<page orientation="portrait" format="F4" style="font-size: 11pt">

    <!-- Judul Lampiran -->
    <table align="right">
        <tr>
            <td colspan="10">Lampiran VIII</td>
        </tr>
        <tr>
            <td colspan="10">Kepdirjen Bimas Islam Nomor 473 Tahun 2020</td>
        </tr>
        <tr>
            <td colspan="10">Tentang</td>
        </tr>
        <tr>
            <td colspan="10">Petunjuk Teknis Pelaksanaan Pencatatan Nikah</td>
        </tr>
        <tr>
            <?php for ($i = 0; $i < 48; $i++) : ?>
                <td>&nbsp;</td>
            <?php endfor; ?>
        </tr>
    </table>

    <!-- Model N4 -->
    <table align="right">
        <tr>
            <td><strong>Model N4</strong></td>
            <td colspan="30">&nbsp;</td>
        </tr>
    </table>

    <p class="title-nikah">PERSETUJUAN CALON PENGANTIN</p>

    <p>Yang bertanda tangan di bawah ini : </p>
    <p class="number">A. Calon Suami :</p>
    <table id="kop" class="disdukcapil">
        <col span="48" style="width: 2.0833%;">
        <tr>
            <td colspan="48">&nbsp;</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">1. Nama lengkap dan alias</td>
            <td>: </td>
            <td colspan="27"><strong>[NAma]</strong></td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">2. Bin</td>
            <td>: </td>
            <td colspan="27">[Form_biN]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">3. Nomor Induk Kependudukan</td>
            <td>: </td>
            <td colspan="27">[NiK]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">4. Tempat dan Tanggal Lahir</td>
            <td>: </td>
            <td colspan="27">[TtL]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">5. Kewarganegaraan</td>
            <td>: </td>
            <td colspan="27">[WArga_negara]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">6. Agama</td>
            <td>: </td>
            <td colspan="27">[AgAma]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">7. Pekerjaan</td>
            <td>: </td>
            <td colspan="27">[PeKerjaan]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">8. Alamat</td>
            <td>: </td>
            <td colspan="27">[AlamaT]</td>
        </tr>
    </table>

    <p class="number">B. Calon Istri :</p>
    <table id="kop" class="disdukcapil">
        <col span="48" style="width: 2.0833%;">
        <tr>
            <td colspan="48">&nbsp;</td>
        </tr>
        <tr class="spasi">
            <td colspan="1">&nbsp;</td>
            <td colspan="20">1. Nama lengkap dan alias</td>
            <td>: </td>
            <td colspan="27"><strong>[NAma_dcpw]</strong></td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">2. Binti</td>
            <td>: </td>
            <td colspan="27">[Form_binti_dcpW]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">3. Nomor Induk Kependudukan</td>
            <td>: </td>
            <td colspan="27">[NiK_dcpw]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">4. Tempat dan Tanggal Lahir</td>
            <td>: </td>
            <td colspan="27">[TtL_dcpw]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">5. Kewarganegaraan</td>
            <td>: </td>
            <td colspan="27">[WArga_negara_dcpw]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">6. Agama</td>
            <td>: </td>
            <td colspan="27">[AgAma_dcpw]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">7. Pekerjaan</td>
            <td>: </td>
            <td colspan="27">[PeKerjaan_dcpw]</td>
        </tr>
        <tr>
            <td colspan="1">&nbsp;</td>
            <td colspan="20">8. Alamat</td>
            <td>: </td>
            <td colspan="27">[Alamat_dcpW]</td>
        </tr>
    </table>

    <p>Menyatakan dengan sesungguhnya bahwa atas dasar sukarela, dengan kesadaran sendiri,
        tanpa ada paksaan dari siapapun juga, setuju untuk melangsungkan pernikahan.
    </p>
    <p>Demikian surat persetujuan ini dibuat untuk digunakan seperlunya.</p>

    <!-- Penandatangan -->
    <table style="border-collapse: collapse; width: 100%; height: 144px;" border="0">
        <tbody>
            <tr style="height: 18px;">
                <td style="width: 26.6281%; text-align: center; height: 18px;">&nbsp;</td>
                <td style="width: 2.75528%; height: 18px;">&nbsp;</td>
                <td style="width: 70.6166%; text-align: center; height: 18px;">[Nama_desA], [TgL_surat]</td>
            </tr>
            <tr style="height: 18px;">
                <td style="width: 26.6281%; text-align: center; height: 18px;">Calon Suami</td>
                <td style="width: 2.75528%; height: 18px;">&nbsp;</td>
                <td style="width: 70.6166%; text-align: center; height: 18px;">Calon Istri</td>
            </tr>
            <tr style="height: 72px;">
                <td style="width: 26.6281%; text-align: center; height: 72px;">&nbsp;</td>
                <td style="width: 2.75528%; height: 72px;"><br /><br /><br /><br /></td>
                <td style="width: 70.6166%; height: 72px;">&nbsp;</td>
            </tr>
            <tr style="height: 18px;">
                <td style="width: 40%; text-align: center; height: 18px;"><strong>([NAma])</strong></td>
                <td style="width: 2.75528%; height: 18px;">&nbsp;</td>
                <td style="width: 60%; text-align: center; height: 18px;"><strong>([NAma_dcpw])</strong></td>
            </tr>
            <tr style="height: 18px;">
                <td style="width: 26.6281%; height: 18px;">&nbsp;</td>
                <td style="width: 2.75528%; height: 18px;">&nbsp;</td>
                <td style="width: 70.6166%; text-align: center; height: 18px;">&nbsp;</td>
            </tr>
        </tbody>
    </table>
    <!-- Akhir Halaman 4 -->
</page>