Contoh Surat Keterangan berdomisili dalam bahasa inggris

PEMERINTAH KOTA LHOKSEUMAWE

                         KECAMATAN MUARA SATU

GAMPONG BLANG PANYANG

Jln. Medan- Banda  Aceh Km. 270, 5 Blang Panyang- Lhokseumawe

SURAT KETERANGAN PENDUDUK

NO .     474        / 769/KP /BLP /2013

Blang  Panyang  village head of  Muara One Lhokseumawe, Aceh Province explains that:

NAME                                     : HAMIDI

NIK                                         :117304302730001

PASSPORT NUMBER             : A. 27 280 35

SEX                                         : MALE

PLACE / DATE OF BIRTH     : VILLAGE  TEUMPOK TEUNGKU, 03-02-1973

MARITAL STATUS                : WEDDING

RELIGION                              : ISLAM

OCCUPATION                                    : SELF EMPLOYED                            :

ADDRESS                               : HAMLET II  Tgk. MONCARAK

VILLAGE                                : BLANG PANYANG

DISTRICT                               : MUARA ONE

CITY GOVERNMENT                        : LHOKSEUMAWE

THE CORRECT NAME IS ABOVE THE VILLAGE PEOPLE BLANG PANYANG, DISTRICT OF THE CITY OF ESTUARY LHOKSEUMAWE, ACEH PROVINCE.

THIS CERTIFICATE SO WE ACTUALLY DO WITH CAN BE USED FOR NECESSARY

BLANG PANYANG, 02 NOVEMBER 2013

                                                                                  VILLAGE HEAD BLANG PANYANG

                                                           IDRIS MAUN

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