ACCOUNTABILITY REPORT

Millennium Centennial Center, Level 38, Jl. Jend. Sudirman No.Kav.

25, RT.10/RW.1, Kuningan, Karet, Kota Jakarta Selatan, Daerah
Khusus Ibukota Jakarta 12920
Phone : 021-39738303

From
Brand : Date :
Name Requestor : No RM :
Vendor Name :

Purpose of payment: :
Payment Method : Bank Cash

Bank Details
Bank Name :
Account Number :

Description Unit Price Qty Amount

 Sub Total

Less Cash Advance

Total Request

Requestor HOD Finance

Amount
Finance
 REIMBURSEMENT FORM

Millennium Centennial Center, Level 38, Jl. Jend. Sudirman No.Kav.

25, RT.10/RW.1, Kuningan, Karet, Kota Jakarta Selatan, Daerah
Khusus Ibukota Jakarta 12920
Phone : 021-39738303

From
Brand : Date :
Name Requestor : Ahmad Fauzi Nazir No RM :
Vendor Name :

Purpose of payment: : Reimburment

Payment Method : Bank Cash

Bank Details
Bank Name : BCA
Account Number : 5271097400

Description Unit Price Qty Amount

29 Oct 2019 - Event at CIBIS 11000 11000

30 Oct 2019 - Event Great Eastern 2000 2000
30 Oct 2019 - Event Great Eastern 16000 16000
05 Nov 2019 - Meeting to USANA 4000 4000
06 Nov 2019 - Event at CIBIS 19000 19000
07 Nov 2019 - Event at CIBIS 19000 19000
08 Nov 2019 - Bensin 81939 81939
14 Nov 2019 - Event Marquee 19000 19000
15 Nov 2019 - Event at Kitabisa 17000 17000
 Sub Total
188939

Less Cash Advance

Total Request
188939

Requestor HOD Finance

Ahmad Fauzi Nazir

Reimbursement until IDR 1.000.000

Amount

11000
2000
16000
4000
19000
19000
81939
19000
17000
188939

188939

Finance
 CASH ADVANCE FORM

Millennium Centennial Center, Level 38, Jl. Jend. Sudirman No.Kav.

25, RT.10/RW.1, Kuningan, Karet, Kota Jakarta Selatan, Daerah
Khusus Ibukota Jakarta 12920
Phone : 021-39738303

From
Brand : Date :
Name Requestor : No CA :
Vendor Name :

Purpose of payment: :
Payment Method : Bank Cash

Bank Details
Bank Name :
Account Number :

Description Unit Price Qty Amount

 Total Request

Requestor HOD Finance

Cash advance until IDR 2.500.000

Amount
Finance
 PURCHASE ORDER FORM

Millennium Centennial Center, Level 38, Jl. Jend. Sudirman No.Kav. 25, RT.10/RW.1,
Kuningan, Karet, Kota Jakarta Selatan, Daerah Khusus Ibukota Jakarta 12920
Phone : 021-39738303

From
Brand : Date :
Name Requestor : No PO :
No PR :

Vendor Details
Name :
Email :
Phone :

Delivery Details
Delivery to :
Delivery Address :
Prefered Delivery Time :

Description Unit Price Qty Amount

 Sub Total

Requestor HOD *BOD

*if your request more than Rp 10.000.000

Amount
CFO

.
 PURCHASE REQUEST FORM

Millennium Centennial Center, Level 38, Jl. Jend. Sudirman No.Kav. 25, RT.10/RW.1,
Kuningan, Karet, Kota Jakarta Selatan, Daerah Khusus Ibukota Jakarta 12920
Phone : 021-39738303

From
Brand :
Name :
Division :

Description Unit Price Qty Amount

Storage Tub With Wheels And Handle Containers 1

Tas X Banner

Sub Total

Requestor Approval from HOD Approval from BOD*

*if your request more than Rp 10.000.000
Date : 18/11/2019
No PR :

Amount

Approval from CFO