Contoh Surat Pembatalan Porsi Tabungan Haji

Hal :    Permohonan Pembatalan                                                         ......................,             2014

            Porsi Tabungan Haji

Kepada

Yth. Kepala Kantor Kementerian Agama

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

Di .............................................................

Assalamu’alaikum. Wr. Wb.

Yang bertanda tangan dibawah ini, saya :

Nama               : ..........................................................................................................                       

Umur               : ..........................................................................................................

Pekerjaan         : ..........................................................................................................

Alamat                        : ..........................................................................................................

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

Status              : ..........................................................................................................

Dengan ini mengajukan permohonan pembatalan Porsi Haji dan penarikan setoran lunas Biaya Perjalanan Ibadah Haji, atas nama: ............... ( Suami / Istri ) Saya :

Nama               : ..........................................................................................................

Alamat                        : ..........................................................................................................

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

No.Porsi          : ..........................................................................................................

No. SPPH       : ..........................................................................................................

Alasan Batal    : ..........................................................................................................

Bersama ini kami lampirkan surat keterangan yang diperlukan sebagai berikut :

1.   Surat Permohonan

2.   Surat Pernyataan

3.   Foto Copy KTP

4.   Foto Copy KK

5.   Foto Copy Surat Nikah

6.   Bukti Porsi Setoran Lunas BPIH

7.   SPPH Asli

8.   Surat Kematian Asli dari desa/Kelurahan atau Foto Copy Akta Kematian Dilegalisir

Demikian permohonan ini kami sampaikan atas perkenan kami sampaikan terimakasih.

Wassalamu’alaikum. Wr.Wb.

SURAT PERNYATAAN

Yang bertanda tangan dibawah ini, saya :

Nama               : ..........................................................................................................

Umur               : ..........................................................................................................

Pekerjaan         : ..........................................................................................................

Alamat                        : ..........................................................................................................

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

Status              : ..........................................................................................................

Dengan ini menyatakan mengajukan pembatalan Porsi Haji dan penarikan setoran lunas biaya perjalanan Ibadah Haji atas nama :

Nama               : ..........................................................................................................

Umur               : ..........................................................................................................

Alamat                        : ..........................................................................................................

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

No.Porsi          : ..........................................................................................................

Nop.SPPH      : ..........................................................................................................

Alasan Batal    : ..........................................................................................................

Dengan pernyataan kami buat sebagai persyaratan permohonan Pembatalan Porsi Tabungan Haji dan Penarikan Setoran Awal Biaya Perjalanan Ibadah Haji.

                                                                                                            Ungaran,

                                                                                                            Yang Menyatakan

	Materai 6000

 

                               

                                  

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

                                                                                                            (Status yang menyatakan)