SETTLEMENT FORM

Legal Entity : DAYA MAHA BERKARYA PT

Activation : POME PAMPERS 2014
NO PE :
NO PO :
NO PCS :
Activity Period : OKT - JUNE 2014
Settlement Date : JUNE ' -2014

Amount Financial Currency

Document
No. Date Description (CV/CR IDR Foreign Currency Note
No.) .. Kurs IDR
Setlement : Pembelian Sadel bag 1 2.00 3 4=2x3

ORIGINAL RECEIVE 2,950,000

1 0.00
2

Total Amount received 2,950,000 0.00 0.00

EXPENSES

Rincian :
1 TOL Rp 208,000
2 PARKIR Rp 333,000
3 BENSIN Rp 894,072
4 OPS AM VISIT Rp 575,000
5 DELIVERY OFFICER OPS Rp 475,000
6 PULSA Rp 410,000
7 BIAYA PENGETIKAN DATA Rp 60,000

Shortage ( + / - ) Rp 2,955,072 2,950,000 0.00 0.00

Prepared by, Approved by, Finance Receive by, Acct Receive by,

DATE : JUNE 10' 2014 DATE : JUNE 23'2014 DATE : DATE :

FITRIAWATY ARSHINTA PRIMADEWI INDRYA LUTFINI

SETTLEMENT FORM
Legal Entity : DAYA MAHA BERKARYA PT
Activation : POME PAMPERS 2014
NO PE :
NO PO :
NO PCS :
Activity Period : OKT - JUNE 2014
Settlement Date : JUNE ' -2014

Amount Financial Currency

Document
No. Date Description (CV/CR IDR Foreign Currency Note
No.) .. Kurs IDR
Setlement : Pembelian Sadel bag 1 2.00 3 4=2x3

ORIGINAL RECEIVE 2,950,000

1 0.00
2

Total Amount received 2,950,000 0.00 0.00

EXPENSES

Rincian :
1 TOL Rp 345,500
2 PARKIR Rp 311,000
3 BENSIN Rp 725,000
4 OPS AM VISIT Rp 575,000
5 DELIVERY OFFICER OPS Rp 475,000
6 PULSA Rp 400,000
7 ENTERTAIN SUSTER Rp 207,600

Shortage ( + / - ) Rp 3,039,100 2,950,000 0.00 0.00

Prepared by, Approved by, Finance Receive by, Acct Receive by,

DATE : JUNE 10' 2014 DATE : JUNE 23'2014 DATE : DATE :

FITRIAWATY ARSHINTA PRIMADEWI INDRYA LUTFINI

SETTLEMENT FORM
Legal Entity : DAYA MAHA BERKARYA PT
Activation : POME PAMPERS 2014
NO PE :
NO PO :
NO PCS :
Activity Period : OKT - JUNE 2014
Settlement Date : JUNE ' -2014

Amount Financial Currency

Document
No. Date Description (CV/CR IDR Foreign Currency Note
No.) .. Kurs IDR
Setlement : Pembelian Sadel bag 1 2.00 3 4=2x3

ORIGINAL RECEIVE 1,500,000

1 0.00
2

Total Amount received 1,500,000 0.00 0.00

EXPENSES

Rincian :
1 KUITANSI OPERATIONAL AM Rp 800,000
2 KUITANSI OPERATIONAL DELIVERY OFFICER Rp 700,000

Shortage ( + / - ) Rp 1,500,000 1,500,000 0.00 0.00

Prepared by, Approved by, Finance Receive by, Acct Receive by,

DATE : JUNE 10' 2014 DATE : JUNE 23'2014 DATE : DATE :

FITRIAWATY ARSHINTA PRIMADEWI INDRYA LUTFINI

SETTLEMENT FORM
Legal Entity : DAYA MAHA BERKARYA PT
Activation : POME PAMPERS 2014
NO PE :
NO PO :
NO PCS :
Activity Period : OKT - JUNE 2014
Settlement Date : JUNE ' -2014

Amount Financial Currency

Document
No. Date Description (CV/CR IDR Foreign Currency Note
No.) .. Kurs IDR
Setlement : Pembelian Sadel bag 1 2.00 3 4=2x3

ORIGINAL RECEIVE 2,000,000

1 0.00
2

Total Amount received 2,000,000 0.00 0.00

EXPENSES

Rincian :
1 INVOICE PEMBELIAN SADEL BAG Rp 2,000,000
2 PARKIR
3 BENSIN

Shortage ( + / - ) Rp 2,000,000 2,000,000 0.00 0.00

Prepared by, Approved by, Finance Receive by, Acct Receive by,

DATE : JUNE 10' 2014 DATE : JUNE 23'2014 DATE : DATE :

FITRIAWATY ARSHINTA PRIMADEWI INDRYA LUTFINI

SETTLEMENT FORM
Legal Entity : DAYA MAHA BERKARYA PT
Activation : ADDITIONAL POME PAMPERS 2014
NO PE :
NO PO :
NO PCS :
Activity Period : MARET - JUNE 2014
Settlement Date : FEB ' 20 -2014

Amount Financial Currency

Document
No. Date Description (CV/CR IDR Foreign Currency Note
No.) .. Kurs IDR
Setlement : Project ADDITIONAL POME Pampers MAY 2014 (PROJECT OFFICER) 1 2.00 3 4=2x3

ORIGINAL RECEIVE 1,600,000

1 0.00
2

Total Amount received 1,600,000 0.00 0.00

EXPENSES

Rincian :
1 TOL Rp 199,000
2 PARKIR Rp 104,500
3 BENSIN Rp 1,315,570

Shortage ( + / - ) Rp 1,619,070 1,600,000 0.00 0.00

Prepared by, Approved by, Finance Receive by, Acct Receive by,

DATE : JUNE 10' 2014 DATE : JUNE 23'2014 DATE : DATE :

FITRIAWATY ARSHINTA PRIMADEWI INDRYA LUTFINI