LAPORAN TRANSAKSI FINANSIAL

STATEMENT OF FINANCIAL TRANSACTION

Halaman 1 dari 4
Page 1 of 4

Kepada Yth / To : Tanggal Laporan : 15/09/23

Statemen Date

HAFIZON ASY'ARI
Periode Transaksi : 01/06/23-30/06/23
Transaction Periode
EMBUNG DUDUK RT00 RW00 KEL KEDIRI
KEC KEDIRI KAB LOMBOK BARAT
LOMBOK BARAT KAB

No. Rekening : 468601040857530 Unit Kerja : UNIT KEDIRI MATARAM

Account No Business Unit

Nama Produk : SIMPEDES - IDR Alamat Unit Kerja : KEDIRI - LOMBOK BARAT
Product Name Business Unit Address

Valuta : IDR
Currency

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

02/06/23 09:26:42 LN Disbur. Ovb SA BRISPOTMB LN- 474201020708109 888931 0.00 3,850,000.00 24,100,500.25
T:4742891:E-FORM

02/06/23 10:26:42 4624368899999999#004132845413#ATM #TRFLA 888038 0.00 700,000.00 24,800,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

03/06/23 11:30:12 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 450,000.00 0.00 24,350,500.25
ESB:NBMB:0001500F:519448158269

03/06/23 13:30:12 NBMB HAFIZON ASY'ARI TO FLIPTECH LENTERA 8888117 550,000.00 0.00 23,800,500.25
ESB:NBMB:0001500F:519461403845

10/06/23 10:22:30 BRIVA91188082339147010NBMBIRCHAM CAHYA R 8888429 300,000.00 0.00 23,500,500.25

BRIVA 91188082339147010NBMBIRCHAM CAHYA
ESB:NBMB:0200200P:520326726777

10/06/23 14:10:12 ATMSTRPRM 08888 000371933 7805995998 8888084 6,500.00 0.00 23,494,000.25
ESB:NBMB:0005T00F:520591371933

10/06/23 15:40:02 ATMSTRPRM 08888 000371933 7805995998 8888084 550,000.00 0.00 22,944,000.25
ESB:NBMB:0005T00F:520591371933

12/06/23 09:26:42 KARUNIA JAY_200001012_242289388 371869 0.00 2,000,000.00 24,944,000.25

WS_OB;A1407545165371749188;89168
ESB:T:0371869:S:0371892:WSOB

12/06/23 16:06:00 6271427150400021#715219605903#MP #TRFHMB 888849 0.00 850,000.00 25,794,000.25

LN 005201170076508MP 6271427150400021

12/06/23 18:00:25 6271427150400021#013711516636#MP #TRFHMB 888240 0.00 1,750,000.00 27,544,000.25

LN 005201170076508MP 6271427150400021

13/06/23 09:26:42 BFST0561935873 NBMB:CENAIDJA 8888022 2,500.00 0.00 27,541,500.25

20230405BRINIDJA010O0241876988
ESB:NBMB:0008G00F:520995367205

13/06/23 10:40:20 BFST0561935873 NBMB:CENAIDJA 8888022 1,250,000.00 0.00 26,291,500.25

20230405BRINIDJA010O0241876988
ESB:NBMB:0008G00F:520995367205

13/06/23 11:22:40 BFST1610005080119 NBMB:BMRIIDJA 8888484 2,500.00 0.00 26,289,000.25

20230406BRINIDJA010O0245100164
ESB:NBMB:0008G00F:521237057280

13/06/23 11:22:40 BFST1610005080119 NBMB:BMRIIDJA 8888484 950,000.00 0.00 25,339,000.25

20230406BRINIDJA010O0245100164
ESB:NBMB:0008G00F:521237057280

15/06/23 12:20:42 Monthly Fee ATM 3,500.00 0.00 25,335,500.25

15/06/23 12:20:42 Admin Fee 12,000.00 0.00 25,323,500.25

17/06/23 08:30:40 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 300,000.00 25,623,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

Created By BRISIM
08/15/2023 10:30:15 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 2 dari 4
Page 2 of 4

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

17/06/23 13:26:42 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 1,750,000.00 27,373,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

17/06/23 15:10:12 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 1,150,000.00 0.00 26,223,500.25
ESB:NBMB:0001500F:519448158269

17/06/23 16:40:55 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 1,500,000.00 27,723,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

17/06/23 16:40:55 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 3,500,000.00 31,223,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

18/06/23 8:20:50 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 450,000.00 31,673,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

9:25:29 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 750,000.00 0.00 30,923,500.25
ESB:NBMB:0001500F:519448158269

18/06/23 12:10;30 BRIVA88099087750126612NBMBOVO YY**G PR** 8888463 2,500,000.00 0.00 28,423,500.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:529189907183

18/06/23 14:30:40 KARUNIA JAY_200001012_242289388 371869 0.00 1,150,000.00 29,573,500.25

WS_OB;A1407545165371749188;89168
ESB:T:0371869:S:0371892:WSOB

19/06/23 09:26:42 GOP01 +6287750126612NBMB5221842106226175 8888366 1,000.00 0.00 29,572,500.25

ESB:NBMB:0201000T:520348481900

19/06/23 09:26:42 GOP01 +6287750126612NBMB5221842106226175 8888366 250,000.00 0.00 29,322,500.25

ESB:NBMB:0201000T:520348481900

19/06/23 12:12:40 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 700,000.00 30,022,500.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

19/06/23 13:22:50 QRIS524078310777#9360000210052701024 8888185 175,000.00 0.00 29,847,500.25

ESB:NBMB:0007I00c:524078310777

19/06/23 13:16:40 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 1,500,000.00 0.00 28,347,500.25
ESB:NBMB:0001500F:519448158269

19/06/23 13:55:20 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 600,000.00 28,947,500.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

19/06/23 14:05:10 QRIS524078310777#9360000210052701024 8888185 1,250,000.00 0.00 27,697,500.25

ESB:NBMB:0007I00c:524078310777

19/06/23 14:25:30 170423SEWAKDO335CR ESB:T:0374605:CMS 374605 0.00 425,500.00 28,123,000.25

19/06/23 12:12:40 087750126612 00161287 000000019205 52976 1,150,000.00 0.00 26,973,000.25

19/06/23 12:12:40 087750126612 00161287 000000019205 52976 800,000.00 0.00 26,173,000.25

19/06/23 16:25:20 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 350,000.00 26,523,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

19/06/23 17:05:20 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 1,400,000.00 27,923,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

19/06/23 19:10:30 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 950,000.00 28,873,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

19/06/23 20:30:10 087750126612 00161287 000000019205 52976 750,000.00 0.00 28,123,000.25

19/06/23 21:12:40 087750126612 00161287 000000019205 52976 1,200,000.00 0.00 26,923,000.25

19/06/23 22:40:10 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 1,500,000.00 28,423,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

Created By BRISIM
08/15/2023 10:30:15 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 3 dari 4
Page 3 of 4

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

21/06/23 08:50:35 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 550,000.00 28,973,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

21/06/23 11:10:12 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 800,000.00 0.00 28,173,000.25
ESB:NBMB:0001500F:519448158269

21/06/23 11:50:15 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 1,000,000.00 29,173,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

21/06/23 11:50:15 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 500,000.00 29,673,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

21/06/23 13:40:30 200001012_OB_1012676687383102 888931 0.00 400,000.00 30,073,000.25

WS_OB;A7093145030736784325;89168
ESB:T:0371862:S:0371892:WSOB

21/06/23 14:20:25 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 150,000.00 0.00 29,923,000.25
ESB:NBMB:0001500F:519448158269

21/06/23 15:00:40 4624368899999999#004132845413#ATM #TRFLA 8888463 3,800,000.00 0.00 26,123,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

23/06/23 9:30:40 KARUNIA JAY_200001012_242289388 371869 0.00 700,000.00 26,823,000.25

WS_OB;A1407545165371749188;89168
ESB:T:0371869:S:0371892:WSOB

23/06/23 10:16:12 GOP01 +6287750126612NBMB5221842106226175 8888366 1,000.00 0.00 26,822,000.25

ESB:NBMB:0201000T:520348481900

23/06/23 11:40:52 GOP01 +6287750126612NBMB5221842106226175 8888366 425,000.00 0.00 26,397,000.25

ESB:NBMB:0201000T:520348481900

23/06/23 12:12:40 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 500,000.00 26,897,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

23/06/23 20:47:30 QRIS524078310777#9360000210052701024 8888185 175,000.00 0.00 26,722,000.25

ESB:NBMB:0007I00c:524078310777

23/06/23 22:16:40 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 10,700,000.00 0.00 16,022,000.25
ESB:NBMB:0001500F:519448158269

25/06/23 07:00:40 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 250,000.00 16,272,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

25/06/23 8:35:20 QRIS524078310777#9360000210052701024 8888185 850,000.00 0.00 15,422,000.25

ESB:NBMB:0007I00c:524078310777

25/06/23 10:10:10 170423SEWAKDO335CR ESB:T:0374605:CMS 374605 0.00 500,000.00 15,922,000.25

25/06/23 13:13:20 087750126612 00161287 000000019205 52976 750,000.00 0.00 15,172,000.25

25/06/23 14:30:10 087750126612 00161287 000000019205 52976 200,000.00 0.00 14,972,000.25

25/06/23 16:25:20 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 1,750,000.00 16,722,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

25/06/23 17:05:20 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 2,900,000.00 19,622,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

25/06/23 19:10:30 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 450,000.00 20,072,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

26/06/23 8:10:10 087750126612 00161287 000000019205 52976 1,000,000.00 0.00 19,072,000.25

26/06/23 10:34:20 087750126612 00161287 000000019205 52976 1,000,000.00 0.00 18,072,000.25

26/06/23 11:10:50 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 500,000.00 18,572,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

Created By BRISIM
08/15/2023 10:30:15 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 4 dari 4
Page 4 of 4

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

27/06/23 08:30:30 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 1,000,000.00 19,572,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

27/06/23 09:26:42 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 2,000,000.00 0.00 17,572,000.25
ESB:NBMB:0001500F:519448158269

27/06/23 09:26:42 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 1,350,000.00 18,922,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

27/06/23 09:26:42 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 250,000.00 19,172,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

27/06/23 09:26:42 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 2,600,000.00 21,772,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

27/06/23 09:26:42 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 500,000.00 0.00 21,272,000.25
ESB:NBMB:0001500F:519448158269

28/06/23 09:50:55 4624368899999999#004132845413#ATM #TRFLA 8888463 4,700,000.00 0.00 16,572,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

28/06/23 10:20:50 KARUNIA JAY_200001012_242289388 371869 0.00 150,000.00 16,722,000.25

WS_OB;A1407545165371749188;89168
ESB:T:0371869:S:0371892:WSOB

28/06/23 11:10:10 GOP01 +6287750126612NBMB5221842106226175 8888366 1,000.00 0.00 16,721,000.25

ESB:NBMB:0201000T:520348481900

28/06/23 11:10:10 GOP01 +6287750126612NBMB5221842106226175 8888366 75,000.00 0.00 16,646,000.25

ESB:NBMB:0201000T:520348481900

28/06/23 12:00:00 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 371869 0.00 12,700,000.00 29,346,000.25

20230410BTANIDJA010O0285439251
ESB:BFST:0008N:20230410BRINIDJA110738082

30/06/23 7:15:10 ATMSTRPRM 08888 000371933 7805995998 8888185 175,000.00 0.00 29,171,000.25
ESB:NBMB:0005T00F:520591371933

30/06/23 8:12:30 NBMB HAFIZON ASY'ARI TO WIRA SURYA PRE 8888463 3,500,000.00 0.00 25,671,000.25
ESB:NBMB:0001500F:519448158269

30/06/23 12:40:46 BRIVA88099087750126612NBMBOVO YY**G PR** 371869 0.00 11,750,000.00 37,421,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

Saldo Awal Total Transaksi Debit Total Transaksi Kredit Saldo Akhir
Opening Balance Total Transaction Debit Total Transaction Credit Closing Balance

20,250,500.25 46,355,000.00 63,525,500.00 37,421,000.25

Terbilang/ In Words

TIGA PULUH TUJUH JUTA EMPAT RATUS DUA PULUH SATU RIBU KOMA DUA PULUH LIMA RUPIAH
THIRTY-SEVEN MILLION FOUR HUNDRED TWENTY-ONE THOUSAND POINT TWENTY-FIVE RUPIAH
Biaya Materai telah dibayar lunas
Revenue Stamp Paid

- Apabila terdapat perbedaan dengan catatan Saudara, harap menghubungi kami selambat-lambatnya 14 hari sejak diterimanya rekening koran ini.
- In the case of any diffrences from your records, please contact us within not later than 14 days from the receipt of this Statement of Account

- Salinan rekening koran ini merupakan hasil cetakan komputer, tidak diperlukan tanda tangan pejabat Bank
- The copy of this Statement of Account is computer-generated, no official signature is required

- Apabila ada perubahan alamat email mohon diinformasikan pada Unit Kerja BANK BRI
- Should there be any change of email address, please notify the relevant Bank BRI Business Unit

Created By BRISIM
08/15/2023 10:30:15 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 1 dari 3
Page 1 of 3

Kepada Yth / To : Tanggal Laporan : 15/09/23

Statemen Date

HAFIZON ASY'ARI
Periode Transaksi : 01/07/23-31/07/23
Transaction Periode
EMBUNG DUDUK RT00 RW00 KEL KEDIRI
KEC KEDIRI KAB LOMBOK BARAT
LOMBOK BARAT KAB

No. Rekening : 468601040857530 Unit Kerja : UNIT KEDIRI MATARAM

Account No Business Unit

Nama Produk : SIMPEDES - IDR Alamat Unit Kerja : KEDIRI - LOMBOK BARAT
Product Name Business Unit Address

Valuta : IDR
Currency

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

01/07/23 08:56:52 EBAYS#11765097 888931 0.00 500,000.00 37,921,000.25

02/07/23 13:26:42 4624368899999999#004132845413#ATM #TRFLA 888038 0.00 350,000.00 38,271,000.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

04/07/23 09:10:12 NBMB HAFIZON ASY'ARIA TO TRINUSA TRAVELIND 8888463 2,500.00 0.00 38,268,500.25
ESB:NBMB:0001500F:521946759161

04/07/23 09:10:12 NBMB HAFIZON ASY'ARIA TO TRINUSA TRAVELIND 8888117 650,000.00 0.00 37,618,500.25
ESB:NBMB:0001500F:521946759161

06/07/23 12:22:30 BRIVA1236213688068613NBMBTikTok Shop BRIVA 8888429 2,750,000.00 0.00 34,868,500.25

1236213688068613NBMBTikTok Shop
ESB:NBMB:0200200P:522228641199

06/07/23 13:10:12 GOP01 +6287750126612NBMB5221842106226175 8888084 6,500.00 0.00 34,862,000.25

ESB:NBMB:0201000T:524219798375

08/07/23 13:10:12 GOP01 +6287750126612NBMB5221842106226175 8888084 800,000.00 0.00 34,062,000.25

ESB:NBMB:0201000T:524219798375

08/07/23 16:26:42 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 371869 0.00 1,250,000.00 35,312,000.25

20230419BTANIDJA010O0285550538
ESB:BFST:0008N:20230419BRINIDJA110773315

08/07/23 17:16:42 6271427150400021#013711516636#MP #TRFHMB 888849 0.00 350,000.00 35,662,000.25

LN 005201170076508MP 6271427150400021

08/07/23 18:11:22 6271427150400021#013711516636#MP #TRFHMB 888240 0.00 450,000.00 36,112,000.25

LN 005201170076508MP 6271427150400021

09/07/23 07:30:12 BFST0561935873 NBMB:CENAIDJA 8888022 2,500.00 0.00 36,109,500.25

20230405BRINIDJA010O0241876988
ESB:NBMB:0008G00F:520995367205

09/07/23 07:30:12 BFST0561935873 NBMB:CENAIDJA 8888022 750,000.00 0.00 35,359,500.25

20230405BRINIDJA010O0241876988
ESB:NBMB:0008G00F:520995367205

09/07/23 12:20:40 BFST1610005080119 NBMB:BMRIIDJA 8888484 2,500.00 0.00 35,357,000.25

20230406BRINIDJA010O0245100164
ESB:NBMB:0008G00F:521237057280

09/07/23 12:20:40 BFST1610005080119 NBMB:BMRIIDJA 8888484 400,000.00 0.00 34,957,000.25

20230406BRINIDJA010O0245100164
ESB:NBMB:0008G00F:521237057280

11/07/23 12:20:42 Monthly Fee ATM 3,500.00 0.00 34,953,500.25

11/07/23 12:20:42 Admin Fee 12,000.00 0.00 34,941,500.25

12/07/23 10:30:40 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 888931 0.00 2,700,000.00 37,641,500.25

20230410BTANIDJA010O0285439251
ESB:BFST:0008N:20230410BRINIDJA110738082

Created By BRISIM
08/15/2023 10:30:15 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 2 dari 3
Page 2 of 3

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

14/07/23 13:26:42 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 888931 0.00 500,000.00 38,141,500.25

20230410BTANIDJA010O0285439251
ESB:BFST:0008N:20230410BRINIDJA110738082

14/07/23 15:10:12 NBMB HAFIZON ASY'ARIA TO HOIRUNNAS 8888463 9,450,000.00 0.00 28,691,500.25
ESB:NBMB:0001500F:522711422921

14/07/23 16:40:55 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 888931 0.00 1,500,000.00 30,191,500.25

20230419BTANIDJA010O0285550538
ESB:BFST:0008N:20230419BRINIDJA110773315

14/07/23 16:40:55 6019005029120396#000000755350#ATM #TRFLA 888931 0.00 350,000.00 30,541,500.25

TRF BERSAMA FROM MIRZA MAULANA S LA
005201170076508ATM 6019005029120396

16/07/23 8:20:50 BFST005201170076508VISIONET INT:BDINIDJA 888931 0.00 1,200,000.00 31,741,500.25

20230425BDINIDJA010O9970885356
ESB:BFST:0008N:20230425BRINIDJA110789971

16/07/23 9:25:29 NBMB HAFIZON ASY'ARIA TO FLIPTECH LENTERA 8888463 1,500,000.00 0.00 30,241,500.25
ESB:NBMB:0001500F:525321249398

16/07/23 12:10;30 BRIVA112085232304847NBMBrXXXXXXXXXh 8888463 12,500,000.00 0.00 17,741,500.25

BRIVA112085232304847NBMBrXXXXXXXXXh
ESB:NBMB:0200200P:529080686217

16/07/23 14:30:40 6019005029120396#000000755350#ATM #TRFLA 371869 0.00 250,000.00 17,991,500.25

TRF BERSAMA FROM MIRZA MAULANA S LA
005201170076508ATM 6019005029120396

20/07/23 09:26:42 GOP01 +6287750126612NBMB5221842106226175 8888366 1,000.00 0.00 17,990,500.25

ESB:NBMB:0201000T:526046680933

20/07/23 09:26:42 GOP01 +6287750126612NBMB5221842106226175 8888366 170,000.00 0.00 17,820,500.25

ESB:NBMB:0201000T:526046680933

20/07/23 12:12:40 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 371869 0.00 250,000.00 18,070,500.25

20230410BTANIDJA010O0285439251
ESB:BFST:0008N:20230410BRINIDJA110738082

21/07/23 10:22:50 ATMSTRPRM 08888 000371933 7805995998 8888185 6,500.00 0.00 18,064,000.25
ESB:NBMB:0005T00F:520591371933

21/07/23 10:22:50 ATMSTRPRM 08888 000371933 7805995998 8888463 3,400,000.00 0.00 14,664,000.25
ESB:NBMB:0005T00F:520591371933

21/07/23 13:55:20 KARUNIA JAY_200001012_242289388 371869 0.00 1,900,000.00 16,564,000.25

WS_OB;A1407545165371749188;89168
ESB:T:0371869:S:0371892:WSOB

21/07/23 14:05:10 NBMB HAFIZON ASY'ARIA TO HOIRUNNAS 8888185 12,000,000.00 0.00 4,564,000.25
ESB:NBMB:0001500F:522711422921

21/07/23 14:25:30 170423SEWAKDO335CR ESB:T:0374605:CMS 374605 0.00 500,000.00 5,064,000.25

21/07/23 20:10:40 087750126612 00161287 000000019205 52976 1,150,000.00 0.00 3,914,000.25

23/07/23 12:12:40 087750126612 00161287 000000019205 52976 800,000.00 0.00 3,114,000.25

23/07/23 16:25:20 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 371869 0.00 650,000.00 3,764,000.25

20230417BTANIDJA010O0285530589
ESB:BFST:0008N:20230417BRINIDJA110767447

24/07/23 17:05:20 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 371869 0.00 600,000.00 4,364,000.25

20230419BTANIDJA010O0285550538
ESB:BFST:0008N:20230419BRINIDJA110773315

24/07/23 19:10:30 6019005029120396#000000755350#ATM #TRFLA 888931 0.00 1,500,000.00 5,864,000.25

TRF BERSAMA FROM MIRZA MAULANA S LA
005201170076508ATM 6019005029120396

24/07/23 20:30:10 087750126612 00161287 000000019205 52976 1,000,000.00 0.00 4,864,000.25

26/07/23 21:12:40 087750126612 00161287 000000019205 52976 3,000,000.00 0.00 1,864,000.25

26/07/23 22:40:10 200001012_OB_1012676687383102 888931 0.00 700,000.00 2,564,000.25

WS_OB;A7093145030736784325;89168
ESB:T:0371862:S:0371892:WSOB

Created By BRISIM
08/15/2023 10:30:15 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 3 dari 3
Page 3 of 3

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

28/07/23 08:30:30 200001012_OB_1012676687383102 888931 0.00 1,250,000.00 3,814,000.25

WS_OB;A7093145030736784325;89168
ESB:T:0371862:S:0371892:WSOB

28/07/23 09:26:42 QRIS527711457348#9360000210052701024 8888463 700,000.00 0.00 3,114,000.25

ESB:NBMB:0007I00c:527711457348

28/07/23 09:26:42 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 450,000.00 3,564,000.25

TRF BERSAMA FROM HAFIZON ASY'ARIA CH LA
005201170076508ATM 4624368899999999

29/07/23 08:55:12 4624368899999999#004132845413#ATM #TRFLA 888931 0.00 700,000.00 4,264,000.25

TRF BERSAMA FROM HAFIZON ASY'ARIA CH LA
005201170076508ATM 4624368899999999

29/07/23 09:26:42 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 888931 0.00 12,700,000.00 16,964,000.25

20230410BTANIDJA010O0285439251
ESB:BFST:0008N:20230410BRINIDJA110738082

29/07/23 09:26:42 NBMB HAFIZON ASY'ARIA TO TRINUSA TRAVELIND 8888463 11,150,000.00 0.00 5,814,000.25
ESB:NBMB:0001500F:521946759161

29/07/23 09:50:55 BRIVA88099087750126612NBMBOVO YY**G PR** 8888463 250,000.00 0.00 5,564,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:522057243904

29/07/23 10:20:50 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 371869 0.00 25,800,000.00 31,364,000.25

20230410BTANIDJA010O0285439251
ESB:BFST:0008N:20230410BRINIDJA110738082

29/07/23 11:10:10 087750126612 00620808 000000014237 8888366 1,000.00 0.00 31,363,000.25

29/07/23 11:10:10 087750126612 00620808 000000014240 8888366 75,000.00 0.00 31,288,000.25

30/07/23 11:00:00 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 371869 0.00 20,500,000.00 51,788,000.25

20230417BTANIDJA010O0285530589
ESB:BFST:0008N:20230417BRINIDJA110767447

30/07/23 11:25:10 GOP01 +6287750126612NBMB5221842106226175 8888185 175,000.00 0.00 51,613,000.25

ESB:NBMB:0201000T:524219798375

31/07/23 11:50:30 GOP01 +6287750126612NBMB5221842106226175 8888463 300,000.00 0.00 51,313,000.25

ESB:NBMB:0201000T:524219798375

31/07/23 14:10:36 6019005029120396#000000755350#ATM #TRFLA 371869 0.00 15,750,000.00 67,063,000.25

TRF BERSAMA FROM MIRZA MAULANA S LA
005201170076508ATM 6019005029120396

Saldo Awal Total Transaksi Debit Total Transaksi Kredit Saldo Akhir
Opening Balance Total Transaction Debit Total Transaction Credit Closing Balance

37,421,000.25 63,008,000.00 92,650,000.00 67,063,000.25

Terbilang/ In Words

ENAM PULUH TUJUH JUTA ENAM PULUH TIGA RIBU KOMA DUA PULUH LIMA RUPIAH
SIXTY-SEVEN MILLION SIXTY-THREE THOUSAND POINT TWENTY-FIVE RUPIAH
Biaya Materai telah dibayar lunas
Revenue Stamp Paid

- Apabila terdapat perbedaan dengan catatan Saudara, harap menghubungi kami selambat-lambatnya 14 hari sejak diterimanya rekening koran ini.
- In the case of any diffrences from your records, please contact us within not later than 14 days from the receipt of this Statement of Account

- Salinan rekening koran ini merupakan hasil cetakan komputer, tidak diperlukan tanda tangan pejabat Bank
- The copy of this Statement of Account is computer-generated, no official signature is required

- Apabila ada perubahan alamat email mohon diinformasikan pada Unit Kerja BANK BRI
- Should there be any change of email address, please notify the relevant Bank BRI Business Unit

Created By BRISIM
08/15/2023 10:30:15 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 1 dari 2
Page 1 of 2

Kepada Yth / To : Tanggal Laporan : 15/09/23

Statemen Date

HAFIZON ASY'ARI
Periode Transaksi : 01/08/23-31/08/23
Transaction Periode
EMBUNG DUDUK RT00 RW00 KEL KEDIRI
KEC KEDIRI KAB LOMBOK BARAT
LOMBOK BARAT KAB

No. Rekening : 468601040857530 Unit Kerja : UNIT KEDIRI MATARAM

Account No Business Unit

Nama Produk : SIMPEDES - IDR Alamat Unit Kerja : KEDIRI - LOMBOK BARAT
Product Name Business Unit Address

Valuta : IDR
Currency

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

01/08/23 09:26:42 QRIS527711457348#9360000210052701024 888931 800,500.00 0.00 66,262,500.25

ESB:NBMB:0007I00c:527711457348

02/08/23 13:26:42 4624368899999999#004132845413#ATM #TRFLA 888038 0.00 3,250,000.00 69,512,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI LA
005201170076508ATM 4624368899999999

03/08/23 09:30:12 GOP01 +6287750126612NBMB5221842106226175 8888463 1,500.00 0.00 69,511,000.25

ESB:NBMB:0201000T:527794927686

03/08/23 09:30:12 GOP01 +6287750126612NBMB5221842106226175 8888117 450,000.00 0.00 69,061,000.25

ESB:NBMB:0201000T:527794927686

03/08/23 12:22:30 BRIVA88099087750126612NBMBOVO YY**G PR** 8888429 7,500,000.00 0.00 61,561,000.25

BRIVA 88099087750126612NBMBOVO YY**G PR*
ESB:NBMB:0200200P:529189907183

03/08/23 14:10:12 NBMB HAFIZON ASY'ARI TO FLIPTECH LENTERA 8888084 11,300,000.00 0.00 50,261,000.25
ESB:NBMB:0001500F:525321249398

03/08/23 16:40:19 NBMB HAFIZON ASY'ARI TO HOIRUNNAS 8888084 17,150,000.00 0.00 33,111,000.25
ESB:NBMB:0001500F:525992995166

03/08/23 09:26:42 200001012_OB_1012676687383102 371869 0.00 1,500,000.00 34,611,000.25

WS_OB;A7093145030736784325;89168
ESB:T:0371862:S:0371892:WSOB

05/08/23 09:26:42 6271427150400021#013711516636#MP #TRFHMB 888931 0.00 1,700,000.00

36,311,000.25
LN 005201170076508MP 6271427150400021

05/08/23 11:11:22 6271427150400021#013711516636#MP #TRFHMB 888240 0.00 1,000,000.00 37,311,000.25

LN 005201170076508MP 6271427150400021

05/08/23 10:40:20 BFST1610005080119 NBMB:BMRIIDJA 8888022 2,500.00 0.00 37,308,500.25

20230406BRINIDJA010O0245100164
ESB:NBMB:0008G00F:521237057280

05/08/23 10:40:20 BFST1610005080119 NBMB:BMRIIDJA 8888022 17,700,000.00 0.00 19,608,500.25

20230406BRINIDJA010O0245100164
ESB:NBMB:0008G00F:521237057280

05/08/23 11:22:40 BFST0002101500437389 NBMB:BTANIDJA 8888484 2,500.00 0.00 19,606,000.25

20230410BRINIDJA010O0213572148
ESB:NBMB:0008G00F:522528457484

05/08/23 11:22:40 BFST0002101500437389 NBMB:BTANIDJA 8888484 21,500,000.00 0.00 - 1,893,999.75

20230410BRINIDJA010O0213572148
ESB:NBMB:0008G00F:522528457484

06/08/23 12:20:42 Monthly Fee ATM 3,500.00 0.00 - 1,897,499.75

06/08/23 12:20:42 Admin Fee 12,000.00 0.00 - 1,909,499.75

06/08/23 08:30:40 BFST005201170076508VISIONET INT:BDINIDJA 888931 0.00 8,450,000.00 6,540,500.25

20230425BDINIDJA010O9970885356
ESB:BFST:0008N:20230425BRINIDJA110789971

Created By BRISIM
08/15/2023 10:30:15 AM
 LAPORAN TRANSAKSI FINANSIAL
STATEMENT OF FINANCIAL TRANSACTION

Halaman 2 dari 2
Page 2 of 2

Tanggal/Transaksi Uraian/Transaksi Teller Debit Kredit Saldo

Transaction Date Transaction Description User ID Debit Credit Balance

08/08/23 08:30:30 200001012_OB_1012676687383102 888931 0.00 11,250,000.00 17,790,500.25

WS_OB;A7093145030736784325;89168
ESB:T:0371862:S:0371892:WSOB

08/08/23 09:26:42 087750126612 00161287 000000019206 8888463 3,500,000.00 0.00 14,290,500.25

08/08/23 09:26:42 BFST005201170076508VISIONET INT:BDINIDJA 888931 0.00 14,900,000.00 29,190,500.25

20230425BDINIDJA010O9970885356
ESB:BFST:0008N:20230425BRINIDJA110789971

08/08/23 09:26:42 BFST005201170076508HAFIZON ASY'ARI:BTANIDJA 888931 0.00 8,700,000.00 37,890,500.25

20230419BTANIDJA010O0285550538
ESB:BFST:0008N:20230419BRINIDJA110773315

09/08/23 09:26:42 6019005029120396#000000755350#ATM #TRFLA 888931 0.00 700,000.00 38,590,500.25

TRF BERSAMA FROM MIRZA MAULANA S LA
005201170076508ATM 6019005029120396

09/08/23 09:26:42 NBMB HAFIZON ASY'ARI TO FLIPTECH LENTERA 8888463 3,350,000.00 0.00 35,240,500.25
ESB:NBMB:0001500F:525321249398

09/08/23 09:50:55 BRIVA1269710226252610NBMBIKN-HAFIZON 8888463 1,700,000.00 0.00 33,540,500.25

ASY'ARIBRIVA 1269710226252610 NBMBIKN-HAFIZON
ASY'ARIESB:NBMB:0200200P:524014030084

10/08/23 10:20:50 KARUNIA JAY_200001012_244851737 371869 0.00 4,400,000.00 37,940,500.25

WS_OB;A1515653079444697326;89168
ESB:T:0371853:S:0371892:WSOB

10/08/23 12:10:10 087750126612 00161287 000000019206 8888366 2,000,000.00 0.00 35,940,500.25

10/08/23 12:10:10 087750126612 00161287 000000019206 8888366 1,500,000.00 0.00 34,440,500.25

31/08/23 14:10:10 4624368899999999#004132845415#ATM #TRFLA 371869 0.00 6,250,000.00 40,690,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI CH LA
005201170076508ATM 4624368899999999

31/08/23 7:15:10 GOP01 +6287750126612NBMB5221842106226175 8888185 1,000.00 0.00 40,689,500.25

ESB:NBMB:0201000T:524219798375

31/08/23 7:15:10 GOP01 +6287750126612NBMB5221842106226175 8888463 350,000.00 0.00 40,339,500.25

ESB:NBMB:0201000T:524219798375

31/08/23 12:40:46 4624368899999999#004132845415#ATM #TRFLA 371869 0.00 1,450,000.00 41,789,500.25

TRF BERSAMA FROM HAFIZON ASY'ARI CH LA
005201170076508ATM 4624368899999999

Saldo Awal Total Transaksi Debit Total Transaksi Kredit Saldo Akhir
Opening Balance Total Transaction Debit Total Transaction Credit Closing Balance

67,063,000.25 88,823,500.00 63,550,000.00 41,789,500.25

Terbilang/ In Words

EMPAT PULUH SATU JUTA TUJUH RATUS DELAPAN PULUH SEMBILAN RIBU LIMA RATUS KOMA DUA PULUH LIMA RUPIAH
FORTY-ONE MILLION SEVEN HUNDRED EIGHTY-NINE THOUSAND FIVE HUNDRED POINT TWENTY-FIVE RUPIAH
Biaya Materai telah dibayar lunas
Revenue Stamp Paid

- Apabila terdapat perbedaan dengan catatan Saudara, harap menghubungi kami selambat-lambatnya 14 hari sejak diterimanya rekening koran ini.
- In the case of any diffrences from your records, please contact us within not later than 14 days from the receipt of this Statement of Account

- Salinan rekening koran ini merupakan hasil cetakan komputer, tidak diperlukan tanda tangan pejabat Bank
- The copy of this Statement of Account is computer-generated, no official signature is required

- Apabila ada perubahan alamat email mohon diinformasikan pada Unit Kerja BANK BRI
- Should there be any change of email address, please notify the relevant Bank BRI Business Unit

Created By BRISIM
08/15/2023 10:30:15 AM