INVOICE

DATE OF EXPORTATION AIRWAYBILL NO.

24 FEBRUARY 2021

SHIPPER/EXPORTER CONSIGNEE
(complete name & address) (complete name & address)

FILTER CITY
Indo karet toko OLD MAKKAH ROAD,KILO-5
Jl. Taman sari raya pasar asem reges blok. A lt. Dasar INFRONT OF ZAHID TRACTOR.
no. 158 JEDDAH,SAUDI ARABIA
Jakarta Barat, Indonesia ZIP CODE:22343
Zip code : 11150 Name:ZISHAN ALI
Name : Aten Haris MOBILE :+966535674608
Mobile : +62083871915848

COUNTRY OF EXPORT IMPORTER - IF OTHER THAN CONSIGNEE

(complete name & address)

COUNTRY OF MANUFACTURE
INDONESIA

COUNTRY OF ULTIMATE DESTINATION

NO OF UNIT TOTAL
FULL DESCRIPTION OF GOODS QTY
PKGS. VALUE VALUE

1 MASTER CYLINDER ASSY TS200 2 $30.00 $60.00

2 MASTER COUPLING ASSY TS200 2 $20.00 $40.00

TOTAL INVOICE VALUE

$100.00

I DECLARE ALL THAT INFORMATION CONTAINED IN THIS INVOICE TO BE TRUE AND CORRECT

SIGNATURE OF SHIPPER/EXPORTER DATE

(type name, title and sign, with co stamp)
24 FEBRUART 2021