GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 006/WEB/V/2023

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 70 73 INDIGO EX PINDO

Problem :

WARNA KERTAS BERBEDA

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 6.850.032

In Words

( Enam juta delapan ratus lima puluh ribu tiga puluh dua 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 :

Jakarta, 14 Juni 2023

Prepared by,

Checked by,

Approved by,

14-06-2023

( Gita Siti )

14-06-2023

( Maurina Gurning )

( ........................ )

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )