LAPORAN PERJALANAN DINAS PIMPINAN/DOSEN/KARYAWAN Data Pejabat yang Melakukan Perjalanan Dinas Nama : ............................................................................................................................................... NIP : ............................................................................................................................................... Pangkat/Golongan : ............................................................................................................................................... Satuan Kerja : ............................................................................................................................................... Uraian Kegiatan Perjalanan Dinas Dasar Kegiatan : ............................................................................................................................................... Tanggal : ............................................................................................................................................... Lokasi Tujuan : ............................................................................................................................................... Judul Kegiatan : ............................................................................................................................................... Hasil Kegiatan : ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... Manfaat untuk Institusi ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... Demikian laporan perjalanan ini dibuat dengan sebenar-benarnya. Semarang, Pembuat Laporan ……………………………………… NIP. LAPORAN PERJALANAN DINAS DRIVER Data Pejabat yang Melakukan Perjalanan Dinas Nama : ............................................................................................................................................... NIP Pangkat/Golongan Satuan Kerja Kendaraan Dinas : : : : ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... Uraian Kegiatan Perjalanan Dinas Dasar Kegiatan : *Terlampir Undangan atau Nota Dinas Pimpinan Tanggal : ............................................................................................................................................... Lokasi Tujuan : ............................................................................................................................................... Kegiatan : ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... ............................................................................................................................................... Demikian laporan perjalanan ini dibuat dengan sebenar-benarnya. Semarang, Pembuat Laporan ……………………………………… NIP.
