LAPORAN TRANSAKSI FINANSIAL

STATEMENT OF FINANCIAL TRANSACTION

Halaman 1 dari 3
Page 1 of 3

Tanggal Laporan : 11/10/23

Kepada Yth. / To : Statement Date

DEWI LOVITA SALEHA Periode Transaksi : 01/10/23 - 11/10/23

Transaction Periode

PADANG PANJANG,KEC TANTA,TABALONG TANTA

TABALONG

No. Rekening : 449701008246504 Unit Kerja : UNIT PANTAI HAMBAWANG BARABAI

Account No Business Unit

Nama Produk : Britama-IDR Alamat Unit Kerja : KANCA BARABAI

Product Name Business Unit Address KANWIL BANJARMASIN

Valuta : IDR
Currency

Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

01/10/23 02:48:15 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888048 0.00 4,900,000.00 18,482,939.00
ESB:NBMB:0001500F:590540091220

01/10/23 09:55:10 BFST7154980428 NBMB:BSMDIDJA 8888169 2,500.00 0.00 18,480,439.00

20231001BRINIDJA010O0236496283
ESB:NBMB:0008G00F:590645151688

01/10/23 09:55:10 BFST7154980428 NBMB:BSMDIDJA 8888169 15,000,000.00 0.00 3,480,439.00

20231001BRINIDJA010O0236496283
ESB:NBMB:0008G00F:590645151688

02/10/23 08:32:07 522184314074721800660197 9914507 0.00 1,900,000.00 5,380,439.00

02/10/23 08:33:31 522184314074721800660197 9914507 0.00 1,300,000.00 6,680,439.00

02/10/23 10:55:23 BRIVA128081288596911NBMBdXXXXXXXy BRIVA 8888032 27,750.00 0.00 6,652,689.00

128081288596911NBMBdXXXXXXXy
ESB:NBMB:0200200P:591117384789

02/10/23 10:57:18 BRIVA1240800722273250NBMBDXXXXXXXXXXXXXX 8888558 518,238.00 0.00 6,134,451.00

BRIVA 1240800722273250NBMBDXXXXXXXXXXXX
ESB:NBMB:0200200P:591118337817

02/10/23 10:57:49 PLNPOST 221200571565NBMB5221843140747218 8888379 3,000.00 0.00 6,131,451.00

ESB:NBMB:0400400T:591118597059

02/10/23 10:57:49 PLNPOST 221200571565NBMB5221843140747218 8888379 107,078.00 0.00 6,024,373.00

ESB:NBMB:0400400T:591118597059

02/10/23 10:59:27 TLKM 161204233006NBMB5221843140747218 8888103 2,500.00 0.00 6,021,873.00

ESB:NBMB:0101301P:591119414101

02/10/23 10:59:27 TLKM 161204233006NBMB5221843140747218 8888103 366,300.00 0.00 5,655,573.00

ESB:NBMB:0101301P:591119414101

02/10/23 18:50:32 NBMB DEWI LOVITA SA TO AKHMAD RIFANI 8888524 100,000.00 0.00 5,555,573.00
ESB:NBMB:0001500F:591348263001

03/10/23 11:16:16 BFST7820685142 NBMB:CENAIDJA 8888003 2,500.00 0.00 5,553,073.00

20231003BRINIDJA010O0203225951
ESB:NBMB:0008G00F:591627697362

10/11/2023 02:07:44 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

03/10/23 11:16:16 BFST7820685142 NBMB:CENAIDJA 8888003 250,000.00 0.00 5,303,073.00

20231003BRINIDJA010O0203225951
ESB:NBMB:0008G00F:591627697362

03/10/23 11:18:05 BFST7131220221 NBMB:BSMDIDJA 8888530 2,500.00 0.00 5,300,573.00

20231003BRINIDJA010O0203247031
ESB:NBMB:0008G00F:591628542631

03/10/23 11:18:05 BFST7131220221 NBMB:BSMDIDJA 8888530 57,000.00 0.00 5,243,573.00

20231003BRINIDJA010O0203247031
ESB:NBMB:0008G00F:591628542631

03/10/23 15:26:10 NBMB DEWI LOVITA SA TO NORMANSYAH 8888406 34,000.00 0.00 5,209,573.00
ESB:NBMB:0001500F:591737791657

03/10/23 15:27:44 NBMB DEWI LOVITA SA TO MUTIAH HERSA AMBA 8888454 236,000.00 0.00 4,973,573.00
ESB:NBMB:0001500F:591738462191

04/10/23 10:51:33 BFST0968140459 NBMB:BNINIDJA 8888491 2,500.00 0.00 4,971,073.00

20231004BRINIDJA010O0210677741
ESB:NBMB:0008G00F:592076657861

04/10/23 10:51:33 BFST0968140459 NBMB:BNINIDJA 8888491 370,000.00 0.00 4,601,073.00

20231004BRINIDJA010O0210677741
ESB:NBMB:0008G00F:592076657861

05/10/23 10:03:22 ATM TOMMY RACHMAN TO DEWI LOVITA SALEH 9914502 0.00 7,000,000.00 11,601,073.00
FROM000301023303508 TO449701008246504ATM

05/10/23 10:05:28 PLNPOST 222010239559NBMB5221843140747218 8888003 10,118.00 0.00 11,590,955.00

ESB:NBMB:0400400T:592494359631

05/10/23 19:32:52 NBMB ENDANG IRSIYAD TO DEWI LOVITA SALEH 8888277 0.00 2,200,000.00 13,790,955.00
ESB:NBMB:0001500F:592743847800

06/10/23 06:57:55 EDC AGUS SUROSO TO DEWI LOVITA SAL 0852312 0.00 2,380,000.00 16,170,955.00
FROM778801004656533 TO449701008246504EDC

06/10/23 08:21:00 NBMB NORHILALIAH TO DEWI LOVITA SALEH 8888524 0.00 500,000.00 16,670,955.00
ESB:NBMB:0001500F:592906449663

06/10/23 08:37:16 BFST1783944778 NBMB:BNINIDJA 8888328 2,500.00 0.00 16,668,455.00

20231006BRINIDJA010O0224916737
ESB:NBMB:0008G00F:592912112174

06/10/23 08:37:16 BFST1783944778 NBMB:BNINIDJA 8888328 2,200,000.00 0.00 14,468,455.00

20231006BRINIDJA010O0224916737
ESB:NBMB:0008G00F:592912112174

06/10/23 08:40:48 BFST7154980428 NBMB:BSMDIDJA 8888465 2,500.00 0.00 14,465,955.00

20231006BRINIDJA010O0224934974
ESB:NBMB:0008G00F:592913270364

06/10/23 08:40:48 BFST7154980428 NBMB:BSMDIDJA 8888465 4,000,000.00 0.00 10,465,955.00

20231006BRINIDJA010O0224934974
ESB:NBMB:0008G00F:592913270364

07/10/23 11:16:10 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888528 641,000.00 0.00 9,824,955.00
ESB:NBMB:0001500F:593399554692

07/10/23 11:18:08 ATMSTRPRM 08888 000291653 7895423327 8888060 6,500.00 0.00 9,818,455.00
ESB:NBMB:0005T00F:593400291653

07/10/23 11:18:08 ATMSTRPRM 08888 000291653 7895423327 8888060 737,000.00 0.00 9,081,455.00
ESB:NBMB:0005T00F:593400291653

10/11/2023 02:07:44 PM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo
Transaction Date Transaction Description User ID Debit Credit Balance

08/10/23 10:09:36 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888193 0.00 2,300,000.00 11,381,455.00
ESB:NBMB:0001500F:593782369682

09/10/23 08:49:35 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888583 0.00 5,000,000.00 16,381,455.00
ESB:NBMB:0001500F:594130273403

09/10/23 08:50:31 NBMB DEWI LOVITA SA TO MUHAMMAD HASBI 8888463 55,000.00 0.00 16,326,455.00
ESB:NBMB:0001500F:594130617824

09/10/23 17:33:21 522184314074721800660197 9914507 0.00 800,000.00 17,126,455.00

09/10/23 21:56:32 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888211 0.00 4,500,000.00 21,626,455.00
ESB:NBMB:0001500F:594455251966

10/10/23 10:16:49 FLP465818522 WS_OB;465818522- 0371873 0.00 50,000.00 21,676,455.00

4497010082;77850
ESB:T:0371873:S:0371892:WSOB

10/10/23 16:28:08 NBMB DEWI LOVITA SA TO RAYSYA DEWI LESTA 8888230 31,000.00 0.00 21,645,455.00
ESB:NBMB:0001500F:594759362770

11/10/23 05:51:05 BRIVA128081288596911NBMBdXXXXXXXy BRIVA 8888345 162,000.00 0.00 21,483,455.00

128081288596911NBMBdXXXXXXXy
ESB:NBMB:0200200P:594970565082

11/10/23 12:03:08 EDC KHAIRUN NI'MAH TO DEWI LOVITA SAL 0852053 0.00 1,000,000.00 22,483,455.00
FROM451101000008562 TO449701008246504EDC

11/10/23 13:02:41 NBMB DEWI LOVITA SA TO ERMA ROSYANA 8888294 55,000.00 0.00 22,428,455.00
ESB:NBMB:0001500F:595115676630

11/10/23 13:33:56 BFST449701008246504DEWI LOVITA :BSMDIDJA 8888619 0.00 30,000,000.00 52,428,455.00

20231011BSMDIDJA010O0217300141
ESB:BFST:0008N:20231011BRINIDJA110146086507
22

11/10/23 13:40:22 BFST449701008246504DEWI LOVITA :BMRIIDJA 8888655 0.00 5,000,000.00 57,428,455.00

20231011BMRIIDJA010O0220321535
ESB:BFST:0008N:20231011BRINIDJA110146089326
65

11/10/23 14:10:01 BFST7154980428 NBMB:BSMDIDJA 8888171 2,500.00 0.00 57,425,955.00

20231011BRINIDJA010O0207318685
ESB:NBMB:0008G00F:595141186243

11/10/23 14:10:01 BFST7154980428 NBMB:BSMDIDJA 8888171 20,000,000.00 0.00 37,425,955.00

20231011BRINIDJA010O0207318685
ESB:NBMB:0008G00F:595141186243

12/10/23 10:36:51 200001012_OB_1017534615642128 0371872 0.00 1,500,000.00 38,925,955.00

WS_OB;A7830356437611442552;89168
ESB:T:0371872:S:0371892:WSOB

12/10/23 17:11:26 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888594 0.00 4,200,000.00 43,125,955.00
ESB:NBMB:0001500F:595617899221

12/10/23 20:08:19 BRIVA128081288596911NBMBdXXXXXXXy BRIVA 8888091 251,300.00 0.00 42,874,655.00

128081288596911NBMBdXXXXXXXy
ESB:NBMB:0200200P:595692593544

12/10/23 20:08:59 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888447 0.00 150,000.00 43,024,655.00
ESB:NBMB:0001500F:595692864609

13/10/23 12:48:44 NBMB DEWI LOVITA SA TO HENNY NADIA KUSUM 8888095 280,400.00 0.00 42,744,255.00
ESB:NBMB:0001500F:595920618719

10/30/2023 10:41:06 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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Tanggal Transaksi Uraian Transaksi Teller Debet Kredit Saldo
Transaction Date Transaction Description User ID Debit Credit Balance

15/10/23 16:06:54 NBMB DEWI LOVITA SA TO NORMANSYAH 8888277 45,000.00 0.00 42,699,255.00
ESB:NBMB:0001500F:596761185558

16/10/23 12:18:30 NBMB DEWI LOVITA SA TO ASIH AYU LESTARI 8888259 200,000.00 0.00 42,499,255.00
ESB:NBMB:0001500F:597066509903

16/10/23 15:30:25 NBMB ENDANG IRSIYAD TO DEWI LOVITA SALEH 8888286 0.00 4,050,000.00 46,549,255.00
ESB:NBMB:0001500F:597142984812

18/10/23 10:24:26 EDC KHAIRUN NIMAH TO DEWI LOVITA SAL 0852292 0.00 1,000,000.00 47,549,255.00
FROM451801011066535 TO449701008246504EDC

18/10/23 14:34:14 NBMB DEWI LOVITA SA TO MUHAMMAD ADAM 8888524 200,000.00 0.00 47,349,255.00
ESB:NBMB:0001500F:597928672413

18/10/23 20:34:20 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888556 44,000,000.00 0.00 3,349,255.00
ESB:NBMB:0001500F:598069973632

19/10/23 10:55:59 EDC BAHARIAH BT MAT TO DEWI LOVITA SAL 0852557 0.00 2,360,000.00 5,709,255.00
FROM458601000019564 TO449701008246504EDC

19/10/23 13:15:18 BFST1783944778 NBMB:BNINIDJA 8888214 2,500.00 0.00 5,706,755.00

20231019BRINIDJA010O0211062124
ESB:NBMB:0008G00F:598290475007

19/10/23 13:15:18 BFST1783944778 NBMB:BNINIDJA 8888214 2,200,000.00 0.00 3,506,755.00

20231019BRINIDJA010O0211062124
ESB:NBMB:0008G00F:598290475007

20/10/23 00:00:00 Monthly Fee ATM 3,500.00 0.00 3,503,255.00

20/10/23 16:28:00 522184314074721800660197 9914507 0.00 500,000.00 4,003,255.00

20/10/23 23:59:59 Admin Fee 12,000.00 0.00 3,991,255.00

22/10/23 05:52:13 NBMB DEWI LOVITA SA TO ASIH AYU LESTARI 8888021 100,000.00 0.00 3,891,255.00
ESB:NBMB:0001500F:599354635314

22/10/23 17:13:41 NBMB DEWI LOVITA SA TO NORMANSYAH 8888113 34,000.00 0.00 3,857,255.00
ESB:NBMB:0001500F:599537015337

23/10/23 22:48:05 NBMB DEWI LOVITA SA TO DEWI LOVITA SALEH 8888501 0.00 50,000,000.00 53,857,255.00
ESB:NBMB:0001500F:600040547944

24/10/23 09:07:15 NBMB BAGUS TRIYOSO TO DEWI LOVITA SALEH 8888593 0.00 1,050,000.00 54,907,255.00
ESB:NBMB:0001500F:600129592866

24/10/23 14:12:59 BPJS8888802720418579NBMBCF41041750C8BF69 8888316 200,000.00 0.00 54,707,255.00

ESB:NBMB:0705800P:600239994852

25/10/23 12:49:27 NBMB DEWI LOVITA SA TO ATIKA RAFIQAH 8888453 5,000,000.00 0.00 49,707,255.00
ESB:NBMB:0001500F:600624818310

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

13,582,939.00 97,515,684.00 133,640,000.00 49,707,255.00

Terbilang / In Words

EMPAT PULUH SEMBILAN JUTA TUJUH RATUS TUJUH RIBU DUA RATUS LIMA PULUH LIMA RUPIAH
FORTY NINE MILLION SEVEN HUNDRED SEVEN THOUSAND TWO HUNDRED FIFTY FIVE RUPIAH
Biaya materai telah dibayar Lunas
Revenue Stamp Paid

10/30/2023 10:41:06 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

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- 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

10/30/2023 10:41:06 AM