PT PUCUK JAYA

Advance Request
2/14/2022

Details

Reff. Number IMPORTANT NOTICE

Date Submitted 11 Juni 2019 By signing and submitting this form you
agree that the requested funds will be
Name Slamet Supriyadi used for the purposes stated in this form.
Position Mill Manager Failure to provide an expense report with
Department Mill receipts within 14 days of your return
Purpose of advance Untuk Pembelian Air galon selama A'an cuti date or completion of works can result in
a payroll deduction to cover the amount
Total Advance Requested Rp 200,000
.of funds advanced to you

Anticipated Expenses
Description of Expense Qty U/Price Total Expenses
Untuk keperluan pembelian air galon selama A'an (supplier galon) cuti Rp 200,000

GRAND TOTAL Rp 200,000

Oustanding/Un-settle Advance (filled by Accounting)
Description of Advance Reff. Date Total Advance

Grand Total Rp -

Recorded By
Name SIGNATURE ACCOUNTING USE ONLY

Requested by
User ……………………………………………………………………………….. Cashier …………………………
……………………………………
Acknowledge by Checked By
Head Of
Department ……………………………………………………………………………….. Acc. Mgr/FC …………………………
……………………………………

Approved By Received By
General Manager ……………………………………………………………………………….. User …………………………
……………………………………
 PT PUCUK JAYA
EXPENSE CLAIM

Name : Slamet S Claim Form No :

Department : Mill Advance Ref No :

Untuk pengecekan dan pembongkaran TK.

Anugrah 8 di jetty KRN bersama Asst Logistik
Date : 07-09 Juli 2019 Purpose of Claim : Pa Darwis

AMOUNT
NO DATE DESCRIPTION
IDR RINGGIT

1 7-Jul-19 Susu Soda 176,000

8-Jul-19 Makan (9 orang) Proses dan Maintenance 120,000
9-Jul-19 Susu Soda 166,000

Total Expenses 462,000 -

Advance (If any) 400,000

Balance (62,000) -
***Minus Balance should return to accounts depratment IDR RINGGIT

Claim Approval Accounting Use Only

Claim by Checked by
User …………………………………………….. Account Assit. ……………………………………………..

Acknowledge by Verified By
Head Of Dept. …………………………………………….. Acc.Mgr/FC ……………………………………………..

Approved By General Cash Received By

Manager …………………………………………….. User ……………………………………………..
 PT PUCUK JAYA Do Not Delete 2/14/2022
ADVANCE SCHDULE
Sep-16

Date of Date of Amount of

Advance No Name of Applicant Advance Amount Balance (If any) Outsanding Days
Advance Settlement Settlement
ADV/09/001 30-Aug-16 Rafles 2,000,000 2,000,000 1,964
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
Total 2,000,000 - 2,000,000