Pengajuan Izin Data PribadiData KegiatanPernyataanNama LengkapNo IdentitasInstansiJabatanFile Kartu IdentitasChoose FileNo file chosenDelete uploaded fileFile JPG atau PNG Maksimal 1 MBAlamatKecamatanKabupaten / KotaProvinsiNegaraAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweSelect countryEmailNo HPData KegiatanKewarganegaraanWNIWNAJumlah PaketKegiatanKunjunganPengambilan GambarSosialReligiPenelitianKunjunganKawasanSPTN Wilayah I Lubuk Kembang BungaSPTN Wilayah II BaserahJudul KegiatanSurat PengantarNo SuratTanggal SuratPerihal SuratPenandatanganan Surat OlehFile Surat PengantarChoose FileNo file chosenDelete uploaded fileFile Maksimal 1 MBWaktu PelaksanaanDariSampaiJumlah PesertaLampiran Daftar PengikutChoose FileNo file chosenDelete uploaded fileFile Maksimal 1 MBFile Proposal KegiatanChoose FileNo file chosenDelete uploaded fileFile Maksimal 1 MBUsulan Presentasi KegiatanPernyataan PermohonanConsent *PERNYATAAN PERMOHONAN IJIN MASUK KAWASAN KONSERVASIDengan ini saya : 1. Selesai memasuki lokasi wajib menyertakan laporan tertulis kepada Kepala BTN Tesso Nilo. 2. Didampingi petugas BTN Tesso Nilo dengan beban tanggung jawab dari pemegang SIMAKSI. 3. Khusus untuk kegiatan pembuatan film / video wajib memuat tulisan Direktorat Jenderal KSDAE dan logo Kementrian Lingkungan Hidup dan Kehutanan. 4. Mematuhi peraturan perundangan yang berlaku 5. Dilarang melepaskan tembakan / ledakan berupa apapun di dalam kawasan.Kirim
