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POLA TEKNIK KWITANSI No.

Number
: …………………………………….

Heavy Equipment Rental Tgl.

RECEIPT
: …………………………………….
Blok Rahayu Selatan RT.18 RW.05 Palimanan Barat, Gempol Cirebon Date
Telp. (0231) 8330295 HP. 081222115171 – 081564788855

Sudah terima dari


: …………………………………………………………………………………………………………………………………………
ReceivedFrom
Banyaknya Uang : …………………………………………………………………………………………………………………………………………
Amount …………………………………………………………………………………………………………………………………………
Untuk Pembayaran
: …………………………………………………………………………………………………………………………………………
For Payment
………………………………………………………………………………………………………………………………………………………………………
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$Rp.
POLA TEKNIK
Heavy Equipment Rental
CASH CHEQUE BILYET GIRO

BANK
: ……………………………………………………………………………………………………………………………………………………
Bank
No.
: ……………………………………………………………………………………………………………………………………………………
Number
Tgl.
: ……………………………………………………………………………………………………………………………………………………
Date
Kwitansi ini baru dianggap sah, setelah pembayaran dengan Bilyet Giro/Cheque tsb. Dapat di Uangkan
This receipt will be cleared after Bilyet Giro/Cheque can be cleared

POLA TEKNIK KWITANSI No.


Number
: …………………………………….

Heavy Equipment Rental Tgl.

RECEIPT
: …………………………………….
Blok Rahayu Selatan RT.18 RW.05 Palimanan Barat, Gempol Cirebon Date
Telp. (0231) 8330295 HP. 081222115171 – 081564788855

Sudah terima dari


: …………………………………………………………………………………………………………………………………………
ReceivedFrom
Banyaknya Uang : …………………………………………………………………………………………………………………………………………
Amount …………………………………………………………………………………………………………………………………………
Untuk Pembayaran
: …………………………………………………………………………………………………………………………………………
For Payment
………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………………………

$Rp.
POLA TEKNIK
Heavy Equipment Rental
CASH CHEQUE BILYET GIRO

BANK
: ……………………………………………………………………………………………………………………………………………………
Bank
No.
: ……………………………………………………………………………………………………………………………………………………
Number
Tgl.
: ……………………………………………………………………………………………………………………………………………………
Date
Kwitansi ini baru dianggap sah, setelah pembayaran dengan Bilyet Giro/Cheque tsb. Dapat di Uangkan
This receipt will be cleared after Bilyet Giro/Cheque can be cleared

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