GAP Portal

COMPLAINT ASSESSMENT FORM

Supplier Name

Cakrawala Mega Indah

Complaint No. :

Address

CIF No.: 012/WEB/XII/2023

Phone

PIC

Invoice No. :

PO

Quality Order

Product : HVS

Quality Complaint

Specification : HVS ROLL 80 82 PPLUS

Problem :

-FLUI

Kategory of Complaint

Claim value (IDR/USD/SGD/EUR) :
Rp. 7.261.000.-

In Words

( Tujuh juta duaratus enam puluh satu ribu 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 : 213392989
NO.DO	5782038283

Jakarta, 26 Desember 2023

Prepared by,

Checked by,

Approved by,

26-12-2023

( Gita Siti )

26-12-2023

( Maurina Gurning )

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

( Staff Pembelian )

( Ka. Bag. Pembelian )

( Supplier )