Pelaporan Gratifikasi<\/h3>\r\n[\/vc_column_text][divider line_type=”Small Line” line_alignment=”default” line_thickness=”3″ divider_color=”extra-color-1″ custom_height=”10″][\/vc_column][\/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” column_margin=”default” column_direction=”default” column_direction_tablet=”default” column_direction_phone=”default” scene_position=”center” text_color=”dark” text_align=”left” row_border_radius=”none” row_border_radius_applies=”bg” overlay_strength=”0.3″ gradient_direction=”left_to_right” shape_divider_position=”bottom” bg_image_animation=”none”][vc_column column_padding=”no-extra-padding” column_padding_tablet=”inherit” column_padding_phone=”inherit” column_padding_position=”all” column_element_spacing=”default” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_shadow=”none” column_border_radius=”none” column_link_target=”_self” gradient_direction=”left_to_right” overlay_strength=”0.3″ width=”1\/1″ tablet_width_inherit=”default” tablet_text_alignment=”default” phone_text_alignment=”default” bg_image_animation=”none” border_type=”simple” column_border_width=”none” column_border_style=”solid”][vc_column_text]

<\/div>

<\/div>

Data Pelapor<\/h3><\/div><\/div><\/div>

Status Pelapor *<\/span><\/label>Status Pelapor<\/option>Tidak Anonim<\/option>Sebagai Anonim<\/option><\/select><\/div><\/div><\/div>

Nama Pelapor *<\/span><\/label>

<\/div><\/div><\/div>

Pekerjaan Pelapor<\/label><\/div><\/div><\/div>

Alamat Pelapor *<\/span><\/label><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6633f42048a9a\" class=\"forminator-label\">No Handphone Pelapor <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"6282xxxxxxx\" id=\"forminator-field-phone-1_6633f42048a9a\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6633f42048a9a\" class=\"forminator-label\">Email Pelapor <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"E.g. john@doe.com\" id=\"forminator-field-email-1_6633f42048a9a\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-1\" class=\"forminator-col forminator-col-12 h3\"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">Penerima Gratifikasi<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-6\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-6_6633f42048a9a\" class=\"forminator-label\">Nama Penerima Gratifikasi <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-6\" value=\"\" placeholder=\"Nama Penerima Gratifikasi\" id=\"forminator-field-name-6_6633f42048a9a\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-7\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-7_6633f42048a9a\" class=\"forminator-label\">Jabatan Penerima Gratifikasi<\/label><input type=\"text\" name=\"name-7\" value=\"\" placeholder=\"Jabatan Penerima Gratifikasi\" id=\"forminator-field-name-7_6633f42048a9a\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-8\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-8_6633f42048a9a\" class=\"forminator-label\">Unit Penerima Gratifikasi<\/label><input type=\"text\" name=\"name-8\" value=\"\" placeholder=\"Unit Penerima Gratifikasi\" id=\"forminator-field-name-8_6633f42048a9a\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-2\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">Data Gratifikasi<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_6633f42048a9a\" class=\"forminator-label\">Uraian \/ Detail Gratifikasi <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-2\" placeholder=\"Uraian \/ Detail Gratifikasi\" id=\"forminator-field-textarea-2_6633f42048a9a\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-5\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-5_6633f42048a9a\" class=\"forminator-label\">Nominal \/ Taksiran Gratifikasi <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-5\" value=\"\" placeholder=\"Nominal \/ Taksiran Gratifikasi\" id=\"forminator-field-name-5_6633f42048a9a\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_6633f42048a9a\" class=\"forminator-label\">Tanggal Kejadian <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><label for=\"forminator-field-date-1-picker_6633f42048a9a\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><\/label><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-1-picker_6633f42048a9a\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"dd-mm-yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1924\" data-end-year=\"2124\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-4\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-4_6633f42048a9a\" class=\"forminator-label\">Lokasi Kejadian <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-4\" value=\"\" placeholder=\"Lokasi Kejadian\" id=\"forminator-field-name-4_6633f42048a9a\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_6633f42048a9a\" class=\"forminator-label\">Bukti Pendukung (Jika Ada)<\/label><div 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