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Lampiran 8

FORM PENEBUSAN PUPUK BERSUBSIDI


KIOS PENGECER LENGKAP (KPL) : SAHAB AT WATES

Nama Petani :
NIK :
Nama Poktan :
Penebusan Pupuk
NO. Jenis Pupuk Volume (kg/liter)
1. Urea
2. SP-36
3. ZA
4. NPK
5. Organik Granul
6. Organik Cair

..............................................20....
Petani

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

Dilampiri foto copy KTP

Lampiran 8
FORM PENEBUSAN PUPUK BERSUBSIDI
KIOS PENGECER LENGKAP (KPL) : SAHAB AT WATES

Nama Petani :
NIK :
Nama Poktan :
Penebusan Pupuk
NO. Jenis Pupuk Volume (kg/liter)
1. Urea
2. SP-36
3. ZA
4. NPK
5. Organik Granul
6. Organik Cair

..............................................20....
Petani

.............................................
Dilampiri foto copy KTP

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