EXPENSE REQUISITION

Expense Requisition No : ER-APM-22-000197 Expense Request Type : Reimbursement

Expense Requisition Date : 10 January, 2022 Project ID : P-APM-21-000029

Revision No : Project Name : RAN NUSRA 2021

Revision Note : Purpose : Project

Requested by : Yan Unedo Required Date :

Div / Dept : OP Project 2 Suggestion Vendor :
Prepared by : SELLY FEBRIANTY Attachment : YES V NO

Line Main Expense Description Unit Qty Crcy Requested Total Requested Amount Budget Remaining Budget keterangan
account Category Amount
1 143030 PROEXP26 0456 Reimb An Yan Biaya Transport 1 IDR 275,000.00 275,000.00 0.00 0.00 Mandiri
perjalanan to jakarta Tgl 19 Des 2021 1640003969138
An. Selly
Febrianty
2 143030 PROEXP35 0456 Reimb An Yan Biaya Kirim 1 IDR 18,000.00 18,000.00 0.00 0.00
Dokumen to Selly tgl 29 2021
GRAND IDR 293,000.00
TOTAL

Requested by Verified by Verified by Approved by Approved by Approved by Acknowledged by

Name RISKO Name RATIH Name LENCY Name WAHYU Name Name Name DHESY

Date 10-JAN-22 Date 10-JAN-22 Date Date 10-JAN-22 Date Date Date

Remark
 SURAT PERMINTAAN BARANG & JASA
No Permintaan : 0456 Tanggal : 10-Jan-2022
Kepada Yth : Finance Kualifikasi : Normal
Yang Mengajukan : SELLY Target Pengiriman : 10-Jan-2022
Bag./Dept : O PROJECT 2 Tipe : Reimbursement

No Deskripsi Project Pos Anggaran Sisa Anggaran Qty Harga Total Keterangan

0456 Reimb An Yan Biaya Transport

1 perjalanan to jakarta Tgl 19 Des 2021 P-21029 - RAN NUSRA 2021 71010110 1 275,000.00 275,000.00
Mandiri 1640003969138
An. Selly Febrianty
0456 Reimb An Yan Biaya Kirim
Dokumen P-21029 - RAN NUSRA 2021 71010117 1 18,000.00 18,000.00
2 to Selly tgl 29 2021
293,000.00

Yang Mengajukan Menyetujui Paraf RAB

SELLY

Mengetahui Catatan Catatan

Bagian Keuangan Bagian Keuangan