PT.

Graha Inti Jaya

EC-1
EXPENSES CLAIM SUMMARY
Month : Jan & Feb 2022

NAME OF CLAIMANT : Johannes OPERATING UNIT : PT. GIJ

DESIGNATION JAKARTA DEPARTEMENT : LEGAL

CROSS (1)
No PARTICULAR OF CLAIM Rp RM
REFERNCE
1 FOOD AND BEVERAGE 6,060,935
2 ENTERTAIN 3,987,252
3 TRANSPORT 466,880

4 MEDICAL 105,000

TOTAL 10,620,067
LESS : ADVENCES (REF: )

BALANCE DUE TO/(FROM) CLAIMANT

10,620,067

FOR A/C DEPARTMENT

SIGNED BY CLAIMANT : _________________ Account Cosw Rp RM
DR/CR

DR/CR

DR/CR

DR/CR

APPROVED BY : _________________ DR/CR

DR/CR

Payment Voucher : ___________________

Note : (1) Only attach Forms that are claimed
(2) Delete where appropriate Cheque Number : ___________________

Certified By : ___________________

Approved By : ___________________

form-blanko-ec
 PT. Graha Inti Jaya
EC-2
TRAVELLING CLAIM
Month : Maret 2022
NAME OF CLAIMANT Zico

DATE PARTICULAR PURPOSE / ACCOUNT. CHARGED RECEIPT Rp RM

18-Mar-22 food and beverage RUMAH MAKAN MEDAN BARU 306,060

19-Mar-22 entertain BIPANG AMBAWANG 1,165,000

19-Mar-22 food and beverage INDOMARET 174,700

19-Mar-22 food and beverage BAKMI GM 41,000

21-Mar-22 food and beverage NOAH EAT DRINK & HAPPY 15,000

21-Mar-22 food and beverage NOAH EAT DRINK & HAPPY 62,000

21-Mar-22 food and beverage NOAH EAT DRINK & HAPPY 1,000

21-Mar-22 food and beverage NOAH EAT DRINK & HAPPY 15,000

21-Mar-22 food and beverage NOAH EAT DRINK & HAPPY 1,000

22-Mar-22 food and beverage BAGOES RESTO & CAFE 326,200

23-Mar-22 food and beverage CITA RASA 287,100

23-Mar-22 food and beverage TENDA BIRU 71,000

23-Mar-22 food and beverage TENDA BIRU 170,000

24-Mar-22 food and beverage DHEA CAFE 48,400

26-Mar-22 food and beverage BAGOES RESTO & CAFE 392,700

27-Mar-22 food and beverage RUMAH MAKAN LIMA 140,000

27-Mar-22 food and beverage ALFA MART 107,400

27-Mar-22 food and beverage BAGOES RESTO & CAFE 387,200

28-Mar-22 entertain RUMAH MAKAN PONDOK LADANG 865,000

29-Mar-22 food and beverage AMING COFEE INDONESIA 27,999

29-Mar-22 food and beverage BILL RESTORAN 140,800

30-Mar-22 food and beverage BAGOES RESTO & CAFE 56,100

29-Mar-22 food and beverage AMING COFEE INDONESIA 137,996

30-Mar-22 food and beverage DHEA CAFE 53,900

31-Mar-22 food and beverage COFFEE 13,000

31-Mar-22 food and beverage CITA RASA 217,800

1-Apr-22 food and beverage GT 185,000

2-Apr-22 food and beverage NOAH EAT DRINK & HAPPY 30,000

2-Apr-22 food and beverage NOAH EAT DRINK & HAPPY 20,000

2-Apr-22 food and beverage NOAH EAT DRINK & HAPPY 36,000

2-Apr-22 food and beverage PASAR BUAH 200,000

2-Apr-22 food and beverage CITA RASA 433,400

3-Apr-22 food and beverage BAKMIE SUPER SEIDURI 114,000

4-Apr-22 food and beverage BAGOES RESTO & CAFE 90,200

4-Apr-22 food and beverage ROMEO KTV 57,500

3-Apr-22 food and beverage AMING COFEE INDONESIA 24,999

4-Apr-22 entertain CAFE HERMES 656,502

7-Apr-22 food and beverage TENTANG KOPI 42,000

6-Apr-22 food and beverage AMING COFEE INDONESIA 14,000

6-Apr-22 food and beverage WARUNG TEKKO 310,860

7-Apr-22 food and beverage IMPERIAL KITCHEN & DIMSUM 395,124

8-Apr-22 food and beverage BLUE SKY PREMIER LOUNGE 150,000

8-Apr-22 food and beverage STARBUCKS 104,000

8-Apr-22 food and beverage STARBUCKS 92,000

8-Apr-22 food and beverage RUMAH SOTO A YANI 2 84,000

10-Apr-22 food and beverage JEJU DON 343,497

9-Apr-22 entertain GIOI PIK 1,300,750

10-Apr-22 food and beverage KWETIAW BAKSO 82,000

11-Apr-22 food and beverage LIMA CAFE 59,000

8-Apr-22 transport BLUE BIRD GROUP 10,500

8-Apr-22 transport BLUE BIRD GROUP 122,880

7-Apr-22 transport SPBU PERTAMINA 300,000

8-Apr-22 transport E TOLL 33,500

6-Apr-22 medical MEDICARE LAB 105,000

10,620,067 -
: (1) Travelling Expenses - state name & the organisation
he / she represents.
(2) Receipts to be attached
SIGNED BY CLAIMANT : ______________________
 审批单
Slip Pembayaran

公司 PT. : GIJ 部门 ： LEGAL

地点 Location : JAKARTA 编号 ： 20220414001-GIJ

日期 Da

付款形式 Payment Method : 银行 Bank 现金 Cash

事由 Description 请款金额 Amount

Reimburse biaya dinas Pak Zico Periode Mar-April 2022 (Zico总3-4
月份出差费用——清借款） Rp 10,620,067

金额合计小写 Total Rp 10,620,067

金额合计大写 Amount in words sepuluh juta enam ratus dua puluh ribu enam puluh tujuh

请款人 Steffani 部门经理

Applicant Department Manager

会计复核 税务审核
Checked by TAX Checked by

财务总监
批准人
Finance
Approved by CEO
Director
 日期 Date : 2022年 04月 14日

备注 Remarks

dua puluh ribu enam puluh tujuh rupiah

部门负责人
Pimpinan
Departemen

预算复核
Budget Verified by

出纳
Kasir
 审批单
Slip Pembayaran

公司 PT. : GIJ 部门 ： LEGAL

地点 Location : JAKARTA 编号 ： 20220414002-GIJ

日期 Da

付款形式 Payment Method : 银行 Bank 现金 Cash

事由 Description 请款金额 Amount

Reimburse biaya operasional Pak Zico Periode Mar-April 2022 (Zico
总3-4月份环境部费用——清借款）
Rp 50,500,000

金额合计小写 Total Rp 50,500,000

金额合计大写 Amount in words lima puluh juta lima ratus ribu rupiah

请款人 Steffani 部门经理

Applicant Department Manager

会计复核 税务审核
Checked by TAX Checked by

财务总监
批准人
Finance
Approved by CEO
Director
 日期 Date : 2022年 04月 14日

备注 Remarks

us ribu rupiah

部门负责人
Pimpinan
Departemen

预算复核
Budget Verified by

出纳
Kasir