PT.

DIGITAL TECHNOLOGY ADVERTISING INDONESIA

SUMMARY REIMBURSEMENT FORM
NAME : LOPING PLEASE PAID TO : LOPING
DATE : 25/11/2019 BANK : BNI
DIV/BRANCH : NO REK : 0865088765

NO MAIN EXPENSE EXPENSE DETAIL INFORMATION NOMINAL GRAND TOTAL

1 TRAVELLING & TRANSPORTATION Flight Ticket
Hotel
Transportation 100,000
Parking & Toll
Gasoline
100,000

2 ENTERTAINMENT EXPENSE Entertainment With Clients Expense

Entertainment With Team
TOTAL -

3 OTHER MARKETING Other Marketing

TOTAL -

4 SALARIES AND BENEFITS Healthy Expense

Other Benefit Expense
TOTAL -

5 ADMINISTRATION OFFICE EXPENSE Office Supplies

Printing, Fotocopy & Scan
Bank Administration Expense
Other Administration Expense
Expedition
Retribution Expense
TOTAL -

6 UTILITIES EXPENSE Other Expense

TOTAL -
TOTAL OF REIMBURSRMENT 100,000

Prepared by Approved by Aknowledge by Issued by

LIVIA WANG YONG