GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 009/WEB/VII/2023

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 70 73 INDIGO

Problem :

KOTOR, FLUI

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 4.090.880,-

In Words

( Empat Juta sembilan puluh ribu delapan 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 :

NO.DO	5781987629, ID ROLL 213197200

Jakarta, 18 Juli 2023

Prepared by,

Checked by,

Approved by,

18-07-2023

( Gita Siti )

18-07-2023

( Maurina Gurning )

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

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )