Page 477 - PMK NOMOR 62 TAHUN 2023

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Tabel VI.6
6) DIPA Petikan Halaman IA Informasi Kinerja
DIPA Petikan Halaman IA Informasi Kinerja

DAFTAR ISIAN PELAKSANAAN ANGGARAN PETIKAN
TAHUN ANGGARAN YYYY
NOMOR : DIPA- aaa.bb.c.dddddd/2XXX DIGITAL STAMP
IA. INFORMASI KINERJA

Kementerian Negara/Lembaga : (XXX) XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Unit Organisasi : (XX) XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Provinsi : (XX) XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Kode/Nama Satker : (XXXXXX) XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

Informasi BLU :
1. Status BLU : (Penuh)/(Bertahap) dengan persentase penggunaan langsung PNBP sebesar xx% 3. Saldo Awal Kas BLU : Rp 999.999.999
2. Besaran Persentase Ambang Batas : xx % dari PNBP 4. Saldo Akhir Kas BLU : Rp 999.999.999

Halaman : I A.xx

Program : xxx.xx.xx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Rp. 999.999.999.999.999.999
Kegiatan : xxxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Rp. 999.999.999.999.999.999
Indikator Kinerja Kegiatan : 1. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
2. xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Klasifikasi Rincian Output : xxxx.xxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 999.999,99 xxxxxx Rp. 999.999.999.999.999.999
Rincian Output : 1. xxxx.xxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 999.999,99 xxxxxx Rp. 999.999.999.999.999.999
: 2. xxxx.xxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 999.999,99 xxxxxx Rp. 999.999.999.999.999.999
: 3. xxxx.xxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 999.999,99 xxxxxx Rp. 999.999.999.999.999.999

xxxxxxxxxx, DD-MM-YYYY
A.N. ………….. ……………………………….

ttd.

…………………………………………………..
NIP/NRP …………………………………………….