ofa ae —-——$
a us Tas we SPANK kaupa®
aReT HOt DSMRTOL OHNO hee aLInanea} Q oa
18-09-2000 18-09-2020 18-09-2020 ge ap Terpercays, Sersahabat din profe
FORM APLIKAS!
RTS Rt | INCAS,
PRESENTS
Cabana SULA ne Treat lll 0 LOLS,
JENISTRANSAKSI: [SETORAN
ADEA _AGISTA, P22
Crmmsrer — Ceunnc
no.rexenne [Ti ToT sf oTo]2 Tol af ol
NaMABANK ZL. = AR
| Grres Dwaso — Crenmonnouuan | gwar aT Uma RuRA. a
| JENIS PEMBAYARAN - ~ noon .0O\2. S6%6.:.65.2 2. 7
[| gree onto: TTT TIT TTT TD | po corms IDSA a
[| Creexrewrer ceo: / aE ”
7 Nasaeanik | NonoaceKres [warTAcumeNe] —NOMNA | Q AVADEML Taunan i) YARS Ka PT
BR uae ks TARRY. -
f
950.2,
TERBLANG éuiesr yaks —enapat eal
creer fli Saag Taine Sa
“a eo | arenosn
rom, c ; nana
Pace Trae TRRTEORET | Sere
Kune
LSBANK KALBAR
‘Seessressee ¥OT
TET ESCO
Terpercaya, Bersahabat dan Profesional
FORM APLIKASI
1) TRANSFER /ATGS/KURING /INKASO
009
Cane SUKAD AR Tn 25/10/2000
NSTRANSAG!: [Jseromn — Ghitneta touane ae SANDRAAGISTAPUTRI
Ceres Bas rennomaununn + SUKADANA
TNS Fev — 4 see ~ sath a
rw Oousrweewe: TTT
rooenmas
D cex/auver cine
aswsank | NoMORcEK/EG [VAWUTACURRENCY| —_ NOrnAL
oe FAR YARSI ET
t ausar STANAK
wo sexennec (Ti Ti To] Jf of of 2 [of of
t rarapinx __PANKKALBAR TS ae
a uae
chien
aie noma aan aye rinaaTOm
JUMAH NOMINAL 2.462.500
aaa 5.009) SUMBER OANA, RRINAANa Rzren AE
TOTAL 2.167.500. TURAN TRANSAKS) FS nee
"a TANGAN PENG PEE
AG PENGINIM/PENYETOR MENYETUIUISYARATSYARAT DAN KETENTUAN
‘ANG TERCANTUM DIBALIK APUKASI IN