BADAN PENGELOLA MASJID AZ-ZAMAN
PASAR BARU KELURAHAN LOMPIO
KEC. BANGGAI KAB.BANGGAI LAUT
PROPINSI SULAWESI TENGA
Jin, Mampaliasan Cp:082196545743-082189726048
Nomor
Sifat
Lampiran
Perinal
S1/BPM-AZM/2022 Bangg... Juli 2022
Masjid AZ-ZAMAN Yth. Pj. Sekda Prov. Sulteng
1 Bundel De
Permohonan NPHD Tempat
an Masjid Az Zaman
‘Sehubungan dengan Hibah daerah yang diajukan, oleh Rumah lbadah/Yayasan/Lembaga
Keagamaan
Nama Masjid AZ- Zeman
Alamat :_ Kompleks pasar baru Kelurahan Lompio
Kecamatan Banggai Kabupaten Banggai Laut
Nominal Rp. 40,000,000, (empat puluh juta rupian )
Dengan ini disampaikan rincian anggaren biayalrencana pengunaan hibah definitive telah
sesvai dengan rincian anggaran biaya/rencana pengunaan hibah yang terlampir pada
Keputusan Gubernur Sulawesi Tengah Nomor 918/16.1/Ro Kesra-G ST/202 tentang Daftar
Penerima, Alamat Penerima, dan Besaran Alokasi Hibah dalam anggaran Pendapatan dan
Belanja Daerah pada Biro Kesejahleraan Rakyat Sekretariat Daerah Provinsi Sulawesi
Tengah Tahun Anggaran 2022
Berkenaan dengan hal tersebut, kami mohon untuk dapat dilaksanakan
penandatangan Naskah Perjanjian Hibeh Daerah (NPHD) sesuai dengan ketentuan yang
tercantum dalam Peraturan Gubemwur Sulawesi tengah Nomor 1 Tahun 2022 tentang tata
cara penganggaran, peleksanaan dan penatausehaan, pelaporan dan pertangunggjawaban
serta monitoring dan evaluasi dan bantuan sosial
Demikian surat permohonan penandatanganan NPHD ini disampaikan, atas
perkenaan dan kerjasemanya diucepkan terima kasin
PENERIMA HIBAH
BADAN PENGELOLA MASJID AZ-ZAMAN
KABUPATEN BANGGA| LAUT
MUSLIM R.BEBELS.Pd. BADAN PENGELOLA MASJID AZ-ZAMAN
PASAR BARU KELURAHAN LOMPIO
KEC. BANGGAI KAB.BANGGAI LAUT
PROPINS! SULAWESI TENGA
Jin. Mampaliasan Cp:082196545743-082189726048
PAKTA INTEGRITAS
Yang bertandatangan di bawah ini ;
Nama : Muslim RBebel,S.Pa.
No.KTP : 7207020311750001
Alamat : Desa Lampa Kec.Banggai kab Banggai Laut
‘Bertindak untuk dan atas nama Ketua Badan Pengelola Masjid AZ - Zaman. Dalam rangka petaksanaan kegiatan yang
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