( Nama Penulis )...............
( Alamat )......................
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Tarikh :
(Tertib menghadapkan surat kepada pihak yang menerima surat ) .............................................................................................................
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Saudara, (atau yang lain)
(Hal-hal yang ingin disampaikan / dinyatakan. Ada baiknya sesuatu isi disampaikan dalam perenggan yang berasingan)
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Yang benar,
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( Nama Huruf Besar )
