PT.

Pertamina (Persero)
JL.Medan Merdeka Timur No. 1A Jakarta 10110
Telp: 021 3815111 FAX: 021 3633585

LAPORAN REALISASI PENYALURAN AGEN LPG KE SUB PENYALUR PERIODE JANUARI 2022

Nama Agen : PT. SLA RENA

Alamat Agen :
Email :
No. Sold To : 782623
Wilayah : JAWA BARAT, KABUPATEN CIAMIS

Nama Total Total Grand

Id Registrasi Alokasi 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Pangkalan Normal Fakultatif Total
346386782623019 AGAM 840 0 0 280 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 100 0 0 940 0 940
346382782623057 AMAN 420 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 140 0 0 0 0 420 0 420
346382782623052 ARIS GAS 500 100 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 220 0 0 140 0 0 0 0 0 0 0 0 0 0 500 100 600

346382782623033 ARIS 1,100 0 0 0 0 0 140 0 0 0 0 0 0 280 0 0 0 0 0 0 0 140 0 0 0 0 0 280 0 0 0 280 1,120 0 1,120
HIDAYAT
346254782623049 BENI 2 240 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 240
346385782623001 CICIH 1,040 140 0 0 0 260 0 0 0 0 0 0 260 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 260 0 0 0 1,040 140 1,180
346383782623044 DADAY 200 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 200 0 200

346384782623046 DE ONI 200 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 200 0 200

HAERONI

346252782623002 DEDI TRIADI 250 0 0 0 0 0 0 0 50 0 0 0 0 0 0 100 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 250 0 250

(UJANG)
346385782623032 EDIH 780 140 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 260 0 0 0 0 0 0 780 140 920

346383782623003 EET 640 0 0 0 0 0 0 160 0 0 0 0 0 0 160 0 0 0 0 0 0 160 0 0 0 0 0 0 160 0 0 0 640 0 640

SUGIANA

346382782623024 ELAN 540 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 180 0 0 0 0 0 0 180 0 0 0 0 0 0 0 540 0 540

SUTISNA

346216782623028 ENDANG 600 100 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 200 0 0 0 600 100 700
HERNAWAN

346212782623039 ENDANG 780 0 0 0 0 0 260 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 780 0 780

SUTISNA
346254782623015 ENJUH 1,440 0 0 0 260 0 0 0 150 0 0 100 0 0 0 130 0 0 260 0 0 0 130 0 0 260 0 0 0 150 0 0 1,440 0 1,440

346251782623023 ESIH 600 0 0 150 0 0 0 0 0 0 150 0 0 0 0 0 0 150 0 0 0 0 0 0 150 0 0 0 0 0 0 0 600 0 600

SUKAESIH

346386782623018 EUIS 840 0 0 280 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 840 0 840

MAESAROH
EUIS
346386782623050 MAESAROH 220 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 220
GAS

346387782623004 H. HASAN 720 0 0 0 0 0 0 0 180 0 0 0 0 0 0 180 0 0 0 0 0 0 180 0 0 0 0 0 0 180 0 0 720 0 720

SUPRIYADI

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 Id Registrasi Nama Alokasi 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Total Total Grand
Pangkalan Normal Fakultatif Total
HENI
346263782623029 HERYANI 900 0 0 0 0 300 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 900 0 900
S.PD
346272782623054 HERDI 200 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 200

346217782623027 HESTI 480 100 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 160 0 0 0 480 100 580
ROSTIANA

346252782623005 IBU EDIH - 250 0 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 100 0 0 0 0 0 0 50 0 0 250 0 250

CICIH
346263782623006 IIM IMAM 1,040 0 0 0 0 0 0 160 0 0 0 0 0 200 0 0 0 0 0 0 260 0 0 0 0 0 0 160 0 0 0 260 1,040 0 1,040

346382782623034 IMAN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
FIRMANSYAH

346274782623007 IMAS 1,040 0 0 260 0 0 0 0 0 0 260 0 0 0 0 0 0 260 0 0 0 0 0 0 260 0 0 0 0 0 0 0 1,040 0 1,040

MEILANTI

346263782623008 IWAN 1,200 0 0 0 0 0 0 200 0 0 0 0 0 200 0 0 0 0 0 0 300 0 0 0 0 0 0 200 0 0 0 300 1,200 0 1,200
DARMAWAN
346272782623009 KARSUM 900 0 0 0 0 0 300 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 900 0 900
346272782623053 KARSUM 2 260 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 260
346254782623035 KURNIA GAS 900 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 300 0 0 0 0 0 0 900 0 900
346219782623037 LIA YULIANTI 560 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 200 0 0 0 600 0 600

346383782623026 LISYE SRI 900 0 0 0 200 0 0 0 0 0 0 200 0 0 0 0 0 0 0 200 0 0 0 0 0 0 300 0 0 0 0 0 900 0 900
RAHAYU
346382782623051 NANO GAS 220 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 220 100 320

346382782623042 NANO 420 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 140 0 0 0 0 420 0 420

ORLANDO

346385782623016 NINA 1,090 0 0 0 0 300 0 0 0 0 0 0 290 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 210 1,080 0 1,080

MARLINA

346382782623025 NITA 1,400 120 0 0 0 0 0 0 0 0 280 0 0 280 0 0 0 280 0 0 0 0 0 0 280 0 0 0 0 0 0 280 1,400 120 1,520
ROSTIAWATI

346385782623020 NOER 800 0 0 0 0 0 0 0 140 0 0 0 0 0 0 140 0 0 0 0 0 0 140 0 0 0 0 200 0 0 0 180 800 0 800
ROHMAN
346251782623022 OHID 600 0 0 150 0 0 0 0 0 0 150 0 0 0 0 0 0 150 0 0 0 0 0 0 150 0 0 0 0 0 0 0 600 0 600
346213782623010 OTONG 580 130 0 0 0 0 0 160 0 0 0 0 130 0 0 0 0 0 100 0 0 0 0 0 0 0 160 0 0 100 0 0 650 130 780
346385782623017 PUJIONO 810 0 0 0 0 260 0 0 0 0 0 0 270 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 810 0 810

346383782623045 RIN RIN 200 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 200 0 200

ANJARSARI
346385782623041 SARINAH 560 120 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 560 120 680
346385782623036 SELAMET 700 0 0 0 0 0 0 0 120 0 0 0 0 0 0 140 0 0 0 0 0 0 140 0 0 0 0 130 0 0 0 170 700 0 700

346263782623056 SETIAWAN 560 0 0 0 0 0 0 200 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 560 0 560

NUGRAHA
346263782623038 SHABILUL 1,340 0 0 0 0 260 0 0 0 0 0 0 200 0 0 260 0 0 0 0 260 0 0 0 0 0 260 0 0 160 0 0 1,400 0 1,400

346382782623056 SITI 120 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 120 120 240

MUDRIKAH
346385782623021 SUBAGIO 1,100 0 0 0 0 0 0 0 300 0 0 0 0 0 0 280 0 0 0 0 0 0 280 0 0 0 0 230 0 0 0 0 1,090 0 1,090
346385782623011 SUKENDAR 1,200 140 0 0 0 300 0 0 0 0 0 0 300 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 300 0 0 0 1,200 140 1,340

346383782623043 SUSI SUCI 200 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0 0 0 200 0 200

RAHAYU
TK.
346213782623012 ANUGRAH (A. 730 0 0 0 0 0 0 200 0 0 0 0 130 0 0 0 0 0 130 0 0 0 0 0 0 0 200 0 0 100 0 0 760 0 760
GUNAWAN)

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 Id Registrasi Nama Alokasi 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Total Total Grand
Pangkalan Normal Fakultatif Total

346261782623013 USUP 730 100 0 0 0 0 0 200 0 0 0 0 100 0 0 0 0 0 130 0 0 0 0 0 0 0 200 0 0 100 0 0 730 100 830
SUPRIADI

346383782623040 WIDYA 560 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 560 0 560

NOVAYANTI

346383782623014 YADI 800 0 0 0 200 0 0 200 0 0 0 160 0 0 200 0 0 0 0 200 0 200 0 0 0 0 0 0 200 0 0 0 1,360 0 1,360
SETIADI

346382782623047 YELIS ERNI 300 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 100 0 0 0 0 0 0 100 0 0 0 0 0 0 0 300 0 300

KURNIAWATI

346383782623030 YUNI 780 0 0 0 160 0 0 0 0 0 0 200 0 0 0 0 0 0 0 160 0 0 0 0 0 0 260 0 0 0 0 0 780 0 780

HASTUTI

346385782623031 YUNI 900 140 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 300 0 0 0 0 0 0 900 140 1,040
WINDARWATI

346213782623047 YUYUN 600 130 0 0 0 0 0 0 130 0 0 100 0 0 0 100 0 0 0 0 100 0 100 0 0 0 0 0 0 130 0 0 660 130 790
ROHAYATI
37,880 1,680 0 1,120 1,120 1,680 1,680 1,680 1,680 0 1,680 1,680 1,680 1,680 1,120 1,680 0 1,680 1,480 1,680 1,480 1,680 1,680 0 1,120 1,680 1,680 1,680 1,680 1,120 0 1,680 38,800 1,680 40,480

Data tersebut diinput ke sistem sales LPG oleh agen LPG sebenar - benarnya dalam keadaan sehat lahir batin, apabila dikemudian hari data yang disampaikan terbukti tidak benar, maka agen LPG bersedia dikenaikan sanksi sesuai peraturan
dan hukum yang berlaku.Laporan ini dibuat oleh sistem

Mengetahui Penerima
PT.Pertamina(Persero)

Agen :
Nama : Nama :
Jabatan : Jabatan :

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