Ranuza Building 2nd Floor Jl. Timor No. 10, Gondangdia, Menteng, Jakarta 10350 Phone : 02140801218 , 02140801219 Fax : 0213106029

Invoice Date Invoice No. Due Date Payment

INVOICE

: : : :

10 Jun,2015

ACI62-15060179 24 Jun,2015 CREDIT

CUSTOMER : CISV (C62190)

NO. PAX'S NAME

PRODUCT

DESCRIPTIONS

1 2 3 4 5 6 7 8

PREMIUM RLD PREMIUM RLD PREMIUM RLD PREMIUM RLD PREMIUM RLD PREMIUM RLD PREMIUM RLD PREMIUM RLD

620-7196 347 0R2 620-7196 348 0R2 620-7196 349 0R2 620-7196 350 0R2 620-7196 351 0R2 620-7196 352 0R2 620-7196 353 0R2 620-7196 354 0R2

DEWI GALUH FAJAR BUANA ROSMALA SEKARNINGRUM ANDARI SANTOSO ANNETTE DAFIRTRI LARASATI WIRORENO ANGGITA AYODYA YULFIAN ALVAND SHAFEEQ PRADNYAWIRA NICHOLAS RANGGA BENGARDI MAHARAKA PUTRA REIHANDRA MUHAMMAD TEIGHAN

In Word

Remark

: #Five Hundred Seventy One and 04/100 USD

AMOUNT (USD) 83.00 83.00 83.00 83.00 83.00 83.00 83.00 83.00

Total

:

664.00

Discount

:

92.96

Nett Total

:

571.04

: FIRMAN

Make all payments to PT INDONESIA ASSIST CARD Danamon Bank 3571083470 - IDR 3543648541 - USD NPWP No 03.203.510.7-076.000

Received by,

Approved by,

(______________)

(______________)

invoice - Groups

Jun 10, 2015 - 7. BENGARDI MAHARAKA PUTRA. 620-7196 353 0R2. PREMIUM RLD. 83.00. 8. REIHANDRA MUHAMMAD TEIGHAN. 620-7196 354 0R2.
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