PRODUCT RETURN REQUISITION FORM

DOC. NO : 06-DM-035 EFFECTIVE DATE : MARCH 2015 REVISION NO : 02

CUSTOMER REASON FOR RETURN (PLEASE SELECT ONE) :

ID : 315343 TRANSFER STOCK - DISTRIBUTOR RESIGN
NAME : Bahagia Intra Niaga - Sidoarjo V TRANSFER STOCK - STOCK NORMALIZATION
MARKET CLEANSING
BUSINESS 202 - PRODUCT RECALL
REGION : BR6 220 - DAMAGE, & DENTED
AREA : BA SURABAYA 230 - QUALITY PROBLEM
270 - NEAR EXPIRED
336 - GOODS EXPIRED
REMARKS : RE DARI BIN. SDA KE BIN SURABAYA - Jan.19 384 - MARKET COMPLAINT
-Hide the unnecessary item, then Copy, and paste to Formal Letter-

MATERIAL AMOUNT IN
PRODUCTION CODE,
NO. ID PRICE (IN 000,-) QUANTITY VALUE
DESCRIPTION PACK CONTENT AND EXPIRED DATE
ALIGN SUMMIT CRT PCS CRT PCS CRT PCS TOTAL
1 1143961 FrF Scm Gold Can 48x490g 756,288 - CAN 48X490g 100 75,628,800 - 75,628,800
2 1143786 FrF Scm BKM Can 48x490g 531,456 - CAN 48X490g - - -
### 794819 SCM FF FC GOLD SCH 120X40GR 171 1 SCH 120 X 40GR - - - -
### 795121 SCM FF GOLDS PCH 24X220GR 187 8 PCH 24 X 220GR - - - -
### 795305 SCM FF BKM PCH 24X560GR 278 12 PCH 24 X 560GR - - - -
### 793995 IMP FF MAMA SPR CHOCO BX 24X200GR 503 21 BOX 24 X 200GR - - - -
### 793996 IMP FB AWAL SPR 0-6 BX 24X 200GR 394 16 BOX 24 X 200GR - - - -
### 794001 IMP FB LANGKAH SPR 6-12 BX 24X 200GR 394 16 BOX 24 X 200GR - - - -
### 794003 IMP FB LANGKAH SPR 6-12 BX 24X 400GR 829 35 BOX 24 X 400GR - - - -
### 794009 IMP FF JELAJAH SPR 1-3 VAN BX 10X1200GR 950 95 BOX 10 X 1200GR - - - -
### 794013 IMP FF JELAJAH SPR 1-3 HON BX 10X1200G 950 95 BOX 10 X 1200GR - - - -
### 794029 IMP FF KARYA SPR 4-6 CHO BX 18X800GR 1,220 68 BOX 18 X 800GR - - - -
### 793958 IMP FRISO MUM VAN CAN 12X400GR RC 852 71 BOX 12 X 400GR - - -
### 661736 IMP FRISOLAC 1 PLAIN CAN 12X400GR 1,293 108 BOX 12 X 400GR - - -
### 661731 IMP FRISOLAC 1 PLAIN CAN 12X900GR 2,706 225 BOX 12 X 900GR - - -
### 661737 IMP FRISOLAC 2 PLAIN CAN 12X400GR 1,217 101 BOX 12 X 400GR - - -
### 661732 IMP FRISOLAC 2 PLAIN CAN 12X900GR 2,600 217 BOX 12 X 900GR - - -
### 793961 IMP FRISO 3 PLAIN CAN 12X400GR RC 1,145 95 BOX 12 X 400GR - - -
### 793963 IMP FRISO 3 PLAIN CAN 12X900GR RC 2,428 202 BOX 12 X 900GR - - -
### 793964 IMP FRISO 4 PLAIN CAN 12X400GR RC 1,012 84 BOX 12 X 400GR - - -
### 793965 IMP FRISO 4 PLAIN CAN 12X900GR RC 2,216 185 BOX 12 X 900GR - - -
### 793818 FMP FF PLAIN PLS BX 18X800GR 1,106 61 BOX 18 X 800GR - - - -
### 793981 IMP FF HONEY PLS BX 18X800GR NF 1,190 66 BOX 18 X 800GR - - - -
### 793816 IMP FF CHOCO PLS BX 24X400GR 695 29 BOX 24 X 400GR - - - -
### 793814 IMP FF CHOCO PLS BX 18X800GR 989 55 BOX 18 X 800GR - - - -
### 795154 IMP FF CHOCO ENERGO PLS 24X400GR 741 31 BOX 24 X 400GR - - - -
### 795164 IMP FF CHOCO ENERGO PLS 18X800GR 1,022 57 BOX 18 X 800GR - - - -
### 794041 SCC FF MUTMUT VANILLA SCH 240X14GR 86 4 BOX 240 X 14GR - - - -
### 794042 SCC FF MUTMUT CHOCO SCH 240X14GR 86 4 BOX 240 X 14GR - - - -
### 794058 PILLO FLEX FF STRAW SCH 48X70ML 46 1 PILLO 48 X 70ML - - -
### 794057 PILLO FLEX FF GRAPE SCH 48X70ML 46 1 PILLO 48 X 70ML - - -
### 794059 PILLO FLEX FF MILKY CHOCO SCH 48X70ML 46 1 PILLO 48 X 70ML - - -
### 794046 UHT FF DISNEY CHOCO CP 36X70ML 41 1 CP 36 X 70ML - - - -
### 794051 UHT FF DISNEY CHOCO CP 36X180ML 99 3 CP 36 X 180ML - - - -
795166 STR FF FRUITY STRAW BT 36X120ML 78 2 BOTTLE 36 X 120ML - - - -
### 795168 STR FF FRUITY GRAPE BT 36X120ML 78 2 BOTTLE 36 X 120ML - - - -
### 793833 UHT FF PLS KID CHOCO CP 36X115ML 73 2 CP 36 X 115ML - - - -
### 793834 UHT FF PLS KID STRAW CP 36X115ML 73 2 CP 36 X 115ML - - - -
### 794063 UHT FF KID CHOCO 36X115ml MP 73 2 CP 6 X 6 X 115ML - - - -
### 794064 UHT FF KID STRAW 36X115ml MP 73 2 CP 6 X 6 X 115ML - - - -
### 794925 UHT FF PLS LF FRENCH VAN CP 36X225ML 136 4 CP 36 X 225ML - - - -
### 794931 UHT FF PLS FULLCREAM CP 36X225ML 123 3 CP 36 X 225ML - - - -
### 732262 UHT FF PLS COCONUT CP 36X225ML 123 3 CP 36 X 225ML - - - -
###
### 743279 UHT FF PLS FAMILY COCONUT CP 12X900ML 139 12 CP 12 X 900ML - - - -
### UHT CHOCO 180ML CF 36X180ML 105 3 CP 36 X 180ML - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
### - - -
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### - - -
### - - -
### - - -
### - - -
### - - -

TOTAL 100 - 75,628,800 - 75,628,800

PROPOSED BY, CHECKED BY, APPROVED BY,

BIN. SIDOARO BUSINESS AREA SUPERVISOR BUSINESS AREA MANAGER BUSINESS REGION MANAGER

DATE : DATE : DATE : DATE :

( ) ( EKO BUDIMAN ) (YOESEP KURNIA) (SAMSUDI HERU)

SEND BY, RECEIVED BY, NOTE :

BIN. SIDOARJO BIN.PASURUAN - CUSTOMER, REGION, AND REASON FOR RETURN DATA MUST BE FILLED.
- PRODUCTION CODE, AND EXPIRED DATE FOR EACH PRODUCT MUST BE FILLED.
-
-
DATE 7/1/2024 DATE : -
(XXXXXXXXXX) -
 PRODUCT RETURN REQUISITION FORM
DOC. NO : 06-DM-035 EFFECTIVE DATE : March 2022 REVISION NO : 02

CUSTOMER REASON FOR RETURN (PLEASE SELECT ONE) :

ID : 315373 TRANSFER STOCK - DISTRIBUTOR RESIGN

NAME : Bahagia Intra Niaga - Surabaya V TRANSFER STOCK - STOCK NORMALIZATION

MARKET CLEANSING
BUSINESS 202 - PRODUCT RECALL
REGION : BR6 220 - DAMAGE, & DENTED
AREA : BA SURABAYA 230 - QUALITY PROBLEM
270 - NEAR EXPIRED
NO FAKTUR : 0100112338399216 336 - GOODS EXPIRED

REMARKS : RE BIN.S KE BIN PASURUAN 384 - MARKET COMPLAINT

-Hide the unnecessary item, then Copy, and paste to Formal Letter-

MATERIAL AMOUNT IN
PRODUCTION
NO. ID PRICE (IN 000,-) QUANTITY VALUE CODE, AND
DESCRIPTION PACK CONTENT EXPIRED DATE
ALIGN SUMMIT CRT PCS CRT PCS CRT PCS TOTAL
1 1177290 FrF Scm Gold Can 48x370g Alg Pre Eur 737,297 48 370 50 36,864,850 - 36,864,850
2 - - -
3 - - -
4 - - -
5 - - -
6 - - -
7 - - - - -
8 - - - - -
9 - - - - -
10 - - - - -
- - - - -
TOTAL 50 - 36,864,850 - 36,864,850

PROPOSED BY, CHECKED BY, APPROVED BY,

BIN. SURABAYA BUSINESS AREA SUPERVISOR BUSINESS AREA MANAGER BUSINESS REGION MANAGER

DATE : 01/07/2024 DATE : DATE : DATE :

( ) ( RAFI ) (LEFKO S. BUDIANOVI) (SAMSUDI HERU)

SEND BY, RECEIVED BY, NOTE :

BIN. SURABAYA BIN. PASURUAN - CUSTOMER, REGION, AND REASON FOR RETURN DATA MUST BE FILLED.
- PRODUCTION CODE, AND EXPIRED DATE FOR EACH PRODUCT MUST BE FILLED.
-
-
DATE : 01/07/2024 DATE : -
( ) ( )
 FRISIAN FLAG INDONESIA
SALES AND TRADE MARKETING DEPARTMENT
PRODUCT RETURN REQUISITION FORM
DOC. NO : 06-DM-035 EFFECTIVE DATE : MARCH 2015 REVISION NO : 02

CUSTOMER REASON FOR RETURN (PLEASE SELECT ONE) :

ID : 315373 TRANSFER STOCK - DISTRIBUTOR RESIGN
NAM : Bahagia Intra Niaga - Surabaya V TRANSFER STOCK - STOCK NORMALIZATION
MARKET CLEANSING
BUSINESS 202 - PRODUCT RECALL
REGI : BR6 220 - DAMAGE, & DENTED
AREA : BA SURABAYA 230 - QUALITY PROBLEM
270 - NEAR EXPIRED
336 - GOODS EXPIRED
REMARKS : RE DARI BIN. SURABAYA KE BIN.SIDOARJO - OCT.17 384 - MARKET COMPLAINT
-Hide the unnecessary item, then Copy, and paste to Formal Letter-

MATERIAL AMOUNT IN
NO. ID PRICE (IN 000,-) QUANTITY VALUE PRODUCTION CODE,
DESCRIPTION PACK CONTENT AND EXPIRED DATE
ALIGN SUMMIT CRT PCS CRT PCS CRT PCS TOTAL
1 976 794903 SCM FF GOLD CAN 48X370GR EOE 528 11 CAN 48 X 370GR - - - -
2 978 794907 SCM FF CHOCO CAN 48X370GR EOE 359 7 CAN 48 X 370GR 2,561 920,065,939 - 920,065,939
3 980 732650 SCM FF KENTAL MANIS CAN 48X370GR EOE 367 8 CAN 48 X 370GR 1,016 373,138,394 - 373,138,394
4 982 794909 SCM OMELA PLAIN CAN 48X370GR 341 7 CAN 48 X 370GR 333 113,559,625 - 113,559,625
5 990 794819 SCM FF FC GOLD SCH 120X40GR 165 1 SCH 120 X 40GR - - - -
6 992 794104 SCM FF CHOCO SCH 120X40GR 115 1 SCH 120 X 40GR 1,224 140,300,867 - 140,300,867
7 994 794103 SCM FF BKM SCH 120X40GR 115 1 SCH 120 X 40GR 1,675 191,983,745 - 191,983,745
8 986 795121 SCM FF GOLDS PCH 24X220GR 183 8 PCH 24 X 220GR - - - -
9 988 794105 SCM FF CHOCO PCH 24X220GR 151 6 PCH 24 X 220GR 207 31,183,434 - 31,183,434
10 1080 795305 SCM FF BKM PCH 24X560GR 265 11 PCH 24 X 560GR - - - -
11 1081 795307 SCM FF CHOCO PCH 24X560GR 265 11 PCH 24 X 560GR 76 20,131,311 - 20,131,311
12 1007 793995 IMP FF MAMA SPR CHOCO BX 24X200GR 492 21 BOX 24 X 200GR - - - -
13 1001 793996 IMP FB AWAL SPR 0-6 BX 24X 200GR 394 16 BOX 24 X 200GR - - - -
14 1002 793998 IMP FB AWAL SPR 0-6 BX 24X 400GR 829 35 BOX 24 X 400GR 28 23,243,741 - 23,243,741
15 1003 794000 IMP FB AWAL SPR 0-6 BX 18X 800GR 1,205 67 BOX 18 X 800GR 114 137,404,419 - 137,404,419
16 1004 794001 IMP FB LANGKAH SPR 6-12 BX 24X 200GR 394 16 BOX 24 X 200GR - - - -
17 1005 794003 IMP FB LANGKAH SPR 6-12 BX 24X 400GR 829 35 BOX 24 X 400GR - - - -
18 1006 794005 IMP FB LANGKAH SPR 6-12 BX 18X 800GR 1,205 67 BOX 18 X 800GR 103 123,754,004 - 123,754,004
19 1008 794006 IMP FF JELAJAH SPR 1-3 VAN BX 24X400GR 818 34 BOX 24 X 400GR 57 46,522,275 - 46,522,275
20 1009 794008 IMP FF JELAJAH SPR 1-3 VAN BX 18X800GR 1,195 66 BOX 18 X 800GR 106 126,158,146 - 126,158,146
21 1010 794009 IMP FF JELAJAH SPR 1-3 VAN BX 10X1200GR 930 93 BOX 10 X 1200GR - - - -
22 1011 794010 IMP FF JELAJAH SPR 1-3 HON BX 24X200G 412 17 BOX 24 X 200GR 28 11,393,090 - 11,393,090
23 1012 794011 IMP FF JELAJAH SPR 1-3 HON BX 24X400G 818 34 BOX 24 X 400GR 173 141,598,192 - 141,598,192
24 1013 794012 IMP FF JELAJAH SPR 1-3 HON BX 18X800G 1,195 66 BOX 18 X 800GR 118 140,840,290 - 140,840,290
25 1014 794013 IMP FF JELAJAH SPR 1-3 HON BX 10X1200G 930 93 BOX 10 X 1200GR - - - -
26 1015 794014 IMP FF JELAJAH SPR 1-3 CHO BX 24X400G 818 34 BOX 24 X 400GR 15 12,425,330 - 12,425,330
27 1016 794016 IMP FF JELAJAH SPR 1-3 CHO BX18X800GR 1,195 66 BOX 18 X 800GR 3 3,804,778 - 3,804,778
28 1017 794017 IMP FF KARYA SPR 4-6 VAN BX 24X400GR 818 34 BOX 24 X 400GR 8 6,226,651 - 6,226,651
29 1018 794019 IMP FF KARYA SPR 4-6 VAN BX 18X800GR 1,195 66 BOX 18 X 800GR 70 83,065,854 - 83,065,854
30 1019 794020 IMP FF KARYA SPR 4-6 VAN BX 10X1200GR 930 93 BOX 10 X 1200GR 11 10,659,218 - 10,659,218
31 1020 794021 IMP FF KARYA SPR 4-6 HON BX 24X200GR 412 17 BOX 24 X 200GR 41 16,874,077 - 16,874,077
32 1021 794023 IMP FF KARYA SPR 4-6 HON BX 24X400GR 818 34 BOX 24 X 400GR 24 19,337,473 - 19,337,473
33 1022 794025 IMP FF KARYA SPR 4-6 HON BX 18X800GR 1,195 66 BOX 18 X 800GR 51 60,398,372 - 60,398,372
34 1023 794026 IMP FF KARYA SPR 4-6 HON BX 10X1200GR 930 93 BOX 10 X 1200GR 10 9,615,543 - 9,615,543
35 1024 794027 IMP FF KARYA SPR 4-6 CHO BX 24X400GR 818 34 BOX 24 X 400GR 18 14,887,756 - 14,887,756
36 1025 794029 IMP FF KARYA SPR 4-6 CHO BX 18X800GR 1,195 66 BOX 18 X 800GR - - - -
37 1044 793958 IMP FRISO MUM VAN CAN 12X400GR RC 834 70 BOX 12 X 400GR - - -
38 1036 661736 IMP FRISOLAC 1 PLAIN CAN 12X400GR 1,293 108 BOX 12 X 400GR - - -
39 1037 661731 IMP FRISOLAC 1 PLAIN CAN 12X900GR 2,706 225 BOX 12 X 900GR - - -
40 1038 661737 IMP FRISOLAC 2 PLAIN CAN 12X400GR 1,217 101 BOX 12 X 400GR - - -
41 1039 661732 IMP FRISOLAC 2 PLAIN CAN 12X900GR 2,600 217 BOX 12 X 900GR - - -
42 1040 793961 IMP FRISO 3 PLAIN CAN 12X400GR RC 1,121 93 BOX 12 X 400GR - - -
43 1041 793963 IMP FRISO 3 PLAIN CAN 12X900GR RC 2,377 198 BOX 12 X 900GR - - -
44 1042 793964 IMP FRISO 4 PLAIN CAN 12X400GR RC 990 83 BOX 12 X 400GR - - -
45 1043 793965 IMP FRISO 4 PLAIN CAN 12X900GR RC 2,169 181 BOX 12 X 900GR - - -
46 1026 793820 FMP FF PLAIN PLS BX 24X400GR 778 32 BOX 24 X 400GR 29 22,638,920 - 22,638,920
47 1027 793818 FMP FF PLAIN PLS BX 18X800GR 1,083 60 BOX 18 X 800GR - - - -
48 1028 794030 IMP FF FILLED PLS BX 24X400GR NF 753 31 BOX 24 X 400GR 3 2,171,548 - 2,171,548
49 1029 794032 IMP FF FILLED PLS BX 18X800GR 1,063 59 BOX 18 X 800GR 7 7,306,120 - 7,306,120
50 1030 793982 IMP FF HONEY PLS BX 24X400GR NF 835 35 BOX 24 X 400GR 3 2,115,330 - 2,115,330
51 1031 793981 IMP FF HONEY PLS BX 18X800GR NF 1,165 65 BOX 18 X 800GR - - - -
52 1032 793816 IMP FF CHOCO PLS BX 24X400GR 680 28 BOX 24 X 400GR - - - -
53 1033 793814 IMP FF CHOCO PLS BX 18X800GR 969 54 BOX 18 X 800GR - - - -
54 1034 795154 IMP FF CHOCO ENERGO PLS 24X400GR 726 30 BOX 24 X 400GR - - - -
55 1035 795164 IMP FF CHOCO ENERGO PLS 18X800GR 1,001 56 BOX 18 X 800GR - - - -
56 1000 794041 SCC FF MUTMUT VANILLA SCH 240X14GR 84 0 BOX 240 X 14GR - - - -
57 996 794042 SCC FF MUTMUT CHOCO SCH 240X14GR 84 0 BOX 240 X 14GR - - - -
58 1069 794058 PILLO FLEX FF STRAW SCH 48X70ML 44 1 PILLO 48 X 70ML - - -
59 1068 794057 PILLO FLEX FF GRAPE SCH 48X70ML 44 1 PILLO 48 X 70ML - - -
60 1070 794059 PILLO FLEX FF MILKY CHOCO SCH 48X70ML 44 1 PILLO 48 X 70ML - - -
61 1077 794046 UHT FF DISNEY CHOCO CP 36X70ML 40 1 CP 36 X 70ML - - - -
62 1078 794815 UHT FF DISNEY STRAW CP 36X70ML 40 1 CP 36 X 70ML 1 45,142 - 45,142
63 1055 794047 UHT FF DISNEY CHOCO CP 36X115ML 62 2 CP 36 X 115ML 323 20,006,651 - 20,006,651
64 1053 794939 UHT FF DISNEY STRAW CP 36X115ML 62 2 CP 36 X 115ML 813 50,444,706 - 50,444,706
65 1056 794048 UHT FF DISNEY CHOCO CP 36X115ML MP 61 2 CP 6 X 6 X 115ML 33 2,029,061 - 2,029,061
66 1054 794940 UHT FF DISNEY STRAW CP 36X115ML MP 61 2 CP 6 X 6 X 115ML 99 5,998,976 - 5,998,976
67 1061 794051 UHT FF DISNEY CHOCO CP 36X180ML 96 3 CP 36 X 180ML - - - -
68 1063 794917 UHT FF DISNEY STRAW CP 36X180ML 96 3 CP 36 X 180ML 5 464,157 - 464,157
FRF UHT CHOC 180ML CF 105 3 CP 36 X 180ML 5 506,427 - 506,427
69 1051 795166 STR FF FRUITY STRAW BT 36X120ML 75 2 BOTTLE 36 X 120ML - - - -
70 1048 795168 STR FF FRUITY GRAPE BT 36X120ML 75 2 BOTTLE 36 X 120ML - - - -
71 1049 795170 STR FF MILKY CHOCO BT 36X120ML 75 2 BOTTLE 36 X 120ML 327 24,605,226 - 24,605,226
72 1050 795172 STR FF MILKY STRAW BT 36X120ML 75 2 BOTTLE 36 X 120ML 104 7,814,642 - 7,814,642
73 1045 794054 STR FF DISNEY CHOCO BT 24X180ML 64 3 BOTTLE 24 X 180ML 315 20,100,725 - 20,100,725
74 1047 794913 STR FF DISNEY STRAW BT 24X180ML 64 3 BOTTLE 24 X 180ML 428 27,311,043 - 27,311,043
75 1057 793833 UHT FF PLS KID CHOCO CP 36X115ML 70 2 CP 36 X 115ML - - - -
76 1058 793834 UHT FF PLS KID STRAW CP 36X115ML 70 2 CP 36 X 115ML - - - -
77 1059 794063 UHT FF KID CHOCO 36X115ml MP 70 2 CP 6 X 6 X 115ML - - - -
78 1060 794064 UHT FF KID STRAW 36X115ml MP 70 2 CP 6 X 6 X 115ML - - - -
79 1076 794925 UHT FF PLS LF FRENCH VAN CP 36X225ML 131 4 CP 36 X 225ML - - - -
80 1075 794927 UHT FF PLS LF BELGIAN CHO CP 36X225ML 131 4 CP 36 X 225ML 8 991,361 - 991,361
81 1074 794929 UHT FF PLS LF CAL STRAW CP 36X225ML 131 4 CP 36 X 225ML 31 4,075,412 - 4,075,412
82 1072 794931 UHT FF PLS FULLCREAM CP 36X225ML 119 3 CP 36 X 225ML - - - -
83 1073 794933 UHT FF PLS STRAW CP 36X225ML 119 3 CP 36 X 225ML 5 647,529 - 647,529
84 1071 794935 UHT FF PLS CHOCO CP 36X225ML 119 3 CP 36 X 225ML 56 6,690,364 - 6,690,364
85 1195 732262 UHT FF PLS COCONUT CP 36X225ML 119 3 CP 36 X 225ML - - - -
86 1067 794919 UHT FF PLS FAMILY FULLCREAM CP 12X900ML 135 11 CP 12 X 900ML 12 1,675,643 - 1,675,643
87 1065 794921 UHT FF PLS FAMILY CHOCO CP 12X900ML 135 11 CP 12 X 900ML 12 1,569,065 - 1,569,065
88 1066 794923 UHT FF PLS FAMILY LOWFAT CP 12X900ML 142 12 CP 12 X 900ML 24 3,442,563 - 3,442,563
89 FRF FAMILY UHT COCONUT 900ML 139 12 CP 12 X 900ML 24 3,362,685 - 3,362,685
90 - - -
91 - - -
92 - - -
93 - - -
94 - - -
95 - - -
96 - - -
97 - - -
98 - - -
99 - - -
100 - - -
101 - - -
102 - - -
103 - - -
104 - - -
105 - - -
106 - - -
107 - - -
108 - - -
109 - - -
110 - - -
111 - - -
112 - - -
113 - - -
114 - - -

TOTAL 10,734 - 2,994,585,820 - 2,994,585,820

PROPOSED BY, CHECKED BY, APPROVED BY,

BIN. SURABAYA BUSINESS AREA SUPERVISOR BUSINESS AREA MANAGER BUSINESS REGION MANAGER

DATE : DATE : DATE : DATE :

( ) ( LILIS SUDARNINGSIH ) (YOESEP KURNIA) (SAMSUDI HERU)

SEND BY, RECEIVED BY, NOTE :

BIN. SURABAYA BIN. SIDOARJO - CUSTOMER, REGION, AND REASON FOR RETURN DATA MUST BE FILLED.
- PRODUCTION CODE, AND EXPIRED DATE FOR EACH PRODUCT MUST BE FILLED.
-
-
DATE 7/1/2024 DATE : -
(XXXXXXXXXX) -