ANNEX A

Date Submitted Period Promo CN Number Sales News Name Claim Type Claim Number Dealer Code Dealer Name Amount Status
01-Feb-21 7C Discount display Cashback ICC259 Concept Shop Waiting evidence
23-Feb-21 Jan 2021 287088766 2472 SALES NEWS (DI ILCE 1 - 31 Jan '21) CM 1,2,3 Cashback CI-INDO-ST4-21030089 ICC259 Concept Shop 119.500.000 Completed
23-Feb-21 Jan 2021 287089393 2472 SALES NEWS (DI ILCE 1 - 31 Jan '21) CM 1,2,3 Add 7M3 PWP Cashback CI-INDO-ST4-21030262 ICC259 Concept Shop 3.000.000 Completed
23-Feb-21 Jan 2021 287088775 2473 SALES NEWS (DI LENS 1 - 31 Jan '21) CM 1,2,3 Cashback CI-INDO-ST4-21030090 ICC259 Concept Shop 22.100.000 Completed
23-Feb-21 Jan 2021 287088777; 287088765 2475 SALES NEWS (DI DSC 1 - 31 Jan '21) CM 1,2,3 Cashback CI-INDO-ST4-21030091; CI-INDO-ST4-21030092
ICC259 Concept Shop 2.500.000 Completed
03-Mar-21 Feb 2021 287088646 - 47 Support Trading Term Feb'21 Achievment CI-INDO-ST4-21030071 ICC259 Concept Shop 1.502.626 Completed
Feb 2021 2582 SALES NEWS (DI ILCE 1 - 28 Feb '21) CM 1,2,3 Cashback CI-INDO-ST4-21030534 ICC259 Concept Shop 33.000.000 Payout
Feb 2021 2583 SALES NEWS (DI LENS 1 - 28 Feb '21) CM 1,2,3 Cashback CI-INDO-ST2-21030187; CI-INDO-ST4-21030535
ICC259 Concept Shop 7.500.000 Raised project (4,5jt) & Payout (3jt)
Feb 2021 2585 SALES NEWS (DI DSC 1 - 28 Feb '21) CM 1,2,3 Cashback CI-INDO-ST4-21030536 ICC259 Concept Shop 2.000.000 Payout
Feb 2021 2628 SALES NEWS (DI - Chinese New Year Promo 12 - 28 Feb '21) CM&S 1,2,3 Cashback CI-INDO-ST4-21040068 ICC259 Concept Shop 21.000.000 Email to Vickya
Feb 2021 Voucher 7C - 10% or max 2,5jt Cashback CI-INDO-ST2-21030190 ICC259 Concept Shop 7.500.000 Raised project

TOTAL AMOUNT 219.602.626

I hereby verified that the list provided in ANNEX A to be correct and accurate.
Dengan ini, saya memverifikasi data pada LAMPIRAN A adalah benar dan akurat.

Stamp Rp 6000

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