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Menindaklanjuti Surat Kepala Biro Kepegawaian Kementerian Pendidikan dan Kebudayaan Nomor : 126767/A4.1/KP/2013 Tanggal 13 November 2013 Tentang Usul Tanda Kehormatan Satyalancana Karya Satya.

Adapun berkas yang harus dilampirkan masing-masing rangkap 2 (dua)

Daftar Riwayat Hidup
FC SK CPNS dan PNS
FC SK Pangkat Terakhir/Jabatan Terakhir
Salinan Sah DP3 dua Tahun Terakhir
Surat Keterangan Tidak Pernah dijatuhi Hukuman Tingkat Sedang dan Berat. (Form untuk Staf) & (Surat Form untuk Dosen)
FC Piagam Satyalancana Karya Satya (Bagi yang memiliki)

Atas Perhatian dan Kerjasamanya diucapkan terima kasih