LAPORAN TRANSAKSI FINANSIAL

STATEMENT OF FINANCIAL TRANSACTION

Halaman 1 dari 5
Page 1 of 5

Tanggal Laporan : 23/11/23

Kepada Yth. / To : Statement Date

TATU MULYANAH Periode Transaksi : 01/11/23 - 23/11/23

Transaction Periode

KAMPUNG CIKOROMOY RT11 RW02,KEL

KADUBUNGBANG KEC CIMANUK,PANDEGLANG
KAB. CIMANUK PANDEGLANG KAB.

No. Rekening : 6201159540501 Unit Kerja : KC Pandeglang

Account No Business Unit

Nama Produk : Britama SME - IDR Alamat Unit Kerja : Jl. Bhayangkara No1
Product Name Business Unit Address Pandeglang

Valuta : IDR
Currency

Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

01/11/23 09:37:47 NBMB TATU MULYANAH TO YOSEP IRAWAN 8888214 200,000.00 0.00 1,100,012.00
ESB:NBMB:0001500F:603523705538

01/11/23 12:40:25 ATMSTRPRM 08888 000339343 5411011161 8888299 6,500.00 0.00 1,093,512.00
ESB:NBMB:0005T00F:603625339343

01/11/23 12:40:25 ATMSTRPRM 08888 000339343 5411011161 8888299 1,000,000.00 0.00 93,512.00
ESB:NBMB:0005T00F:603625339343

01/11/23 13:08:36 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888409 43,500.00 0.00 50,012.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:603640225490

07/11/23 14:49:24 6281736107143154#577546661099#ATM #TRFLA 0888932 0.00 2,050,000.00 2,100,012.00

TRF BERSAMA FROM IQBAL SUPRIATNA LA
006201159540501ATM 6281736107143154

07/11/23 14:56:46 NBMB TATU MULYANAH TO NENI SULISTIA 8888521 800,000.00 0.00 1,300,012.00
ESB:NBMB:0001500F:606389335459

07/11/23 15:48:09 BRIVA1270113468511477NBMBIQBAL SUPRIATNA 8888569 1,250,000.00 0.00 50,012.00

BRIVA 1270113468511477NBMBIQBAL SUPRIAT
ESB:NBMB:0200200P:606409657060

07/11/23 18:55:21 NBMB MUHAMAD SAHADI TO TATU MULYANAH 8888508 0.00 5,020,000.00 5,070,012.00
ESB:NBMB:0001500F:606489984029

08/11/23 09:08:08 NBMBTT 505310584504 WBNK 006201159540501 8888034 3,000.00 0.00 5,067,012.00
WBNKTRIK006201159540501TO006201158511509
ESB:NBMB:000GZ00W:505310584504

08/11/23 09:08:08 NBMBTT 505310584504 WBNK 006201159540501 8888034 2,500,000.00 0.00 2,567,012.00
WBNKTRIK006201159540501TO006201158511509
ESB:NBMB:000GZ00W:505310584504

08/11/23 09:25:18 BRIVA1270111027569083NBMBIQBAL SUPRIATNA 8888565 2,517,000.00 0.00 50,012.00

BRIVA 1270111027569083NBMBIQBAL SUPRIAT
ESB:NBMB:0200200P:606682672897

09/11/23 15:23:40 NBMB MUHAMAD SAHADI TO TATU MULYANAH 8888057 0.00 1,430,000.00 1,480,012.00
ESB:NBMB:0001500F:607236874961

11/23/2023 08:28:32 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 2 dari 5
Page 2 of 5
Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo
Transaction Date Transaction Description User ID Debit Credit Balance

09/11/23 22:01:19 BRIVA1270114203800657NBMBIQBAL SUPRIATNA 8888087 250,000.00 0.00 1,230,012.00

BRIVA 1270114203800657NBMBIQBAL SUPRIAT
ESB:NBMB:0200200P:607397329869

10/11/23 12:41:15 QRIS607593158505#9360000210055518322 8888064 149,500.00 0.00 1,080,512.00

ESB:NBMB:0007I00P:607593158505

10/11/23 22:12:39 BPJS8888803341020173NBMB826A4FDAE395CE2F 8888380 35,000.00 0.00 1,045,512.00

ESB:NBMB:0705800P:607831675540

10/11/23 22:13:05 BPJS8888801855035764NBMBD47A4BC086D17D89 8888282 70,000.00 0.00 975,512.00

ESB:NBMB:0705800P:607831799237

11/11/23 11:55:52 QRIS608009750490#9360000210055518322 8888335 150,000.00 0.00 825,512.00

ESB:NBMB:0007I00P:608009750490

11/11/23 12:02:03 QRIS608012125929#9360000210055518322 8888380 25,000.00 0.00 800,512.00

ESB:NBMB:0007I00P:608012125929

12/11/23 04:56:11 BRIVA1270113973834971NBMBIQBAL SUPRIATNA 8888327 200,000.00 0.00 600,512.00

BRIVA 1270113973834971NBMBIQBAL SUPRIAT
ESB:NBMB:0200200P:608307676419

12/11/23 08:42:13 BRIVA124120006422010016NBMBIqbal Supriat 8888305 188,400.00 0.00 412,112.00

ESB:NBMB:0200200P:608346802833

12/11/23 10:40:37 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888484 106,000.00 0.00 306,112.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:608382147880

12/11/23 20:09:58 QRIS608576220290#9360000210055518322 8888543 50,000.00 0.00 256,112.00

ESB:NBMB:0007I00P:608576220290

13/11/23 08:04:18 BRIVA91188085219810968NBMBFIRMAN BRIVA 8888415 1,000.00 0.00 255,112.00

91188085219810968NBMBFIRMAN
ESB:NBMB:0200200P:608694611264

13/11/23 08:04:18 BRIVA91188085219810968NBMBFIRMAN BRIVA 8888415 84,000.00 0.00 171,112.00

91188085219810968NBMBFIRMAN
ESB:NBMB:0200200P:608694611264

13/11/23 08:19:30 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888390 50,000.00 0.00 121,112.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:608699501135

13/11/23 09:34:25 QRIS608726854479#9360000210055518322 8888100 50,353.00 0.00 70,759.00

ESB:NBMB:0007I00P:608726854479

13/11/23 11:44:46 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888508 20,000.00 0.00 50,759.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:608779883114

14/11/23 18:24:54 00620115954050100160654160654014287 9909516 0.00 2,450,000.00 2,500,759.00

14/11/23 18:27:15 BRIVA1270116119742017NBMBIQBAL SUPRIATNA 8888444 2,450,000.00 0.00 50,759.00

BRIVA 1270116119742017NBMBIQBAL SUPRIAT
ESB:NBMB:0200200P:609352537352

16/11/23 11:55:11 NBMB MUHAMAD SAHADI TO TATU MULYANAH 8888360 0.00 1,970,000.00 2,020,759.00
ESB:NBMB:0001500F:610040111098

16/11/23 11:57:00 NBMB TATU MULYANAH TO HENDRAWAN 8888559 480,000.00 0.00 1,540,759.00
ESB:NBMB:0001500F:610040893891

11/23/2023 08:28:32 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 3 dari 5
Page 3 of 5
Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo
Transaction Date Transaction Description User ID Debit Credit Balance

16/11/23 17:45:01 NBMB TATU MULYANAH TO YOSEP IRAWAN 8888111 100,000.00 0.00 1,440,759.00
ESB:NBMB:0001500F:610184167217

16/11/23 18:12:25 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888348 100,000.00 0.00 1,340,759.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:610196222828

16/11/23 21:42:21 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888186 147,000.00 0.00 1,193,759.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:610284836577

17/11/23 01:11:01 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888599 49,000.00 0.00 1,144,759.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:610327532293

17/11/23 07:09:40 QRIS610366761404#9360000210055518322 8888472 100,000.00 0.00 1,044,759.00

ESB:NBMB:0007I00P:610366761404

17/11/23 08:20:48 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888012 94,000.00 0.00 950,759.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:610387662443

17/11/23 08:34:44 083824950959 00986216 000000001787 9909555 900,000.00 0.00 50,759.00

17/11/23 12:25:10 NBMB RIYAN MUNANDAR TO TATU MULYANAH 8888096 0.00 1,000,000.00 1,050,759.00
ESB:NBMB:0001500F:610481981431

17/11/23 16:48:16 083824950959 00090692 000000017208 9909223 1,000,000.00 0.00 50,759.00

18/11/23 11:58:12 EDC YUNITA NUR ANIS TO TATU MULYANAH 0852098 0.00 200,000.00 250,759.00
FROM006201212465501 TO006201159540501EDC

18/11/23 11:59:27 BRIVA1270118351489289NBMBIQBAL SUPRIATNA 8888182 200,000.00 0.00 50,759.00

BRIVA 1270118351489289NBMBIQBAL SUPRIAT
ESB:NBMB:0200200P:610881113995

18/11/23 18:49:49 DANA20231118015562742199TATUMULYANAH 0371856 0.00 100,000.00 150,759.00

WS_OB;20231118015562742199;72133
ESB:T:0371856:S:0371892:WSOB

18/11/23 19:29:46 083824950959 00058655 000000018192 9909228 100,000.00 0.00 50,759.00

19/11/23 17:28:13 00620115954050100986218986218019412 9909584 0.00 200,000.00 250,759.00

19/11/23 17:30:15 QRIS611375592348#9360000210055518322 8888335 200,000.00 0.00 50,759.00

ESB:NBMB:0007I00P:611375592348

20/11/23 06:24:33 BFST006201159540501TRI USAHA BE:BDINIDJA 8888701 0.00 44,000.00 94,759.00

20231120BDINIDJA010O9950453805
ESB:BFST:0008N:20231120FASTIDJA01030632295

20/11/23 06:34:02 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888238 44,700.00 0.00 50,059.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:611536384658

20/11/23 23:59:59 Admin Fee 12,000.00 0.00 38,059.00

21/11/23 20:04:21 00620115954050100986218986218021313 9909584 0.00 1,850,000.00 1,888,059.00

21/11/23 20:05:46 00620115954050100986218986218021315 9909584 0.00 1,800,000.00 3,688,059.00

21/11/23 20:14:21 BRIVA91188085219810968NBMBFIRMAN BRIVA 8888242 1,000.00 0.00 3,687,059.00

91188085219810968NBMBFIRMAN
ESB:NBMB:0200200P:612290107552

11/23/2023 08:28:32 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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Page 4 of 5
Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo
Transaction Date Transaction Description User ID Debit Credit Balance

21/11/23 20:14:21 BRIVA91188085219810968NBMBFIRMAN BRIVA 8888242 200,000.00 0.00 3,487,059.00

91188085219810968NBMBFIRMAN
ESB:NBMB:0200200P:612290107552

21/11/23 20:38:15 BRIVA88810087773592935NBMBDNID IQBXX SUP 8888095 40,000.00 0.00 3,447,059.00

BRIVA 88810087773592935NBMBDNID IQBXX SU
ESB:NBMB:0200200P:612299983404

21/11/23 21:39:31 BRIVA91188085219810968NBMBFIRMAN BRIVA 8888123 1,000.00 0.00 3,446,059.00

91188085219810968NBMBFIRMAN
ESB:NBMB:0200200P:612322073320

21/11/23 21:39:31 BRIVA91188085219810968NBMBFIRMAN BRIVA 8888123 50,000.00 0.00 3,396,059.00

91188085219810968NBMBFIRMAN
ESB:NBMB:0200200P:612322073320

22/11/23 06:53:58 GOP01 +6283824950959NBMB5221840000000000 8888134 1,000.00 0.00 3,395,059.00

ESB:NBMB:0201000T:612396214091

22/11/23 06:53:58 GOP01 +6283824950959NBMB5221840000000000 8888134 150,000.00 0.00 3,245,059.00

ESB:NBMB:0201000T:612396214091

22/11/23 16:16:30 NBMB TATU MULYANAH TO MUHAMAD SAHADI 8888251 2,600,000.00 0.00 645,059.00
ESB:NBMB:0001500F:612596789582

22/11/23 16:17:22 NBMB TATU MULYANAH TO HENDRAWAN 8888277 480,000.00 0.00 165,059.00
ESB:NBMB:0001500F:612597119735

22/11/23 16:53:32 BRIVA1270114678596139NBMBIQBAL SUPRIATNA 8888490 115,000.00 0.00 50,059.00

BRIVA 1270114678596139NBMBIQBAL SUPRIAT
ESB:NBMB:0200200P:612610890227

22/11/23 16:57:07 ATMLTRPRM 39455 000439455 00620115954050 0888829 0.00 200,000.00 250,059.00
TRF PRIMA FROM IQBAL SUPRIATNA ATMLTRPRM
39455 000439455 006201159540501

22/11/23 17:00:27 083824950959 00090692 000000022176 9909223 200,000.00 0.00 50,059.00

22/11/23 19:05:23 6281736107309946#000000000602#ATM #TRFLA 0888218 0.00 4,000,000.00 4,050,059.00

TRF BERSAMA FROM DODI HIDROSIN LA
006201159540501ATM 6281736107309946

22/11/23 19:10:51 ATMSTRPRM 08888 000931174 6097013065 8888372 6,500.00 0.00 4,043,559.00
ESB:NBMB:0005T00F:612667931174

22/11/23 19:10:51 ATMSTRPRM 08888 000931174 6097013065 8888372 3,000,000.00 0.00 1,043,559.00
ESB:NBMB:0005T00F:612667931174

22/11/23 21:06:27 BRIVA1270116195221752NBMBIQBAL SUPRIATNA 8888249 993,000.00 0.00 50,559.00

BRIVA 1270116195221752NBMBIQBAL SUPRIAT
ESB:NBMB:0200200P:612714377468

23/11/23 07:45:05 6281736107309946#000000006247#ATM #TRFLA 0888934 0.00 10,000,000.00 10,050,559.00

23/11/23 07:46:35 6281736107309946#000000006249#ATM #TRFLA 0888745 0.00 3,000,000.00 13,050,559.00

23/11/23 08:08:05 083824950959 00090692 000000000236 9909223 1,000,000.00 0.00 12,050,559.00

23/11/23 08:08:48 083824950959 00090692 000000000237 9909223 1,000,000.00 0.00 11,050,559.00

23/11/23 08:09:30 083824950959 00090692 000000000238 9909223 1,000,000.00 0.00 10,050,559.00

23/11/23 08:25:00 BFST5411011161 NBMB:CENAIDJA 8888103 3,000,000.00 0.00 7,050,559.00

23/11/23 08:25:00 BFST5411011161 NBMB:CENAIDJA 8888103 2,500.00 0.00 7,048,059.00

11/23/2023 08:28:32 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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Page 5 of 5

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

1,300,012.00 29,565,953.00 35,314,000.00 7,048,059.00

Terbilang / In Words

TUJUH JUTA EMPAT PULUH DELAPAN RIBU LIMA PULUH SEMBILAN RUPIAH
SEVEN MILLION FORTY EIGHT THOUSAND FIFTY NINE 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

11/23/2023 08:28:32 AM