Professional Documents
Culture Documents
Number of
Number of Number of
No. Vessel Name Transfer to Bank Account Location/ Charterer Passenger Days Food/Person Total Crew Food Remark
Crew Others (Cadet)
(CB/not)
1 KM LBN 03 1560011563725 MANDIRI GINOMGOM SIHOMBING SIBOLGA 16 1 IDR 15 IDR 40.000 IDR 10.200.000
IDR -
IDR -
Total IDR 10.200.000
Remark
1) Transfer of fund shall be to Vessel Master only
2) Supporting Document should be provided for the requested amount (Crew List with date stamp)
3) Computation in details / explanation including special request (passenger) should be reflected in the form
4) Food Allowance transfer for 15 days
Rev 1