STK REPLACEMENT REQUEST FORM

Doc No. : 023/STK/GBU-KTP/III/2023

Date : 21 Maret 2023

Request Type : Replace DSTK

Distributor Name : PT. Global Bima Utama

Distributor STK MSISDN : 089634551444
Distributor Contact Name : Restu Imam Azmi
Distributor Contact Phone : 089634551444

Current STK Ownership :

Retailer Name : Trend Acesoris 222
Retailer STK MSISDN : 089502035807
Retailer Contact Name : Pandapotan Siahaan
Retailer Contact Phone : 089502035807
Retailer Address : S-4 Aek Nabara, Kec. Bilah Hulu
(including Kecamatan)

Remarks :

ID Toko : 00038396
Saldo :
D3 / K3 :

FRC Terakhir : 0
:
:

Alasan Replace : DSTK HILANG

Requested By, Received By, Performed By,

(Restu Imam Azmi) ( Ilham Tri Wardhana ) ( )

Sales Executive Business Executive HCPT Helpdesk / 3Store Agent
Date : 21 Maret 2023 Date : 21 Maret 2023 Date : 21 Maret 2023

Approved By, Approved By, Approved By,

( Hasnul Arifin Hasibuan ) ( Mitra Alim Gea ) ( Ika Lestari )
Head Of Branch SOM/GM MP3 Finance MP3
Date : 21 Maret 2023 Date : 21 Maret 2023 Date : 21 Maret 2023