GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 005/WEB/V/2023

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 70 73 INDIGO

Problem :

-FLUI

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 4.942.280

In Words

( Empat juta sembilan ratus empat puluh dua ribu dua ratus delapan puluh rupiah )

Ect ..................................................................................................................................

Data :

Original sample / before process	Copy of DN
Sample after process	Photo
Comparison sample	Packaging
Inspection Card	Pull Tape ( for Picking / Dusting problem )
Ream Label
Ect

Notes :

ID ROLL: 213111941, 213112887
NO DO: 578961069

Jakarta, 05 Mei 2023

Prepared by,

Checked by,

Approved by,

05-05-2023

( Gita Siti )

08-05-2023

( Maurina Gurning )

10-05-2023

( Oscar )

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )