{"id":1136,"date":"2019-09-04T06:47:43","date_gmt":"2019-09-04T06:47:43","guid":{"rendered":"http:\/\/kecgajah.demakkab.go.id\/?page_id=1136"},"modified":"2019-09-04T06:47:43","modified_gmt":"2019-09-04T06:47:43","slug":"formulir-keberatan-informasi","status":"publish","type":"page","link":"https:\/\/kecgajah.demakkab.go.id\/?page_id=1136","title":{"rendered":"Formulir Keberatan Informasi"},"content":{"rendered":"<div id=\"vfb-form-2\" class=\"visual-form-builder-container\"><form id=\"keberatan-2\" class=\"visual-form-builder vfb-form-2 \" method=\"post\" enctype=\"multipart\/form-data\">\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"2\" \/><fieldset class=\"vfb-fieldset vfb-fieldset-1 form-pengajuan-keberatan \" id=\"item-vfb-16\"><div class=\"vfb-legend\"><h3>Form Pengajuan Keberatan<\/h3><\/div><ul class=\"vfb-section vfb-section-1\"><div id=\"item-vfb-21\" class=\"vfb-section-div \"><h4>A. INFORMASI KEBERATAN INFORMASI (diisi petugas)<\/h4><\/div><div class=\"vfb-clear\"><\/div><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-20\"><label for=\"vfb-20\" class=\"vfb-desc\">Nomor Pendaftaran Permohonan Informasi  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-20\" id=\"vfb-20\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-22\"><label for=\"vfb-22\" class=\"vfb-desc\">Tujuan Penggunaan Informasi  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-22\" id=\"vfb-22\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><div id=\"item-vfb-23\" class=\"vfb-section-div \"><h4>Identitas pemohon<\/h4><\/div><div class=\"vfb-clear\"><\/div><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-24\"><label for=\"vfb-24\" class=\"vfb-desc\">Nama  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-24\" id=\"vfb-24\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-textarea  \" id=\"item-vfb-26\"><label for=\"vfb-26\" class=\"vfb-desc\">Alamat  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><textarea name=\"vfb-26\" id=\"vfb-26\" class=\"vfb-textarea  vfb-medium  required \"><\/textarea><\/div><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-27\"><label for=\"vfb-27\" class=\"vfb-desc\">Pekerjaan <\/label><input type=\"text\" name=\"vfb-27\" id=\"vfb-27\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-number  \" id=\"item-vfb-35\"><label for=\"vfb-35\" class=\"vfb-desc\">No. HP  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-35\" id=\"vfb-35\" value=\"\" class=\"vfb-text  vfb-medium  required  digits \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-29\"><label for=\"vfb-29\" class=\"vfb-desc\">No. Identitas  <span class=\"vfb-required-asterisk\">*<\/span><\/label><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-29\" id=\"vfb-29\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><label>KTP\/SIM\/Paspor<\/label><\/span><\/li><li class=\"vfb-item vfb-item-file-upload  \" id=\"item-vfb-30\"><label for=\"vfb-30\" class=\"vfb-desc\">KTP\/SIM\/Paspor  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"file\" name=\"vfb-30\" id=\"vfb-30\" value=\"\" class=\"vfb-text  vfb-medium  required    {accept:'png|jpe?g|gif'}\" \/><\/li><div id=\"item-vfb-31\" class=\"vfb-section-div \"><h4>Identitas Kuasa Pemohon<\/h4><\/div><div class=\"vfb-clear\"><\/div><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-32\"><label for=\"vfb-32\" class=\"vfb-desc\">Nama  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-32\" id=\"vfb-32\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-number  \" id=\"item-vfb-36\"><label for=\"vfb-36\" class=\"vfb-desc\">No. HP  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-36\" id=\"vfb-36\" value=\"\" class=\"vfb-text  vfb-medium  required  digits \" \/><\/li><li class=\"vfb-item vfb-item-textarea  \" id=\"item-vfb-33\"><label for=\"vfb-33\" class=\"vfb-desc\">Alamat  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><textarea name=\"vfb-33\" id=\"vfb-33\" class=\"vfb-textarea  vfb-medium  required \"><\/textarea><\/div><\/li><div id=\"item-vfb-38\" class=\"vfb-section-div \"><h4>B. ALASAN PENGAJUAN KEBERATAN<\/h4><\/div><div class=\"vfb-clear\"><\/div><li class=\"vfb-item vfb-item-checkbox  \" id=\"item-vfb-39\"><label class=\"vfb-desc\">Alasan Pengajuan Keberatan  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-39[]\" id=\"vfb-39-0\" value=\"Permohonan Informasi ditolak\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-39-0\" class=\"vfb-choice\">Permohonan Informasi ditolak<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-39[]\" id=\"vfb-39-1\" value=\"Permintaan Informasi ditanggapi tidak sebagaimana yang diminta\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-39-1\" class=\"vfb-choice\">Permintaan Informasi ditanggapi tidak sebagaimana yang diminta<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-39[]\" id=\"vfb-39-2\" value=\"Informasi berkala tidak disediakan\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-39-2\" class=\"vfb-choice\">Informasi berkala tidak disediakan<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-39[]\" id=\"vfb-39-3\" value=\"Permintaan Informasi tidak dipenuhi\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-39-3\" class=\"vfb-choice\">Permintaan Informasi tidak dipenuhi<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-39[]\" id=\"vfb-39-4\" value=\"Informasi disampaikan melebihi jangka waktu yang ditentukan\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-39-4\" class=\"vfb-choice\">Informasi disampaikan melebihi jangka waktu yang ditentukan<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-39[]\" id=\"vfb-39-5\" value=\"Permintaan Informasi tidak ditanggapi\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-39-5\" class=\"vfb-choice\">Permintaan Informasi tidak ditanggapi<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-39[]\" id=\"vfb-39-6\" value=\"Biaya yang dikenakan tidak wajar\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-39-6\" class=\"vfb-choice\">Biaya yang dikenakan tidak wajar<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-2 verification \" id=\"item-vfb-17\" style=\"display:block\"><div class=\"vfb-legend\"><h3>Verification<\/h3><\/div><ul class=\"vfb-section vfb-section-2\"><li class=\"vfb-item vfb-item-secret\"  style=\"display:block\"><label for=\"vfb-18\" class=\"vfb-desc\">Please enter any two digits <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"hidden\" name=\"_vfb-secret\" value=\"vfb-18\" \/><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-18\" id=\"vfb-18\" value=\"\" class=\"vfb-text  vfb-medium  required {digits:true,maxlength:2,minlength:2} \" style=\"display:block\" \/><label>Example: 12<\/label><\/span><li style=\"display:none;\"><label>This box is for spam protection - <strong>please leave it blank<\/strong>:<\/label><div><input name=\"vfb-spam\" \/><\/div><\/li>\n\t\t\t<li class=\"vfb-item vfb-item-submit\" id=\"item-vfb-19\">\n\t\t\t\t\t\t<input type=\"submit\" name=\"vfb-submit\" id=\"vfb-19\" value=\"Submit\" class=\"vfb-submit \" \/>\n\t\t\t\t\t\t<\/li><\/ul>\n\t\t\t<\/fieldset><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F1136\" \/><\/form><\/div> <!-- .visual-form-builder-container -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/pages\/1136"}],"collection":[{"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1136"}],"version-history":[{"count":2,"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/pages\/1136\/revisions"}],"predecessor-version":[{"id":1139,"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=\/wp\/v2\/pages\/1136\/revisions\/1139"}],"wp:attachment":[{"href":"https:\/\/kecgajah.demakkab.go.id\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1136"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}