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    Super BKT SS2022099185

    Uploaded by

    Koswara
    1. Aqilla Chessa Oktafina declares that she is not currently receiving a scholarship from any government or private institution in central or regional Indonesia. If it is proven that she is receiving a scholarship from another party, she will return the full scholarship amount to the Regional Treasury. 2. She states that the uploaded documents and inputted data are true. If found to be untrue, she agrees for her scholarship application to be cancelled and declared void. 3. If the statement is untrue, she agrees to accept sanctions according to applicable regulations.

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    Super BKT SS2022099185

    Uploaded by

    Koswara
    9 views1 page
    1. Aqilla Chessa Oktafina declares that she is not currently receiving a scholarship from any government or private institution in central or regional Indonesia. If it is proven that she is receiving a scholarship from another party, she will return the full scholarship amount to the Regional Treasury. 2. She states that the uploaded documents and inputted data are true. If found to be untrue, she agrees for her scholarship application to be cancelled and declared void. 3. If the statement is untrue, she agrees to accept sanctions according to applicable regulations.

    Original Description:

    Beasiswa

    Original Title

    super-bkt-SS2022099185 (1)

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    1. Aqilla Chessa Oktafina declares that she is not currently receiving a scholarship from any government or private institution in central or regional Indonesia. If it is proven that she is receiving a scholarship from another party, she will return the full scholarship amount to the Regional Treasury. 2. She states that the uploaded documents and inputted data are true. If found to be untrue, she agrees for her scholarship application to be cancelled and declared void. 3. If the statement is untrue, she agrees to accept sanctions according to applicable regulations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    9 views1 page

    Super BKT SS2022099185

    Uploaded by

    Koswara
    1. Aqilla Chessa Oktafina declares that she is not currently receiving a scholarship from any government or private institution in central or regional Indonesia. If it is proven that she is receiving a scholarship from another party, she will return the full scholarship amount to the Regional Treasury. 2. She states that the uploaded documents and inputted data are true. If found to be untrue, she agrees for her scholarship application to be cancelled and declared void. 3. If the statement is untrue, she agrees to accept sanctions according to applicable regulations.

    Copyright:

    © All Rights Reserved
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    of 1

    SURAT PERNYATAAN

    Saya yang bertanda tangan dibawah ini:

    Nama : AQILLA CHESSA OKTAVINA

    Tempat/Tanggal Lahir : Balikpapan, 05 Oktober 2013

    NIK : 6471064510130001

    NPSN : 30402854

    NISN : 3130939453

    No. Telepon : 089520606161

    1. Dengan ini menyatakan bahwa saya saat ini tidak sedang menerima beasiswa dari
    lembaga pemerintah maupun swasta baik di pusat maupun di daerah. Jika terbukti
    menerima beasiswa dari pihak lain maka saya akan menyetorkan kembali ke Kas
    Daerah seluruh beasiswa yang telah diterima.
    2. Menyatakan bahwa berkas yang diunggah maupun data yang diinput adalah benar,
    jika ternyata tidak benar, Saya bersedia untuk dibatalkan permohonan beasiswa saya
    dan dinyatakan gugur.

    Apabila surat pernyataan ini tidak benar maka saya bersedia menerima sangsi sesuai
    ketentuan yang berlaku.

    Demikian surat pernyataan ini saya buat dengan sebenarnya dan untuk dipergunakan
    sebagaimana mestinya.

    .................., .... ......... 2022

    Yang membuat
    pernyataan,

    SS2022099185 materai 10rb*

    AQILLA CHESSA OKTAVINA

    *nb
    materai harus asli (bukan hasil foto/scan)

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