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Contoh Surat Keterangan Kematian - Contohsurat
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Contoh Surat Keterangan Kematian

Surat Keterangan Kematian pada umumnya diterbitkan oleh rumah sakit. Surat ini biasa menjadi salah satu syarat lampiran untuk mengajukan pencairan dana asuransi jiwa atau hal lainnya. Format Surat Keterangan Kematian pada umumnya berisi nama, tempat tanggal lahir, umur, status dan alamat. Surat Keterangan Kematian dapat diterbitkan melalui beberapa proses. Seperti harus memiliki surat pengantar penerbitan dari ketua RT, RW dan Kelurahan.

Surat Keterangan Kematian juga dapat diterbitkan oleh pihak kepolisian jika ada alasan khusus seperti karena telah melewati otopsi jenazah atau yang lainnya. Dalam beberapa situasi dan kondisi, Surat Keterangan Kematian juga dapat menjadi salah satu faktor pertimbangan untuk melunaskan hutang jika pihak terkait atau yang berhutang telah meninggal dunia.

Kegunaan Surat Keterangan Kematian :

  1. Mengajukan pencairan dana asuransi jiwa
  2. Pembagian hak waris
  3. Mengurus dana pensiunan
  4. Mengurus hutang piutang (situasi dan kondisi)
  5. Penetapan status janda atau duda kepada pasangan yang ditinggalkan

Kali ini saya ingin mencoba membuat Contoh Surat Keterangan Kematian  yang simpel tetapi tanpa mengesampingkan format yang utama didalamnya.

Contoh surat yang saya buat ada 2 tipe, yaitu :

  1. Contoh Surat Keterangan Kematian 1 adalah Surat Keterangan Kematian yang diterbitkan oleh pihak rumah sakit untuk keluarga yang ditinggalkan.
  2. Contoh Surat Keterangan Kematian 2 adalah Surat Keterangan Kematian yang diterbitkan oleh Dinas Kependudukan dan Catatas Sipil (Disdukcapil), yang biasa digunakan untuk mengajukan pencairan dana asuransi jiwa, pembagian hak waris, dl.

Kedua surat ini sama pentingnya karena pengurusan dokumen terkadang membutuhkan surat dari rumah sakit namun terkadang membutuhkan surat dari desa atau kelurahan setempat.

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Contoh Surat Keterangan Kematian Dari RS dan Kelurahan

Contoh Surat keterangan kematian dari Rumah Sakit

RS KARYA MEDIKA JAKARTA
Jl. Melatie Blok G No. 12, Jakarta selatan
021 – 5859549 : email@medikamediako.com

Surat Keterangan Kematian

 

Saya yang bertanda tangan dibawah ini :

Nama                                     : dr. Widya Ningrum
Jabatan                                 : Kepala Rumah Sakit

Menyatakan bahwa,

TELAH MENINGGAL DUNIA, Saudara :

Nama Lengkap                    : Nur Arifin Satya
Nomor Ktp                            : 3859591259125
Jenis Kelamin                       : Laki-Laki
Tempat, Tanggal Lahir      : Jakarta, 2 Agustus 1957
Pada Umur                           : 55 tahun
Status                                     : Sudah Menikah
Alamat                                  : Jl. Cendana No. 3, Jakarta Selatan

Pada tanggal  9 April 2012 tepatnya pada pukul 23.15 WIB dikarenakan penyakit komplikasi yang disebabkan oleh penyakit diabetes.

Demikian Surat Keterangan Kematian ini kami terbitkan untuk dapat digunakan semestinya dan sebijak-bijaknya.

 

Jakarta, 10 April 2012

Mengetahui,

Kepala Rumah Sakit

 

 

Dr. Widya Ningrum

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Contoh Surat keterangan kematian dari kelurahan Desa

DISDUKCAPIL JAGAKARSA
Jl. Rawa Jasa, Jagakarsa, Jakarta Selatan
Tlp : 021-95829405; email@jakar@jagakarase.com

20 Januari 2015

 

No                           : XII/23/2015
Perihal    : Surat Keterangan Kematian

 

Sesuai dengan surat keterangan dokter dan surat keterangan terusan yang telah melalui Rukun Tetangga dan Rukun Warga.

Dengan ini kami selaku pejabat daerah kelurahan, menerbitkan surat keterangan kematian atas nama Saudara :

Nama                                     : Fulan
Tempat, tanggal Lahir : Sidoarjo, 21 Maret 1950
Umur                                      : 65 tahun
Status                     : Sudah Menikah
Alamat                  : Jl. Pejaten Utara No. 2

Dengan No Kartu Keluarga 2834792JF dinyatakan telah meninggal dunia pada tanggal 16 Januari 2015 dikarenakan sakit.

Demikian surat keterangan kematian ini kami terbitkan sesuai bukti-bukti yang sah dan dapat dipertanggung jawabkan didepan hukum untuk digunakan sebagai salah satu syarat khusus mengajukan pencairan dana asuransi jiwa di PT. JASURANJIW.

 

Mengetahui,

Ketua Kelurahan

 

Ridwan Kamal

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Format Penting dalam surat keterangan kematian

Bagi anda petugas yang membuat surat keterangan meninggalnya seseorang, anda wajib melampirkan data resmi dari rumah sakit ataupun data lainnya yang mendukung. Berikut adalah bagian bagian penting dalam surat ini.

  1. Siapa yang menerangkan kematian tersebut. Bagian ini memuat informasi siapa yang menerangkan bahwa orang tersebut telah meninggal contoh nya adalah kades, dokter, atau kepala rukun warga setempat.
  2. Data orang yang dimaksud. Rincikan data orang yang telah meninggal tersebut dengan lugas sesuai dengan KTPnya.
  3. Kapan waktu meninggal serta penyebabnya. Anda wajib memberikan informasi waktu dan kapan tempat kejadian meninggalnya orang tersebut.
  4. Ttd jelas. Tanda tangan oknum yang membuat surat tersebut.

Sekian Postingan saya kali ini mengenai Contoh Surat Keterangan Kematian yang simpel dan tanpa mengesampingkan isi format utamanya. Semoga bermanfaat dan dapat menjadi salah satu referensi bagi anda untuk membuat Surat Keterangan Kematian. Terima Kasih..!


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Post Date: Wednesday 06th, May 2015 / 11:03 Oleh :
Kategori : Surat Keterangan

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