KEMENTERIAN AGAMA

KELOMPOK KERJA PENGAWAS PAI (POKJAWAS PAI)

KANTOR KABUPATEN CILACAP
Alamat : Jalan DI. Panjaitan No.44 Telp. (0282)531155 Cilacap

PEMANTAUAN DANA BOS REGULER DAN BOS BUKU

SEMESTER I (Bulan Januari s.d. Juni)

NAMA SEKOLAH/MADRASAH : ..................................................................................................

ALAMAT SEKOLAH/MADRASAH : ..................................................................................................
MAMA RESPONDEN : ..................................................................................................
JABATAN RESPONDEN : ..................................................................................................
HARI, TANGGAL MONITORING : ..................................................................................................

A. BOS REGULER
1. Jumlah Siswa Penerima : L = ................... P= ................... Jml
= .......................
2. Jumlah Dana BOS yang diterima : Rp ........................................................
3. Jumlah Dana BOS yang dikeluarkan : Rp ........................................................
4. Saldo Dana BOS per Juni ................ : Rp ........................................................
5. Administrasi Keuangan Dana BOS
a. Buku Kas Umum : Ada / Tidak Baik / Cukup / Kurang
b. Buku Kas Tunai : Ada / Tidak Baik / Cukup / Kurang
c. Buku BAnk : Ada / Tidak Baik / Cukup / Kurang
d. Buku Pajak : Ada / Tidak Baik / Cukup / Kurang
e. Buku Pembelian Barang : Ada / Tidak Baik / Cukup / Kurang
f. SPJ Dana BOS : Sudah Dikerjakan / Dalam Proses / Belum
6. Pajak : Ada / Tidak Sudah dibayar / Belum
7. Penggunaan Dana BOS : Tepat Sasaran / Kurang Tepat / Tidak Tepat
8. Temuan/saran-saran :

B. BOS BUKU
1. Jumlah Siswa Penerima : L = ..................P= .................... Jml = .......................
2. Jumlah Dana BOS yang diterima : Rp .................................................
3. Jumlah Dana BOS yang dikeluarkan : Rp .................................................
4. Saldo Dana BOS per Juni ........ : Rp .................................................
5. Jumlah Buku yang dibeli : .................................................
6. Judul Buku yang dibeli : .................................................
7. Temuan/saran-saran : .................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................

Cilacap, ............................................

RESPONDEN Pengawas RA/Madrasah Ibtidaiyah

______________________________ ....................................................
NIP: ............................................. NIP: ........................................................
 KEMENTERIAN AGAMA
KELOMPOK KERJA PENGAWAS PAI (POKJAWAS PAI)
KANTOR KABUPATEN CILACAP
Alamat : Jalan DI. Panjaitan No.44 Telp. (0282)531155 Cilacap

PEMANTAUAN DANA BOS REGULER DAN BOS BUKU

SEMESTER II (Juli Januari s.d. Desember)

NAMA SEKOLAH/MADRASAH : ..................................................................................................

ALAMAT SEKOLAH/MADRASAH : ..................................................................................................
MAMA RESPONDEN : ..................................................................................................
JABATAN RESPONDEN : ..................................................................................................
HARI, TANGGAL MONITORING : ..................................................................................................

A. BOS REGULER
1. Jumlah Siswa Penerima : L = ................ P=...................... Jml
=..............................
2. Jumlah Dana BOS yang diterima : Rp .........................................................
3. Jumlah Dana BOS yang dikeluarkan : Rp .........................................................
4. Saldo Dana BOS per Desember ........ : Rp .........................................................
5. Administrasi Keuangan Dana BOS
a. Buku Kas Umum : Ada / Tidak Baik / Cukup / Kurang
b. Buku Kas Tunai : Ada / Tidak Baik / Cukup / Kurang
c. Buku BAnk : Ada / Tidak Baik / Cukup / Kurang
d. Buku Pajak : Ada / Tidak Baik / Cukup / Kurang
e. Buku Pembelian Barang : Ada / Tidak Baik / Cukup / Kurang
f. SPJ Dana BOS : Sudah Dikerjakan / Dalam Proses / Belum
6. Pajak : Ada / Tidak Sudah dibayar / Belum
7. Penggunaan Dana BOS : Tepat Sasaran / Kurang Tepat / Tidak Tepat
8. Temuan/saran-saran :
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................

B. BOS BUKU
1. Jumlah Siswa Penerima : L = ............... P=.................... Jml =...........................
2. Jumlah Dana BOS yang diterima : Rp .........................................................
3. Jumlah Dana BOS yang dikeluarkan : Rp .........................................................
4. Saldo Dana BOS per Desember........ : Rp .........................................................
5. Jumlah Buku yang dibeli : .........................................................
6. Judul Buku yang dibeli : .........................................................
7. Temuan/saran-saran : .........................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................
.............................................................................................................................................

Cilacap, ............................................

RESPONDEN Pengawas RA/Madrasah Ibtidaiyah

______________________________ .....................................................
NIP: ............................................. NIP: ........................................................