMIS GARUT CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS WONOGIRI CIAMIS

01-07-1958 01-02-1995 20-10-1963 24-11-1965 09-12-1992 19-06-1970 08-08-1980 03-02-1986 08-09-1946 30-04-1990 29-10-1980 08-04-1988 06-01-1990 19-03-1963 10-12-1968 25-12-1978 27-04-1939 01-01-1945 06-04-1975 10-10-1936 13-03-1990 12-02-1992 04-12-1942 01-07-1977 01-07-1940 22-03-1962 08-12-1939 06-06-1979 16-04-1953 06-06-1966 04-04-1995 22-02-1969 25-12-1958 01-07-1978

54 18 49 47 20 42 32 27 66 22 32 24 23 49 44 34 73 68 37 76 22 21 70 35 72 50 73 33 59 46 17 44 54 34

S B S S B S S S S B S S B S S B S S B S S S P S P P S B S S B S S S

L P P L P P L P L L L P L L P L L P L L L P P L P P L P P L P P L P

002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291

3207085306450001 3207080107490019 3207081603940003 3207081605570002 3207084105650001 3207083108870001 3207084512620001 3207082004730001 3207086201820002 3207080810750001 3207082307450001 3207086808930001 3207087011550001 3207084503800001 3207082505770001 3207086306780002 3207081002430001 3207081504830002 3207084202870001 3207081609420001 3207082307830001 3207084704470002 3207082307780001 3207086403840002 3207080312590001 3207084104700001 3207085107900001 3207081202480002 3207084506620001 3207080503740002 3207082702880001 3207084102690002 3207080410570001 3207082005920001

3207082408070160 3207082408070178 3207082408070182 3207082408070182 3207082408070182 3207082408070194 3207082408070194 3207082408070203 3207082408070203 3207082408070213 3207082408070213 3207082408070213 3207082408070213 3207082408070228 3207082408070232 3207082408070232 3207082408070245 3207082408070245 3207082408070245 3207082408070568 3207082408070568 3207082408070568 3207082508070167 3207082508070167 3207082508070171 3207082508070171 3207082508070171 3207082508070179 3207082508070179 3207082508070243 3207082508070243 3207082508070243 3207082508070250 3207082508070250

E.ATIKAH WARDI SOMA ADE ROBI ROBIANSYAH ANAS SUBARNAS YUYU RUHYATI ASEP HERDIANA DAYUDIN OOM SITI ROHIMAH DENI HERMANSYAH HERLIN SUPARTINI ADE MAMAT UDIN JAENUDIN WIKA NIRMALA NINING SUMIATI LIA SUMIATI OMAN RUKMAN ATIKAH OOH JUHADI ANI NURAENI IIN MASRIAH DEDE SUNARYADINATA ROFA AHADIYAT FARID IING SUKILAH EDI SETIADI ADE LISNA WATI SUDIANA SRI ARYATI YULIA ARYANTINA LUKMAN PAIJO JUNAH YUNINGSIH MAMAN ROHMAN ENDANG SUHERMAN NENOH DARMAN SUSILA WINATA ARIEF HERMAWAN

CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS TASIKMALAYA CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG BANDUNG

13-06-1945 01-07-1949 16-03-1994 16-05-1957 01-05-1965 31-08-1987 05-12-1962 20-04-1973 22-01-1982 08-10-1975 23-07-1945 28-08-1993 30-11-1955 05-03-1980 25-05-1977 23-06-1978 10-02-1943 15-04-1983 02-02-1987 16-09-1942 23-07-1983 07-04-1947 23-07-1978 24-03-1984 03-12-1959 01-04-1970 11-07-1990 12-02-1948 05-06-1962 05-03-1974 27-02-1988 01-02-1969 04-10-1957 20-05-1992

67 63 18 55 47 25 50 39 31 37 67 19 57 32 35 34 70 29 26 70 29 65 34 28 53 42 22 65 50 38 24 44 55 20

P P B S S B S S S B S B S P S S P B B S B S S S S S B S S S B S S B

P L L L P L P L P L L P P P L P L L P L L P L P L P P L P L L P L L

002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324

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3207082508070250 3207082508070250 3207082508070261 3207082508070261 3207082508070267 3207082508070267 3207082508070267 3207082508070278 3207082508070278 3207082508070278 3207082508070288 3207082508070288 3207082508070288 3207082508070299 3207082508070299 3207082508070299 3207082508070299 3207082508070308 3207082508070308 3207082508070316 3207082508070591 3207082508070591 3207082608080003 3207082608080003 3207082910110006 3207082910110006 3207083005080005 3207083108070166 3207083108070166 3207083108070166 3207083108070166 3207083108070166 3207083108070166 3207082308070369

ESIH RATNANINGSIH NENI NURAENI IYOS ROSKENDAR IMAS HERLINA ALDI RAMANDA RUSPIADI WIWI SUHARTIWI YANA SURYANA NANAN SETIANA ROHMAH ENDANG KUSWANDA TEGUH KHUSNA SURYADINATA NURHAYATI API SUPARMAN SONI MARDIANA CUCU GUSNIAWAN TIAH SUMARTINI UCU SAMSU IIS KURNIASIH SITI SURAHMIN AAN LILIS SULASTRI YAYAT RUHIAT SRI WIDANINGSIH JAJAT SUDRAJAT SITI MARYAM ENCUM USMAN GUNARDI KURNIAWAN AGUS HIDAYAT DODI RAHMADI CECEP ANUR GUMILAR MINI RUKMINI ENI SUMARNI DEDI SUNARYA

CIAMIS BANDUNG CIAMIS CIAMIS BANDUNG BANDUNG BANDUNG CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS MAJALENGKA MAJALENGKA MAJALENGKA CIAMIS CIREBON CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS BANDUNG CIAMIS BANDUNG BANDUNG CIAMIS

13-10-1962 20-01-1986 20-02-1966 02-02-1974 10-04-1991 10-11-1960 13-12-1970 06-06-1970 11-11-1989 07-05-1971 12-01-1966 18-08-1993 23-07-1968 15-03-1957 18-03-1984 24-08-1987 06-04-1954 05-06-1969 05-10-1979 15-05-1942 05-05-1977 09-09-1984 02-04-1978 04-05-1982 20-10-1981 18-05-1985 01-07-1942 05-09-1978 11-08-1961 21-04-1986 22-09-1989 04-05-1958 18-08-1980 08-07-1962

50 27 47 39 21 52 42 42 23 41 47 19 44 55 28 25 58 43 33 70 35 28 34 30 31 27 70 34 51 26 23 54 32

S B S S B S S S B S S B S S B B S S S P S S S S S S P B S B B S P 50 B

P P L P L L P L L P L L P L L L P L P P L P L P L P P L L L L P P L

002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002

001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001 001

325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356

3207082309660001 3207084107450008 0 0 3207082006810002 3207085604770001 3207071502720001 3207075612750002 3207084101810003 3207082505840001 3207086707850001 3207081505730002 3207084905850006 3207082310730001 3207086303820004 3207081610800002 3207084511820001 3207082811780002 3207084601770004 3207080402550001 3207085402560001 3207081502500001 3207085705450001 3207086508900001 3207080107560022 3207081301730001 3207082808810005 3207086209560001 3207080312530002 3207087108880001 3207082505740001 3207084708800001 3207080302920001 3207083012640001

3207082308070369 3207082508070284

3207080406120002 3207080406120002 3207080706110004 3207080706110004 3207080907080001 3207081310100012 3207081310100012 3207082110090007 3207082110090007 3207082110090008 3207082110090008 3207082406100001 3207082406100001 3207082408070166 3207082408070166 3207082508070414 3207082508070414 3207082508070423 3207082508070423 3207082508070423 3207082508070429 3207082508070429 3207082508070429 3207082508070429 3207082508070434 3207082508070434 3207082508070440 3207082508070440 3207082508070448 3207082508070448

MAMAY YAYAH ROKAYAH LILIS MULYATI MINDA SUHADA FIRMANSYAH RACHMANI DEDE SYARIFUDIN NENGSIH LAELA ROHMAH AAN SUMARNA ARI YULI PRAMAYANTI TETEN SETIANA LETI KUSUMAWATI EKA SUKMAWAN YENI MULYANI ANDI RISWANDI NUNUR NURHAENI HENDRA TETI HARYATI MAMAN PERMANA YETI SUMIATI AHUM SUJAI AAH SARIAH SRI LESTARI NONO KARNO OYO WAHYO YADI SUPRIADI UAS WASNIASIH OHIM YANI SUMARNI ENDANG NINING JUANINGSIH SIGIT PERMADI JAI TARKAS

CIAMIS CIAMIS KARAWANG PALEMBANG PALEMBANG BANDUNG CIAMIS CIAMIS CIAMIS CIAMIS GARUT CIAMIS CIAMIS BANDUNG GARUT CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS GARUT CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS GARUT CIAMIS CIAMIS CIAMIS

23-09-1966 01-07-1945 20-06-1985 19-11-1983 20-06-1981 16-04-1977 15-02-1972 16-12-1975 01-01-1981 25-05-1984 27-07-1985 15-05-1973 09-05-1985 23-10-1973 23-03-1982 16-10-1980 05-11-1982 28-11-1978 06-01-1977 04-02-1955 14-02-1956 15-02-1950 17-05-1945 25-08-1990 01-07-1956 13-01-1973 28-08-1981 22-09-1956 03-12-1953 31-08-1988 25-05-1974 07-08-1980 03-02-1992 30-12-1964

27 29 31 35 41 37 32 28 27 39 27 39 30 32 30 34 36 58 57 63 67 22 56 40 31 56 59 24 38 32 21 48

46 P 67 P S S B B S S P S S S S S S S S S S S S S S B S B B S P B S S B S

L P P L L P L P P L P L P L P L P L P L P L P P L L L P L P L P L L

002 002 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003

001 001 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002

357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390

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3207082508070448 3207082508070457 3207082508070457 3207082508070457 3207082508070470 3207082508070470 3207082508070470 3207082508070480 3207082508070480 3207082508070480 3207082508070490 3207082508070490 3207082508070501 3207082508070501 3207082508070501 3207082508070501 3207082508070510 3207082508070510 3207082508070514 3207082508070514 3207082508070518 3207082508070518 3207082508070526 3207082508070535 3207082508070535 3207082508070537 3207082508070537 3207082508070543 3207082508070543 3207082508070559 3207082508070559 3207082508070567 3207082508070567 3207082508070567

ATIN PRIYATIN ASEP AHMAD RAMDANI YUDI HARIS ANDRIANSYAH KOKOM KOMARIAH MUHAMAD ROJALI MUHAMMAD EKO PRASETYO LILIS YUYUN YUHARAS E RASWA ROSALINA INDRIANI YULI SURYANI SALEH WIRAATMADJA R.SITI KAMSAH AMAS HIDAYAT TAUFIK FATUROHMAN HIDAYAT SANDY SOFA HIDAYAT SUPIASIH RIDWAN ENAN SURYANTINA YEYEN SETIAWAN KARTIKA PURNAMASARI DJUMHANA HETY ROHAYATI JAJANG BUDIMAN GALIH NATAKUSUMAH JUNAH DADAN SUKMA PERMANA NURHAENI YADI BUDIMAN LELI KARNIA DEWI IWAN SETIAWAN EROS ROSTIKA ENTIS SUTISNA GUGUN GUMILAR CICIH MINTARSIH

CIAMIS BANDUNG BANDUNG CIAMIS JAKARTA CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS TASIKMALAYA CIAMIS CIAMIS JAKARTA CIAMIS BANDUNG TASIKMALAYA PONTIANAK CIAMIS CIAMIS CIANJUR TASIKMALAYA CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS

08-05-1969 01-08-1991 07-06-1987 21-06-1952 05-06-1963 06-10-1991 28-06-1966 03-09-1960 12-06-1994 20-07-1968 04-06-1932 16-02-1936 20-06-1959 21-01-1996 24-05-1990 29-09-1962 23-08-1947 14-06-1952 02-02-1974 22-10-1981 10-10-1948 09-12-1954 12-03-1942 05-03-1988 27-07-1929 27-01-1975 02-08-1987 30-09-1976 15-07-1986 24-10-1983 09-10-1987 03-06-1965 28-10-1992 01-02-1970

43 21 25 60 49 21 46 52 18 44 80 77 53 17 22 50 65 60 39 31 64 58 70 24 83 38 25 36 26 29 25 47 20 43

S B B P S B S S B S S S S B B S S S S S S S P B P S S S S S S S B S

P L L P L L P L P P L P L L L P L P L P L P L L P L P L P L P L L P

003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003

002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002

391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424

3207080402520002 3207085104550002 3207080508570002 3207084603950001 3207080512460001 3207082610700002 3207084809810002 3207080604620003 3207081010900002 3207086008720001 3207081006940004 3207084107340011 3207086003850002 3207086004650001 3207081006760001 3207085007780001 3207080707790001 3207084101900003 3207081708740002 3207086209790002 3207080605820001 3207085708840002 3207081303380001 3207085506440001 3207083101740001 3207084701860001 3207080604870002 3207081105550002 3207084208580001 3207080107680014 3207081004900001 3207084107680028 3207080203570001 3207081005900002

3207082508070586 3207082508070586 3207082508070598 3207082508070598 3207082508070607 3207082608070230 3207082608070230 3207082608070237 3207082608070237 3207082608070237 3207082608070243 3207082608070243 3207082608070243 3207082608070243 3207082608070249 3207082608070249 3207082608070257 3207082608070257 3207082608070263 3207082608070263 3207082608070271 3207082608070271 3207082608070279 3207082608070279 3207082608070285 3207082608070285 3207082608070295 3207082608070295 3207082608070295 3207082608070301 3207082608070301 3207082608070301 3207082608070311 3207082608070311

DAYAT HIDAYAT TATI HANDAYANI EDED PERMANA MARTHA ROSA RINA MAMAD TATANG RIDWAN ISUS SUSANA MAMAN SUHERMAN PAJAR MAULANA IDA ROSIDA JUJUN GUNAWAN ISAH PRITA PERDAYANI NIA KURNIASIH MAMAN SUDIRMAN DIAN SUHAENI ENDANG SOLIHIN IIS SUMIATI UTANG MULYANA ROSSY NURHAYATI YOYO IIS ROHIMAH AMAN K. KURNIASIH YEDI MULYADI YUNI YULIANI IYAN SUPIANDI DIAT HADIAT DEDE ROHANAH SARIFUDIN ANDRI SOBARI ENDOH CAHYATI MEMED ATMAJA KENDI MARDIANSYAH

CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS GARUT CIAMIS CIAMIS CIAMIS TASIKMALAYA CIAMIS CIAMIS CIAMIS MAJALENGKA CIAMIS CIAMIS CIAMIS CIAMIS CIANJUR CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS

04-02-1952 11-04-1955 05-08-1957 06-03-1995 05-12-1946 26-10-1970 08-09-1981 06-04-1962 10-10-1990 20-08-1972 10-06-1994 01-07-1934 20-03-1985 20-04-1965 10-06-1976 10-07-1978 07-07-1979 01-01-1990 17-08-1974 22-09-1979 06-05-1982 17-08-1984 13-03-1938 15-06-1944 31-01-1974 07-01-1986 06-04-1987 11-05-1955 02-08-1958 01-07-1968 10-04-1990 01-07-1968 02-03-1957 10-05-1990

61 57 55 17 66 42 31 50 22 40 18 78 27 47 36 34 33 23 38 33 30 28 74 68 39 27 25 57 54 44 22 44 55 22

S S P B P S S S B S B P B P S S S S S S S S S S S S B S S S B S S B

L P L P L L P L L P L P P P L P L P L P L P L P L P L L P L L P L L

003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003 003

002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002 002

425 426 427 428 429 430 431 432 433 434 435 436

3207081909870001 3207085608650001 3207081312750001 3207085009780001 3207082311730001 3207085506740002 3207087009950001 3207081702560001 3207085702580001 3207085810930003 3207086705860001 3207084808500002

3207082608070311 3207082608070311 3207082608070320 3207082608070320 3207082608070325 3207082608070325 3207082608070325 3207082608070334 3207082608070334 3207082608070334 3207082608070334 3207082308070248

SONNY SOPYAN DEDE SAADAH ENDANG HIDAYAT ANI HERYANI WAHYU SUTISNA IDA ROSIDA SELLY WIDYA WATI DARMAN ESIN KURNIASIH RIRI NIDYA BUDIARTI RIZKY PUSPITA WULANDARI ATING

CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS BANDUNG CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS CIAMIS

19-09-1987 16-08-1965 13-12-1975 10-09-1978 23-11-1973 15-06-1974 30-09-1995 17-02-1956 17-02-1958 18-10-1993 27-05-1986 08-08-1950

25 47 37 34 39 38 17 57 55 19 26 62

B S S S S S B S S B B S

L P L P L P P L P P P P

PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN

003 003 003 003 003 003 003 003 003 003 003 002

002 002 002 002 002 002 002 002 002 002 002 001

PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN PABUARAN

............., ............... Catatan: Status Perkainan: B = Belum nikah S = Sudah nikah P = Pernah nikah Jenis Kelamin: Lk = Laki-laki Pr = Perempuan 1) = Coret yang tidak perlu 2) = Cacat yang disandang pemilih kalau ada

Disahkan dalam Rapat Pleno PPS Tanggal ...... PANITIA PEMUNGUTAN SUARA Nama

Tanda Tangan

1. Ketua

ENDEH SUKAJAT

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

2. Anggota

MOHAMAD SAMSA

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

3. Anggota

RINA ROHAETI

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