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PEMERINTAH PROVINSI SUMATERA SELATAN

DINAS PENDIDIKAN
SMA NEGERI 13 PALEMBANG
Alamat : Jl. Adi Sucipto No. 2803 SMB II Telepon (0711) 410079 Palembang Email : sma13plg@gmail.com

NSS : 301116007046, NPSN : 10603847

LETTER OF STATEMENT
No. 822.4/422-1291/SMAN.13/Disdik.SS/2019

The undersigned, the Principal of Palembang 13 Public High School explains that:

Name : PUTRI AGUSTIN

Class /program : XI/MIPA 4

NIS : 12071

Account number : 780469303

The name above is true of Palembang 13 Public High School students in the 2019/2020
school year.

Thus this statement was actually made, to be used to benefit from the assistance of the
INDONESIA PINTAR PROGRAM (PIP).

Palembang, November 2, 2019


Plt. Headmaster

Heryanto, S.Pd
Builder Tk. I
NIP 19671171990031006

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