Formulir KMD

 

RC][QH]HYHL RC[C]YH JS][S[ RCDMALH R]HDSJH YALNJHY IH[H] J^H]YA] KHMHLN NC]HJHL R]HDSJH [SJHMSDA YHGSL =2=8

8. RC RC][ ][QH QH]H ]HYH YHL L RC[ RC[C] C]YH YH

h. Ssah Ssah dala daladh dhee 8> 8> tthg hgul ul  m. [cght @hsdhla ihl ]fghla iamujtaj iamujtajhl hl surht jctcrhlnhl scght ihra Ifjtcr: k.

Dcd Dcdmhw mhwhh surht surht tunhs tunhs ihra ihra Nunus Nunus icph icphl: l:

i. Dcln Dclnas asaa m maf afih ihth th pcs pcscr crth th:: c. Dclna Dclnasa sa surht surht pcrlyhthhl pcrlyhthhl jcscia jcsciahhl hhl dcln dclnajut ajutaa sceurug sceurug prfscs prfscs jcnahthl jcnahthl JDI: JDI: o.

Dcdmhwh Dcdmhwh oftf mcrscrh mcrscrhnhd nhd Rrhdujh Rrhdujh ujurhl ujurhl ; x 9 scmhly scmhlyhj hj 9 (cdpht (cdpht)) ecdmhr  ecdmhr 

mhkjnrfuli dcrhg (iatueas lhdh eclnjhp): n. Dcdcluga Dcdcluga Jfltramu Jfltramusa sa pcscrth pcscrth JDI scmcshr scmcshr ]p. >32.222,>32.222,- (Yu`ug (Yu`ug ]h ]htus tus Ea Eadh dh Rueug ]amu). ]amu). =. JC JCYC YCLY LYSH SHL L ]C ]CNA NA[Y [Y]H ]H[A [A

Rclihothrh Rclih othrhl l Rcscrth Rcscrth Rhealn Rhealn Ehdmht Ehdmht 81 Lfvcdmcr Lfvcdmcr =2=8 iclnhl dclnaradjhl Mafihth Rcscrth ihl dcdmhyhr Jfltramusa scmcshr ]p. >32.222- jc OJ RJMD Jhmuphtcl [ujhmuda. Rcscrth dclihothr uehln phih ghra ……………… pujue ……………. ^AM ia ……………….., Jck. ……………..Jhmuphtcl [ujhmuda.

;. RC RC]E ]ECL CLNJ NJHR HRHL HL RC[ RC[C] C]YH YH

h. Fm Fmht ht-f -fmh mhth thl l pr pram amhi hia: a:  m. Dcdmhwh phjhahl [crhnhd Rrhdujh, mh`u nhlta, mh`u fehg rhnh, rhnh, ihl pcreclnjhphl pramhia. k.

Yclih

 

MAFIHYH RC[C]YH JS][S[ RCDMALH R]HDSJH YALNJHY IH[H] J^H]YA] KHMHLN NC]HJHL R]HDSJH JHM. [SJHMSDA YHGSL =2=8

Lhdh Stushl Jwhrrhl Ycdpht Yhlnnhe Ehgar @clas Jcehdal

▨ Ehja-ehja

▨ Rcrdpuhl

Hnhdh Hehdht c-dhae

Hehdht ]udhg

Lf GR Lf Ycep

Rcjcr`hhl

Hehdht Ycdpht Jcr`h Ycep Nunus Icphl scmhnha @hmhthl ia Ncrhjhl Rrhdujh

Jwhrtar ]hltaln scmhnha Jwhrtar Khmhln scmhnha

Rhlnjhehl / [cjfehg @cl`hln

Rcliaiajhl Sdul Ycrhjgar Lf

Jursus

Ycdpht Ycdpht

Yhgul Eueus Yhgul

8. Jursus Qhln Rcrlhg Iaajuta

=. ;. 9. 3.

.................... ,......… =2=8 Rcscrth,

 

[S]HY JC[HLNNSRHL RC[C]YH JS][S[ RCDMALH R]HDSJH YALNJHY IH[H] J^H]YA] KHMHLN NC]HJHL R]HDSJH JHM. [SJHMSDA YHGSL =2=8

Qhln mcrthlih thlnhl iamhwhg ala, shyh 0 Lhdh

0

Ycdpht, Yhlnnhe Ehgar

0

Hehdht

0

Iclnhl ala shyh

dclyhthjhl

shlnnup

dclnajuta

ihl

dclthhta

scnheh

jctcltuhl jcnahthl Jursus Rcdmalh Rrhdujh Yalnjht Ihshr yhln iasceclnnhrhjhl fecg Jwhrtar Khmhln Ncrhjhl Rrhdujh Rhsuruhl

hln nnhe =3 s.i phih thl

;8

Icscdmcr =2=8. Hphmaeh shyh dcehlnnhr, dhjh shyh sahp iamcrajhl shlnsa yhln mcrehju.

Icdajahl surht jcshlnnuphl ala shyh muht sckhrh shihr ihl thlph phjshhl ihra paghj dhlhpul.

..................... .......... .................,.... ......,...... ...…. .…. =2=8 Rcscrth