LAPORAN TRANSAKSI FINANSIAL

STATEMENT OF FINANCIAL TRANSACTION

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Page 1 of 2

Tanggal Laporan : 05/02/24

Kepada Yth. / To : Statement Date

ACHMAD FAUZAN Periode Transaksi : 01/12/23 - 31/12/23

Transaction Periode

DSN GADOG RT3 RW2 KEL TAMANSURUH KEC

GLA,GAH,BANYUWANGI GLAGAH BANYUWANGI

No. Rekening : 611601020837537 Unit Kerja : UNIT GLAGAH BANYUWANGI

Account No Business Unit

Nama Produk : SIMPEDES UMUM Alamat Unit Kerja : KANCA BANYUWANGI

Product Name Business Unit Address KANWIL MALANG

Valuta : IDR
Currency

Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

01/12/23 23:59:59 082127208300|5SMS|28/11/2023-29/11/2023 DDY402 2,500.00 0.00 9,868,064.00

06/12/23 18:38:56 EDC ANDIKA WASESO TO ACHMAD FAUZAN 0852115 0.00 4,000,000.00 13,868,064.00
FROM762901009302535 TO611601020837537EDC

06/12/23 19:23:11 PRTT601301223722811601328428#10246321 0852672 25,400.00 0.00 13,843,664.00

06/12/23 19:23:11 PRTT601301223722811601328428#10246321 0852672 154,000.00 0.00 13,688,664.00

06/12/23 19:23:11 PRTT601301223722811601328428#10246321 0852672 50,000.00 0.00 13,638,664.00

06/12/23 23:59:59 082127208300|3SMS|30/11/2023-30/11/2023 DDY402 1,500.00 0.00 13,637,664.00

11/12/23 20:24:00 NBMB SUMARI TO ACHMAD FAUZAN 8888002 0.00 1,500,000.00 15,137,164.00
ESB:NBMB:0001500F:608213927541

12/12/23 11:58:10 601301223722811600161006 9879507 500,000.00 0.00 14,637,164.00

14/12/23 23:59:59 082127208300|2SMS|05/12/2023-05/12/2023 DDY402 1,000.00 0.00 14,636,164.00

16/12/23 00:00:00 Monthly Fee ATM 2,500.00 0.00 14,663,664.00

16/12/23 23:59:59 Admin Fee 5,500.00 0.00 14,628,164.00

17/12/23 10:27:39 NBMB SUMARI TO ACHMAD FAUZAN 8888276 0.00 1,500,000.00 16,128,164.00
ESB:NBMB:0001500F:610435792088

17/12/23 10:44:47 6013012237228116000000004846 0888295 7,500.00 0.00 16,120,664.00

17/12/23 10:44:47 6013012237228116000000004846 0888295 1,000,000.00 0.00 15,120,664.00

18/12/23 11:42:55 NBMB SAMARA TO ACHMAD FAUZAN 8888099 0.00 2,800,000.00 17,920,664.00
ESB:NBMB:0001500F:610875048429

18/12/23 23:31:29 6013012237228116000000003191 0888330 100,000.00 0.00 17,820,664.00

18/12/23 23:59:59 082127208300|2SMS|11/12/2023-12/12/2023 DDY402 1,000.00 0.00 17,819,664.00

18/12/23 03:19:00 FROM:611601020837537 TO:611601019964105 LN0063 763,900.00 0.00 17,055,764.00

21/12/23 23:59:59 082127208300|4SMS|17/12/2023-18/12/2023 DDY402 2,000.00 0.00 17,053,764.00

Created By BRISIM
02/05/2024 12:08:10 PM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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

22/12/23 19:47:34 6013012237228116000000004572 0888337 50,000.00 0.00 17,003,764.00

25/12/23 20:23:55 NBMB SUMARI TO ACHMAD FAUZAN 8888322 0.00 1,700,000.00 18,703,764.00
ESB:NBMB:0001500F:613968140586

25/12/23 20:31:41 6013012237228116CASH08521115#3116562 0852115 3,000.00 0.00 18,700,764.00

25/12/23 20:31:41 6013012237228116CASH08521115#3116562 0852115 100,000.00 0.00 18,600,764.00

25/12/23 23:59:59 082127208300|1SMS|19/12/2023-19/12/2023 DDY402 500.00 0.00 18,600,264.00

26/12/23 20:24:32 6013012237228116000000005865 0888313 50,000.00 0.00 18,550,264.00

29/12/23 23:59:59 082127208300|2SMS|25/12/2023-25/11l2/2023 DDY402 1,000.00 0.00 18,549,264.00

30/12/23 20:05:06 NBMB SUMARI TO ACHMAD FAUZAN 8888542 0.00 2,000,000.00 20,549,264.00
ESB:NBMB:0001500F:616071734831

30/12/23 20:14:02 6013012237228116000000006130 0888296 7,500.00 0.00 20,541,764.00

30/12/23 20:14:02 6013012237228116000000006130 0888296 5,000.00 0.00 20,536,764.00

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

9,870,564.00 2,883,800.00 13,500,000.00 20,536,764.00

Terbilang / In Words

DUA PULUH JUTA LIMA RATUS TIGA PULUH ENAM RIBU TUJUH RATUS ENAM PULUH EMPAT RUPIAH
TWENTY MILLION FIVE HUNDRED THIRTY SIX THREE THOUSAND SEVEN HUNDRED SIXTY FOUR 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
02/05/2024 12:08:10 PM