Contoh Sampul Berkas Perkara

Sampul Berkas Perkara

KEPOLISIAN REPUBLIK INDONESIA

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Logo Kepolisian RI

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            PRO JUSTITIA

                                                           

                                                           

SAMPUL BERKAS PERKARA

No. Pol.: BP/ ......................

Kejadian perkara Pidana tanggal .................................... di ....................................................

Dilaporkan tanggal ..................................................................................................................

Uraian singkat perkara pidana yang terjadi ............................................................................

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Melanggar Pasal ........................................................................................................................

No. Laporan Polosi	Nama, nama kecil, alias, tempat dan tgl lahir/umur. agama, kewarganegaraan, tempat tinggal, pekerjaan, sudah pernah dihukum berapa kali	Tanggal		Keterangan
		ditahan	dikeluarkan

                       

                                                                 Malang, ...................................., 2013

Mengetahui,

..............................                                                Penyidik/Penyidik Pembantu

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