Annex 1: Proof of Attendance and Payment Receipt by Global Green Growth Institute

I hereby acknowledge the payment in GGGI-funded event and receipt during the “Social and Economic Assessment of Communities
Surrounding KHG Utar-Sarapat in Central and South Kalimantan” on 10-20 May 2018 as support of:
☒ Participants at GGGI-funded event (local lodging)
By signing this I verify that I have not received any financial support to attend this event from my employer or any other third party.

Name of Consultant/ Nama Konsultan:

Signature/ Seal if Supporting

Total Payment/ Recipients
Name of Hotel or Homestay/ available/ Document/
No Date / Tanggal Pembayaran Name/ Nama
Nama Hotel/ penginapan Tanda Tangan/ Dokumen
(IDR) Penerima
Cap pendukung 1
1.

2.

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Kuitansi pembayaran wajib dilampirkan
Annex 1: Proof of Attendance and Payment Receipt by GGGI on ““Consultation on Achievement of Emission Reduction in Land Based Sector at National level” - 11 May 2018

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 Signature/ Seal if Supporting
Total Payment/ Recipients
Name of Hotel or Homestay/ available/ Document/
No Date / Tanggal Pembayaran Name/ Nama
Nama Hotel/ penginapan Tanda Tangan/ Dokumen
(IDR) Penerima
Cap pendukung
3.

4.

5.

6.

7.

8.

Annex 1: Proof of Attendance and Payment Receipt by GGGI on ““Consultation on Achievement of Emission Reduction in Land Based Sector at National level” - 11 May 2018

Page 2
 Signature/ Seal if Supporting
Total Payment/ Recipients
Name of Hotel or Homestay/ available/ Document/
No Date / Tanggal Pembayaran Name/ Nama
Nama Hotel/ penginapan Tanda Tangan/ Dokumen
(IDR) Penerima
Cap pendukung

9.

10.

11.

12.

Annex 1: Proof of Attendance and Payment Receipt by GGGI on ““Consultation on Achievement of Emission Reduction in Land Based Sector at National level” - 11 May 2018

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