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CABANG SRAGEN

Teller

Pemohon aPqlicant

Dengan ditandatanganinya resi ini maka p"rohorS"&;rffiB O3016nsaksi yang tertera pada resi dan membebaskan Bank Mandiri serta pegawainya
atas tuntutan berupa apapun dari pihak manapun juga.
By signing on this receipt, applicant agrees of the transaction data stated on the receipt and releases Bank Mandii and its employees from any forms by any parties.
BPR.BST 05/13
Lembar 2 = Copy

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