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Contoh Surat Pernyataan Meninggal Dunia yang Baik - Contohsurat
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Contoh Surat Pernyataan Meninggal Dunia yang Baik

Bila seseorang telah meninggal dunia diperlukan surat pernyataan meninggal dunia untuk berbagai keperluan yang terkait. Misalnya seperti untuk Mengajukan pencairan dana asuransi jiwa, Pembagian hak waris, Mengurus dana pensiunan, Mengurus hutang piutang (situasi dan kondisi), dan atau penetapan status janda atau duda kepada pasangan yang ditinggalkan.

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Surat pernyataan adalah surat yang dibuat oleh seseorang yang berisi pernyataan dirinya atau menerangkan orang lain bahwa orang tersebut pernah atau tidak pernah melakukan sesuatu.  Selain itu, ada juga pengertian lain, yaitu surat pernyataan adalah pernyataan tertulis yang mengemukakan mengenai kesediaan atau kesanggupan seseorang atau kelompok untuk menanggung segala risiko yang berkaitan dengannnya. Surat pernyataan yang menyangkut aspek hukum harus di tulis di atas kertas segel atau kertas biasa yang di bubuhi materai.

Surat Pernyataan Meninggal pada umumnya diterbitkan oleh rumah sakit. Atau Surat Keterangan Kematian juga dapat diterbitkan oleh pihak kepolisian jika ada alasan khusus seperti karena telah melewati otopsi jenazah atau yang lainnya. Format Surat Pernyataan Meninggal pada umumnya berisi nama, tempat tanggal lahir, umur, status dan alamat.

Untuk lebih jelasnya dapat dilihat beberapa contoh surat pernyataan meninggal berikut di bawah ini.

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Contoh Surat Pernyataan Meninggal Dunia dari RW

Contoh Surat Pernyataan Meninggal Dunia dari RW

RUKUN TETANGGA 14 RUKUN WARGA 04
KELURAHAN MELODI INDAH KECAMATAN MUSIK KALER
KOTA BANDUNG PROVINSI JAWA BARAT
Sekretariat. Jl.  Jeruk Manis No. 59  Telp. 022 332769 Mobile. 09762467925

SURAT PENYATAAN MENINGGAL DUNIA
No. : 03/RT14/X/MM/2016

Saya yang bertanda tangan di bawah ini, Ketua RT 14 RW 04 Desa Melodi Indah Kecamatan Musik Kaler Kota Bandung, Menerangkan bahwa :
Nama                                    : Alexander Suwiryo
Tempat tanggal lahir         : Bandung, 10 November 1980
Jenis kelamin                     : Laki – Laki
Kewarganegaraan             : Indonesia
Agama yang terdahulu     : Kristen
Alamat                                 : Jalan Harimau Belang No. 13/ 40B Kota Bandung

TELAH MENINGGAL DUNIA 

Pada  :
Hari/ Tanggal   : Sabtu, 8 Oktober 2016
Pukul                    : 07.30
Tempat                : RSU. Sehat Selalu Kota Bandung
Dimakamkan di: TPU Wangi Abadi

Demikian ini dibuat dengan sebenar-benarnya agar dapat dipergunakan sebagaimana mestinya.

Bandung, 9 Oktober 2016

Ketua RW 30

Sujiwo Tejo

download format words


Contoh Surat Pernyataan Meninggal Dunia dari Kelurahan

Contoh Surat Pernyataan Meninggal Dunia dari Kelurahan

KELURAHAN MELODI INDAH KECAMATAN MUSIK KALER
KOTA BANDUNG PROVINSI JAWA BARAT
Sekretariat. Jl.  Jeruk Manis No. 59  Telp. 022 332769 Mobile. 09762467925

SURAT PENYATAAN MENINGGAL DUNIA
No. : 03/RT14/X/MM/2016

Saya yang bertanda tangan di bawah ini:
Nama                    : Sujiwo  Tejo
Jabatan                : Lurah Melodi Indah

Menerangkan bahwa :
Nama                                    : Alexander Suwiryo
Tempat tanggal lahir         : Bandung, 10 November 1980
Jenis kelamin                      : Laki – Laki
Kewarganegaraan               : Indonesia
Agama yang terdahulu      : Kristen
Alamat                                  : Jalan Harimau Belang No. 13/ 40B Kota Bandung

adalah benar warga kami di lingkungan RT 02 RW 03 Kelurahan Melodi Indah Kecamatan Musik Kaler, Kota Bandung yang telah meninggal pada :
Hari/ Tanggal   : Sabtu, 8 Oktober 2016
Pukul                    : 07.30
Tempat                : RSU Sehat Selalu Kota Bandung
Dimakamkan di: TPU Wangi Abadi

Demikian surat pernyataan ini dibuat untuk dapat dipergunakan sebagaimana mestinya.

Bandung, 9 Oktober 2016

Mengetahui,

Lurah  Melodi Indah,

Sujiwo Tejo

download format words


Contoh Surat Pernyataan Meninggal Dunia dari Rumah Sakit

Contoh Surat Pernyataan Meninggal Dunia dari Rumah Sakit

Departemen Kesehatan Kota Bandung
Rumah Sakit Umum Sehat Selalu
Jalan Asem Jawa No. 60 Bandung
Tlp. 022 – 690210  Fax. 022 – 690211

SURAT PENYATAAN MENINGGAL DUNIA
No. : 03/RT14/X/MM/2016

Saya yang bertanda tangan dibawah ini:
Nama                    : dr. Sujiwo  Tejo
Jabatan                 : Kepala Rumah Sakit

Menyatakan bahwa :

TELAH MENINGGAL DUNIA 

Saudara :
Nama                                    : Alexander Suwiryo
Tempat tanggal lahir         : Bandung, 10 November 1980
Jenis kelamin                      : Laki – Laki
Kewarganegaraan              : Indonesia
Agama yang terdahulu     : Kristen
Alamat                                 : Jalan Harimau Belang No. 13/ 40B Kota Bandung

Pada Tanggal 8 Oktober 2016, pukul 05.45 WIB dikarenakan serangan jantung.

Demikian Surat Keterangan Meninggal Dunia ini kami terbitkan untuk dapat digunakan semestinya dan sebijak-bijaknya

Bandung, 9 Oktober 2016

Mengetahui,
Kepala Rumah Sakit

Dr. Sujiwo Tejo

download format words


Terdapat beberapa hal penting yag harus tercantum di dalam surat pernyataan meninggal dunia. Hal – hal tersebut antara lain:

  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.

Itulah mengenai beberapa Contoh surat pernyataan meninggal dunia yang baik. Semoga dapat menjadi bahan referensi dalam membuat surat pernyataan yang benar.


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Post Date: Sunday 09th, October 2016 / 12:35 Oleh :
Kategori : Surat Pernyataan

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