FORMULIR PERMOHONAN REFUND

REFUND REQUEST FORM

Nama Pelanggan
1 Julius
Customer Name
Nomor Pelanggan
2 82143853907
Customer number
Jenis Layanan
3 Take Way
Service type
Jumlah yang akan di-refund
4 49.500 (inc.ppn)
Amount for refund
Alasan Refund
5 1 varian kurang (cinnamon bun walnut )
Refund reason
Informasi Bank
6
Bank Information
Nama Penerima
Julius Rubianto
Recipient Name
Nama Bank dan Cabang
Bank BCA
Bank Name & Branch
Nomor Rekening Penerima
4400011911
Recipient Account Number

Pelanggan
Head division Accounting Head Manager Approval
Customer

Tanggal Tanggal Tanggal Tanggal Tanggal

Date Date Date Date Date

Catatan:
pelanggan wajib mencantumkan foto bukti pembayaran yang telah dilakukan
Formulir permohonan wajib dilengkapi dan ditanda tangani oleh pelanggan
Proses pengembalian dana (return) ke rekening pelanggan akan dilakukan dalam tempo 2 (dua) hari kerja
setelah seluruh data diterima oleh pihak Retawu Deli

Note:
Customers are required to include a photo of payment that has been made
The application form must be completed and signed by the customer
The refund process to the customer's account will be carried out within 2 (two) working days
after all data is received by Retawu Deli
(dua) hari kerja
 FORMULIR PERMOHONAN REFUND
REFUND REQUEST FORM

Nama Pelanggan
1 YUNITA
Customer Name
Nomor Pelanggan
2 0811333399
Customer number
Jenis Layanan
3 Take Away
Service type
Jumlah yang akan di-refund
4 55,000
Amount for refund
Alasan Refund
5 Pesanan tidak lengkap (kurang 1 gentlement cake)
Refund reason
Informasi Bank
6
Bank Information
Nama Penerima
SANTOSO UNTUNG
Recipient Name
Nama Bank dan Cabang
Bank BCA
Bank Name & Branch
Nomor Rekening Penerima
0720002582
Recipient Account Number

Pelanggan
Head division Accounting Head Manager Approval
Customer

Tanggal Tanggal Tanggal Tanggal Tanggal

Date Date Date Date Date

Catatan:
pelanggan wajib mencantumkan foto bukti pembayaran yang telah dilakukan
Formulir permohonan wajib dilengkapi dan ditanda tangani oleh pelanggan
Proses pengembalian dana (return) ke rekening pelanggan akan dilakukan dalam tempo 2 (dua) hari kerja
setelah seluruh data diterima oleh pihak Retawu Deli

Note:
Customers are required to include a photo of payment that has been made
The application form must be completed and signed by the customer
The refund process to the customer's account will be carried out within 2 (two) working days
after all data is received by Retawu Deli
(dua) hari kerja