GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 004/WRH/XI/2023

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS ROLL

Quality Complaint

Specification : HVS ROLL 80 82 PPLUS

Problem :

KERTAS TERKENA GESEKAN WINGBOX DAN KERTAS TIDAK DIIKAT DENGAN TALI

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 7.332.514,-

In Words

( Tujuh juta tiga ratus tiga puluh dua ribu lima ratus emapat belas 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 ID ROLL :213390741	  QTY:  530,18 kg ,  NO ID ROLL : 213390806	  QTY:  530,18	kg  
NO.DO : 5782035649

Jakarta, 29 November 2023

Prepared by,

Checked by,

Approved by,

29-11-2023

( Gita Siti )

29-11-2023

( Maurina Gurning )

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

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )