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BANK AKUNTANSI RENGEL

SLIP PENARIKAN

WITHDRAWAL SLIP
.....…………….…………………………………………………………………………………........
BARUtama BARDollar Simpedes Tabungan Haji Pinjaman …………………………

Mata Uang / Currency Jumlah / Amount


Nomar rekening/Acc No :……………………………………………………………………… Rupiah
Nama/Name :……………………………………………………………………… Kurs / Rate
Kanca/KCP/BAR Unit/Branch :………………………………………………………………………
Biaya / Charge
Alamat/Address :……………………………………………………………………… Jumlah / Amount

Valas / Forex
Penarikan / Withdrawal
Tunai / Cash
Pemindahbukuan Terbilang / Amount In Words……………………………………………………
No.Rek / Transfer to Acc. No :……………………………………………………………………… …………………………………………………………………………………..
Atas Nama / Beneficiary :……………………………………………………………………..

Disahkan / Approved Teller TTD. Penarik / Customer Signature

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