tps 01 dpt ok
TRANSCRIPT
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8/12/2019 TPS 01 DPT OK
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Page 1 of 23
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1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
1 2171106007710001 A SOI TANJUNG UBAN 20-Jul-71 37 S P KOMP. CITRA BATAM BLOK C NO. 85 1 1 ---
2 2171100901489001 ABDUL HAMID BATANG 9-Jan-48 38 S L PER CITRA BATAM D1 55, 1 1 ---
3 2171101606840002 ABDUL HAZIMI LUBUK SIKAPING 16-Jun-84 39 S L KOMP. CITRA BATAM BLOK C NO. 86 1 1 ---
2171105303839004 ADE MARIA ASNON METRO 13-Mar-83 40 S P CITRA BATAM BLOK C NO.48 1 1 ---
5 2171105503729002 ADE RIANI PADANG PARIAMAN 15-Mar-72 37 S P PER CITRA BATAM C1 66 1 1 ---
6 2171106212799001 ADE SYARIFAH JAKARTA SELATAN 6-Mar-68 41 S P KOMP. CITRA BATAM D NO. 95 1 1 ---
7 2171102408760003 ADEK MARLIAN AGUS MANJAYA PALEMBANG 24-Aug-76 32 S P KOMP. CITRA BATAM BLOK C NO. 98 1 1 ---
8 2171061205830001 ADY RACHMAD WISUDA SUNGAI JODOH-BTM 2-Nov-71 25 S L MASJID RAYA BATAM CENTRE 1 1 ---
9 2171102404849004 AFRED ADISKA JAWI-JAWI 24-Apr-84 25 S L CITRA BATAM 1 1 ---
10 2171101911589001 AGRY JOHANES TALIMBEKAS SURABAYA 19-Nov-58 50 S L PERUMAHN CITRA BATAM, D 20 1 1 ---
11 2171102604849002 AGUS PRIYANTO MAGELANG 26-Apr-84 25 S L KOMPLEK CITRA BATAM BLOK D NO91 1 1 ---
12 2171102508760001 AGUS SUSANTO YOGYAKARTA 25-Aug-76 32 S L KOMP CITRA BATAM BLOK D NO.70 1 1 ---
13 2171102704739001 AHMAD KHODIRI KEDIRI 27-Apr-73 36 S L PERUMAHAN CITRA BATAM, C 04 1 1 ---
14 2171102508629002 AHPIN BANGKA 25-Aug-62 46 S L CITRA BATAM C.87 1 1 ---
15 2171104211710001 AI GEK TANJUNG PINANG 2-Nov-71 37 S P KOMP CITRA BATAM BLOK D NO. 73 1 1 ---
16 2171102202890001 AJENG MAHARANI KUSUMAH PERTIWI CICADAS-BANDUNG 14-Mar-83 26 S P KOMP. CITRA BATAM BLOK D NO. 103 1 1 ---
17 2171101407529001 ALAWY M JAZULI BELAKANG PADANG 14-Jul-52 56 S L PER CITRA BATAM C1 18 1 1 ---
18 2171106908810001 ALFIA RIKA LUBUK SIKAPING 29-Aug-81 27 S P KOMP. CITRA BATAM BLOK C NO. 86 1 1 ---
19 2171103110769004 ALIARDI SEMARANG 31-Oct-76 33 S L CITRA BATAM BLOK D NO 07 1 1 ---
20 2171100608710001 ALIMI TEGAL 6-Aug-71 37 S L KOMP. CITRA BATAM BLOK D NO. 72 1 1 ---
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
T T T T
T T T T T T
T T T T T T T T
T T T T
T T T T
T T T T T T T T
Model A.1-KPU
T T T T T T T T T T T T
T T T T T T
T T T T T T T T
T T T T
T T T T T T T T
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8/12/2019 TPS 01 DPT OK
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Page 2 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
21 520201421107926141 ALIMIN GORANG ALOR KECI 12-Dec-78 30 S L KOMP.CITRA BATAM D 70 1 1 ---
22 2171106804669002 ALING BANGKA 28-Apr-66 43 S P CITRA BATAM C.87 1 1 ---
23 2171104808730001 AMI WULANDANI MAJALENGKA 8-Aug-73 35 S P KOMP. CITRA BATAM BLOK C NO. 97 1 1 ---
24 2171102606720002 AMIN BUDIARTO KUTOWINANGUN KEBUMEN 26-Jun-72 37 S L KOMP CITRA BATAM BLOK C NO.12 1 1 ---
25 2171104803470001 AMITATI JEMBER 8-Mar-47 62 S P CITRA BATAM BLOK C NO 97 1 1 ---
26 2171100512769009 ANDA FIADI PADANG KANDIS 5-Dec-76 32 S L KOMP CITRA BATAM BLOK C NO.80 1 1 ---
27 2171100109719001 ANDI KUSUMA BANGKA BELITUNG 1-Sep-71 37 S L PER CITRA BATAM D 66 1 1 ---
28 2171102006500001 ANDI TAJUDDIN BONE 20-Jun-50 59 S L KOMP. CITRA BATAM BLOK D NO. 22 1 1 ---
29 2171101304540001 ANDREY SAMUEL DJALEL BEKUAN 13-Apr-54 55 S L KOMP CITRA BATAM BLOK D NO. 54 1 1 ---
30 2171100810670001 ANDRINO AKMAN PADANG 8-Oct-67 41 S L KOMP. CITRA BATAM BLOK D NO. 23 1 1 ---
31 2171106002870001 ANG YESSI BENGKALIS 20-Feb-87 22 B P KOMP. CITRA BATAM BLOK C NO. 56 1 1 ---
32 2171104205909005 ANGEL YEW MEDAN 2-May-90 19 B P KOMP CITRA BATAM BLOK D NO.85 1 1 ---
33 2171105005829005 ANITA PUTRI JAKARTA 10-May-82 27 S P CITRA BATAM D NO 12 1 1 ---
34 2171106006719001 ANNA SELAT PANJANG 20-Jun-71 38 S P PERUMAHN CITRA BATAM D 33 1 1 ---
35 2171106009749003 ANNEKE WIDYAWATY MEDAN 20-Sep-74 34 S P CITRA BATAM BLK C 77 1 1 ---
36 2171104507799005 ARINA KEDIRI 5-Jul-79 29 S P PERUMAHAN CITRA BATAM,C 04 1 1 ---
37 2171102112639002 ARMON BAHAR JAKARTA 21-Dec-63 45 S L PERUMAHAN CITRA BATAM, C 30 1 1 ---
38 2171104403710003 ARUM INDRASTUTI BANDUNG 4-Mar-71 38 S P KOMP. CITRA BATAM BLOK D NO. 34 1 1 ---
39 2171105807699002 ASIANUS PADA KARI ALOR KALABAHI 10-Aug-85 23 B L RULI CITRA BATAM 1 1 ---
40 2171101010729001 ASRIFHALDI PADANG 10-Oct-72 36 S L KOMP. CITRA BATAM BLOK C NO. 94 1 1 ---
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
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8/12/2019 TPS 01 DPT OK
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Page 3 of 23
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*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
41 21711200110106904252 ASSIKIN ASKING TANJUNG RAJ 10-Oct-69 40 S L PERUMAHN CITRA BATAM,C 11 1 1 ---
42 2171105404660001 ATIKA PALEMBANG 14-Apr-66 43 S P KOMP. CITRA BATAM BLOK D NO. 71 1 1 ---
43 2171100308890001 BAGAS FRANISWORO PAMUNGKAS SEMARANG 3-Aug-89 19 B L KOMP. CITRA BATAM BLOK D NO. 25 1 1 ---
44 2171101005599002 BAKRIM SENGGARANG 10-May-59 50 S L PERUMAHAN CITRA BATAM, C 38 1 1 ---
45 520704321018390400 BAMBANG IRAWAN PALEMBANG 11-Jan-79 23 S L PERUMAHN CITRA BATAM C 19 1 1 ---
46 2171104909879003 BARLIA JEMBANGAN 9-Sep-87 21 B P KOMP MASJID RAYA BATAM 1 1 ---
47 2171100110759005 BASRI LEWA IMANG ALOR 1-Oct-75 33 S L KOMP CITRA BATAM, C 21 1 1 ---
48 2171106403719001 BENG HUI BENGKALIS 24-Mar-71 38 S P PER CITRA BATAM C 55 1 1 ---
49 5207040010582115687 BENI MURDANI PACUA 5-Jan-82 27 S L PERUMAHN CITRA BATAM C 31 1 1 ---
50 2171103006710001 BERLINA BR HULU RINANG SORY 16-Oct-86 22 S P PERUMAHN CITRA BATAM, C19 1 1 ---
51 2171101705849001 BERTOLOMEUS ERICSON KUPANG 17-May-84 25 S L PERUMAHN CITRA BATAM, C19 1 1 ---
52 2171101306789009 BINSAR ALBERTO HARIANJA BELAWAN 13-Jun-78 31 S L CITRA BATAM BLOK D NO.18 1 1 ---
53 2171034311880006 BINTANG AM SITORUS SOSOR SIDUPAN 11-Mar-88 21 B P PERUM CITRA BATAM BLOK C NO. 47 1 1 ---
54 2171106806779002 BUDI SARI PURBA MEDAN 28-Jun-77 32 S L KOMP. CITRA BATAM BLOK C NO. 94 1 1 ---
55 2171102901740001 BUN TJHUNG TJIN SINGKAWANG 29-Jan-74 35 S L KOMP. CITRA BATAM BLOK C NO. 22 1 1 ---
56 2171100709679004 CAHYO SURABAYA 7-Sep-67 41 S L PER CITRA BATAM C1 18 1 1 ---
57 2171105111850001 CATUR WICAKSONO MEDAN 27-Sep-83 25 S L KOMP. CITRA BATAM BLOK D NO. 101 1 1 ---
58 2171102503779002 CATUR YUSJIANTO NGANJUK 25-Mar-77 32 S L KOMP CITRA BATAM BLOK D NO.07 1 1 ---
59 2171100512919003 CHARLIE MEDAN 5-Dec-91 17 B L KOMP CITRA BATAM BLOK D NO.85 1 1 ---
60 2171105907750001 CUT JULI FAZRINA BANDA ACEH 19-Jul-75 33 S P KOMP CITRA BATAM BLOK C. NO. 26 1 1 ---T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
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8/12/2019 TPS 01 DPT OK
4/23
Page 4 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
61 21711000163086610389 DAMERIA SARAGIH ASAHA 23-Sep-89 43 S P PERUMAHAN CITRA BATAM, C 62 1 1 ---
62 2171102412850001 DASA LAKU SAMUEL BATU MALANG 24-Dec-85 23 B L KOMP CITRA BATAM BLOK D NO. 54 1 1 ---
63 2171102612859002 DAVID KRISTIANTORO BANYUMAS 26-Dec-85 23 S L KOMP. CITRA BATAM BLOK D NO. 54 1 1 ---
64 2171102012900001 DAVY BUDIMAN DWIDJANTARA SEMARANG 20-Dec-90 18 B L KOMP. CITRA BATAM BLOK D NO. 53 1 1 ---
65 2171100303839004 DEDY ISKANDAR BANDARJAYA 3-Mar-83 26 S L KOMP.CITRA BATAM BLOK.D NO.7 1 1 ---
66 2171105010730002 DELPI HOTRIA SIMBOLON GALUNG 10-Oct-73 35 S P PERUM. CITRA BATAM BLOK C NO. 65 1 1 ---
67 2171100501749006 DEMAK DEWI SINURAT SEI JURAGAN 5-Nov-82 26 S P KOMPLEK CITRA BATA BLOK D 1 1 ---
68 2171103006710001 DENI ARDIANSYAH LIMBON 13-Dec-77 19 S L PERUMAHN CITRA BATAM D 69 1 1 ---
69 2171104111739001 DESI JANTI TG PINANG 1-Nov-73 35 B P PER CITRA BATAM D 66 1 1 ---
70 2171104412810001 DESMARITA GURUN PANJANG 4-Dec-81 27 B P KOMP. CITRA BATAM BLOK D NO. 43 1 1 ---
71 0650015430850005 DESMIATI PALEMBANG 27-Mar-87 22 B P PERUMAHN CITRA BATAM, C19 1 1 ---
72 2171105312779001 DESNARIA KRISTINA SIMANJUNTAK P SIDEMPUAN 13-Dec-77 31 B P CITRA BATAM BLK D 13 1 1 ---
73 2171025805770003 DIAN MAYASARI SEMARAN 13-Dec-77 32 S P PERUMAHN CITRA BATAM,C 81 1 1 ---
74 2171100512770002 DIAN SETYAWAN SLEMA 12-May-77 32 S L PERUMAHN CITRA BATAM C 11 1 1 ---
75 2171104505729005 DINI ANDRIYANI JAKARTA 5-May-72 37 S L CITRA BATAM, 1 1 ---
76 2171102002769005 DINO SILUNGKANG 20-Feb-76 33 S L KOMP. CITRA BATA BLOK D NO. 95, 1 1 ---
77 2171100509660001 DODI SUHARTO BOGOR 5-Sep-66 42 S L KOMP. CITRA BATAM BLOK D NO. 90 1 1 ---
78 2171101804709001 DODI ZULHAM SIREGAR JAKARTA 18-Apr-70 39 S L CITRA BATAM D NO 12 1 1 ---
79 2171106903689001 DOLLY MORINA PEKANBARU 29-Mar-68 41 S P KOMPEK CITRA BATAM 1 1 ---
80 2171107009859002 DWI INDARTI BANTUL 30-Sep-85 23 B P CITRA BATAM BLOK C NO.73 1 1 ---
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
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8/12/2019 TPS 01 DPT OK
5/23
Page 5 of 23
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*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
81 2171103011649001 E. SAIFUL HIDAYAT BOGOR 30-Nov-64 44 S L CITRABATAM BLOK C 72 1 1 ---
82 2171101803789002 EDI YANTO URUNG KUNDUR 18-Mar-78 31 S L CITRA BATAM,RT 1 1 ---
83 2171100301709002 EDWARD YANTRI ODANG TG. BALAI KARIMUN 3-Jan-70 39 S L CITRA BATAM,RT 1 1 ---
84 217106138720001 EFDI GUSTIZAL BUKIT GOMBAK SITU 13 Aug 72 36 S L PER CITRA BATAM,C 52 1 1 ---
85 2171066806829006 EKA WATI LAMPUN 28-Jun-82 27 S P PERUMAHN CITRA BATAM D 04 1 1 ---
86 2171071612869004 EKO INDRAWANDI TANJUNG RAJ 16-Dec-86 23 B L PERUMAHAN CITRA BATAM, C 11 1 1 ---
87 107840012130301 ELIAZAR BUKANGPETI ALO 10-Oct-58 51 S L KOMP. CITRA BATAM BLOK D NO. 90 1 1 ---
88 2171105905819001 ELISAH RAHMAH SURABAYA 19-May-81 28 B P CITRABATAM BLOK C 54 1 1 ---
89 2171106807589003 ELVA NORA PADANG PANJAN 28-Jul-58 51 S P PERUMAHN CITRA BATAM C 02 1 1 ---
90 2171104310779002 ENDANG FAHRIYANTI SEI PIRING 3-Oct-77 31 S P PER CITRA BATAM,C 24 1 1 ---
91 2171104810530001 ENDANG WOELANDARI SOEKAMTO BANGSRI JEPARA 8-Oct-53 55 S P KOMP. CITRA BATAM BLOK D NO. 53 1 1 ---
92 2171104805869002 ERAWATI PADANG 8-May-86 23 B P CITRA BATAM D 174 1 1 ---
93 2171100704679001 ERLIAN CINTA RAJA 7-Apr-67 42 S L PER CITRA BATAM C1 6 1 1 ---
94 2171103006710001 ERMA WATI MEDAN 19-Feb-90 19 B P PERUMAHN CITRA BATAM, C19 1 1 ---
95 2171103003699002 ERRY HERMONO KLATEN 30-Mar-69 40 S L KOMP. CITRA BATAM BLOK D NO. 34 1 1 ---
96 2171102708789004 ERWIN SURYANTO IDRAMAYU 27-Aug-78 30 S L CITRA BATAM BLK D 47 1 1 ---
97 2171105706810001 ETIK RUSTIANI TULUNG AGUNG 17-Jun-81 27 S P PERUMAHN CITRA BATAM, D 20 1 1 ---
98 3202500163088701181 FADILA SILPIYANI KARAWAN 23 Aug 87 22 B P KOMP. CITRA BATAM BLOK C NO. 36 1 1 ---
99 2171100911590001 FADLY SELAT PANJANG 9-Nov-59 49 S L KOMP CITRA BATAM BLOK C NO.57 1 1 ---
100 2171106204839001 FEBRIANSYAH JAKARTA 9-Feb-70 39 S L KOMP. CITRA BATAM D NO. 95 1 1 ---
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
6/23
Page 6 of 23
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*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
101 2171104805840001 FERNIARNI DABO SINGKEP 8-May-84 25 B P KOMP. CITRA BATAM BLOK C NO. 79 1 1 ---
102 2171032102860004 FERRI ADRIAN BUKITTINGG 21-Feb-86 23 B L PERUMAHN CITRA BATAM C 36 1 1 ---
103 2171100407729004 FERRY WARNIAWAN BOGOR 4-Jul-72 36 S L KOMP CITRA BATAM C 62 1 1 ---
104 2171107108839008 FINA VENESSIA PEKANBARU 31-Aug-83 25 B P CITRA BATAM BLOK C NO.57 1 1 ---
105 217106010101759005 FIRMAN HARI BLITA 1-Jan-75 34 S L KOMP.CITRA BATAM D.04 1 1 ---
106 2171100405620001 FIRMANSYAH PANGKAL PINANG 4-May-62 47 S L KOMP. CITRA BATAM BLOK D NO. 71 1 1 ---
107 2171104107729010 FITRINA ROSA SELAT PANJANG 1-Jul-72 37 S P CITRABATAM BLOK C 72 1 1 ---
108 2171103010769001 FRANSISKUS NONG BUKO FLORES 30-Oct-76 32 S L PERUMAHA CITRA BATAM D 55 1 1 ---
109 2171104904800001 GALUH SHINTA ALIMIN BALIKPAPAN 9-Apr-80 29 S P KOMP. CITRA BATAM BLOK D NO. 23 1 1 ---
110 2171102409839002 GERADUS LELIAPE FLORES 24-Sep-83 25 B L CITRA BATAM, 1 1 ---
111 2171105610859001 HADRIA BARPAK MAROS 16-Oct-85 23 B P PER CITRA BATAM C 63 1 1 ---
112 2171020032007760 HAPPY JOHN SEPANG TONDAN 20-Jul-76 33 S L KOMP. CITRA BATAM BLOK C NO. 17 1 1 ---
113 2171100101760003 HARI AGUS NUGROHO SLEMAN 1-Jan-76 33 S L KOMP. CITRA BATAM BLOK D NO. 07 1 1 ---
114 2171105506760003 HARLIA JAKARTA 15-Jun-76 33 S P KOMP. CITRA BATAM BLOK D NO. 67 1 1 ---
115 2171101512839002 HASAN BASRI P MEDAN 15-Dec-83 25 S L PER CITRA BATAM, C 43 1 1 ---
116 2171101805880002 HASNO BENGKALIS 18-May-88 21 S L KOMP. CITRA BATAM BLOK C NO. 56 1 1 ---
117 2171105606729001 HENNY WIDYASTUTI MALANG 16-Jun-72 37 S P CITRA BATAM BLOK C NO.03 1 1 ---
118 2171105109589001 HENY YOHAN NAJOAN MANADO 11-Sep-58 50 S P PERUMAHN CITRA BATAM, D 20 1 1 ---
119 2171042212710004 HERA PANDANA, SH PADAN 22-Dec-71 38 S L KOMP. CITRA BATAM BLOK D NO. 95 1 1 ---
120 2171100101549001 HERIANTO SOEKAMTO JEPERA 1-Jan-54 55 S L KOMPLEK CITRA BATAM, D 09 1 1 ---
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
7/23
Page 7 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
121 2171102905739003 HERMANTO BENGKALIS 29-May-73 36 S L PER CITRA BATAM C 55 1 1 ---
122 2171103006710001 HERY BUDAYA PEKANBARU 30-Jun-71 38 S L KOMP. CITRA BATAM BLOK C NO. 97 1 1 ---
123 2171105807699002 HINDOENIFA TG PINANG 18-Jul-69 39 S P PERUM CITRA BATAM D.98 1 1 ---
124 2171102908750002 IMANSYAH LUBIS MEDAN 29-Aug-75 33 S L KOMP. CITRA BATAM BLOK D NO. 67 1 1 ---
125 21710600415010812047 INDRA FANDI SIREGAR PIJORKOLIN 15-Jan-88 21 S L PERUMAHN CITRA BATAM C 36 1 1 ---
126 2171101912739002 INDRA WAHYUDI PROBOLINGGO 19-Dec-73 35 S L PERUM CITRA BATAM, D 26 1 1 ---
127 59.07.013.31.12.63.00111 INDRAWATI SUNGAI PIRIN 31-Dec-63 45 S P PERUMAHN CITRA BATAM, C 24 1 1 ---
128 2171104305680001 IRMA RITA LUSIANA BENGKULU 3-May-68 41 S P KOMP CITRA BATAM BLOK D NO.80 1 1 ---
129 2171100107760002 IRWAN FIRDAUS PALEMBANG 1-Jul-76 33 S L KOMP. CITRA BATAM BLOK D NO. 07 1 1 ---
130 2171102503859003 ISKANDAR BUDIMAN PALEMBANG 25-Mar-85 24 S L CITRABATAM BLOK C1 NO 95 1 1 ---
131 2171074407759003 ISMAWATI BANYUWANG 7-Apr-75 34 S P PERUMAHAN CITRA BATAM, D 19 1 1 ---
132 2171101512780001 ISNAINI SIREGAR SIGALA GALA 26-Oct-87 21 S P KOMPLEK CITRA BATA BLOK D 1 1 ---
133 2171100905700004 ISYA ANSARI GRESIK 9-May-70 39 S L KOMP CITRA BATAM BLOK C NO. 39 1 1 ---
134 2171100310719001 IWAN KUALA ASAM 3-Oct-71 37 S L PERUMAHN CITRA BATAM, D 33 1 1 ---
135 2171026005740002 JANE CHERRIE W WUISAN BATA 20-Jun-74 35 S P PERUMAHAN CITRA BATAM, C 17 1 1 ---
136 2171100511669003 JANG SOEN SIMPANG 5-Nov-66 42 S L KOMP.CITRA BATAM D.73 1 1 ---
137 2171072411860005 JOKO SANTOSO PONOROG 24-Oct-86 23 S L PERUM CITRA BATAM D 76 1 1 ---
138 2171105009759002 JURITA PALEMBANG 10-Sep-75 33 S P KOMP. CITRA BATAM BLOK D NO. 96 1 1 ---
139 2171100711609001 KAMSO CILACAP 7-Nov-60 48 S L PERUM. CITRA BATAM BLOK C NO. 07 1 1 ---
140 2171106104829004 KARTIKA SUANDA PAYAKUMBUH 21-Apr-82 27 S P CITRA BATAM BLOK D 69,RT 1 1 ---
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
8/23
Page 8 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
141 2171101802660001 KAU TIE TANJUNG PINANG 18-Feb-66 43 S L KOMP. CITRA BATAM BLOK C NO. 85 1 1 ---
142 2171100302519001 KIEM MIAU SELAT BINTAN 3-Feb-51 58 S L KOMP.CITRA BATAM D.31 1 1 ---
143 2171101603499001 KRIS DWI PURNOMO NGAWI 16-Mar-49 60 S L PER CITRA BATAM C1 18 1 1 ---
144 2171101206759002 KUSNO PREHANTORO PATI 12-Jun-75 34 S L CITRABATAM BLOK D 79 1 1 ---
145 2171100811789001 KUSTURI SRAGEN 8-Nov-78 30 S L PER CITRA BATAM,C 43 1 1 ---
146 2171100712819001 KWADIYANTO SRAGEN 7-Dec-81 27 S L PER CITRA BATAM, C 43 1 1 ---
147 2171100908719001 LALU AGUS AZRIN RARANG LOTIM 9-Aug-71 37 S L CITRA BATAM BLOK C NO.58 1 1 ---
148 2171021008719003 LAMBANG MALANG 10 Aug 71 37 S L PER CITRA BATAM D1 55 1 1 ---
149 2171106502749001 LENNY E SARAGIH MEDAN 25-Feb-74 35 S P CITRA BATAM BLK C 49 1 1 ---
150 21.71.10.001.23. 12.70. LIE SENG KEP.RIAU, 13-Dec-77 38 S P PERUMAHN CITRA BATAM, C 99 1 1 ---
151 2171104109690002 LIE TIANG TG BATU KUNDUR 1-Sep-69 39 S P KOMP CITRA BATAM BLOK C NO. 99 1 1 ---
152 2171105504759002 LILI L.PAKAM 15-Apr-75 34 S P KOMP CITRA BATAM D,63 1 1 ---
153 2171104407700002 LINAWATI JAKARTA 4-Jul-70 38 S P KOMP. CITRA BATAM BLOK D NO. 22 1 1 ---
154 21710200554066802992 LIS WIDAWATY TG. MORAWA 14-Jun-68 41 B P PERUMAHN CITRA BATAM D 72 1 1 ---
155 2171103006710001 LISTAULI MANURUNG PACONGI 27-Sep-89 19 B P PERUMAHN CITRA BATAM, C19 1 1 ---
156 2171100212850001 LIYONO BENGKALIS 2-Dec-85 23 S L KOMP. CITRA BATAM BLOK C NO. 55 1 1 ---
157 2171100107919003 LU KY BANGKA 1-Jul-91 18 B L CITRA BATAM C.87 1 1 ---
158 2171100912730001 LUDDIN MARDHANI RAMBE MEDAN 9-Dec-73 35 S L KOMP CITRA BATAM BLOK C. NO. 26 1 1 ---
159 2171102502699001 LUIS HORMENDRA BELINYU 25-Feb-69 40 S L KOMP. CITRA BATAM BLOK D NO. 96 1 1 ---
160 2171106109779001 LUWISTIANI JEPARA 21-Sep-77 31 S P PER CITRA BATAM, C 50 1 1 ---
T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
9/23
Page 9 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
161 2171103011789002 M DENNY NOVIAR M PALEMBANG 30-Nov-78 30 S L CITRA BATAM BLK C 53 1 1 ---
162 21710600210068104478 M NIZAR LUBIS LUBUK AR 6-Oct-81 28 S L PERUMAHN CITRA BATAM C 31 1 1 ---
163 2171031004900001 M. RIO FEBRIANSYAH PALEMBANG 4-Oct-90 19 B L PERUMAHN CITRA BATAM D 72 1 1 ---
164 2171022011839002 M.KHOLID AMRULLOH JOMBAN 13-Dec-77 24 S L CITRA BATAM BLOK C NO 47 1 1 ---
165 21710200109057509877 MAHMUD RAFIDI BINJA 5-Sep-75 34 S L PERUM CITRA BATAM D 70 1 1 ---
166 2171102304669002 MARIHOT MANURUNG GURAH BAFU 23-Apr-66 43 S L PERUMAHN CITRA BATAM, D 62 1 1 ---
167 2171105201570001 MARISTINA. B MEDAN 29-Mar-82 27 S P PERUMAHN CITRA BATAM, C19 1 1 ---
168 2171104407780002 MARTINA RINI SULIATI TASMIN SEMARANG 4-Jul-78 30 S P KOMP CITRA BATAM BLOK D NO. 81 1 1 ---
169 2171100210910001 MASDI BENGKALIS 2-Oct-91 17 S L KOMP. CITRA BATAM BLOK C NO. 56 1 1 ---
170 2171042512749002 MEGGI WAIRIAN 13-Dec-77 34 S L PER CITRA BATAM D 66 1 1 ---
171 2171104404780001 METRI EKAPIANTI KEBAN JATI 4-Apr-78 31 B P KOMP CITRA BATAM BLOK C NO.12 1 1 ---
172 2171106405880001 MILASARI LUBUK SIKAPING 24-May-88 21 S P KOMP. CITRA BATAM BLOK C NO. 86 1 1 ---
173 2171105410709001 MIMI SELAT PANJANG 14-Oct-70 38 S P KOMP CITRA BATAM C, 62 1 1 ---
174 1217142014101170005049 MINANTO PACITA 11-Oct-70 39 S L PERUM CITRA BATAM C 44 1 1 ---
175 2171102206580001 MUDJIJO GORANGGARENG 10-Aug-48 60 S L KOMP. CITRA BATAM BLOK D NO. 101 1 1 ---
176 2171101208819004 MUH. ALIUDDIN ARIEF LARANTUKA 11-Sep-83 25 S L KOMP. CITRA BATAM BLOK D/203 1 1 ---
177 2171091907790001 MUHAMMAD FARUP BATAM, 28-Sep-87 29 S L PER CITRA BATAM D1 55 1 1 ---
178 2171105005779003 MUSLINA BUKIT TINGGI 10-May-77 32 S P PERUM CITRA BATAM D.71 1 1 ---
179 2171105102710003 NADA ZULFA SEMARANG 11-Feb-71 38 S P KOMP CITRA BATAM BLOK C NO. 39 1 1 ---
180 2171106206829002 NANI JAWA TIMUR 22-Jun-82 27 S P PERUMAHA CITRA BATAM, D 55 1 1 ---
T T T T T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
10/23
Page 10 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
181 2171102311819001 NASORI BATANG 23-Nov-81 27 S L PER CITRA BATAM D1 55 1 1 ---
182 2171021905769002 NASRUL KUDUS 2-Aug-85 32 S L PER CITRA BATAM D1 55 1 1 ---
183 2171107010759004 NATAEL NAJOAN WAROKKA SURABAYA, 28-Sep-87 23 S P PERUMAHN CITRA BATAM, D 20 1 1 ---
184 2171104612769002 NATALIA CANDRA WAHYUNINGRUM MALANG 6-Dec-76 32 S P PERUM. CITRA BATAM BLOK D NO. 13 1 1 ---
185 2171105109909001 NATASYA UZU BERSELA TG AMPALU 11-Sep-90 18 B P PERUMAHAN CITRA BATAM, D 104 1 1 ---
186 21.71.10.001.57.11.79.02657 NELY KEP.RIAU 17-Nov-79 29 S P PERUMAHN CITRA BATAM, C 99 1 1 ---
187 2171104703879001 NENENG PURWANTI JAKARTA 7-Mar-87 22 S P CITRA BATAM BLOK C-81 1 1 ---
188 2171106006719001 NENTI MURHAYANI PEDEKANDIS 7-Nov-55 53 S P PERUMAHN CITRA BATAM, D 80 1 1 ---
189 2171105201570001 NEPPI MEDAN 28-Sep-87 21 B P PERUMAHN CITRA BATAM, C19 1 1 ---
190 2171106112629001 NGAN LAN FA DABO SINGKEP 21-Dec-62 46 B P CITRA BATAM C.79 1 1 ---
191 2171101208479001 NGATEMI NGAWI 12-Aug-47 61 S L PER CITRA BATAM C1 18 1 1 ---
192 2171060806780001 NICOLAUS OLA TURA SEI JODOH BATAM 8-Jun-78 30 S L MASJID RAYA BATAM CENTRE 1 1 ---
193 2171102109869001 NIRWAN DARMAWAN PALEMBANG 21-Sep-86 22 B L CITRABATAM BLOK C1 NO 95 1 1 ---
194 2171101311829002 NOFRIZAL RENGAT 13-Nov-82 26 B L KOMPLEK CITRA BATAM BLOK D NO91 1 1 ---
195 2171105209570001 NONA SELVIE MANADO 12-Sep-57 51 S P KOMP CITRA BATAM BLOK D NO. 54 1 1 ---
196 2171105211819005 NOVI YANTI MEDAN 12-Nov-81 27 S P PERUMAHAN CITRA BATAM D 216 1 1 ---
197 2171106710890001 NOVIRMARIA DORISCHA TANJUNG BATU KUNDUR 27-Oct-89 19 B P KOMP CITRA BATAM BLOK D NO.80 1 1 ---
198 2171105707770001 NOVVY YULIAR SURABAYA 17-Jul-77 31 S P KOMP. CITRA BATAM BLOK D NO. 72 1 1 ---
199 2171100106749002 NUGROHO MEDAN 1-Jun-74 35 B L CITRA BATAM BLK C 15 1 1 ---
200 2171030606819002 NUR ALIB BLITAR 6-Jun-81 28 S L PERUM CITRA BATAM D 04 1 1 ---
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
11/23
Page 11 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
201 2171115511890003 NURDEWI SITORUS LUMBAN TAGUR 2-Aug-85 20 B P PERUM CITRA BATAM BLOK C NO. 47 1 1 ---
202 2171102808759002 NUZULUR RIZQI SURABAYA 28-Aug-75 33 S L CITRABATAM BLOK C 54 1 1 ---
203 2171101905799001 OBED MEIRIA SULISTIYONO GROBOGAN 19-May-79 30 B L CITRA BATAM BLK D 13 1 1 ---
204 2171100208850001 PAJRUR RAHMAN BOGOR 2-Aug-85 23 B L KOMP CITRA BATAM BLOK C NO. 72 1 1 ---
205 2171102207890001 PANDO SIGALINGGING HUTAGINJANG 22-Jul-89 19 B L PERUM. CITRA BATAM BLOK C NO.65 1 1 ---
206 2171105001640001 PARSIH PURNANINGSIH MIRA SEMARANG 10-Jan-64 45 S P KOMP. CITRA BATAM BLOK D NO. 25 1 1 ---
207 2171102806880002 PENDI ERIKSON KOTA PINANG 28-Jun-88 21 B L PERUM. CITRA BATAM BLOK C NO. 65 1 1 ---
208 2171102402090020 PETRA PAULUS TARIGAN PEMATANG SIANTA 10-Dec-70 39 S L PERUMAHN CITRA BATAM,D 43 1 1 ---
209 2171101103749001 PHO LIONG DABO SINGKEP 11-Mar-74 35 S L CITRA BATAM BLOK D 60 1 1 ---
210 2171107006750002 PUJI RAHAYU DUMAI 30-Jun-75 34 S P KOMP. CITRA BATAM BLOK C NO. 98 1 1 ---
211 2171101012819002 PURWANTO KENDAL 10-Dec-81 27 B L CITRA BATAM D.55 1 1 ---
212 2171102305689001 R GURBADA KARSANA PUTRA CIAMIS 23-May-68 41 S L KOMPEK CITRA BATAM 1 1 ---
213 2171102907729002 RAFA I LAIS BATAM 29-Jul-72 36 S L KOMP CITRA BATAM D 63 1 1 ---
214 2171101810770002 RAHIMI DUMAI 18-Oct-77 31 B L KOMP. CITRA BATAM BLOK D NO. 43 1 1 ---
215 2171104705819004 RAMIATI SITORUS PARBUTARAN 7-May-81 28 S P KOMP CITRA BATAM BLOK D NO. 54 1 1 ---
216 2171100405689001 RAMLI TG PINANG 4-May-68 41 S L PERUM CITRA BATAM D.98 1 1 ---
217 2171092305880001 RAMON MAYWAN CUSADAK LILIN 28-Sep-87 20 B L PER CITRA BATAM D 1 1 1 ---
218 2171101504809003 REZKI HENDIKI MEDAN 15-Apr-80 29 S L CITRA BATAM BLOK C NO.73 1 1 ---
219 2171101205769010 RIKO PADANG 12-May-76 33 S L KOMP. CITRA BATAM BLOK C NO. 74 1 1 ---
220 2171106708719002 RINI SUNDARI TUNGKAR 27-Aug-71 37 S P PERUMAHAN CITRA BATAM, C 30 1 1 ---
T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
12/23
Page 12 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
221 031301200003297 RIRI NAYUNINGTIAS BOGOR 28-Sep-87 18 B P PERUMAHN CITRA BATAM, C 08 1 1 ---
222 2171105207819002 RISMAWATI SIDABUTAR PEMATANG SIANTAR 12-Jul-81 27 S P CITRABATAM BLOK D 79 1 1 ---
223 2171102411720002 RISTON SIBURIAN TG. HARAPAN 24-Nov-72 36 S L PERUM. CITRA BATAM BLOK C NO. 65 1 1 ---
224 2171102406799004 RISWANTO BATANG 24-Jun-79 30 S L PER CITRA BATAM D1 55 1 1 ---
225 2171105709700001 ROHMAH TULUNGAGUNG 17-Sep-70 38 S P KOMP CITRA BATAM BLOK D NO.79 1 1 ---
226 2171105712759003 ROSIDAH CILACAP 17-Dec-75 33 S P CITRA BATAM BLOK C NO.52 1 1 ---
227 2171105001840001 ROSITA TEMBILAHAN 10-Jan-84 25 B P KOMP. CITRA BATAM BLOK D NO. 07 1 1 ---
228 2171102912889001 RUDY HARTONO BANYUWANGI 29-Dec-88 20 B L PER CITRA BATAM C 63 1 1 ---
229 2171110306660001 SAMPE MIDUK SIHOMBING SIMASOM 28-Sep-87 42 S L PER CITRA BATAM C 55 1 1 ---
230 2171105310840001 SANTI SITORUS KAMPUNG RAWANG 13-Oct-84 24 B P KOMP. CITRA BATAM BLOK D NO. 96 1 1 ---
231 2171101102829003 SARDI UDIN CANDRA JERAMBANG 11-Feb-82 27 S L KOMPLEK CITRA BATAM BLOK D NO91 1 1 ---
232 2171102402829002 SARSONO SRAGEN 24-Feb-82 27 B L PER CITRA BATAM C 43 1 1 ---
233 2171070301830001 SARWONO MAGETAN, 1-Jan-83 25 B L PER CITRA BATAM D 1 1 1 ---
234 2171101907849003 SAUT MARPAUNG RIANIATE 19-Jul-84 24 B L PERUM. CITRA BATAM BLOK C.1 NO. 41 1 1 ---
235 52.02.012.54.09.86.24429 SEPTA DIANA NABELA SUNGAI PIRING 4-Sep-86 22 B P PERUMAHN CITRA BATAM C 24 1 1 ---
236 2171102109889001 SEPTIAN LESSELICH PRABOWO PURWOKERTO 21-Sep-88 20 S L PERUM. CITRA BATAM BLOK C NO. 07 1 1 ---
237 2171104601799001 SETIA ATIKAH JAKARTA 6-Jan-79 30 S P CITRA BATAM BLOK C-81 1 1 ---
238 2171105503839003 SHANTY RIMAWATI SITIO JAKARTA 15-Mar-83 26 B P CITRA BATAM BLOK C NO.69 1 1 ---
239 2171106608579001 SHARA SILVANA JAKARTA 26-Aug-57 51 S P CITRA BATAM BLOK D NO.18 1 1 ---
240 2171107008769004 SHELVIE MORITA PADANG 30-Aug-76 32 S P KOMP. CITRA BATAM BLOK C NO. 74 1 1 ---
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
13/23
Page 13 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
241 0319048/ 02/ 0556 SIANG BOI TG.PINANG 22-Apr-73 35 S P PERUMAHN CITRA BATAM, C 51 1 1 ---
242 2171100201440001 SILAS DWIDJANTARA JEPARA 2-Jan-44 65 S L KOMP. CITRA BATAM BLOK D NO. 53 1 1 ---
243 2171105211869001 SISKA NOVIANA UTAMI PURWOKERTO 12-Nov-86 22 B P PERUM. CITRA BATAM BLOK C NO. 07 1 1 ---
244 2171104605849002 SITI KHASANAH BANJAR NEGARA 6-May-84 25 S P KOMPLEK CITRA BATAM BLOK D NO91 1 1 ---
245 2171104804669001 SITI ROCHAYAH PURWOKERTO-BANYUMAS 8-Apr-66 43 S P PERUM. CITRA BATAM BLOK C NO. 07 1 1 ---
246 2171104909620001 SIW NGO KP. SELINDUNG 9-Sep-62 46 S P KOMP CITRA BATAM BLOK C NO. 100 1 1 ---
247 2171100510620001 SLAMET RIYADI SEMARANG 5-Oct-62 46 S L KOMP. CITRA BATAM BLOK D NO. 25 1 1 ---
248 2171106502660001 SO HUI BENGKALIS 25-Feb-66 43 S P KOMP. CITRA BATAM BLOK C NO. 56 1 1 ---
249 0319048/ 02/ 0556 SOETISNO RACHMAT PONTIANAK 28-Sep-87 43 S L PERUMAHN CITRA BATAM, C 51 1 1 ---
250 2171106512799005 SOFYAN MEDAN 14-May-58 51 S L KOMP. CITRA BATAM BLOK D/243 1 1 ---
251 3311026707800002 SRI LESTARI KUPAN 27-Jul-80 29 B P KOMP. CITRA BATAM BLOK C NO. 11 1 1 ---
252 2171107012689003 SRI PURWATI KEBUMEN 30-Dec-68 40 S P KOMP CITRA BATAM, D 100 1 1 ---
253 520201452067618619 SRI SETIA NINGSIH LAMONGAN, 28-Sep-87 33 S P CITRA BATAM BLOK C NO 47 1 1 ---
254 2171104410809005 SRI SURIATI KISARAN 4-Oct-80 28 B P CITRA BATAM BLK C 15 1 1 ---
255 2171106901759004 SRI SUSILO EKOWATI KLATEN 29-Jan-75 34 S P PER CITRA BATAM,C 52 1 1 ---
256 2171104102749001 SRI YULIATI MALANG 1-Feb-74 35 S P PERUMAHAN CITRA BATAM- C 23 1 1 ---
257 3318055202870002 SRIPUJI PAT 2-Dec-87 22 B P PERUMAHN CITRA BATAM,D 76 1 1 ---
258 2171101401489001 SUDIONO M RAMLI YOGYAKARTA 14-Jan-48 61 S L PER CITRA BATAM C1 18 1 1 ---
259 2171101108710001 SUGINO PURWOSARI 11-Aug-71 37 S L KOMP CITRA BATAM BLOK D NO.79 1 1 ---
260 2171026005740002 SUHAYATI BATAM 28-Sep-87 24 B P PERUM CITRA B ATAM BLOK D 64 1 1 ---T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
14/23
Page 14 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
261 2171104605739004 SUKINI BELAKANG PADANG 6-May-73 36 S P CITRA BATAM BLOK C NO.58 1 1 ---
262 2171030407830009 SUKINO PACITAN 4-Jul-83 25 B L KOMP. CITRA BATAM D NO 1 1 ---
263 0313012/00/002162 SUMIATI S.PANJANG 31-Jan-37 71 S P PERUMAHN CITRA BATAM, D 29 1 1 ---
264 2171101506709001 SUNARTO CILACAP 15-Jun-70 39 S L CITRA BATAM BLOK C NO.52 1 1 ---
265 2171102407729003 SUNARTO YOGYAKARTA 24-Jul-72 36 S L CITRA BATAM BLOK C-81 1 1 ---
266 2171105209680001 SUNDARIYAH SUMEDANG 12-Sep-68 40 S P KOMP CITRA BATAM BLOK D NO. 76 1 1 ---
267 2171100412689001 SUPRIYADI SEMARANG 4-Dec-68 40 S L PER CITRA BATAM,C 24 1 1 ---
268 2171100312720002 SUPRIYANTO PONOROGO 3-Dec-72 36 S L KOMP CITRA BATAM BLOK D NO. 76 1 1 ---
269 2171106809819002 SURATMI INDRAMAYU 28-Sep-81 27 S P KOMPLEK CITRA BATAM BLOK D NO 91 1 1 ---
270 2171105207680001 SUSANNA REBECCA SELAT PANJANG 12-Jul-68 40 S P KOMP CITRA BATAM BLOK C NO. 45-46 1 1 ---
271 2171107012890001 SUSI SELAT PANJANG 30-Dec-89 19 B P KOMP. CITRA BATAM BLOK D NO. 33 1 1 ---
272 2171106411850001 SUSI LAWATI LUBUK SIKAPING 24-Nov-85 23 B P KOMP. CITRA BATAM BLOK C NO. 86 1 1 ---
273 2171100807869002 SUTARMAN DURI 13-Jun-86 23 B L KOMP. CITRA BATAM BLOK D/212 1 1 ---
274 21710200430124907159 SYAIFUL AGUS PADANG PANJANG 28-Sep-87 60 S L KOMP.CITRA BATAM C 02 1 1 ---
275 2171071904819002 TAGOR PANGONDIAN PURBA TUALANG, 1-Apr-81 27 B L MASJID RAYA BATAM CENTRE, 1 1 ---
276 2171106106599003 TAN HUI FEN MEDAN 21-Jun-59 50 S P KOMP CITRA BATAM BLOK D NO.85 1 1 ---
277 2171105804739003 TAN MIYATI LUBUK LINGGAU 18-Apr-73 36 S P CITRA BATAM BLK D 47, 1 1 ---
278 2171071071507739003 TARMUJI HASAN BANYUWANGI 15-Jul-73 36 S L PERUMAHN CITRA BATAM D 19 RT 1 1 ---
279 2171106507689001 TATI MEDAN 25-Jul-68 40 S P KOMPLEK CITRA BATAM BLOK D NO91 1 1 ---
280 21711000519077909640 TAUFIK MANURUNG KAPIAS BAT 19-Jul-80 29 B L PERUMAHN CITRA BATAM C 31 1 1 ---
T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
15/23
Page 15 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
281 21710600415010812047 TEGUH PRAKOSO SURAKART 11-Dec-75 39 S L PERUM CITRA B ATAM BLOK D 64 1 1 ---
282 2171102104620001 TJAI TJUN BENGKALIS 21-Apr-62 47 S L KOMP. CITRA BATAM BLOK C NO. 56 1 1 ---
283 2171106711790001 TJANG DJUNG THO SINGKAWANG 27-Nov-79 29 S P KOMP. CITRA BATAM BLOK C NO. 22 1 1 ---
284 52.02.012.26.02.77.04677 TJENG TJIUNG PONTIANAK, 6-Feb-77 31 S L PERUMAHN CITRA BATAM,C 100 1 1 ---
285 21.71.10.001.03.08.69.07051 TJHAI KIT LIONG SAMBAS, 28-Sep-87 39 S L PERUMAHN CITRA BATAMC 99 1 1 ---
286 2171106405579001 TJI KUANG MORO RIAU 24-May-57 52 S P KOMPLEK CITRA BATAM,D 09 1 1 ---
287 2171104511529001 TJIA KIM THU BANGKA 5-Nov-52 56 S P KOMP CITRA BATAM D, 63 1 1 ---
288 2171104412810001 TJUI SENG BURU KARIMUN 2-Sep-56 52 S P KOMPLEK CITRA INDAH BLOK C NO 15 1 1 ---
289 2171105201570001 TRIONO WIBOWO BANDUNG 11-Jun-76 33 S P KOMP. CITRA BATAM BLOK D NO. 101 1 1 ---
290 2171100601850002 TRIYONO GETASAN SEMARAN 1-Jun-85 24 B L PERUMAHN CITRA BATAM C 11 1 1 ---
291 2171105112759002 TUTY HOENDRAWATI MOJO KERTO 11-Dec-75 33 S P PERUM CITRA BATAM, D 26 1 1 ---
292 2171100302779001 UDIN CHANDRA TELUK SUNGKA 3-Feb-77 32 S L KOMPLEK CITRA BATAM BLOK D NO91 1 1 ---
293 2171104102559002 UTAMY KENDAL 1-Feb-55 54 S P PER CITRA BATAM D1 55 1 1 ---
294 2171102402090020 VERA SARI MEDAN 2-Feb-73 36 B P KOMP. CITRA BATAM BLOK D 43 1 1 ---
295 2171107108839003 VINA VANESIA PEKAN BARU 31-Aug-83 25 B P KOMP CITRA BATAM BLOK C NO.57 1 1 ---
296 2171042212710004 VIVA MORIETA ADEL PADANG 11-Dec-75 31 S P PERUMAHN CITRA BATAM D 95 1 1 ---
297 10351720120130301 WATI BINTI MANGAD KARAWAN 5-Jan-61 48 S P PERUMAHN CITRA BATAM D 90 1 1 ---
298 2171101912889001 WELL FING SAMARINDA 19-Dec-88 20 B L KOMP.CITRA BATAM D.31 1 1 ---
299 2171102110740001 WERYANDY PEKANBARU 1-Sep-74 34 S L PERUMAHN CITRA BATAM, D 15 1 1 ---
300 2171104907849002 WILI T.SUSANTI KALIMANTAN 9-Jul-84 24 B P KOMP.CITRA BATAM D.31 1 1 ---
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
16/23
Page 16 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
301 1050215707633007 WIWI SUDEWI BANDUNG 27-Jul-63 30 S P CITRA BATAM BLOK C NO 97 1 1 ---
302 2171105802759003 YANTI SINGAPORE 18-Feb-75 34 S P PER CITRA BATAM D 1 1 1 ---
303 2171105909739001 YANTI ERANTY CIREBON 19-Sep-73 35 S P KOMP. CITRA BATAM 1 1 ---
304 2171100512770002 YANTO LAMONGA 11-Dec-75 39 S L PERUM CITRA B ATAM BLOK D 67 1 1 ---
305 2171100702689002 YEK HONYA ROBBY WTALIMBEKAS SURABAYA 19-Jan-67 19 B L PERUMAHN CITRA BATAM,D 20 1 1 ---
306 2171105003900001 YENI BENGKALIS 10-Mar-90 19 S P KOMP. CITRA BATAM BLOK C NO. 56 1 1 ---
307 2171102712649001 YUDI WAHYUDI JAKARTA 3-Jan-76 44 S L PERUMAHAN CITRA BATAM, C 08 1 1 ---
308 2171104307820002 YULI ROHMIATUN BANTUL 3-Jul-82 26 S P KOMP. CITRA BATAM BLOK D NO. 07 1 1 ---
309 52.02.014.06.215 YUYUN KURNIA PUSPITA AN BANDUNG, 8-Jun-71 37 S P PERUMAHN CITRA BATAM D 82 1 1 ---
310 2171091809720001 ZAINAL ARIFIN PADANG 15-Sep-72 47 S L PERUMAHN CITRA BATAM D 07 1 1 ---
311 2171103012579001 ZAINUDDIN DABOSINGKEP 12-Feb-79 51 S L CITRA BATAM BLOK D NO.18 1 1 ---
312 2171102302639003 ZAKARIAS SE DJERIKI RUTENG - PLORES 23-Feb-63 46 S L PERUMAHAN CITRA BATAM C 23 1 1 ---
313 2171101204719010 REINHART HALASAN SIANTURI JAKARTA 12-Apr-71 34 S L CITRA BATAM BLOK C NO 66 1 1 ---
314 2171104809739004 VIRNA ANGELA MURTI M BANDUNG 8-Sep-73 38 S P CITRA BATAM BLOK C NO 66 1 1 ---
315 2171104809739004 VERA BATAM 8-Jan-90 38 S P CITRA BATAM BLOK D NO 104 1 1 ---
316 2171091809720001 FRI YANSEN GINTING MEDAN 30-Apr-67 43 S L PERUM. CITRA BATAM BLOK D. 67 1 1 ---
317 2171103012579001 BETTY R TARIGAN MEDAN 19-Jan-67 43 S P PERUM. CITRA BATAM BLOK D. 67 1 1 ---
318 2171101505670001 TUNGGUL JHONSON E. O. P. BARU 15-May-67 33 S L PERUM. CITRA BATAM BLOK D. 84 1 1 ---
319 2171105609800001 JENNY ROSSEIDA S. MEDAN 16-Sep-80 30 S P PERUM. CITRA BATAM BLOK D. 84 1 1 ---
320 21711060088200001 AGUSMAWATI SITUMORANG MEDAN 20-Aug-82 18 B P PERUM. CITRA BATAM BLOK D. 84 1 1 ---
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
T T T T T T T T
-
8/12/2019 TPS 01 DPT OK
17/23
Page 17 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
321 2171075708830006 RISNAULI SITUMORANG MEDAN 17-Aug-83 17 S P PERUM. CITRA BATAM BLOK D. 84 1 1 ---
322 21711000663117304602 YENI NOVITA G. RANDAH 23-Nov-73 37 S P PERUM. CITRA BATAM BLOK D. 103 1 1 ---
323 520201201117406968 DELVI PAYAKUMBUH 1-Nov-74 36 S P PERUM. CITRA BATAM BLOK D. 10 1 1 ---
324 520201260067026386 RAMOT YANTI PANJAITAN PINTU BATU 20-Jun-79 31 S P PERUM. CITRA BATAM BLOK D. 79 1 1 ---
325 217110520665002 WAHYU MAHATMANINGRUM UNGARAN 12-Jun-65 45 S P PERUM. CITRA BATAM BLOK C. 27 1 1 ---
326 217110170781001 RANTONIUS HAREFA TELUK DALAM 17-Jul-81 19 B P PERUM. CITRA BATAM BLOK C. 27 1 1 ---
327 217110590282001 FEBERTINA DACHI HILISMAETANO 19-Feb-82 28 S L PERUM. CITRA BATAM BLOK C. 63 1 1 ---
328 2171101502819005 EDISAMA ZAI HILIGARA 15-Feb-81 29 B L PERUM. CITRA BATAM BLOK C. 27 1 1 ---
329 21710200453028113627 SITINA LEMBU NIAS 13-Feb-81 29 S L PERUM. CITRA BATAM BLOK C. 63 1 1 ---
330 010404021012031978 SARMAH SEMANAK MEDAN 12-Mar-78 32 S P PERUM. CITRA BATAM BLOK C. 27 1 1 ---
331 2171064803839005 NURSITI BUTAR BUTAR MEDAN 8-Mar-83 27 B P PERUM. CITRA BATAM BLOK C. 63 1 1 ---
332 21711000123097708292 NASRUDIN BOGOR 23-Sep-77 33 S L PERUM. CITRA BATAM BLOK C. 72 1 1 ---
333 520201222028306813 SUARTONO PONTIANAK 1-Feb-83 27 B L PERUM. CITRA BATAM BLOK C. 11 1 1 ---
334 2171104905839003 NANI SUSANTI TJ. PINANG 9-May-83 27 B P PERUM. CITRA BATAM BLOK C 85 1 1 ---
335 2171102501081890 BIANCA SABADO BAKRIM C. PHILIPINA 27-Jun-92 18 B P PERUM. CITRA BATAM BLOK C 38 1 1 ---
336 2171101312889002 RAMBO GUNAWAN DUMAI 13-Dec-88 22 B L PERUM. CITRA BATAM BLOK C 98 1 1 ---
337 2171101204719010 NIKSON SIGAOL 23-Sep-87 23 B L PERUM. CITRA BATAM BLOK C. 01 1 1 ---
338 21711020679007 PANATARAN SINURAT MEDAN 19-Jan-67 29 S L PERUM. CITRA BATAM BLOK C. 01 1 1 ---
339 2171106505759008 MASRANI LUMBAN TOBING MEDAN 14-Apr-78 29 S L PERUM. CITRA BATAM BLOK C. 01 1 1 ---
340 520100308048215419 SANG PUTRA DUHA MEDAN 8-Apr-82 28 S L PERUM. CITRA BATAM BLOK D. 33 1 1 ---
M d lA 1 KPU
-
8/12/2019 TPS 01 DPT OK
18/23
Page 18 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
341 2171021008022405 ANDRIANTO LAHAGU MEDAN 28-May-85 25 B L PERUM. CITRA BATAM BLOK D. 33 1 1 ---
342 217110170781001 IRINAWATI TANAH LULU 22-Feb-40 70 S P PERUM. CITRA BATAM BLOK D. 34 1 1 ---
343 217110590282001 LILI MAKASAR 17-Aug-75 35 S P PERUM. CITRA BATAM BLOK D. 34 1 1 ---
344 2171105201570001 PITER MAKASAR 14-Apr-78 32 S L PERUM. CITRA BATAM BLOK D 34 1 1 ---
345 2171090910819008 SURYANTO BATAM 9-Oct-81 29 S L PERUM. CITRA BATAM BLOK D. 25 1 1 ---
346 2171101108710001 SUGINO PURWOSARI 11-Aug-71 39 S L PERUM. CITRA BATAM BLOK D. 79 1 1 ---
347 520201557097016917 ROHMAH TULUNG AGUNG 17-Sep-70 40 S P PERUM. CITRA BATAM BLOK D. 79 1 1 ---
348 2171034212710003 WARI'AH JAKARTA 2-Dec-71 39 S P PERUM. CITRA BATAM BLOK D. 79 1 1 ---
349 2171101208759012 ASMUDI WONOSOBO 12-Aug-75 35 S L PERUM. CITRA BATAM BLOK D. 79 1 1 ---
350 2171104905839003 ABDUL SUKRI LAMPUNG 3-Oct-76 34 S L PERUM. CITRA BATAM BLOK D. 79 1 1 ---
351 2171102501081890 NURDIN YOGYAKARTA 14-Apr-78 29 S L PERUM. CITRA BATAM BLOK D. 69 1 1 ---
352 2171020803780003 ADI PURWA LAMPUNG SEL. 8-Mar-74 29 S L PERUM. CITRA BATAM BLOK D. 81 1 1 ---
353 2171103011789002 M. DENNY NOVIAR MUHARYADI PALEMBANG 30-Nov-78 32 S L PERUM. CITRA BATAM BLOK D. 92 1 1 ---
354 217110670769005 IDA INDRIASTUTI YOGYAKARTA 27-Oct-76 34 S P PERUM. CITRA BATAM BLOK D. 92 1 1 ---
355 127108091282003 TOGU SIREGAR BELAWAN 9-Dec-82 28 S L PERUM. CITRA BATAM BLOK D. 69 1 1 ---
356 2171106412839005 DELLIA FITRI LUBUK SIKAPING 24-Dec-83 27 B P PERUM. CITRA BATAM BLOK D. 72 1 1 ---
357 2171104405879004 MEGA IRAWATI LUBUK SIKAPING 4-May-87 23 B P PERUM. CITRA BATAM BLOK D. 72 1 1 ---
358 21308024503790001 YELNALISMAR LUBUK SIKAPING 5-Mar-79 31 S P PERUM. CITRA BATAM BLOK D. 72 1 1 ---
359 2171104905839003 TULUS YOHANES RANTAU PRAPAT 10-Jun-92 18 B L PERUM. CITRA BATAM BLOK D. 80 1 1 ---
360 2171102501081890 YULIANA SIDOREJO 14-Apr-78 30 S P PERUM. CITRA BATAM BLOK D. 80 1 1 ---
ModelA 1-KPU
-
8/12/2019 TPS 01 DPT OK
19/23
Page 19 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
Model A.1-KPU
361 2171100512770002 RIO FEBIANSYAH PALEMBANG 10-Apr-90 20 B L PERUM. CITRA BATAM BLOK D. 71 1 1 ---
362 2171100702689002 EMANUEL FRENKY SOE 24-Feb-75 35 S L PERUM. CITRA BATAM BLOK D. 68 1 1 ---
363 2171105003900001 WELL MINCE KUPANG 3-Jul-7832
S P PERUM. CITRA BATAM BLOK D. 68 1 1 ---
364 2171106603859009 RATI PUZI ASTUTIK MALANG 26-Mar-85 28 S P PERUMAHAN CITRA BATAM BLOK D NO 76 1 1 ---
365 2171104606620001 ERIAWATI PADANG 6-Jun-62 29 B P PERUMAHAN CITRA BATAM BLOK C NO 57 1 1 ---
366 21711000104058107485 QIDRO SUBEJO BANJAR NEGARA 4-May-81 29 S L PERUMAHAN CITRA BATAM BLOK C NO 37 1 1 ---
367 2171104109779011 YATI DJAMALUDIN KALABAHI 1-Sep-77 32 S P PERUMAHAN CITRA BATAM BLOK D NO 71 1 1 ---
368 2171105606729001 AZWAR KOTO GUNUNG 8-Jun-82 27 B L PERUMAHAN CITRA BATAM BLOK D NO 42 1 1 ---
369 2171104401779006 SOFIAH LUBIS HUTABARINGIN 4-Jan-77 33 S P PERUMAHAN CITRA BATAM BLOK D NO 84 1 1 ---
370 211106706929002 BIANCA SABADO BAKRIM CHEUNG SAN FERNANDO 27-Jun-92 27 B P PERUMAHAN CITRA BATAM BLOK C NO 37/38 1 1 ---
371 2171100209660001 TAN POI AN TANJUNG BATU,KUNDUR 2-Sep-66 27 S L PERUMAHAN CITRA BATAM BLOK C NO 96 1 1 ---
372 21711000210126905290 MAKSUM ALHADI TULUNG AGUNG 10-Dec-69 18 B L PERUMAHAN CITRA BATAM BLOK C NO 94 1 1 ---
373 2171100101549001 MAISAROH TANJUNG RAJA 20-Jan-88 22 B P PERUMAHAN CITRA BATAM BLOK C NO 36 1 1 ---
374 520201`203068725887 LIAN PRIHATN MULYONO SINGKAWANG 3-Jan-87 23 B L PERUMAHAN CITRA BATAM BLOK C NO 100 1 1 ---
375 520804826126084864 HARRIS PANDIANGAN TAPANULI UTARA 26-Dec-60 29 S L PERUMAHAN CITRA BATAM BLOK D NO 24 1 1 ---
376 2171066810620001 RIMENDA BR TARIGAN KABAN JAHE,KARO 28-Oct-62 29 S P PERUMAHAN CITRA BATAM BLOK D NO 24 1 1 ---
377 2171061511830003 MC GATRA PANDIANGAN KABAN JAHE,KARO 15-Nov-83 28 S L PERUMAHAN CITRA BATAM BLOK D NO 24 1 1 ---
378 2171066312900001 DENATALIA PAIDIANGAN BATAM 23-Dec-90 25 B P PERUMAHAN CITRA BATAM BLOK D NO 24 1 1 ---
379 21711000104058307521 RISMAN PATI 4-May-83 70 S L PERUMAHAN CITRA BATAM BLOK C NO 64 1 1 ---
380 217110146739006 GUNANTO PONOROGO 14-Jun-73 35 S L PERUMAHAN CITRA BATAM BLOK D NO 76 1 1 ---
Model A.1-KPU
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Page 20 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
381 2171102905739003 YENNY PUTRY BATU SANGKAR 1-Oct-78 32 S P PERUMAHAN CITRA BATAM BLOK D NO 71 1 1 ---
382 2171103006710001 GUNGUN GUMILAR BOGOR 15-Jun-82 29 S L PERUMAHAN CITRA BATAM BLOK C NO 66 1 1 ---
383 21712030405820001 HERDANI SEI TAWAR 4-May-82 39 S L PERUMAHAN CITRA BATAM BLOK D NO 76 1 1 ---
384 2171074509859004 TETRI VADONA TABING 5-Sep-85 40 S P PERUMAHAN CITRA BATAM BLOK D NO 76 1 1 ---
385 2171100702490001 ANDI ASKAR PETTA RANI WATA M PONE 7-Feb-49 39 S L PERUMAHAN CITRA BATAM BLOK C NO 21 1 1 ---
386 21711000162016505010 ANDI SUKMAWATI JAMBI 22-Jan-65 35 S P PERUMAHAN CITRA BATAM BLOK C NO 102 1 1 ---
387 217104020369004 APUL SITANGGANG TAPUNULI UTARA 2-Mar-63 34 S L PERUMAHAN CITRA BATAM BLOK D NO 58 1 1 ---
388 217104605719001 ANGELYNA SITORUS TEBING TINNGI 24-May-71 34 S P PERUMAHAN CITRA BATAM BLOK D NO 58 1 1 ---
389 52020212038009960 NURSUPRIUHATIN PATI 12-Mar-80 36 S P PERUMAHAN CITRA BATAM BLOK C NO 69 1 1 ---
390 2171101305759002 ARIS TRI ARIANTO SURABAYA 13-May-75 32 S L PERUMAHAN CITRA BATAM BLOK D NO 30 1 1 ---
391 21710600324015519984 RIZALDY LAMARDI JAKARTA 24-Jan-55 34 S L PERUMAHAN CITRA BATAM BLOK C NO 05 1 1 ---
392 2171103006710001 KARNO MELKY KAHIMPON KAYUWATU 8-Sep-80 28 S L PERUMAHAN CITRA BATAM BLOK D NO 32 1 1 ---
393 2171104111739001 LIDYA GERUNGAN KAYUWATU 05 AGUST 1981 28 S P PERUMAHAN CITRA BATAM BLOK D NO 32 1 1 ---
394 2171104412810001 KRISTINA NATHALIA M LUMBAN DATU 06 AGUST 1982 29 S P PERUMAHAN CITRA BATAM BLOK D NO 42 1 1 ---
395 0650015430850005 IR IWAN BUDI SETIAWAN BANYUWANGI 14-Jun-70 29 S L PERUMAHAN CITRA BATAM BLOK D NO 37 1 1 ---
396 2171105312779001 OMI MARIA CIAMIS 12-Jul-68 32 S P PERUMAHAN CITRA BATAM BLOK D NO 37 1 1 ---
397 2171025805770003 IDA FURWATI KARAWANG 5-Sep-74 27 S P PERUMAHAN CITRA BATAM BLOK C NO 94 1 1 ---
398 2171100512770002 URSULA MANIT BIANE 6-Apr-68 33 S P PERUMAHAN CITRA BATAM BLOK C NO 49 1 1 ---
399 2171104505729005 VICTOR SANY DATH SITEPU TALUN KENAS 17-Jul-92 27 S L PERUMAHAN CITRA BATAM BLOK C NO 49 1 1 ---
400 2171101004900001 RIO FEBRIANSYAH PALEMBANG 10-Apr-90 27 S L PERUMAHAN CITRA BATAM BLOK D NO 71 1 1 ---
T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T
T T T T T T T T T T T T T T T T T T T T T T T T
T T T T T T T T
Model A.1-KPU
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Page 21 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
401 2171102912920001 M RIZKY FATAHILLIAH BATAM 29-Dec-92 18 B L PERUMAHAN CITRA BATAM BLOK D NO 71 1 1 ---
402 2171106104759005 AH WE SELAT PANJANG 21-Apr-75 22 B P PERUMAHAN CITRA BATAM BLOK C NO 96 1 1 ---
403 2171100811789001 RISWANTI PALENTINA TJ HARAPAN 18-Apr-91 23 B L PERUMAHAN CITRA BATAM BLOK D NO 19 1 1 ---
404 2171106204739004 SIANG BOI TANJUNG PINANG 22-Apr-73 29 S P PERUMAHAN CITRA BATAM BLOK C NO 51 1 1 ---
405 2171102410920001 ARI FERNANDO RA CHMAT TANJUNG PINANG 24-Oct-92 29 S L PERUMAHAN CITRA BATAM BLOK C NO 51 1 1 ---
406 21710600766027524945 SRI MURNIATI MELATI 26-Feb-75 28 S P PERUMAHAN CITRA BATAM BLOK NO 1 1 ---
407 2171105303590001 ASRI SUJIATI SURABAYA 13-Mar-59 25 B P PERUMAHAN CITRA BATAM BLOK D NO 76 1 1 ---
408 2171070301830001 MARMAN MALANG 1 AGUST 1959 70 S L PERUMAHAN CITRA BATAM BLOK C NO 64 1 1 ---
409 TAURAN HASIBUAN TAPANULI SELATAN 3-Sep-79 35 S L PERUMAHAN CITRA BATAM BLOK C NO 36 1 1 ---
410 ANDI PATIROI OSKHANO UJUNG PANDANG 28-Oct-88 32 S L PERUMAHAN CITRA BATAM BLOK D NO 21 1 1 ---
411 2171104612909003 ROMA ISMA LW. KINGA 6-Dec-90 29 S L PERUMAHAN CITRA BATAM BLOK C NO 61 1 1 ---
412 21711000262097413453 SRI NASROTUN BLITAR 22-Sep-74 39 S P PERUMAHAN CITRA BATAM BLOK D NO 81 1 1 ---
413 WERI PAKAN RABOA 12 AGUS 77 40 S P PERUMAHAN CITRA BATAM BLOK D NO 95 1 1 ---
414 520100809058597422 MAY TULUS PANDIANGAN PUSUK 9-May-85 39 S L PERUMAHAN CITRA BATAM BLOK D NO 83 1 1 ---
415 2171101403879002 RICHARD SIBURIAN LINTONG NIHUTA 14-Mar-87 35 S L PERUMAHAN CITRA BATAM BLOK D NO 58 1 1 ---
416 2171071001789002 RONI PRANATA MEDAN 10-Jan-78 34 S L PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
417 BAGUS IMAM NURCAHYA GROBOGAN 15 AGUS 90 29 S L PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
418 ROESDY TJ, RAJA 28-Jul-86 29 S L PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
419 MIM IN SUMINAR BANDUNG 15-Jun-60 32 S P PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
420 2171012007910001 DARMAWAN BIN HASAN GERANTING 20-Jul-91 34 S L PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
Model A.1-KPU
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Page 22 of 23
!"#$%&'% ( *+!,-.,.& "%., *+/.0.1.& ( 2.1.0 *#1.
*.2,!.1+& 3 *#1. ( 2.1.0 4+'.3*+-,".5.& ( 1+-,* 1+"%&6
1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat
421 AFRIZAL TIKU 21-Apr-84 28 S L PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
422 DARMADI B DANTO PANDEGELANG 5-Mar-88 36 S L PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
423 520200969068609088 ROGANDA SIRINGO RINGO TARUTUNG 29-Jun-86 32 S P PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
424 2171100512770002 DIAN SETYAWAN SLEMAN 5-Dec-77 34 S L PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
425 2171064307830001 SRI RUSILAWATI SLEMAN 3-Jul-83 28 S P PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
426 YESI BINTI ENGKAR BANDUNG 15-Nov-83 29 S P PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
427 2171024602900001 ADHI WIJAYATI GROBOGAN 6-Feb-90 29 S P PERUMAHAN CITRA BATAM BLOK C NO 11 1 1 ---
428 820414400195 JOHANES GOSPEL BLORA 6-Apr-82 30 S L PERUMAHAN CITRA BATAM BLOK C NO 47 1 1 ---
429 3576022703830002 DANNY MARDIANTO MOJOKERTO 27-Mar-83 29 S L PERUMAHAN CITRA BATAM BLOK C NO 47 1 1 ---
430 ZULKIPLI KUNINGAN JABAR 10-Oct-81 31 S L PERUMAHAN CITRA BATAM BLOK C NO 47 1 1 ---
431 TIARNI MEDAN 27-May-83 29 S P PERUMAHAN CITRA BATAM BLOK C NO 47 1 1 ---
432 ASWAN P/B MEDAN 13-Jan-87 28 S L PERUMAHAN CITRA BATAM BLOK C NO 47 1 1 ---
433 HERMAN HARAHAP MEDAN 16-Sep-90 29 S L PERUMAHAN CITRA BATAM BLOK C NO 47 1 1 ---
434 OKMIDIANSYAH PALEMBANG 20-Oct-90 29 S L PERUMAHAN CITRA BATAM BLOK C NO 47 1 1 ---
435 DARWIN PASARIBU SUMBAR 27-Apr-89 19 B L PERUMAHAN CITRA BATAM BLOK C NO 47 1 1 ---
Batam, 10 Juli 2013
Catatan : KETERANGAN : Disahkan dalam Rapat Pleno PPS tanggal 10 Juli 2013
Status Perkawinan LAKI-LAKI 233 PANITIA PEMUNGUTAN SUARA TELUK TERING
B = Belum Nikah PEREMPUAN 202 Nama
S = Sudah Nikah TOTAL 435
P = Pernah Nikah 1. Ketua : MILA SRI RIZKI
Jenis Kelamin : 2. Anggota : AMIR LUBIS
Lk = Laki-Laki
Pr = Perempuan 3. Anggota : DIAN NOVITA
2) = Cacat yang disandang Pemilih kalau ada
T T T T T T
Model A.1-KPU
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Page 23 of 23
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1!' ( 78
No No. KK NIK Nama Tempat Lahir Tanggal Lahir Umur
Status
PerkawinanB/S/P
Jenis
Kelamin L/P
Jalan/Dukuh Rt Rw
8 9 : ; < = > ? @ 87 88 89 8:
Keterangan
4.1. !+0%-%5 '+0+&1.".!ABCDCEFG ,BHB .GIIJKF 4!"L 4!4L 4!"4 !MJNCGOC PFG 4!"4 *FQHRFKAG3*JKF
1FEHG 978;
Alamat