PT TRAKINDO UTAMA

EXPENSE CLAIM VOUCHER

Month :
Year
:
Name
S. N.
Dept.
Branch
Division

:
:
:
:
:

Virgoes Indra Wijaya

U866 / 8866
SERVICE
BALIKPAPAN
KALIMANTAN

Date

Payment by :
Acc. No.

Bank

Entertaiment
Expenses *)

Description

Foreign
Currency

Cash / Transfer

Rupiah
Equivalent

1-Oct-05

MARC PT LBE - GN BAYAN

Rp

42,500.00

2-Oct-05
3-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

4-Oct-05
5-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

6-Oct-05
7-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

8-Oct-05
9-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

10-Oct-05
11-Oct-05
12-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN
MARC PT LBE - GN BAYAN

Rp
Rp
Rp

42,500.00
42,500.00
42,500.00

13-Oct-05
14-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

15-Oct-05
16-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

17-Oct-05
18-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

19-Oct-05
20-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

21-Oct-05
22-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

23-Oct-05
23-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

24-Oct-05
25-Oct-05
26-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN
MARC PT LBE - GN BAYAN

Rp
Rp
Rp

42,500.00
42,500.00
42,500.00

27-Oct-05
28-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

29-Oct-05
30-Oct-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

31-Oct-05

MARC PT LBE - GN BAYAN

Rp

42,500.00

Rp.

Total

Rp 1,360,000.00
Rp 1,000,000.00

Rp.
USD.

Rp

Rp.

( Refund ) / Claim

360,000.00

USD.

Tiga Ratus Enam Puluh Ribu Rupiah

Claimant

Approved

Account Dept.

Sign Receipt

(VIRGOES INDRA W.)

( .... )

( ..... )

( )

Cashier Sign Receipt

For REFUND
( )
BN Ref :
.
( . )
Date :
.
Date :
. / . /
BDS Ref :
.
Date :
.
- *) Please complete this column for the Tax Allowable Entertainment Expenses and complete the "DAFTAR NOMINATIF"
- Please cross unused lines

Account Code

Note:

Expense
Code

USD.

Advance Received

( Amount of Refund / Claim in Words:

October
2005

For Account use only

Amount

Input by,

Form 163R-01

PT TRAKINDO UTAMA

EXPENSE CLAIM VOUCHER

Month
Year
Name
S. N.
Dept.
Branch
Division

:
:
:
:
:

Virgoes Indra Wijaya

U866 / 8866
SERVICE
BALIKPAPAN
KALIMANTAN

Date

Payment by :
Acc. No.

Bank

Entertaiment
Expenses *)

Description

:
:

November
2005

Cash / Transfer

Foreign
Currency

Rupiah
Equivalent

1-Nov-05
6-Nov-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

7-Nov-05
8-Nov-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

9-Nov-05
10-Nov-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
17,000.00

10-Nov-05
16-Nov-05

TRANSPORT GN BAYAN - BPN

MARC PT LBE - GN BAYAN

Rp
Rp

180,000.00
42,500.00

16-Nov-05
17-Nov-05

TRANSPORT BPN - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

180,000.00
42,500.00

18-Nov-05
19-Nov-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

20-Nov-05
21-Nov-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

22-Nov-05
23-Nov-05
24-Nov-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN
MARC PT LBE - GN BAYAN

Rp
Rp
Rp

42,500.00
42,500.00
42,500.00

25-Nov-05
26-Nov-05

MARC PT LBE - GN BAYAN

MARC PT LBE - GN BAYAN

Rp
Rp

42,500.00
42,500.00

27-Nov-05
27-Nov-05

MARC PT LBE - GN BAYAN

TRANSPORT GN BAYAN - BPN

Rp
Rp

17,000.00
180,000.00

Rp

1,254,000.00

Rp

1,000,000.00

Rp

254,000.00

Rp.

Total

USD.
Rp.

Advance Received

USD.
Rp.

( Refund ) / Claim
( Amount of Refund / Claim in Words:

USD.

Dua Ratus Lima Puluh Empat Ribu Rupiah

Claimant

Approved

Account Dept.

Sign Receipt

( VIRGOES INDRA W. )

( .... )

( ..... )

( )

Cashier Sign Receipt

For REFUND
( )
BN Ref :
.
( . )
Date :
.
Date :
. / . /
BDS Ref :
.
Date :
.
- *) Please complete this column for the Tax Allowable Entertainment Expenses and complete the "DAFTAR NOMINATIF"
- Please cross unused lines

Account Code

Note:

Expense
Code

For Account use only

Amount

Input by,

Form 163R-01

PT TRAKINDO UTAMA

EXPENSE CLAIM VOUCHER

Month
Year
Name
S. N.
Dept.
Branch
Division

:
:
:
:
:

ADITYA PANDU WINATA

I648 / 30870
SERVICE
BALIKPAPAN
NORTHERN

Date

Payment by :
Acc. No.

Bank

Entertaiment
Expenses *)

Description

CASH

Foreign
Currency

:
:
/

APRIL
2016
TRANSFER

Rupiah
Equivalent

10-Apr-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

11-Apr-16

DAILY BUSINESS PT. PETROSEA

Rp

20,000.00

12-Apr-16

DAILY BUSINESS PT. PETROSEA

Rp

20,000.00

13-Apr-16

DAILY BUSINESS PT. PETROSEA

Rp

20,000.00

14-Apr-16

DAILY BUSINESS PT. PETROSEA

Rp

20,000.00

15-Apr-16

DAILY BUSINESS PT. PETROSEA

Rp

20,000.00

18-Apr-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

20-Apr-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

21-Apr-16

DAILY BUSINESS PT. BFI

Rp

20,000.00

22-Apr-16

DAILY BUSINESS PT. BFI

Rp

20,000.00

23-Apr-16

DAILY BUSINESS PT. BFI

Rp

62,500.00

25-Apr-16

DAILY BUSINESS PT. CK

Rp

20,000.00

26-Apr-16

DAILY BUSINESS PT. BFI

Rp

62,500.00

27-Apr-16

DAILY BUSINESS PT. CK

Rp

20,000.00

28-Apr-16

DAILY BUSINESS PT. CK

Rp

20,000.00

29-Apr-16

DAILY BUSINESS PT. CK

Rp

20,000.00

Rp

405,000.00

Rp

405,000.00

Rp.

Total

Expense
Code

USD.
Rp.
USD.

Refund

Rp.

Claim

USD.

Sembilan ratus lima puluh lima ribu rupiah

Claimant

Approved

Account Dept.

ADITYA PANDU WINATA

( NURKOLIS )

( ..... )

For Account use only

Amount

Sign Receipt

Cashier Sign Receipt

For REFUND
( )
BN Ref :
.
( . )
Date :
.
Date :
. / . /
BDS Ref :
.
Date :
.
- *) Please complete this column for the Tax Allowable Entertainment Expenses and complete the "DAFTAR NOMINATIF"
- Please cross unused lines

Account Code

Note:

Input by,

Form 163R-01

PT TRAKINDO UTAMA

EXPENSE CLAIM VOUCHER

Month
Year
Name
S. N.
Dept.
Branch
Division

:
:
:
:
:

ADITYA PANDU WINATA

I648 / 30870
SERVICE
BALIKPAPAN
NORTHERN

Date

Payment by :
Acc. No.

Bank

Entertaiment
Expenses *)

Description

CASH

Foreign
Currency

:
:
/

MARCH
2016
TRANSFER

Rupiah
Equivalent

01-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

02-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

03-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

04-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

05-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

05-Mar-16

FUEL KT8798KY KM:101031

Rp

100,000.00

07-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

08-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

10-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

62,500.00

11-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

13-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

15-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

16-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

17-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

18-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

19-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

19-Mar-16

FUEL KT8046KN KM:76909

Rp

200,000.00

21-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

22-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

23-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

24-Mar-16

DAILY BUSINESS PT. KARYA TUGAS ANDA

Rp

62,500.00

28-Mar-16

DAILY BUSINESS PT. REP

Rp

20,000.00

30-Mar-16

DAILY BUSINESS PT. BWL

Rp

250,000.00

31-Mar-16

DAILY BUSINESS PT. BWL

Rp

125,000.00

31-Mar-16

TRANSPORT FERRY PENAJAM - KARIANGAU

Rp

402,500.00

Rp

1,562,500.00

Rp

1,562,500.00

Rp.

Total

Expense
Code

USD.
Rp.
USD.

Refund

Rp.

Claim

USD.

Sembilan ratus lima puluh lima ribu rupiah

Claimant

Approved

Account Dept.

ADITYA PANDU WINATA

( NURKOLIS )

( ..... )

For Account use only

Amount

Sign Receipt

Cashier Sign Receipt

For REFUND
( )
BN Ref :
.
( . )
Date :
.
Date :
. / . /
BDS Ref :
.
Date :
.
- *) Please complete this column for the Tax Allowable Entertainment Expenses and complete the "DAFTAR NOMINATIF"
- Please cross unused lines

Account Code

Note:

Input by,

Form 163R-01

PT TRAKINDO UTAMA

EXPENSE CLAIM VOUCHER

Month
Year
Name
S. N.
Dept.
Branch
Division

:
:
:
:
:

ADITYA PANDU WINATA

I648 / 30870
SERVICE
BALIKPAPAN
NORTHERN

Date

Payment by :
Acc. No.

Bank

Entertaiment
Expenses *)

Description

CASH

Foreign
Currency

:
:
/

MARCH
2016
TRANSFER

Rupiah
Equivalent

01-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

02-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

03-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

04-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

05-Mar-16

DAILY BUSINESS PT. CK

Rp

20,000.00

05-Mar-16

FUEL KT8798KY KM:101031

Rp

100,000.00

07-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

08-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

10-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

62,500.00

11-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

13-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

15-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

16-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

17-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

18-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

19-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

19-Mar-16

FUEL KT8046KN KM:76909

Rp

200,000.00

21-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

22-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

23-Mar-16

DAILY BUSINESS RENTAL STORE

Rp

20,000.00

24-Mar-16

DAILY BUSINESS PT. KARYA TUGAS ANDA

Rp

62,500.00

28-Mar-16

DAILY BUSINESS PT. REP

Rp

20,000.00

30-Mar-16

DAILY BUSINESS PT. BWL

Rp

250,000.00

31-Mar-16

DAILY BUSINESS PT. BWL

Rp

125,000.00

31-Mar-16

TRANSPORT FERRY PENAJAM - KARIANGAU

Rp

402,500.00

02-Apr-16

DAILY BUSINESS RENTAL STORE

Rp

62,500.00

03-Apr-16

DAILY BUSINESS RENTAL STORE

Rp

62,500.00

15-Apr-16

FUEL KT8352KL KM:133179

Rp

150,000.00

27-Apr-16

FUEL KT8046KN KM:77562

Rp

150,000.00

Rp

1,987,500.00

Rp

1,987,500.00

Rp.

Total

Expense
Code

USD.
Rp.
USD.

Refund

Rp.

Claim

USD.

Sembilan ratus lima puluh lima ribu rupiah

Claimant

Approved

Account Dept.

ADITYA PANDU WINATA

( NURKOLIS )

( ..... )

For Account use only

Amount

Sign Receipt

Cashier Sign Receipt

For REFUND
( )
BN Ref :
.
( . )
Date :
.
Date :
. / . /
BDS Ref :
.
Date :
.
- *) Please complete this column for the Tax Allowable Entertainment Expenses and complete the "DAFTAR NOMINATIF"
- Please cross unused lines

Account Code

Note:

Input by,

Form 163R-01