LAPORAN TRANSAKSI FINANSIAL

STATEMENT OF FINANCIAL TRANSACTION

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Page 1 of 3

Kepada Yth . / To : Tanggal Laporan : 13/11/23

Statement Date

DESTI LULISTIYANI Periode Transaksi : 01/08/23 - 31/08/23

PASUTAN RT 001 RW 000 Transaction Periode

KELURAHAN TRIRENGGO,KEC BANTUL

KAB BANTUL
DAERAH ISTIMEWA YOGYAKARTA
No. Rekening : 358801032803532
Account No Unit Kerja : KC Bantul
Business Unit
Nama Produk : Britama
Product Name Alamat Unit Kerja : JL Jend Sudirman No 3
Business Unit Address Bantul
Valuta : IDR
Currency

Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

01/08/23 23:59:59 082293653469|12SMS|01/08/2023-01/08/2023 DDY402 6,000.00 0.00 10,650,563.00

02/08/23 14:30:29 6013014080267316#511133019279#NBMB#TRFLA 8888040 5,006,500.00 0.00 5,644,063.00

LA 13500502010030738NBMB6013014080267316

02/08/23 14:30:29 6013014080267316#511133019279 8888040 1,200,000.00 0.00 4,444,063.00

#NBMB#TRFLALA 13500502010030738NBMB60130

02/08/23 17:09:41 082293653469 00160860 000000002453 0644901 400,000.00 0.00 4,044,063.00

03/08/23 04:33:38 HALO 0811412973NBMB6013014080267316 8888087 2,500.00 0.00 4,041,563.00

ESB:NBMB:0101101P:511301529515

03/08/23 04:33:38 HALO 0811412973NBMB6013014080267316 8888087 111,000.00 0.00 3,930,563.00

ESB:NBMB:0101101P:511301529515

04/08/23 05:15:04 NBMB DESTI LULISTIYANI TO ARHAM 8888360 300,000.00 0.00 3,630,563.00
ESB:NBMB:0001500F:511598874062

04/08/23 13:53:44 ATMSTRPRM 08888 000784360 7911003914 8888044 6,500.00 0.00 3,624,063.00
ESB:NBMB:0005T00F:511700784360

04/08/23 13:53:44 ATMSTRPRM 08888 000784360 7911003914 8888044 150,000.00 0.00 3,474,063.00
ESB:NBMB:0005T00F:511700784360

04/08/23 18:45:40 NBMB DESTI LULISTIYANITO TRINUSA TRAVELIND 8888462 1,352,322.00 0.00 2,121,741.00
ESB:NBMB:0001500F:511773994811

04/08/23 19:31:36 NBMB DESTI LULISTIYANI TO TRINUSA TRAVELIND 8888297 1,185,256.00 0.00 936,485.00
ESB:NBMB:0001500F:511787554525

05/08/23 09:03:01 DANA20230305090258707870MAYAARDILLAS 0371851 0.00 5,000,000.00 5,936,485.00

WS_OB;20230305090258707870
72133 ESB:T: 0371851:S:0371892:WSOB

05/08/23 12:32:14 QRIS511934746633#9360000210051315489 8888475 281,250.00 0.00 5,655,235.00

ESB:NBMB:0007I00c:511934746633

05/08/23 13:09:57 NBMB DESTI LULISTIYANI TO AMBARWATI 8888317 1,000,000.00 0.00 4,655,235.00
ESB:NBMB:0001500F:511943077227

Created By BRISIM
11/13/2023 09:24:46 PM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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Page 2 of 3
Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo
Transaction Date Transaction Description User ID Debit Credit Balance

05/08/23 23:59:59 082293653469|3SMS|05/08/2023-05/08/2023 DDY402 1,500.00 0.00 4,653,735.00

06/08/23 07:32:30 TEKNIK JAYA MANDIRI-BANK MANDIRI-Travelok BRI0372 0.00 1,319,346.00 5,973,081.00

06/08/23 09:29:23 082293653469 00650176 000000000663 9944183 400,000.00 0.00 5,573,081.00

06/08/23 11:27:53 6013014080267316#512175377579#NBMB#TRFLA 8888308 6,500.00 0.00 5,566,581.00

LA 13523102011970381NBMB6013014080267316

06/08/23 11:27:53 6013014080267316#512175377579#NBMB#TRFLA 8888308 300,000.00 0.00 5,266,581.00

LA 13523102011970381NBMB6013014080267316
ESB:NBMB:0005N00F:512175377579

06/08/23 19:51:38 BRIVA1236213678588492NBMBTikTok Shop BRIVA 8888390 130,720.00 0.00 5,135,861.00

1236213678588492NBMBTikTok Shop
ESB:NBMB:0200200P:512322558366

07/08/23 15:24:40 PLN-PRA 39120816903NBMB6013014080267316 8888192 3,000.00 0.00 5,132,861.00

ESB:NBMB:0400200T:512524958315

07/08/23 15:24:40 PLN-PRA 39120816903NBMB6013014080267316 8888192 50,000.00 0.00 5,082,861.00

ESB:NBMB:0400200T:512524958315

08/08/23 09:17:29 NBMB DESTI LULISTIYANI TO REZAH SANGIA 8888218 200,000.00 0.00 4,882,861.00
ESB:NBMB:0001500F:512700261724

09/08/23 23:59:59 082293653469|14SMS|02/03/2023-06/03/2023 DDY402 7,000.00 0.00 4,875,861.00

11/08/23 22:11:15 ATMSTRPRM 08888 000445367 7245326891 8888296 6,500.00 0.00 4,869,361.00
ESB:NBMB:0005T00F:513715445367

11/08/23 22:11:15 ATMSTRPRM 08888 000445367 7245326891 8888296 500,000.00 0.00 4,369,361.00
ESB:NBMB:0005T00F:513715445367

11/08/23 22:26:47 BFST1620004245779 NBMB:BMRIIDJA 8888151 2,500.00 0.00 4,366,861.00

20230311BRINIDJA010O0247223992
ESB:NBMB:0008G00F:513718313097

11/08/23 22:26:47 BFST1620004245779 NBMB:BMRIIDJA 8888151 62,000.00 0.00 4,304,861.00

20230311BRINIDJA010O0247223992
ESB:NBMB:0008G00F:513718313097

12/08/23 10:06:18 082293653469 00057790 000000012165 0192952 200,000.00 0.00 4,104,861.00

13/08/23 23:59:59 0070I86293653469|1|15/08/2023-15/08/2023 DDY402 0.00 17,000,000.00 21,104,361.00

16/08/23 00:00:00 Biaya Bulanan ATM 2,500.00 0.00 21,101,861.00

16/08/23 23:59:59 Biaya Administrasi 5,500.00 0.00

17/08/23 19:10:22 PLN-PRA 39120816903NBMB6013014080267316 8888016 3,000.00 0.00

ESB:NBMB:0400200T:515324760385

28/08/23 19:10:22 057675876506469|1|28/08/2023-28/08/2023 8888016 0.00 20,000,000.00 41,043,361.00

28/08/23 20:59:59 NBMB DESTI LULISTIYANI TO TRIAWATI 888151 1,000,000.00 0.00 40,043,361.00
ESB:NBMB:0001500F:51270094540

Saldo Awal Total Transaksi Debet Total Transaksi Kredit Saldo Akhir
Opening Balance Total Debit Transaction Total Credit Transaction Closing Balance

10,650,563.00 13,927,548.00 43,319,346.00 40,042,361.00

Created By BRISIM
11/13/2023 09:24:46 PM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 3 dari 3
Page 3 of 3
Terbilang / In Words

EMPAT PULUH JUTA EMPAT PULUH DUA RIBU TIGA RATUS ENAM PULUH SATU RUPIAH
FOURTY MILLION FOURTY TWO THOUSAND THREE HUNDRED AND SIXTY ONE RUPIAH
Biaya materai telah dibayar Lunas
Revenue Stamp Paid

- Apabila terdapat perbedaan dengan catatan Saudara, harap menghubungi kami selambat-lambatnya 14 hari sejak diterimanya rekening koran ini.
- In the case of any differences from your records, please contact us within not later than 14 days from the receipt of this Statement of Account
- Salinan rekening koran ini merupakan hasil cetakan komputer, tidak diperlukan tanda tangan pejabat Bank
- The copy of this Statement of Account is computer-generated, no official signature is required.
- Apabila ada perubahan alamat email mohon diinformasikan pada Unit Kerja BANK BRI
- Should there be any change of email address, please notify the relevant Bank BRI Business Unit

Created By BRISIM
11/13/2023 09:24:46 PM