MODEL BB.2KWK
DAFTAR R I W A Y A T HIDUP C A L O N GUBERNUR
A . D a t a P r i b a d i N a m a L e n g k a p I T T > A X T / A T Z A T T \ T A O T T ~ > HL R A N G K A R N O , S.1P T e m p a t / T a n g g a l L a h i r T A 17~ A n T A A O / " \ . -| / \ / "g \ I A K A R T A , 0 8 - O c t - 1 9 6 0 N I K 1 7 4 0 6 0 8 1 0 6 0 0 0 0 6 U s i a D O A l a m a t T e m o a t T i n c e a l I L . K A R A N G A S R I V I I N O . I A R T 0 0 8 R W 0 0 9 , L E B A K B U L U S , C I L A N D A K , J A K A R T A S E L A T A N , D K I J A K A R T A E m a i l ranokarno 1 9 6 0 @ y a h o o . c o m Jenis K e l a m i n L a k i - l a k i Status P e r k a w i n a n K A W 1 N A g a m a 1 S A L A M N P W P 0 6 . 2 6 8 . 2 3 7 . 2 - 0 1 6 . 0 0 0 H o b i Olahraga, N o n t o n F i l m M o t o H i d u p Vlengalir B a g a i k a n A i r R i w a y a t P e n d i d i k a n * * ) P e n d i d i k a n F o r m a l Jenjang Institusi T a h u n ( m a s u k - l u l u s ) S e k o l a h D a s r a ( S D ) Strada V a n L i t h Jakarta 1 9 6 6 - L u l u s T a h u n 1973 S e k o l a h M e n e n g a h P e r t a m a ( S M P ) V a n L i t h Jakarta 1 9 7 4 - L u l u s T a h u n 1 9 7 6 S e k o l a h M e n e n g a h A t a s ( S M A ) S M A N e g e r i V I Jakarta 1 9 7 7 - L u l u s T a h u n 1980 P e r g u m a n T i n g g i / Strata S a t u ( S I ) S e k o l a h T i n g g i I l m u P e m e r i n t a h A b d i N e g a r a Jakrata L u l u s T a h u n 2 0 1 3
P e n d i d i k a n I n f o r m a l
Jenjang Institusi T a h u n
Course A c t i n g film d i A m e r i k a East W e s t P l a y e r A m e r i k a 1981 - 1982
P e n g a l a m a n P e k e r j a a n * * ) Jabatan Institusi T a h u n A n g g o t a M P R R I 1 9 9 7 - 2 0 0 2 D u t a K h u s u s U n i c e f U n i c e f I n d o n e s i a 2 0 0 2 W a k i l B u p a t i K a b u p a t e n T a n g e r a n g P e r i o d e 2 0 0 8 - 2 0 1 3 W a k i l G u b e m u r P r o v i n s i B a n t e n P e r i o d e 2 0 1 2 - 2 0 1 7 G u b e m u r P r o v i n s i B a n t e n S i s a M a s a Jabatan P e r i o d e T a h u n 2 0 1 2 - 2 0 1 7 P e n g a l a m a n O r g a n i s a s i * * ) Jabatan Institusi T a h u n K e t u a B i d a n g I n f o k o m P a r t a i D e m o k r a s i Indnesia Perjuangan 2 0 1 1 E . P u b l i k a s i * * ) J u d u l T a h u n T e r b i t F . Penghargaan * * ) N a m a P e n g h a r g a a n I n s t i t u s i T a h u n A k t o r H a r a p a n 1 B e s t A c t o r Persatuan W a r t a w a n Indonesai ( P W I ) 1974 Best C h i l d A c t o r F e s t i v a l F i l m A s i a ( F F A ) - T a i w a n 1973 P e m a i n F i l m A n k a T e r b a i k F e s t i v a l F i l m I n d o n e s i a ( F F I ) 1974 A k t o r U t a m a T e r b a i k F i l m " T a k s i " F e s t i v a l F i l m I n d o n e s i a ( F F I ) 1991 N o m i n a s i A k t o r F i l m " K u b e r i k a n Segalanya" F e s t i v a l F i l m I n d o n e s i a ( F F I ) 1992 N o m i n a s i A k t o r F i l m " A i r i n " F e s t i v a l F i l m I n d o n e s i a ( F F I ) 1 9 8 7 N o m i n a s i A k t o r F i l m " R a n j a u R a n j a u C i n t a " F e s t i v a l F i l m I n d o n e s i a ( F F I ) 1985 N o m i n a s i A k t o r F i l m " Y a n g " F e s t i v a l F i l m I n d o n e s i a ( F F I ) 1984
N a m a Penghargaan Institusi T a h u n Penghargaan B P 2 N D e w a n F i l m N a s i o n a l 1 n m B i n t a n g D r a m a P r i a T e r f a v o r i t Panasonic A w a r d 1997 T o k o h I n s p i r a t i f C & R sebagai A r t i s
P e r t a m a y a n g m e n j a d i G u b e m u r Tt M a j a l a h I ' l l 2 0 1 6
K e n a l a Daerah Inovatif Kateeori
P e m b a n g u n a n I n f r a s t r u k t u r K o r a n S i n d o 7 0 1 0 M a j e l i s P e m b i m b i n g D a e r a h ( M a b i d a ) P e d u l i K w a r t i r D a e r a h Presiden R I *D/\ 1 £ 2 0 1 6 Lencana M e l a t i G e r a k a n P r a m u k a Presiden R I 2 0 1 6 A n u g e r a h A k s a r a U t a m a P e m e r i n t a h R I 2 0 1 5 G . D a t a K e l u a r g a H u b u n g a n K e l u a r g a N a m a Pekerjaan I s t r i / S u a m i H j . D e w i l n d r i a t i I b u R u m a h T a n g g a J u m l a h A n a k A n a k 1. R a k a W i d y a r m a n S w a s t a 2. D e a n t i R a k a s i w i M a h a s i s w i 3. dst... H . L a i n - l a i n :
Daftar r i w a y a t h i d u p i n i dibuat dengan sebenamya u n t u k d i g u n a k a n sebagaimana m e s t i n y a dan bersedia/tidak bersedia*) d i p u b l i k a s i k a n o l e h K P U P r o v i n s i / K I P A c e h / K P U / K I P K a b u p a t e n / K o t a * ) . S e r a n g , 2 3 - 0 9 - 2 0 1 6 Y a n g M e m b u a t pernyataan, Gtfdrx GUBERNUR ? / l L i t A . I !
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IBURUPIAHMengetahui, G A B U N G A N P A R T A I P O L I T I K P R O V I N S I B A N T E N ^AWAN [klAWAN, SH, MH K e t u a H. AGUS SETIAWAN, SH
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Yang Mengajukan Pasangan Calon Partai PersatyanPembangunan IES HALAWANI R, SH. M M H. ISKANDAR, S. Ag Keterangan ; *) c o r e t y a n g t i d a k p e r l u . * * ) d i m u l a i d a r i t a h u n y a n g l e b i h a w a l . * * * ) d i i s i a p a b i l a C a l o n d i a j u k a n o l e h P a r t a i P o l i t i k / G a b u n g a n P a r t a i P o l i t i k .
MODEL BB.2KWK
DAFTAR R I W A Y A T HEDUP C A L O N W A K I L GUBERNUR
A . D a t a P r i b a d i N a m a L e n g k a p H F M R A Y M T I T Y A 8 Y A R T F F T e m p a t / T a n g g a l L a h i r P A N F T F O I A N F 0 4 - M n r - l Q S 9 N I K 1 U 4 U 9 j / U U U n T U s i a 64 A l a m a t T e m p a t T i n g g a l JL. J I W A N T A K A 1 N O 0 9 P E K A R U N G A N K A G U N G A N , S E R A N G , K O T A S E R A N G , B A N T E N E m a i l Jenis K e l a m i n L a k i - l a k i Status P e r k a w i n a n K A W I N A g a m a I S L A M N P W P 0 6 . 4 1 5 . 1 3 3 . 5 - 4 0 1 . 0 0 0 H o b i M e m b a c a , Olahraga, Jalan K a k i M o t o H i d u p H i d u p A d a l a h Ibadah B . R i w a y a t P e n d i d i k a n * * ) P e n d i d i k a n F o r m a l Jenjang Institusi T a h u n ( m a s u k - l u l u s ) S e k o l a h Dasar ( S D ) S D N 1 Serang 1 9 5 9 - 1965 S e k o l a h M e n e n g a h P e r t a m a N e g e r i ( S M P N ) S M P N 1 Serang 1 9 6 5 - 1968 S e k o l a h M e n e n g a h A t a s N e g e r i ( S M A N ) S M A N 1 Serang 1968 - 1971
P e n d i d i k a n I n f o r m a l Jenjang I n s t i t u s i T a h u n K u r s u s B i d a n g P e m a s a r a n K u r s u s B i d a n g K o n t r u k s i C. P e n g a l a m a n Pekerjaan * * ) j a o a r a n I n s t i t u s i T a h u n D i r e k s i P T . S i n a r C i o m a s 1 9 7 4 - 1978 D i r e k t u r U t a m a P T . B e r k a h Saputra 1978 - 1992 D i r e k t u r U t a m a B a n k S y a r i a h B a i t u l M u a w a n a h 1 9 9 4 - 1999 D i r e k t u r u t a m a P T . B u a n a C e n t r a S w a k a r y a 2 0 0 0 - 2 0 0 9 K o m i s a r i s U t a m a B a n k S y a r i a h B e r k a h R a m a d h a n 2 0 0 0 - 2 0 1 1 K o m i saris P T . W a l i e j a s a P r a t a m a 2 0 0 3 - 2 0 1 0 K o m i s a r i s P T . A l b a n t a n i C i p t a N i a g a 2 0 0 9 - 2 0 1 1 K o m i s a r i s T a m a n G r a h a A s r i 2 0 0 9 - 2 0 1 1 K o m i s a r i s U t a m a B a n k S y a r i a h B a i t u l M u a w a n a h 1999 - 2 0 1 2 K o m i s a r i s P T . K a r a k a t a u I n d u s t r i Estate C i l e g o n ( K I E C ) Sekarang P e n g a l a m a n Organisasi * * ) Jabatan I n s t i t u s i T a h u n K e t u a K A D I N K a b u p a t e n Serang 1 9 8 4 - 1994 K e t u a P e m u d a P a n c a M a r g a K a b u p a t e n Serang 1 9 8 4 - 1998 Bendahara I C M I K a b u p t e n Serang 1 9 8 6 - 1990 Bendahara U m u m M U I K a b u p a t e n Serang 1995 - 1999 Bendahara U m u m M U I P r o v i n s i B a n t e n 2 0 0 0 - 2 0 0 5 K e t u a m e m b i d a n g i E k o n o m i M U I P r o v i n s i B a n t e n 2 0 0 6 - 2 0 0 9 K e t u a D e w a n K e h o r m a t a n P G R I P r o v i n s i B a n t e n K e t u a G P F a r m a s i P r o v i n s i B a n t e n 2 0 0 0 - 2 0 1 5 K e t u a D e w a n P e n d i d i k a n K a b u p a t e n Serang 2 0 1 0 - 0 1 5 K e t u a M e m b i d a n g i E k o n m i P B M a t h l a u T A n w a r 2 0 1 0 - 2 0 1 5 K e t u a Persatuan U m a t I s l a m P r o v i n s i B a n t e n 2 0 1 0 - 2 0 1 5
Jabatan Institusi T a h u n A n g g o t a D e w a n P e r t i m b a n g a n B A Z D A K a b u p a t e n Serang 2 0 1 0 - 2 0 1 5 A n g g o t a B a d a n g P e r t i m b a n g a n K A D I N P r o v i n s i B a n t e n 2 0 0 9 - 2 0 1 4 E . P u b l i k a s i * * ) J u d u l T a h u n T e r b i t F . Penghargaan * * ) N a m a Penghargaan I n s t i t u s i T a h u n U P A K A R T I P E N G A B D I A N P R E S I D E N R I 1990 S A T Y A L E N C A N A L V R I 2 0 0 0 B I N T A N G L E G I U N V e t e r a n R I 2 0 0 0 G . D a t a K e l u a r g a H u b u n g a n K e l u a r g a N a m a Pekerjaan I s t r i / S u a m i H j . M u n a w a r o h I b u R u m a h T a n g g a J u m l a h A n a k A n a k I . H . M u h a m m a d Y u s u f M W i r a s w a s t a 2. A r i e a r y a d i l l a ( A i m ) 3. M e i r i n a M e g a w a t i Ibu r u m a h T a n g g a 4. T e g u h D a r m a w a n g s a W i r a s w a s t a H . L a i n - l a i n :
D a f t a r r i w a y a t h i d u p i n i dibuat dengan s e b e n a m y a u n t u k d i g u n a k a n sebagaimana m e s t i n y a d a n bersedia/tidak bersedia*) d i p u b l i k a s i k a n o l e h K P U P r o v i n s i / K I P A c e h / K P U / K I P K a b u p a t e n / K o t a * ) .
S e r a n g , 2 3 - 0 9 - 2 0 1 6 Y a n g M e m b u a t pernyataan,
Calon W A K I L GUBERNUR
Mengetahui,
G A B U N G A N P A R T A I P O L I T I K P R O V I N S I B A N T E N
Yang Mengajukan Pasangan Calon
K e t u a Yang Mengajukan Pasangan Calon f 7 S e k r e t a r i s
Keterangan :
*) c o r e t y a n g t i d a k p e r l u .
**) d i m u l a i d a r i t a h u n y a n g l e b i h a w a l .
