FORM TERM OF PAYMENT CONFIRMATION

Perusahaan/ Company Name :

Alamat/ Address :
Telp/ Telp :

Contact Person :

Email :

Bank Name / Nama Bank :

Bank Account / Nomor Rekening :

Account Holder/Pemilik Rekening :

Currency :

Bank Branch / Cabang :

Swift Code :

IBAN (if any – for Europe Bank) :

This is to confirm that, I agree to use Term of Payment (TOP) 30 days after invoice received by
finance Account Payable (AP) of PT Tirta Investama

Dengan ini saya menyatakan bahwa saya menyetujui untuk Term of payment 30 hari setelah
invoice diterima oleh finance AP PT Tirta Investama

Tanggal/ Date :
Tanda tangan/ sign off :

VENDOR

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